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Background: Obesity is a medical condition in which excess body fat has accumulated to extend that it may has an adverse effect on health. Leading to reduction of life expectancy or increasing health problems. Objective: To evaluate the improvement in plasma glucose level and lipid profile in type 2 diabetes mellitus obese patients after Laparoscopic Sleeve Gastrectomy (LSG). Patients and methods: This prospective study was conducted at Surgery Department, Al-Azhar University Hospitals during the period between December 2019 and August 2020. Study included 30 cases of type 2 diabetes mellitus morbidly obese patients (with BMI ≥35 Kg/m²) and all of them had failed in trials of conservative management including dietary control, and they were bulky eater but non sweet eater. Laparoscopic sleeve gastrectomy technique was done for all cases. Results: Our result showed that there was a significant improvement of the HbA1c measured at three and six months post-operatively. Five patients (17%) completely cured from T2DM, while 12 patients (40%) became pre-diabetic, and 13 patients (43%) remained diabetic with great improvement of their previous follow up of HbA1c. Conclusion: LSG was efficient in the remission and/or improvement of symptoms of T2DM and other obesity-related comorbidities, with a significant reduction in serum HbA1c and lipid profile.

Background: Diffusion-weighted magnetic resonance imaging (DW-MRI) has the ability of tissue characterization and can differentiate between benign and malignant tissues, including differentiation between benign post-radiotherapy changes and residual or recurrent malignancy. Objective: This study aimed to assess the role of diffusion-weighted magnetic resonance imaging in the evaluation of laryngeal and hypopharyngeal cancer as an initial diagnosis and the post-treatment surveillance protocol. Patients and methods: This study was a cross-sectional analytical study including twenty-five patients who presented with laryngeal or hypopharyngeal masses, thirteen cases were pretreatment cases, and twelve cases were post-treatment cases after completion of treatment. Seven cases had a hypopharyngeal origin, and eighteen cases had a laryngeal origin. The patients were assessed using history taking, a telescopic examination of the larynx and hypopharynx, computed tomography scanning, and diffusion-weighted magnetic resonance imaging on the neck. Direct laryngoscopic examination and biopsy taking from suspicious lesions were done. Biopsies were subjected to histopathological examination with a correlation between pathological and DW- MRI radiological results. Results: DW-MRI had a 100% sensitivity, 82.4 % specificity, and 88% accuracy compared to histopathological findings of biopsies from the studied group. There was a non-significant difference between DW-MRI and biopsy findings for either pretreatment or post-treatment cases of both laryngeal and hypopharyngeal origin of the lesions (p-value > 0.05 for all). Conclusion: DW-MRI is a sensitive tool for detecting laryngeal and hypopharyngeal cancers in new cases and excluding tumor residual after chemo-radiotherapy in cases with suspicious lesions after completion of treatment.

Propranolol (PPL) administered orally is considered as the first line drug for the treatment of infantile hemangioma, however several systemic adverse effects limit its use. For this reason, our work tackles the development and evaluation of PPL loaded chitosan nanoparticles (NPs), as an effective alternative for the treatment of infantile hemangioma. PPL -NPs were prepared using the double emulsion technique and the influence of the formulation variables on drug entrapment efficiency (EE), particle size (PS), percent released after 24 h (%R24h) and zeta potential (ZP) were optimized using full factorial design. Two systems, namely F3 and F28 showing highest E.E., ZP and %R24h with lowest PS, were fully characterized for DSC and TEM and incorporated into hydrogel with adequate viscosity. After ensuring safety for the selected nanoparticle, the hydrogel containing the optimized system was applied topically to rats. The in-vivo skin deposition in rats showed an accumulation of propranolol from the lecithin/chitosan nanocarrier by 1.56–1.91-fold when compared to the drug solution. The obtained result was further supported by the confocal laser scanning microscopy which showed fluorescence across the skin. PPL-HCL-loaded lecithin/chitosan nanoparticles could be considered as a potential candidate for treating infantile hemangiomas (IH) by maintaining therapeutic concentration topically while minimizing systemic side effects.

Objective: To investigate the modulatory effects of bitter gourd extract on the insulin signaling pathway in the liver and skeletal muscle tissues of diabetic rats. Methods: The ethanolic extract of bitter gourd was prepared and its contents of total polyphenols and flavonoids were assayed. A neonatal streptozotocin-induced diabetic rat model was established and the diabetic rats were assigned into different groups and were treated with different doses of bitter gourd extract (100, 200, 400, or 600 mg/kg) or with glibenclamide (0.1 mg/kg) for 30 d. Fasting blood glucose, insulin, and lipid profile were evaluated and the insulin signaling pathway in the liver and skeletal muscle of rats was investigated. The correlations between homeostasis model assessment (HOMA) and the components of insulin signaling pathway were also evaluated. Results: Different doses of bitter gourd extract significantly ameliorated fasting blood glucose level and HOMA index for insulin resistance. Moreover, bitter gourd extract increased serum insulin and improved disrupted serum lipid profile. The levels of insulin receptor substrate-1 (IRS-1), p-insulin receptor β (p-IR-β), protein kinase C (PKC), GLUT2, and GLUT4 were improved by treatment with bitter gourd extract. The best results were obtained with 400 mg/kg dose of the extract, the effect of which was equivalent to that of glibenclamide. HOMA in the bitter gourd treated rats was negatively correlated with p-IR-β, IRS-1 and PKC in hepatic and skeletal muscle. HOMA was also negatively correlated with skeletal muscle GLUT4. Conclusions: Bitter gourd extract improves glucose homeostasis and lipid profile in diabetic rats via enhancement of insulin secretion and sensitivity. Therefore, bitter gourd can be used as a potential pharmacological agent for the treatment of type 2 diabetes mellitus.

The environment and the physiological conditions play a vital role in the thermal processes in the human tissues, such as the multi-layered human-eye. In this work, a mathematical model of the human eye concerning the change in blood perfusion, porosity, evaporation rate, and ambient temperatures has been formulated based on non-Fourier heat conduction law with appropriate boundary and interface conditions. A direct method and MAPLE 17 software was used to get the numerical solution, and the results have been shown in figures. The temperature distribution based on various values of the relaxation times parameters has been discussed first to stand on its effect on the value of the temperature in each layer of the human eye. The impact of the blood perfusion, porosity, evaporation rate, time, and ambient temperatures have been discussed; they have significant effects on the thermal wave passing through the human eye layers. For validity, the results of this model have agreed with the results of some other works.

