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5-Fluorouracil (5-FU) as anticancer drug has many side effects. Site-specific delivery of 5-FU would reduce the systemic side effects and provide effective and safe therapy. Chitosan nanoparticles (CNPs) are used in drug delivery systems. In the present study the effects of 5-fluorouracil chitosan nanoparticles (5FUCNPs) on decreasing the oxidative stress were investigating within a model of female mice bearing solid Ehrlich carcinoma (EC). 7 days After solid tumor induction, 5-FUCNPs were administrated by gavages (0.5 mg/kg body weight) to mice for 15 days. Tumor size was monitored; oxidative stress markers were assessed. In addition, the angiogenic markers concentrations were evaluated. In vitro, 5FUCNPs showed high cytotoxic effect on EC tumor cells. Gavages of EC-bearing mice with 5FUCNPs significantly reduced tumor size, increased MDA level, decreased GSH level and recorded great destruction in tumor tissues. Meanwhile, in liver tissue MDA level significantly decreased and GSH level increased. On the other hand, a significant decrease in the levels of angiogenic markers were recorded. In conclusion: CNPs as a drug carrier for 5-FU have a role in reducing tumor growth and may represent a novel class of anticancer drug.

Objectives Decompressive craniectomy (DC) is a last-tier therapy in the treatment of raised intracranial pressure after traumatic brain injury (TBI). We report the association of comparative radiographic factors in predicting functional outcomes after DC in patients with severe TBI. Methods A retrospective analysis of a prospectively maintained database of cases between 2015 and 2018 at an academic tertiary care hospital was carried out. Univariate and multivariable regression analyses were performed for an array of comparative radiographic variables (pre- and post-DC) in relationship to functional outcome according to Glasgow Outcome Scale Extended (GOSE) at 180 days. GOSE was further dichotomized into favorable (GOSE:5–8) and unfavorable (GOSE:0–4) functional outcomes. All associations were reported as odds ratio (OR) with 95% confidence interval (CI). Results Statistical analysis included a cohort of 43 patients with a median age of 30.5 years (range: 18–62 years). The median GOSE at 180 days was 7. Multivariable regression analysis after adjusting for confounding variables (age, sex, comorbidities, site of surgery and size of decompression) showed that comparative radiographic findings of midline shift (MLS) > 10 mm (OR 3.2 (95% CI 1.25–8.04); P = 0.01); external cerebral herniation (ECH) > 2.5 cm (OR 2.5 [95% CI 1.18–5.2]; P = 0.02); and effacement of basal cisterns (OR 3.9 [95%CI 1.1–13.9]; P = 0.03), were significant independent predictors of poor functional outcome at 180 days after DC for severe TBI. However, the presence of infarction (OR 2.7 [95%CI 0.43–17.2]; P = 0.28) and absence of gray-white matter differentiation (OR 0.18 [95%CI 0.03–1.2]; P = 0.07) did not reach statistical significance. Conclusions The comparative radiographic findings that include MLS > 10mm, ECH > 2.5cm, and effacement of basal cisterns are predictive of poor functional outcome in severe TBI.

A 21-year-old single female with a large swelling of the vulva’s left labia majora was diagnosed with a case of primary lymphedema of the left lower limb and external genitalia. The giant labial swelling was excised, and the patient experiences no complications or recurrence for 7 months postoperatively. Following the surgical excision of the swelling, the left labia majora and minora were reconstructed successfully. The excised mass weighed 6.3 kg and measured 40 cm x 35 cm x 30 cm. There were no complications postoperatively, and the patient has not experienced recurrence during the 7-month follow-up period. The patient returned to her normal life. Level of evidence: Level V, therapeutic study.

Background: Implanted port is an implanted device giving access to veins for patients with difficult veins or who need regular long-term administration of drugs often need to be delivered into a large central vein. Aim: The aim of this study was conducted to assess nurses' performance (knowledge, practice& attitude) for caring of patients with implanted port undergoing chemotherapy. Research design: An exploratory descriptive design was utilized to achieve the aim of the study. Setting: The study was conducted at the oncology department in the El-Demerdash Hospital affiliated to Ain Shams University. Study subject: A convenience sample of (50) nurses working in the previously mentioned unit within 6 months. Tools: three tools were used including: - I- Self-administered questionnaire: it used to assess nurses’ knowledge, factors affecting on their performance and demographic characteristics of the study nurses. II-Nurses’ performance observational checklist: it used to assess nurses’ practice in caring of patients with implanted port. III-Likert scale: it used to assess nurses’ attitude in caring of patients with implanted port. Results & Conclusion: more than three quarter of nurses had inadequate practice, and more than two third of them had inadequate knowledge while more than half of them had a positive attitude regarding caring of patients with implanted port. Recommendations: Further research are recommended periodically to study new approaches in the area of management of patients with implanted port and evaluate its reflection on patient’s outcomes.

Hypospadias is one of the most common birth defects. However, its etiology remains largely unknown. Genetic and also intrauterine environmental factors have a principal role in causing familial hypospadias. Hypospadias repair is done through several techniques, one of which is Snodgrass technique which has many advantages. The 4 cousins underwent repair with no complications during 6 months follow up period. Methods: Urethroplasty using Snodgrass hypospadias repair of 4 cousins with positive parental consanguinity and absent family history of hypospadias. Results: 4 cousins underwent Snodgrass (Tubularized incised plate urethroplasty) with no complications after 6 months follow up. Conclusion: Although there is high heritability of hypospadias that also aggregates within second- and third-degree relatives, environmental factors may play a principal role in causing familial hypospadias. Hypospadias repair has a long learning curve. The continuous auditing should be done to improve the results.

Background Tacrolimus is an approved first-line immunosuppressive agent for kidney transplantations. Part of interindividual and interethnic differences in the response of patients to tacrolimus is attributed to polymorphisms at CYP3A5 metabolic enzyme. CYP3A5 gene expression status is associated with tacrolimus dose requirement in renal transplant recipients. Materials and methods In this study, we determined the allelic frequency of CYP3A5*3 in 76 renal transplanted patients of Egyptian descent. Secondly, we evaluated the influence of the CYP3A5 gene variant on tacrolimus doses required for these patients as well on dose-adjusted tacrolimus trough-concentrations. Results The CYP3A5*3 variant was the most frequent allele detected at 85.53%. Additionally, our results showed that, mean tacrolimus daily requirements for heterozygous patients (CYP3A5*1/*3) were significantly higher compared to homozygous patients (CYP3A5*3/*3) during the first year after kidney transplantation. Conclusion This is the first study in Egypt contributing to the individualization of tacrolimus dosing in Egyptian patients, informed by the CYP3A5 genotype.