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AbstractTraditional eye drops used for topically administering drugs have poor ocular bioavailability due to the biological barriers of the eye. There is an interest to design and develop novel drug delivery systems that would extend the precorneal residence time, reduce the frequency of administration and decrease dose-related toxicity. This study aimed to prepare Nanoparticles of Gemifloxacin Mesylate and incorporate them into an in situ gel. The nanoparticles were prepared by ionic gelation technique, using 32 factorial design. Sodium tripolyphosphate (STPP) was used to crosslink Chitosan. The optimized formulation of the nanoparticles (GF4) contained 0.15% Gemifloxacin Mesylate, 0.15% Chitosan and 0.20% STPP, producing 71 nm particle size and 81.11% entrapment efficiency. The prepared nanoparticles showed biphasic release, with an initial burst release of 15% in 1.0 hr and a cumulative drug release of 90.53% at the end of 24 hrs. After that, the prepared nanoparticles were incorporated into an in situ gel, using Poloxamer 407, producing a sustained drug release with efficient antimicrobial activity against gram-positive and gram-negative bacteria as confirmed by the cup plate method.

Due to the high cost of bioplastic production, sesame wastewater, generated from the sesame seed hulling process, was investigated to be used as inexpensive and renewable carbon source for the production of biodegradable polyhydroxyalkanoate (PHA) by extreme Haloferax mediterranei. The sesame wastewater (SWW) was hydrolyzed using different concentrations of hydrochloric acid (0.4. 1.00 and 2.00 M) at different period of times (15, 60 and 90 min). The concentration of salt (NaCl) and nitrogen source (NH4Cl and yeast) required for H. mediterranei cells growth and the accumulation of PHA biopolymer was optimized. A maximum 0.53 g/L concentration of PHA was achieved when the SWW extract media was supplemented with 100 g/L NaCl and 6.0 g/L yeast extract. The cultivation was scaled-up using sequencing batch reactor (SBR) fermentation under non-sterile conditions. The SBR results showed that SWW needs an auxiliary carbon source to obtain high PHA production. Consequently, the system fed with SWW and glucose produced higher PHA (20.9 g/L) than the system fed with SWW.

Monthly variations in Physio-chemical parameters of Al-Garraf water in Waist province, one of the main tributaries of the Tigris River to investigate the water quality of the river from August 2014 to January 2015. The study location situated in the southeastern sector of Iraq and surrounded by wide and fertile agricultural lands. Three stations were selected for collecting samples monthly, samples were taken each month. Station one is located at 500 m of the AL - KUT Dam. The second is situated at distance of 15 Km away from the former (Kut- Muwafaqiya) and the latter station is located at 18 Km apart from the second one upon entering the river hand Muwafaqiya. In the present study fourteen physical and chemical parameters were analyzed based on the importance of these parameters. These fourteen parameters are ranged as following: Air temperature (12 to 37.2) ºC, water temperature (12.1 to 28.4) ºC, pH (7.2 to 7.8), EC (490 to 1860) µS/cm, Salinity (0.64 to 1.19) ‰, DO (2.7 to 9.3) mg/L, BOD5 (0.2 to 7.1) mg/L, Turbidity (21.44 to 74) NTU, TDS (0.580 to 0.99 ) g/L, TSS (0.0006 to 0.059) mg/L, TH (388 to 504) µg/L, Ca+2 (100 to 160.32) mg/L, Mg+2 (3.69 to 52.07) mg/L and NO3-2 (0.034 to 3.69) mg/L and PO4-2 (0.015 to 0.225) µg/L. , Bicarbonate (130 to 180) mg/L , Sulfate (80 to 180) mg/L, the percentage of oxygen saturation (32.25 to 306.29) % ,Water flow (2.5 to 10.7)m\sec. and total Alkalinity(12.2 to 25)mg/L. The results revealed that water parameters were within the Iraqi standards for the raw water.

The physical and chemical parameters of Tigris River water in AL- Kut City have been studied. Three stations have been chosen. . The sampling of study was made monthly and for six months from September 2014 until February 2015.The result of turbidity values showed height mean in summer 84 NTU, The decrease of turbidity was one of the positive results to the effect of AL-Kut Dam on the Tigris River after the Dam and on the total suspended solids. The electrical conductivity was 1340 µs/cm in winter that may be due to the existence of the polluted elements. The river water was fresh (0.48‰ semiebrachish) with a good aerated water and the height of the dissolved oxygen mean value has been noticed 13.1mg/L at many times. Over saturated Oxygen condition was noticed 135 mg/L but the biological demand of oxygen didn,t pass the national specifics with oscillation in some values. The result of hydrogen ion concentration values varied from 7.1 - 8.2 on the weak alkaline side. Height values of total hardness were recorded 600mg/L, Calcium and magnesium were the cause of hardness. The alkaline is caused by carbonate and bicarbonate ions.The present study result showed that the sulphates are more than other ions with average of 148.33mg/L.The phosphate passed the decisions of the surface water in average 0.0388µg/L.The nitrate were in the acceptable ranges in concentration from 0.296-1.75mg/L.