Background: Infected femoral artery pseudoaneurysms (IFAPs) in Intravenous drug abusers (IVDAs) are very common nowadays with increasing incidence and controversial management strategy with little data about correlation between IFAPs criteria and limb outcome.Aim of the work: to estimate incidenceand determinants of limb salvage post arterial ligation in patients with infected pseudoaneurysms.Patients and Methods: Prospective cohortwith18 months follow up of 40 IVDA patients presented with groin pseudoaneurysms to estimate incidence and determinants of Lower Limb salvage following Arterial Ligation.Results:Duration of Intravenous (IV) addiction ranged from half a year to 30 years and affected groin use ranged from half a year to 10 years and duration of symptoms ranged from 1 to 6 weeks. Symptoms ranged between swelling in 13 cases (32.5%), pulsating mass in 12 cases (30%) and hemorrhage in 15 cases (37.5 %). DVT found in 31 cases (77.5 %). Incidence of limb salvage post arterial ligation is 75%(N 30), threatened limbs found in 25% of cases (N 10). Amputation required in 15%(N 6) and bypass in 12.5%(N 5) bypass followed by amputation in one patient. Primary patency of all constructed bypasses is 6 months for 80% (N 4) and 3 months for 20% (N 1).Viral markers showed 33 patients were HCV +ve (82.5%), 8 patients HBV +ve (20%), 9 patients HIV +ve (22.5%). There was statistically significant difference between both groups as regard duration of affected groin use, duration of symptoms, nature of presenting symptom, Pre and immediate post-operative ABI and percent of reduction between both and Level of ligation are determinants of limb salvageConclusion: Ligation and debridement with selective revascularization strategy is a safe option in IFAPs management.Incidence of limb salvage following arterial ligation is 75%. Duration of affected groin use, duration of symptoms, nature of presenting symptom, Pre and immediate post-operative ABI and percent of reduction between both and Level of ligation are determinants of limb salvage.

Palliative care is an approach to improve the quality of life for patients and their families through the prevention and relief of suffering Purpose: to determine the effect of an educational palliative nursing interventions on selected outcomes among patients having advanced cancer. Design: A quasi-experimental design was utilized (pre and posttest). Setting: The study was carried out at the oncology department of Menoufia University Hospital at Menoufia governorate. Sample: A purposive sample of 107 adults advanced cancer patients were selected for this study. Instruments: Three instruments were used. First instrument was a structured interview questionnaire about social characteristics. Second instrument was alikert scale for functional assessment of cancer. Instrument three was center for epidemiological studies depression scale. Results: there was a highly statistically significant decrease in the total mean score of depression symptoms and an improvement in theoverall quality of life domains mean score 48.64±11.52 Vs 54.38±12.79 and 62.14±17.51. Conclusion: Patients who had advanced cancer had improved quality of life and reduced level of depression after they received the educational palliative nursing intervention on posttest and follow up. Recommendation: palliative nursing interventions should be included routinely in the management of patients with advanced cancer besides conventional therapy.

People with advanced cancer often experience physical symptoms that depend on the specific type of cancer a person has and where it has spread. Purpose: To assess the effect of a palliative nursing interventions on symptoms intensity among patients with advanced cancer. Design: A quasi-experimental research design was utilized. Setting: The study was carried out at the Oncology Department of Menoufia University Hospital at Menoufia governorate. Sample: A purposive sample of one hundred and seven adult patients with advanced cancer was selected. Instruments: Two instruments were used. Instrument one: structured interview questionnaire. Instrument two: Edmonton symptom assessment system. Results: All symptoms intensity related to cancer were reduced on posttest and follow up tests than pretest such as pain 3.81±3.72, 2.64±2.92 Vs 4.48±4.29. Conclusion: The study concluded that a palliative nursing intervention had a positive effect on reducing symptoms intensity among advanced cancer patients. Recommendation: A palliative nursing intervention should form an important component and should be included routinely in the management of patients with advanced cancer besides conventional therapy.

Purpose: The aim of this study was to evaluate and compare clinical retention values of metal and poly ether-ether Ketone secondary copings for rigid telescopic retained implant supported mandibular overdentures Material and methods: Eight edentulous patients (4 males and 4 females) who were unsatisfied with the retention of mandibular dentures were randomly assigned equally into 2 groups then received 4 implants in the interforaminal region of the mandible. Group I received telescopic overdentures with metal secondary coping (control group), Group II received telescopic overdentures with Poly ether-ether secondary copings (PEEK) (test group). Measurement of clinical retention forces (in Newton) were performed by digital force meter device attached to a special device that ensure application of vertical dislodging perpendicular to the patient’s occlusal plan. Measurements were performed at time of overdenture insertion, 3 months and 6 months after insertion. Results: For all times of measurements, PEEK secondary copings were associated with significant higher clinical retention values than metal secondary copings. For metal and PEEK groups, retention values at base line were the highest values followed by retention values after 3 months and the least retention forces were noted after 6 months. Conclusion: Within the limitations of this study caused by small patient sample and short evaluation period, PEEK secondary copings for telescopic attachments of mandibular implant overdentures is recommended than cobalt chromium secondary copings as it was associated with increased clinical retention values even after 6 months of clinical use.

Background: The knowledge of anatomical measurements of cerebral arteries has a great value for understanding of several neurologic disorders. Aim of the work: To measure diameters and lengths of anterior cerebral artery (ACA), posterior cerebral artery (PCA) and middle cerebral artery (MCA) on both sides to give basis for normal Egyptian measurements of cerebral arteries using Digital Subtraction Angiography (DSA). Subjects and Methods: Fifty healthy individuals who had normal DSA, including 33 males and 17 females aged from 20 years to 60 years were examined during this study. Chosen subjects were classified into two age groups, Group 1: that included 18 persons (between 20-39 years old). Group 2: that included 32 persons (between 40-60 years old). DSA used to measure the diameters and lengths of main cerebral arteries (ACA , MCA and PCA) at different segments. Results: Regarding to the age of studied subjects, there was statistical significant difference between the diameters of cerebral arteries at different segments in the studied groups and the diameters of these arteries were decreased by advancing in age. There was statistical significant difference between the lengths of cerebral arteries at different segments in the studied groups and the lengths of these arteries were more in the older age group. The differences between means of lengths of cerebral arteries on the right and on the left side was statistically non-significant in all segments except that of middle cerebral artery-segment 1 (M1) which was statistically significant. Conclusion: Establishment of Egyptian normal measurements of cerebral arteries using Digital Subtraction Angiography has a great value in interpretation of cranial angiograms as these measurements may vary in different races .

Background: Most men diagnosed with prostate cancer (PCa) are aged 50 years old or more treated by androgen deprivation therapy (ADT) treatment has been associated with interconnected adverse effects as decreased bone mineral density (BMD) and a loss in the structure and strength of bone leading to osteoporosis. Exercise has been proposed as a treatment to mitigate side effects of ADT. Objective: This study was conducted to evaluate the effect of weight bearing exercises on osteoporosis in prostate cancer patients undergoing androgen deprivation therapy. Patients and methods: The current study was conducted during a period of 3 months starting from 1st October 2019 till 31st December 2019.Thirty PCa patients who had osteoporosis induced by ADT were participated in this study, their ages were over 50 years old. They were selected from the Oncology Hospital Menoufia University and randomly distributed into two equal groups, group A: included 15 patients who received 30 minutes of weight bearing exercises through walking on treadmill, in addition to conventional medical care 3 days /week and group B: included 15 patients who on their conventional medical care. Results: Our study showed that there was a statistically significant improvement in BMD and T-score mean of spine, femoral neck and total femur post treatment compared to that pre-treatment in the group A and B. Conclusion: It can be concluded that weight bearing exercises had fruitful effects in cases of osteoporosis in prostate cancer patients undergoing androgen deprivation therapy as evidenced by the significant increase in BMD and T-score mean.

Purpose: The aim of the present study was to evaluate clinical and radiological outcomes of “All on 4” Versus “All on 6” implant concepts for rehabilitation of edentulous maxilla. Materials and methods: 10 patients with complete maxillary edentulism and distal extension mandibular ridges who had resorption in the posterior aspects of the maxillary ridge were randomly assigned into 2 groups: Group 1 included 5 patients who received All on four maxillary prosthesis, and group 2 included 5 patients who received All on six maxillary prosthesis. Four (group 1) or six (group 2) implants were inserted between the maxillary sinuses and immediately loaded by provisional acrylic dentures. Definite screw retained porcelain fused to metal fixed prosthesis were inserted after 6 months. Plaque index, gingival index, probing depth, implant stability, and peri-implant bone loss were measured for both groups at base line (after insertion), 6 months and 12 months after insertion. Results: The survival rate was 85% and 100% for group 1 and group 2 respectively. Plaque and gingival scores significantly increased with time in group 1 only. At 6 and 12 months, group 1 showed significant higher plaque and gingival scores than group 2. Pocket depth and implant stability increased significantly with time in both groups. Group 1 showed significant higher pocket depth and reduced implant stability than group 2 at all observations. Bone resorption significantly increased after 12 months compared to 6 months in both groups. Group 1 recorded significant higher bone loss than group 2 after 6 and 12 months of prosthesis delivery. Conclusion: Within the limitations of this study, it could be concluded that All on 6 implant concept is recommended for restoration of atrophied maxilla compared to All on 4 implant concept as it was associated with improved clinical and radiographic parameters after one year.

Sertraline HCl (SRT) is a selective serotonin reuptake inhibitor (SSRI) that is used to treat depression and anxiety disorders. SRT is characterized by limited water solubility and suffers from low bioavailability due to first-pass effect. Therefore, this study aims to formulate SRT-Cyclodextrin (CD) orodispersible tablet (ODT) using direct compression technique to avoid SRT drawbacks. A 22 × 3 full factorial design was adopted using three factors, namely, CD type (βCD and HPβCD), SRT-CD mixing type (physical and solid dispersion), and type of diluent/superdisintegrant (xylitol/polyvinylpyrrolidone, maltitol/polyvinylpyrrolidone, and maltitol/co-processed mixture of polyvinylpyrrolidone and Ac-Di-Sol). Precompression studies were carried out on each formulation blend followed by the characterization of the prepared ODTs. All the ODTs were assessed for weight variation, hardness, friability, content uniformity, in vitro disintegration time, wetting time, water absorption ratio, in vitro dispersion time, and in vitro dissolution study. Accelerated and long-term stability studies were executed on the selected formulation. A pharmacokinetic study of the selected SRT ODT was accomplished through sublingual administration using LC/MS/MS assay in comparison to the conventional oral tablet Lustral®. ODT prepared with SRT-βCD solid dispersion with maltitol/polyvinylpyrrolidone (F4) led to reducing the disintegration time (9 ± 1.41 sec) and enhancing the dissolution efficiency (84 ± 2.5%). It showed a significant decrease of Tmax to 4 h instead of 8 h for Lustral® and increased the extent of drug absorption with a relative bioavailability of 117%. SRT orodispersible sublingual tablet can be considered as a promising delivery system for the treatment of depression. SRT sublingual ODT can avoid first-pass effect of SRT and hence improve its bioavailability due to the enhancement of SRT dissolution and rapid absorption through the oral mucosa.

Thermal processes in human tissues, such as the multi-layered human eye, are influenced by the environment and physiological factors. Based on a non-Fourier heat conduction rule with proper boundary and interface conditions, a mathematical model of the human eye concerns changes in blood perfusion, porosity, evaporation rate, and ambient temperatures has been formulated in this study. The numerical solution was obtained using a direct technique and MAPLE 17 software, and the results are presented in figures. The temperature distribution based on various values of the relaxation times factors was first examined to determine its impact on the temperature value in each layer of the human eye. The effects of blood perfusion, porosity, evaporation rate, time, and ambient temperatures on the thermal wave passing through the human eye layers have been discussed; they have considerable influence on the thermal wave travelling through the human eye layers. The results of this model have agreed with the results of other studies in terms of validity.

Objective: This study aimed to evaluate the immunohistochemical expression of forkhead boxP3 (Foxp3), CD8, CD68, and CD21 in stroma between tumor cells of colorectal cancer (CRC) patients and examines the relationship between these variables and clinicopathological parameter and patients’ prognosis. Methods: In this work, 50 cases of colorectal carcinomas were included and immunohistochemical evaluation of Foxp3, CD8, CD68, and CD21 in tumor tissue samples. Results: Tumor-infiltrating lymphocytes (TILs) including cytotoxic T cells and regulatory T cells as well as tumor-associated macrophages and follicular dendritic cells (FDCs) were studied in the stroma of the tumor using immunostaining technique for CD8, Foxp3, CD68, and CD21, respectively. Cases were followed up. CD8-positive cytotoxic T cells, Foxp3-positive regulatory T cells, and CD21 positive-FDCs were significantly more pronounced in early tumors and those with longer overall survival. On the other hand, CD68 positive macrophages were more encountered in late stage and metastatic tumors as well as tumors with shorter overall survival, but these results not reached the level of significance. Conclusion: We concluded that (TILs) and FDCs are conferring better prognosis in CRCs, they may act synergistically in stimulating a protective immune response in the tumor microenvironment that hinders tumor progression, while the role of tumor-associated macrophages in CRCs is still controversial and needs further studies.