This study investigates the biodiversity, diversity, and distribution of Rotifera in the upper sector of the Tigris River, Wasit Province, Iraq, from January to December 2022. Five sites, approximately 10 Km apart, were selected along a 1415 Km stretch of the river. A total of 67 rotifer taxa were identified. The highest density recorded was 27,454 individuals/m² in November, and the lowest was 710.6 individuals/mMuda² in July. The relative abundance index identified five less abundant rotifer species. The species richness index ranged from moderate to ideal, while the Shannon-Wiener index indicated moderate diversity. The species uniformity index varied from unbalanced up to highly balanced. Sites 2 and 3 had the highest similarity index values, whereas sites 1 and 4 had the lowest. Thirty-four taxa were constant species, with others being accidental or accessory. Our results concluded that upstream areas recorded lower relative abundance compared to downstream. According to the Shannon-Wiener index, the Tigris River can be classified as having high diversity, suggesting a good and diversified aquatic ecosystem. [ABSTRACT FROM AUTHOR]

Traditional eye drops used for topically administering drugs have poor ocular bioavailability due to the biological barriers of the eye. There is an interest to design and develop novel drug delivery systems that would extend the precorneal residence time, reduce the frequency of administration and decrease dose-related toxicity. This study aimed to prepare Nanoparticles of Gemifloxacin Mesylate and incorporate them into an in situ gel. The nanoparticles were prepared by ionic gelation technique, using 32 factorial design. Sodium tripolyphosphate (STPP) was used to crosslink Chitosan. The optimized formulation of the nanoparticles (GF4) contained 0.15% Gemifloxacin Mesylate, 0.15% Chitosan and 0.20% STPP, producing 71 nm particle size and 81.11% entrapment efficiency. The prepared nanoparticles showed biphasic release, with an initial burst release of 15% in 1.0 hr and a cumulative drug release of 90.53% at the end of 24 hrs. After that, the prepared nanoparticles were incorporated into an in situ gel, using Poloxamer 407, producing a sustained drug release with efficient antimicrobial activity against gram-positive and gram-negative bacteria as confirmed by the cup plate method. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is an autoimmune condition characterized by persistent inflammation in synovial joints. Interleukine-32 (IL32) is known to have significant pro-inflammatory effects in RA, and IL37 is an anti-inflammatory cytokine that reduces the immune response and inflammation. This study aimed to investigate serum levels of IL32 and IL73 in RA patients. The sample included 50 patients (46 females and four males) with RA and 40 healthy controls. The enzyme-linked immunosorbent assay (ELISA) detected serum levels of IL32 and IL37. The disease parameters’ activity was measured by the clinical disease activity index, and the Erythrocyte sedimentation rate was measured by the Westergren method. Moreover, C-Reactive protein, Rheumatoid factor, and Anti-Cyclic Citrullinated Peptide antibodies were measured using the ELISA. The results showed elevated serum levels of IL32 and IL37 in patients with RA (P<0.05). The mean duration of RA in most patients was <12 years, and the level of disease activity among the cases group was mainly moderate (70%). There was no significant difference between the mean levels of IL32 and IL37 in patients with RA. This study showed that although IL32 and IL37 played an essential role in RA pathogenesis, there was no significant correlation between serum levels of IL32 and IL37 and disease duration or activity. [ABSTRACT FROM AUTHOR]

Abstract Allergies have a significant impact on health and quality of life worldwide, yet there is limited research on the awareness and knowledge of allergies. This study aimed to explore the level of awareness and knowledge of allergies among visitors in Syrian hospitals. A cross-sectional study was conducted between May and September 2022, and a standardized international questionnaire was administered to 504 visitors in three hospitals in Syria. Data analysis was performed using the Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA) version 23. The final sample comprised 504 questionnaires with 61.7% of participants achieving an average score. Statistical analysis revealed a significant difference in knowledge of allergy scores between the group with only elementary education (M = 3.76, SD = 1.67, p = 0.011), the group with no education (M = 3.65, SD = 1.65, p = 0.006), and the group with a university education (M = 4.44, SD = 1.25). Notably, no significant differences were found between the other educational groups. A one-way ANOVA was employed to assess the effect of place of living on knowledge of allergy, but no significant differences were observed between the groups (p = 0.462). Lastly, a significant negative correlation was detected between participant age and knowledge of allergy scores (r(502) = − 0.102, p = 0.022). Allergies represent a substantial global health concern that demands attention from healthcare providers, policymakers, and the public. This study emphasizes the importance of investing in health education and awareness campaigns to enhance knowledge and comprehension of allergies, particularly individuals with lower levels of education levels. By equipping individuals with the requisite information to effectively manage their allergies, their overall health and wellbeing can be improved.

Abstract Background and Aims This article examines the prevalence of burnout among healthcare providers in the aftermath of the recent earthquakes in Syria and Turkey and explores the associated risk factors. Methods This cross‐sectional study included 270 healthcare providers in three Syrian cities damaged by earthquakes. Participants were asked to fill out a validated questionnaire on the fifth day of emergency response using the Geldard Occupational Burnout questionnaire. Results The mean score for the Geldard Occupational Burnout Questionnaire was 129.79, with 81.4% indicating moderate burnout risk and only 3% indicating high risk. Gender was not significantly associated with burnout, but there was a significant difference in burnout scores between city groups, with Latakia scoring significantly lower than Aleppo. Conclusion This study highlights the prevalence of burnout among healthcare providers in the aftermath of an earthquake in Syria, with the majority having a moderate risk of burnout. Gender was not significantly associated with burnout risk. Further research is needed to develop effective interventions and address study limitations. The study emphasizes the importance of prioritizing healthcare providers' mental health to ensure high‐quality care after natural disasters.

Superior mesenteric artery syndrome is a rare condition that causes duodenal obstruction due to compression by the superior mesenteric artery and the aorta. It can be related to congenital or acquired factors that reduce the aortomesenteric angle and distance. The clinical presentation is nonspecific and often mimics other causes of upper gastrointestinal obstruction. The diagnosis requires a high index of suspicion and a correlation of clinical symptoms with radiographic findings. We report a case of a 17-year-old female patient who presented with chronic abdominal pain, vomiting, and weight loss. She was diagnosed with superior mesenteric artery syndrome based on an abdominal computed tomography scan that showed a reduced aortomesenteric angle of 30° and a reduced aortomesenteric distance of 7 mm. She was treated conservatively with anticoagulation therapy, dietary modification, and physical activity. She reported symptom improvement and weight gain after 2 weeks of treatment. This case illustrates the challenges and pitfalls in diagnosing superior mesenteric artery syndrome.

The idea of the IoT began back in 1982 when a vending machine was connected to the internet, then to the concept of Mark Weiser in 1992, then RFID, and so on. A detailed evolution of the IoT and how it was transforming is given. Due to the wide embracement of IoT by industries and home users, it has become the cornerstone of the Information and Communication Technology (ICT) market. The market value of the IoT was worth 1.90 billion in 2018; 25 billion in 2020; 925.2 billion as of 2023; while it is forecasted to hit 6 trillion in 2025 at 15.12% growth rate. This work presented some major technologies integrated with the IoT to achieve a certain goal and improve an existing system. IoT’s capability to create smart applications is demonstrated and some major distinctions between IoT & the Internet were highlighted.

The integration of deep learning in healthcare has propelled advancements in diagnostics and decision support. However, the inherent opacity of deep neural networks (DNNs) poses challenges to their acceptance and trust in clinical settings. This survey paper delves into the landscape of explainable deep learning techniques within the healthcare domain, offering a thorough examination of deep learning explainability techniques. Recognizing the pressing need for nuanced interpretability, we extend our focus to include the integration of fuzzy logic as a novel and vital category. The survey begins by categorizing and critically analyzing existing intrinsic, visualization, and distillation techniques, shedding light on their strengths and limitations in healthcare applications. Building upon this foundation, we introduce fuzzy logic as a distinct category, emphasizing its capacity to address uncertainties inherent in medical data, thus contributing to the interpretability of DNNs. Fuzzy logic, traditionally applied in decision-making contexts, offers a unique perspective on unraveling the black box of DNNs, providing a structured framework for capturing and explaining complex decision processes. Through a comprehensive exploration of techniques, we showcase the effectiveness of fuzzy logic as an additional layer of interpretability, complementing intrinsic, visualization, and distillation methods. Our survey contributes to a holistic understanding of explainable deep learning in healthcare, facilitating the seamless integration of DNNs into clinical workflows. By combining traditional methods with the novel inclusion of fuzzy logic, we aim to provide a nuanced and comprehensive view of interpretability techniques, advancing the transparency and trustworthiness of deep learning models in the healthcare landscape.