In the current work, a full factorial experimental design was utilized to formulate piroxicam into orodispersible films while investigating the effects of some formulation factors on the pr...

BACKGROUND Egypt is the most populous country in the Middle East and North Africa and has more than 15% of the cardiovascular deaths in the region, but little is known about the prevalence of traditional risk factors and treatment strategies in acute coronary syndrome (ACS) patients across Egypt. METHODS From November 2015 to August 2017, data were collected from 1 681 patients with ACS in 30 coronary care centres, covering 11 governorates across Egypt, spanning the Mediterranean coast, Nile Delta and Upper Egypt, with a focus on risk factors and management strategies. RESULTS Women constituted 25% of the patients. Premature ACS was common, with 43% of men aged less than 55 years, and 67% of women under 65 years. Most men had ST-elevation myocardial infarction (STEMI) (49%), while a larger percentage of women had unstable angina and non-ST-elevation myocardial infarction (NSTEMI) (32% each; p < 0.001). Central obesity was present in 80% of men and 89% of women, with 32% of men and women having atherogenic dyslipidaemia. Current smoking was reported by 62% of men and by 72% of men under 55 years. A larger proportion of women had type 2 diabetes (53 vs 34% of men), hypertension (69 vs 49%), dyslipidaemia, and obesity (71 vs 41%) (p < 0.001 for all). There were no gender differences in most diagnostic and therapeutic procedures, but among STEMI patients, 51% of men underwent primary percutaneous coronary intervention compared to 46% of women (p = 0.064). CONCLUSIONS Central obesity and smoking are extremely prevalent in Egypt, contributing to an increased burden of premature ACS, which warrants tailored prevention strategies. The recognised tendency worldwide to treat men more aggressively was less pronounced than expected.

Background: Extracorporeal membrane oxygenation (EC-MO) or Extracorporeal life support (ECLS) is a technique of providing both cardiac and respiratory support for apatient whose heart and lung are unable to provide an adequate gas exchange to sustain life. Therefore, crtical care nurses should have specific knowledge and practice to provide safe, and efficient care for such group of patients.Aim of Study: This study was carried out to evaluate the effect of ECMO educational program on nurses' knowledge and practices.Subject and Methods: A quasi-experimental research design was utilized in the current study. Research hypotheses:(1)Critical care nurses who attend the educational program about care of patient connected to ECMO will have a higher post-test mean knowledge scores as compared to their pre-test mean knowledge scores all through the assessment times.(2)Critical care nurses who attend the educational program about care of patients connected to ECMO will have a higher post mean practice scores as compared to their pre-test mean practice scores all through the assessment times. A conven-ience sample of 34 nurses was included in the current study. The study was conducted in a selected Critical Care Depart-ment affiliated to Cairo University Hospitals. Three tools were utilized to collect data pertinent to the study: Critical care nurses personal Data sheet; Critical care Nurses' knowl-edge Questionnaire regarding care of patients connected to ECMO; and Critical Care Nurses' observational check list about care of patient connected to ECMO. The current study revealed that, the majority (94.1%) of nurses did not attend any training courses about care of patient connected to ECMO. The two stated research hypotheses were supported indicating significant improvement of critical care nurses knowledge and practices after implementation of ECMO educational program (F-ratio 494.8 at p£0.0001* & 242.204 at p£.0001 respectively).Conclusion: Impementation of a nursing educational program about care of patient connected to ECMO helped in assessment and enhancement of nursing knowledge and prac-tices. This will be reflected on critically ill patients' care.Recommendations: Carrying out in-service training, work-shops and continuing educational program a bout ECMO; provision of written guidelines about care of patients on ECMO; and strict observation of nurses practices.

Introduction: Eustachian tube is often involved in the pathological processes of the nasal, paranasal, and nasopharynx cavities; therefore, nasal obstruction can alter Eustachian tube function (ETF). The pathogenesis of otitis media has been related to the presence of previous or concurrent nasal diseases. Objective: to study whether there are changes in middle ear pressure after sinonasal surgery. Materials and methods: 59 patients who had different nasal pathologies were subjected to History taking, Clinical examination and Tympanometry. ETF tests in the form of valsalva, Toynbee maneuvers and tympanometry had been performed the day before the operation and after 6 weeks. The postoperative middle ear pressure levels were determined using tympanometry. The middle ear pressure values obtained before and after surgery were compared to determine if there is a statistically significant result. Results: There were a significant improvement of nasal obstruction, ear fullness and tinnitus after surgery. The relation between the middle ear pressure preoperatively and at 6 weeks after removal of nasal packs showed a significant improvement in middle ear pressure (P < 0.05) in both ears. Conclusions: Sino-nasal surgery has a favorable effect on the middle ear pressure and Eustachian tube function.

Thesis Abstract Several cytokines are known to be involved in the pathogenesis of non-Hodgkin Lymphomas (NHL). Given the importance of understanding the genetic predisposition involved in the pathogenesis of NHL, this work was designed to study the impact of IL-10 (-1082 G/A; rs1800896 and -819 C/T; rs1800871), IL-6 (-174 G/C; rs1800795) and CD38 (184C/G; rs6449182) gene polymorphisms on the susceptibility of Egyptians to NHL. Both loci of IL10 were genotyped using polymerase chain reaction- sequence-specific primers (PCR-SSP), IL6 rs1800795 G/C was genotyped using mutagenically separated PCR (MS-PCR) and restriction fragment length polymorphism-PCR (RFLP-PCR) was used to genotype CD38 (rs6449182 C/G) in 100 Egyptian patients and 119 controls. Plasma levels of IL-6 and IL-10 were measured using enzyme-linked immunosorbent assay (ELISA). An insignificant change in IL-10 (rs1800896 and rs1800871) genotypes were recorded. GT haplotype was significantly elevated.