Abstract Background Breast cancer (BC) represents an important cause of cancer death, its incidence rate has been rising gradually in the Arab world, and in Syria, BC is the most common cancer and the leading cause of cancer death; its prognosis gets better as we detect it early in its first stages. So, it is very important to implement one or more early detection methods such as Breast Self-Examination (BSE), Clinical Breast Examination (CBE), and mammography. BSE represents an effective method to find out changes in breast structure when they happen. This study investigates the knowledge of BSE and its practice in BC patients. Methods A quantitative cross-sectional study in Al-Bairouni hospital in Damascus-Syria was carried out using face-to-face interviews based on a structured questionnaire, which consisted of 4 sections. The data were subjected to statistical analysis using various analytical tests, including the independent t-test, one-way analysis of variance (ANOVA), and Chi-square test. Results Five hundred patients were interviewed. Only 27.4% of patients had a good knowledge of BSE, 17.4% had average knowledge, and 55.2% had low knowledge of BSE. The factors that have an impact on the knowledge of BSE were: family breast cancer history (first and second-degree relatives), education, and the region of living (between governorates). The effect of knowledge of BSE on its practice was positive. However, only 24.8% of patients have been practicing BSE; the reasons for not practicing BSE were: no one has told the patient about it (64.8% of cases), and the patient does not have any symptoms relating to the breast (21.4%).Breast cancer was identified through breast self-examination (BSE) in 15.6% of cases. Conclusion There is a low degree of knowledge and little practice of BSE among Syrian breast cancer patients. Family breast cancer history, governate, occupation, and level of education had a statistically significant effect on knowledge scores of BSE, unlike age and social status. So, some steps should be taken to increase awareness about BSE among Syrian females.

Abstract Organ donation is vital to saving lives, but its success depends on people's willingness to donate organs. This descriptive cross-sectional survey aimed to investigate attitudes towards organ donation in Damascus, Syria. Understanding attitudes is crucial for the success of organ donation programs, especially in countries with similar settings. This study was a descriptive cross-sectional survey aimed at understanding patients’ attitudes towards organ donation in Damascus, Syria. Data was collected through a carefully constructed validated survey through face-to-face interviews. 600 participants were randomly interviewed, 62.8% agreed to donate their organs after death, with helping others being the primary reason. Religious beliefs were the primary reason for organ refusal in males, while for females, it was lack of knowledge and religious beliefs. However, there were no significant differences between genders or educational level and age groups in the acceptance of organ donation. The percentage of those who agree to donate their organs after death encourages taking an effective step to build an integrated donation system, not just a center. Bearing in mind that there is no correlation with age, gender or even educational level, which means that the system may include different groups of society.

Novel high-entropy alloy compositions having the same valence electron concentration (Al0.5FeCrNiTi0.25 –xSix) were developed with molar ratio x = 0.09, 0.125, and 0.25. Microstructure and corrosion behaviour were investigated using X-ray diffraction analysis, scanning electron microscopy, and electrochemical studies in 3.5 wt % NaCl solution at room temperature. Increasing the molar ratio x in Al0.5FeCrNiTi0.25 –xSix alloys stabilised face-centred cubic phase. Among the studied compositions, Al0.5FeCrNiTi0.12Si0.12 offered good corrosion resistance exhibiting the least corrosion current density (Icorr), the highest charge transfer resistance (Rct) with double layer capacitive value (Cdl), and the lowest Warburg coefficient (σ). [ABSTRACT FROM AUTHOR]

Assessing the impact of war on medical residents' specialty choices and migration decisions is critical to ensure the sustainability of healthcare systems worldwide. This study aimed to evaluate the effect of the Syrian crisis on specialty choices, related factors, and decisions to work in Syria among residents of six major university hospitals in Damascus. A cross-sectional study was conducted using a validated questionnaire from 20/4/2022 to 20/5/2022, including all eligible residents with no missing data. The questionnaire was comprised of 68 items, and residents were divided into two groups: group 1 included residents who made their specialty choice after the end of the military war in Damascus 2018, while group 2 included residents who made their specialty choice (the point of submitting their lists and applying for residency) during the war. A total of 370 residents were included, with 38.4% females and 61.6% males. Our findings revealed that 30% of residents preferred working in Syria, while 43.5% preferred working abroad. The factor of a "safer and more stable life" was significantly higher in Group 1 than in Group 2 (3.86>3.5, p-value = 0.026). Additionally, Group 1 residents were more likely to choose radiology, pathology, laboratory, and psychiatry specialization as their specialties, while choosing surgical specializations and hematology decreased compared to Group 2 (p-value2.21, Standard deviation = 0.22, p-value = 0.033). The Syrian crisis and its economic aftermath have influenced residents' specialty choices and practice locations. Even after the war's end, the high level of migration intentions could negatively affect the quality of provided healthcare services.