This work aims to study the influence of the rotation on a thermoelastic solid sphere in the context of the hyperbolic two-temperature generalized thermoelasticity theory based on the mechanical damage consideration. Therefore, a mathematical model of thermoelastic, homogenous, and isotropic solid sphere with a rotation based on the mechanical damage definition has been constructed. The governing equations have been written in the context of hyperbolic two-temperature generalized thermoelasticity theory. The bounding surface of the sphere is thermally shocked and without volumetric deformation. The singularities of the studied functions at the center of the sphere have been deleted using L’Hopital’s rule. The numerical results have been represented graphically with various mechanical damage values, two-temperature parameters, and rotation parameter values. The two-temperature parameter has significant effects on all the studied functions. Damage and rotation have a major impact on deformation, displacement, stress, and stress–strain energy, while their effects on conductive and dynamical temperature rise are minimal. The thermal and mechanical waves propagate with finite speeds on the thermoelastic body in the hyperbolic two-temperature theory and the one-temperature theory (Lord-Shulman model).

Background: Understanding the molecular basis of lung cancer has led to the development of targeted agents with a significant clinical benefit. This benefit is confined to patients with specific molecular tumor characteristics. However, chemotherapy represents the backbone of treatment in fit patients and is associated with a significant overall survival prolongation and quality of life improvement. Aim: To evaluate the effect of a continuation maintenance therapy with paclitaxel in advanced NSCLC patients with weekly paclitaxel. Patients and Methods: The current study included patients with advanced non-small-cell lung cancer (NSCLC) (stage IIIB or IV) with performance status ≤ 2 who experienced good initial good response, or stable disease after receiving 4 cycles of paclitaxel carboplatin. Patients were randomized into 2 arms, the first arm received weekly paclitaxel (70 mg/m2) as continuation maintenance therapy for 3 weeks of 4 weeks cycle. The treatment was continued until disease progression or unacceptable toxicity (maintenance arm). The second arm was kept under observation (observation arm). Results: There was a better lung cancer symptoms scale in the maintenance arm. Both times to progression and overall survival for the maintenance arm was higher (P value 0.16 and 0.047, respectively). Treatment-related toxicities were significantly higher in the maintenance arm as compared to the observation arm (P value

Background Patients with acute respiratory acidosis caused by an acute exacerbation of chronic obstructive pulmonary disease(AECOPD)constitute the group that benefits most from noninvasive positive-pressure ventilation (NIPPV). However, there are some patients who do not respond to NIPPV. Studies from the west report variable failure rates. Delaysin recognizing non responders can increase hospital morbidity and mortality. Objective The aim of this study was to assess the effectiveness and safety of NIPPV in patients with acute hypercapnia respiratory failure (AHRF) secondary to AECOPD. Patients and methods This was a prospective observational study of 119 consecutive chronic obstructive pulmonary disease patients who were admitted with a diagnosis of AHRF and in whom NIPPV was applied. Results The overall success rate of NIPPV in the studied group was 94%. Mortality and duration of hospitalization were significantly higher in the failure group (P=0.0001 and 0.002, respectively). The most encountered complications were air leak (29%) and mask discomfort (24%). Comparison between the success and the failure group at the time of hospital admission revealed that the failure group was associated with old age (P=0.043), low hemoglobin (Hb) (P=0.037), low albumin (0.017), lower Glasgow Coma Scale (GCS) score (P=0.0001), higher Acute Physiology and Chronic Health Evaluation II (APACHE II) score (P=0.001), higher heart rate (P=0.002), lower systolic blood pressure (SBP) (P=0.013), lower diastolic blood pressure (DBP) (P=0.034), and higher white blood cells (WBCs) (P=0.0001). Multiple regression analysis identified age more than 65years, respiratory rate35ormore,pHless than 7.26, and WBCs more than or equal to 20 000 or less than 4000 as significant independent predictors of NIPPV failure in our patients. Conclusion NIPPV is an effective and safe modality for treating patients with AHRF secondary to AECOPD. Widespread availability and training of medical staff in the use of NIPPV is recommended.

This study aimed to increase ocular residence time of levofloxacin by formulation into zero-order sustained release mucoadhesive minitablets for once daily administration using a hydrophobic-hydrophilic polymeric matrix. Levofloxacin was first formulated into solid dispersion with different ratios of Eudragit

Background Parenteral anticoagulants and vitamin K antagonists (VKAs) have constituted the cornerstone of venous thromboembolism (VTE) treatment. Meanwhile, direct oral anticoagulants (DOACs) provide physicians with an alternative. The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE observes real-world treatment practices. Objectives Describe initial anticoagulation (AC) treatment patterns in VTE patients who received parenteral AC, VKAs, and/or DOACs within ±30 days of diagnosis. Methods VTE patients were categorized into parenteral AC only, parenteral AC with transition to VKA, VKA only, parenteral AC with transition to DOAC, and DOAC only. Results A total of 9647 patients were initiated on AC treatment alone. 4781 (49.6%) patients received DOACs ± parenteral ACs; 3187 (33.0%), VKA ± parenteral ACs; and 1679 (17.4%) parenteral ACs alone. Rivaroxaban was the most frequently used DOAC (79.4%). DOACs were more frequently used in North America/Australia (58.1%), Europe (52.2%), and Asia (47.6%) than in Latin America (29.7%) and the Middle East/South Africa (32.5%). In patients with suspected VTE, most received parenteral AC monotherapy (67.7%). Patients with deep vein thrombosis were more likely to receive DOACs alone than those with pulmonary embolism with or without deep vein thrombosis (36.2% vs 25.9%). Active cancer patients received parenteral AC alone (58.9%), with 25.5% receiving DOAC ± parenteral AC and 12.8% parenteral AC and VKA. A total of 46.5% of pregnant patients received parenteral AC monotherapy, 34.0% were treated with VKA ± parenteral AC, and 19.5% received a DOAC (± parenteral AC). Conclusion AC treatment patterns vary by patient population, geographic region and site of VTE. Guidelines for AC therapy are not always adhered to.

In this paper, we work on the fundamental collocation strategy using the moved Vieta–Lucas polynomials type (SVLPT). A numeral method is used for unwinding the nonlinear Rubella illness Tributes. The quality of the SVLPT is presented. The limited contrast system is used to understand the game plan of conditions. The mathematical model is given to attest the resolute quality and ampleness of the recommended procedure. The oddity and meaning of the outcomes are cleared utilizing a 3D plot. We examine free sickness harmony, security balance point and the presence of a consistently steady arrangement.

Carvedilol, a beta-adrenergic blocker, suffers from poor systemic availability (25%) due to first-pass metabolism. The aim of this work was to improve carvedilol bioavailability through developing carvedilol-loaded solid lipid nanoparticles (SLNs) for nasal administration. SLNs were prepared by emulsion/solvent evaporation method. A 23 factorial design was employed with lipid type (Compritol or Precirol), surfactant (1 or 2% w/v poloxamer 188), and co-surfactant (0.25 or 0.5% w/v lecithin) concentrations as independent variables, while entrapment efficiency (EE%), particle size, and amount of carvedilol permeated/unit area in 24 h (Q 24) were the dependent variables. Regression analysis was performed to identify the optimum formulation conditions. The in vivo behavior was evaluated in rabbits comparing the bioavailability of carvedilol after intravenous, nasal, and oral administration. The results revealed high drug EE% ranging from 68 to 87.62%. Carvedilol-loaded SLNs showed a spherical shape with an enriched core drug loading pattern having a particle size in the range of 66 to 352 nm. The developed SLNs exhibited significant high amounts of carvedilol permeated through the nasal mucosa as confirmed by confocal laser scanning microscopy. The in vivo pharmacokinetic study revealed that the absolute bioavailability of the optimized intranasal SLNs (50.63%) was significantly higher than oral carvedilol formulation (24.11%). Hence, we conclude that our developed SLNs represent a promising carrier for the nasal delivery of carvedilol.

The development of cancer theranostic nanomedicines is recommended to concurrently achieve and evaluate the therapeutic benefit and progress. The current work aims to develop gallic acid-gold nanoparticles (GA-Au NPs) as a theranostic probe for 99mTc-Doxorubicin (99mTc-DOX) based on the spatiotemporal release pattern induced intra-tumoral (IT) delivery. DOX-loaded GA-Au NPs were developed and identified via UV–Vis spectroscopy. The system was characterized for drug loading efficiency%, particle size, zeta potential, topography, in vitro DOX release and anti-proliferative activity against the MCF-7 cell-line. The factors influencing radiolabeling efficiency of DOX with 99mTc (DOX concentration, stannous chloride concentration, reaction time and pH) were optimized. The in vitro stability in mice serum and in vivo distribution studies in mice of 99mTc-DOX-loaded GA-Au NPs were investigated following IV and IT administration. Dox-loaded GA-Au NPs had a loading efficiency of 91%, a small particle size (≈50 nm), a promising zeta potential (−20 mV) and a sustained drug release profile at pH 5.3. GA-Au NPs exhibited increased anti-proliferative activity, with approximately a four-fold lower IC50 value (0.15 μg/ml) than free DOX. The optimized radiolabeling efficiency of 99mTc-DOX was ≈93%. It showed good physiological stability in mice serum for at least 8 h. The IT delivery of 99mTc-DOX-loaded GA-Au NPs in tumor-induced mice showed dramatic tumor accumulation. A maximum magnitude of 86.73%ID/g was achieved, at 15 min post-injection, with a target/non-target ratio of ≈56. 99mTc-DOX-loaded GA-Au NPs could be used for the selective IT delivery of a chemotherapeutic agent and an imaging agent to a target organ.

Background Myocardial infarction (MI) is the major cause of death and disability worldwide. Many recent studies revealed the relationship between circulating irisin levels, endothelial dysfunctions and subclinical atherosclerosis in adult patients. Objectives The aim of this study was to investigate the distribution of Irisin gene single nucleotide polymorphism in patients with MI and its association with other clinical and laboratory variables in these patients. Patients and methods This study was carried out in 100 patients with MI, and 100 healthy subjects served as controls. All studied subjects underwent laboratory investigations, including measurement of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c) high-density lipoprotein cholesterol (HDL-c), creatinine kinase-MB (CK-MB), troponin I (TnI) and genotyping of rs 3480 and rs726344 of Irisin genes using the TaqMan Allelic Discrimination assay technique. Results There was a significant difference of Irisin genotypes in patients when compared to controls. By estimating odd ratio (OR) an association was found between G allele of rs 3480 and A allele of rs726344with increase the risk of developing myocardial infarction by 4.03 and 3.47 fold respectively. GG of rs 3480 carriers had significantly increased Troponin I and triglyceride levels, while GA carriers of rs726344 had significantly increased CKMB, Total cholesterol, LDLc, HDLc, troponin I and triglyceride levels compared with other genotypes. Conclusion G allele of rs 3480 and A allele of rs726344can considered as genetic risk factors for MI; these findings could have an impact on preventive strategy for myocardial infarction., Highlights • Irisin gene SNP GG genotype and G allele of rs3480 and GA genotype and A allele of rs 726,344 may confer susceptibility to MI. • Patients carrying GG genotype of rs3480 and GA genotype and A allele of rs 726,344 are associated with criteria of hypertension, diabetes, hyperlipidaemia. • Irisin gene expression are necessary to explain its role in pathology of MI and to evaluate the role in management.

Oral diseases as gingivitis, periodontitis, aphthous ulcers and dental caries are widespread in infants and children especially in developing countries. In this study, different Cetylpyridinium chloride (CPC) mucoadhesive buccal films based on chitosan (CS) blended with hydroxypropyl methylcellulose (HPMC), methylcellulose (MC), hydroxyethyl cellulose (HEC) and polyvinyl alcohol (PVA) were developed and thoroughly characterized to improve the conventional treatment of oral diseases. Physicochemical characterization, surface pH, mechanical properties, mucoadhesion, swelling, in vitro release and microbiological activity were assessed. All films showed homogeneous content, thickness and acceptable pH for buccal mucosa. Films formulated from CS only showed the highest swelling index while blended CS films formulated using PVA and HEC showed the highest mucoadhesion however PVA based films showed higher tensile strength. The developed blended CS film with PVA (F11) displayed good antimicrobial activity and good kill-time against Streptococus mutans indicating that films based on CS-PVA could be a promising substitute for the treatment of oral diseases.

Patients with chronic hepatitis C virus (HCV) infection have neuropsychiatric and cognitive problems, leading to impairment of quality of life. The aim of the study was to assess the prevalence of psychiatric morbidity, cognitive impairment, and depression in a group of Egyptian patients with chronic HCV infection. A total of 150 chronic HCV infection noncirrhotic Egyptian patients were enrolled. Mental health, cognitive functions, and depression were assessed using General Health Questionnaire, mini-mental state test, and BDI-II questionnaire respectively. The study included 82 (54.67%) male patients and 68 (45.33%) female patients with mean age of 40.5±10.74 years. In all, 73 (48.67%) patients had current psychiatric morbidity, 61 (40.67%) patients were suffering from depression, whereas 24 (16%) patients had cognitive impairment. Depression was associated with younger age (P

This study describes the preparation of radioiodinated anastrozole and epirubicin and their biological evaluation as potential solid tumor imaging gents. Radioiodinated anastrozole and epirubicin were successfully prepared via direct electrophilic substitution reaction at ambient temperature. The radiochemical yields for radioiodinated anastrozole and epirubicin were maximized to 92.9 ± 0.1 and 98.8 ± 0.1 %, respectively by studying different reaction parameters such as substrate amount, chloramine-T, pH of the reaction mixture, reaction temperature and reaction time. They showed in vitro stability up to 4 and 24 h, respectively. The preclinical evaluation and biodistribution in mice bearing solid tumor showed high retention and biological accumulation in solid tumor cells (12.4 and 25.3 % injected activity/g tissue) and high T/NT ratio equal to 4.7 ± 0.1 and 5.2 ± 0.1 at 2 and 1 h post-injection, respectively. Data described before could recommend radioiodinated anastrozole and radioiodinated epirubicin as potential targeting radiopharmaceuticals for solid tumor imaging.