Key Clinical Message Cutaneous oxalosis is a rare manifestation of systemic oxalosis, typically associated with primary or secondary hyperoxaluria. We present a rare case of a 23‐year‐old female diagnosed with primary hyperoxaluria and end‐stage renal disease, who presented with papules on the palms without any vascular complications. The skin can be affected by oxalate deposition, resulting in various manifestations such as vascular complications or calcified nodules. In our case, the patient had primary hyperoxaluria and end‐stage renal disease but exhibited atypical features of cutaneous oxalosis. Histopathology confirmed the presence of oxalate crystals in the dermis, subcutis, and medium‐sized arteries. The mechanism of oxalate deposition in this case remains unclear. This case underscores the importance of considering cutaneous oxalosis in the differential diagnosis of patients with renal failure and skin lesions, and highlights the variability of clinical presentations in primary hyperoxaluria.

Background Natural disasters have a significant impact on the mental health of affected populations. The February 2023 earthquakes in Syria and Turkey caused widespread devastation. Aims To explore the mental health impact of the earthquakes in Syria on the population across areas differentially damaged by the disaster. Method This cross-sectional study conducted in Syria included 1406 adults recruited via social media platforms 1 month after the February 2023 earthquakes. Demographic information, earthquake exposure questions, the PTSD Checklist for DSM-5 (PCL-5: for probable post-traumatic stress disorder, PTSD), the Patient Health Questionnaire-9 (PHQ-9: for probable depression) and the seven-item Generalized Anxiety Disorder scale (GAD-7: for probable anxiety) were included to compare outcomes across areas severely, moderately and slightly damaged by the earthquakes. Results Probable PTSD and GAD rates were higher in the severely (57.9 and 57.3% respectively) and moderately damaged regions (55.4 and 56.3% respectively) than in the slightly damaged regions (44.6 and 48.3% respectively) (PTSD: P < 0.001, GAD: P = 0.005). More participants in severely damaged regions (60.6%) reported symptoms of depression compared with moderately (53.1%) and slightly damaged (50.8%) regions (P = 0.003). Poorer mental health outcomes were associated with being female, single, younger, having a damaged or destroyed house, seeing something tragic in person and hearing tragic stories. Seeing something tragic on social media was not statistically significant. Conclusions This study highlights the higher prevalence of probable mental disorders in areas with more severe earthquake damage, with over 50% of the population reporting probable PTSD, depression or anxiety. The study also suggests a significant cumulative effect of these earthquakes on an already trauma- and disaster-affected population.

Congenital infantile fibrosarcoma (CIFS) is a rare malignant soft tissue tumor. The incidence of fibrosarcoma is estimated to be 0.3 per 100 000 population per year, and it accounts for less than 1% of all soft tissue sarcomas. We present a case of a 7-day-old newborn with a large ulcerated and necrotic lesion on the left forearm, which was initially misdiagnosed as rhabdomyosarcoma. Magnetic resonance imaging (MRI) revealed a soft tissue mass with cystic components affecting the forearm and distal humerus muscles. Fine-needle biopsy was performed and initially diagnosed as rhabdomyosarcoma but later confirmed as low-grade fibrosarcoma with positive immunostaining for vimentin. The patient underwent a transhumeral amputation with follow-up chemotherapy at a specialized oncology center. This case underscores the importance of interdisciplinary collaboration and specialized care in managing complex medical conditions in infants. Early detection and appropriate management of these tumors are essential for improving outcomes and reducing morbidity and mortality. Despite the rarity of this case, it serves as a reminder of the importance of considering neoplastic lesions in the differential diagnosis of soft tissue masses in newborns.

Background:. Despite efforts to promote gender equity in medicine, gender disparities persist in various medical specialties, including plastic surgery. This study aimed to investigate the representation of female physicians in leadership positions in German plastic surgery departments. Methods:. This cross-sectional study collected data about the physician workforce in the German plastic surgery field. The primary outcome was the proportion of female physicians in plastic surgery departments. Data were collected from 94 departments. The physician workforce was stratified based on gender and leadership. Results:. We included 812 physicians working in different German plastic surgery departments. Of those, 76.8% were in leadership positions, and 35.1% were women. There was a significant association between being male sex and holding a leadership position (n = 158/188, 84% versus n = 30/188, 16%, P