Acebutolol was successfully labeled with (125) I via direct electrophilic substitution reaction. Radioiodinated acebutolol was prepared with a maximum radiochemical yield of 96.5 ± 0.3% and in vitro stability up to 72 h. The in vivo biological distribution of radioiodinated acebutolol showed high heart uptake of 37.8 ± 0.14% injected activity/g organ with low lungs and liver uptakes at 5 min post-injection. In vivo receptor blocking study was carried out in mice to evaluate its selectivity to heart. Radioiodinated acebutolol showed fast heart accumulation with high heart/liver ratio, which provides the ability for fast myocardial imaging with significant decrease in the radiation hazards risk on patients. So, radioiodinated acebutolol could be displayed as a radiotracer drug of choice in case of emergency patients for myocardial perfusion imaging.

Radioiodinated fenoterol and reproterol were prepared by electrophilic radioiodination reaction using chloramin-T as oxidizing agent with radiochemical yields of 97.7 ± 0.7 and 95.2 ± 0.3 %, respectively, and in vitro stability up to 72 h. Biodistribution study performed in male Albino Swiss mice showed maximum radioactivity accumulation in lungs tissue to the extent of 52 ± 1.03 and 50.6 ± 1.2 % ID/g at 15 and 30 min post injection (p.i.) for radioiodinated fenoterol and reproterol, respectively, with low accumulation in heart and blood. The clearance pathway of both iodo-compounds was through renal and hepatobiliary routes. The selectivity of iodo-compounds to lung was examined by in vivo receptor blocking study. Radioiodinated fenoterol and reproterol are not a blood products and so they are more safer than the currently available 99mTc-MAA, and their lungs uptake is higher than that of the recently discovered 125/123I-IPMPD, 99mTc(CO)5I, 99mTc-DHPM and 125/123I-paroxetine. So, radioiodinated fenoterol and reproterol could be introduced as a new compromising radiopharmaceuticals for lung perfusion scintigraphy more safe than the currently available 99mTc-MAA and more potential than the recently discovered 125/123I-IPMPD, 99mTc(CO)5I, 99mTc-DHPM and 125/123I-paroxetine.

To assess the impact of multiple access tracts during percutaneous nephrolithotomy (PCNL) on short- and midterm renal function, and to determine risk factors predicting renal function deterioration and/or recoverability.Patients undergoing PCNL with multiple punctures were prospectively enrolled. Preoperative evaluation included dimercaptosuccinic acid and diethylenetriaminepentaacetic acid renography. Patients were classified according to baseline renal function into patients with normal (1.4 mg/dL) serum creatinine (group A) and patients with elevated (≥1.4 mg/dL) serum creatinine (group B). Patients were followed with serial serum creatinine evaluations and a repeated renography at 12 months. Factors evaluated for possible impact on renal function changes included preoperative renal function, number of access tracts, hypertension, and diabetes mellitus.There were 102 patients 21 to 65 (mean 39.9) years who completed the study. Fifty patients (group A) had normal preoperative serum creatinine levels and glomerular filtration rate (GFR), which showed no statistically significant change 12 months after PCNL. Fifty-two patients had baseline renal impairment (group B), and they experienced statistically significant worsening of the serum creatinine level and GFR at 12 months postoperatively (P0.001). Ten (19.23%) patients in group B had a significant deterioration of GFR more than 25%. Independent risk factors for this poor outcome were elevated (≥1.4 mg/dL) preoperative serum creatinine level, diabetes, and hypertension.PCNL with multiple tracts carries a risk of adversely affecting renal function. Preoperative baseline renal impairment, diabetes, and hypertension are risk factors for significant renal function deterioration after the procedure.

Cefaclor and ampicillin, β-lactam antibiotics capable to penetrate the outer membrane of Grampositive and some Gram-negative bacteria, were labeled with 125I via electrophilic substitution of the hydrogen atom with the iodonium ion I+. The reaction yield strongly depends on pH of the medium, reaching a maximum at pH 7. This may be due to efficient protonation and high performance of the oxidizing agent at this pH value. In alkaline solutions, the labeling yield decreased, because cefaclor and ampicillin are unstable at these pH values. The produced 125I-cefaclor and 125I-ampicillin are stable in vivo, as the thyroid gland uptake does not exceed 1.2%. Labeled cefaclor and ampicillin are efficiently localized in bacterial inflamed muscle. The abscess to muscle ratio for 125I-cefaclor and 125I-ampicillin was found to be 5.1 and 6.8, respectively. The imaging should be carried out at 2 h post injection, because at this time the activity is concentrated in the target site and the background activity has been cleared.

The aim of this study is the formulation of a new radiopharmaceutical for imaging solid tumor bearing. Gemcitabine is a nucleoside analogue used as chemotherapeutic agent. Gemcitabine was formulated and radiolabeled with one of the most important diagnostic radioactive isotopes (technetium-99m) to be investigated in solid tumor imaging. The labeling parameters such as gemcitabine amount, stannous chloride amount, pH of the reaction mixture, and reaction time were optimized. 99mTc–gemcitabine was prepared at pH 9 with a maximum labeling yield of 96 ± 0.3 % without any notable decomposition at room temperature over a period of 8 h. The preclinical evaluation and biodistribution in solid tumor bearing mice showed that 99mTc–gemcitabine had solid tumor selectivity, preclinical high biological accumulation in tumor cells and high retention. Tumor/normal muscle (T/NT) ratios increased with time showing high T/NT ratio (T/NT = 4.9 ± 0.27 at 120 min post injection) and high Tumor/Blood ratio (3.4 ± 0.06), suggesting 99mTc–gemcitabine as a novel solid tumor imaging agent.

Ritodrine (a beta-2 adrenergic receptor agonist) was successfully labeled with 125I via direct electrophilic substitution reaction at ambient temperature. 125I-ritodrine was obtained with a maximum labeling yield of 97 ± 0.163 % and in vitro stability up to 24 h. Biodistribution studies showed that maximum in vivo uptake of 125I-ritodrine in lungs was 20.4 ± 0.22 % injected activity/g tissue at 1 h post-injection, whereas the clearance from mice appeared to proceed mainly via the renal pathway. 125I-ritodrine is not a blood product and so it is more safe than the currently available 99mTc-MAA, and its lung uptake is higher than that of the recently discovered 99mTc(CO)5I and 99mTc-DHPM. As a conclusion, radioiodinated ritodrine could be used as a novel radiopharmaceutical for lung perfusion scan safer than the currently available 99mTc-MAA and more potential than the recently discovered 99mTc(CO)5I and 99mTc-DHPM.

Aims: The objective of the current study was to formulate nystatin (Nyst) into nanostructured lipid carriers (NLCs) to enhance its antifungal activity. Place and Duration of Study: Department of pharmaceutical technology, national research centre, Egypt, between mars 2011 to april 2013 Methodology: Nyst loaded NLCs (NYST-NLCs) were prepared by the hot homogenization and ultrasonication method followed by evaluation of its topical effect on Original Research Article British Journal of Pharmaceutical Research, 4(4): 490-512, 2014 491 the cutaneous candidiasis. The prepared Nyst-NLCs were characterized for entrapment efficiency, particle size, zeta potential, morphology (transmission electron microscopy), thermal characterisation (differential scanning calorimetry) and in vitro drug release. The study design involves the investigation of the effect of three independent variables namely liquid lipid type (Miglyol 812 and Squalene), liquid lipid concentration (30 and 50%) and Nyst concentration (0.125 and 0.25%). A stability study for 6 months was performed. A microbiological study was conducted in male rats infected with Candida albicans. Results: NLC dispersions were spherical in shape with particle size ranging from 68.06±6.56 to 141.8±3.33 nm. The entrapment efficiencies ranged from 45.50±2.34 to 92.73±0.33% with zeta potential ranging from -26.2 to -39.2 mV. The stability studies done for 6 months indicated that Nyst-NLCs were stable for more than 6 monthes.the microbiological studies showed A least number of colonies forming units (cfu/ml) were recorded for the selected Nyst-NLCs compared to the drug solution and the Nystatin® cream present in the market. Conclusion: It can be fulfilled from this work that NLCs represent promising carrier for topical delivery of Nyst offering good physical stability, high entrapment efficiency and controlled drug release. Nyst-NLCs are a good candidate for cutaneous treatment of fungal infection.

Genetic analyses have provided evidence to suggest that Bax and Bak are the essential genes for apoptosis in mammalians cells. This study aimed to search for biomarkers in breast cancer to be used as prognostic markers for the disease. The Bak and Bax genes expressions were analyzed in 23 breast cancer patients by RT-PCR technique. SSCP technique was used to detect the mobility of the abnormal fragment in Bak exon 4. PCR for Bax promoter was digested with Tau 1 restriction enzyme to identify a single polymorphism G(-248)A. The expression of Bak gene is related to several clinical factors of breast cancer. The analysis of Bax RNA showed 4 isoforms of Bax with different distributions in the normal and tumor tissues. These isoforms were Baxα, d,δ, andζ. Exon 4 had a normal pattern in all cases of breast cancer. There was a statistically significant difference in the frequency distribution of the G(-248)A genotypes in the breast cancer tissues with grade 3+high, T2 stage, lobular +other, and PR −ve subgroups. In this study, Bak expression seems to lead to development of breast cancer and affects the disease progression. Also, Bax d and Baxδcould be used as risk factor and biomarker for breast cancer with the distribution of G284A.

This work aims to improve the dissolution of the poorly water soluble drug olmesartan medoxomil by using the surface solid dispersion (SSD) technique. Insoluble carriers, namely Avicel PH102, Aerosil 200, silicified microcrystalline cellulose, Lycatab, Starlac, sodium starch glycolate (SSG), and Kyron T-314, were used at three different drug: carrier ratios (1:1,1:5, and 1:9 w/w) to prepare SSDs by solvent evaporation method. SSD18 consisting of drug:SSG at 1:9 ratio and SSD20 consisting of drug:Kyron T-314 at 1:5 ratio showed the highest enhancement in the dissolution rate and efficiency compared to the plain drug and the physical mixture. The selected dispersion was formulated into orodispersible tablets (ODTs) by using four different disintegrants. F3 DC ODT (consisting of SSD20 and 5 % crospovidone) and F6 DC ODT (consisting of SSD18 and no disintegrant) exhibited low in vitro disintegration time and high percentage of olmesartan medoxomil dissoluted within 10 min.

Background Maintenance therapy is one strategy that has been investigated as a way of improving outcomes in patients with non-small cell lung cancer. This study was conducted to evaluate the effect of weekly paclitaxel as a continuation maintenance therapy in advanced NSCLC patients. Methods This prospective study included patients with advanced non-small cell lung cancer (NSCLC) patients with stage IIIB (T4 N2 or any T N3 disease) and Stage IV disease (T any N M1) with performance status (P.S) ≤ 2 who presented to Clinical Oncology Department in Menoufia University. All patients received carboplatin – paclitaxel for 4 cycles. the patients with initial good response, or stable disease were randomized into 2 arms, the first arm, received weekly paclitaxel (70 mg/m2) as continuation maintenance therapy for 3 weeks of 4 weeks cycle, and evaluated every 12 weeks, continued till disease progression or unacceptable toxicity (maintenance arm), and the second arm was kept under observation (observation arm). The Primary end-point was time to progression, and the Secondary end-point was toxicity of the drug, and the quality of life of the patients, and overall survival. Results Total 92 patients were included, 46 patients were in the maintenance arm, and 46 patients were in the observation arm. only 14 patients continued maintenance paclitaxel till end of the study (30.4%). Most patients who completed paclitaxel maintenance therapy till the end of follow up period was 0 PS (85.7%), stage IIIB (57.1%), grade II (42.9%), and all of them was adenocarcinoma. Treatment related toxicities were significantly higher in the maintenance arm compared to observation arm p value: (0.017, 0.001 and Conclusions continuation Maintenance with paclitaxel can be a reasonable treatment option in patients with NSCLC with performance status 0, stage IIIB, grade II tumors of adenocarcinoma histology who experienced complete or partial response after initial paclitaxel carboplatin combination. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.