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Tarek A Ahmed1,2 1Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; 2Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt Background: This work aimed to develop a new solid dosage formulation of vinpocetine (VPN) in the form of buccal freeze-dried pullulan-based tablets (lyoplant-tabs) loaded with physically modified drug binary system. Methods: Different polyvinyl pyrrolidone (PVP) grades were studied to prepare an efficient VPN binary system characterized by enhanced equilibrium saturation solubility, solubilization efficiency, thermodynamic stability, and permeation through oral mucosal cell lines. The concentrations of pullulan and swelling-aid polymer that affect the quality attributes of lyoplant-tabs were optimized. Clinical pharmacokinetics study on human volunteers for the optimized lyoplant-tabs compared to marketed product was accomplished. Results: A promising drug binary system with polyvinyl pyrrolidone vinyl acetate (PVP-VA64) utilizing the lyophilization technique was developed. Solid-state characterization confirmed transformation of VPN completely into the amorphous form. The concentrations of pullulan and swelling-aid polymer were significantly affecting the characteristics of the tablets. Compared to the commercial VPN tablets, pullulan-based buccal tablets demonstrated enhancement in the studied pharmacokinetic parameters with positive impact on the drug bioavailability. Conclusion: These VPN lyoplant-tabs containing lyophilized PVP-VA64-VPN binary system can be considered as an alternative to currently available marketed tablets; however, further preclinical investigations using large number of volunteers are required. Keywords: vinpocetin, freeze-drying, binary system, buccal tablets, permeation, clinical pharmacokinetics

The aim of this study was to develop optimized simvastatin (SMV) solid lipid nanoparticles (SLNs) with subsequent loading into a thermosensitive in situ gel (ISG) to enhance and control intranasal drug permeation. Three formulation factors were optimized for their effect on particle size and entrapment efficiency (EE). SLNs components were studied thru solid-state characterization. The optimized formulation was morphologically characterized and loaded into poloxamer ISG formulations of different concentrations. Evaluations were done for gelation temperature, viscosity, muco-adhesion strength, and in vitro and ex vivo permeations. Transport across nasal mucosal layers was characterized using a fluorescence laser microscope. The studied factors significantly affected particle size and EE. The drug was successfully encapsulated and homogenously dispersed in the lipid matrix and changed from a crystalline to amorphous state in the optimized SLNs. Transmission electron microscope illustrated the presence of nanoparticles, while scanning electron microscope observations indicated fusion of the particles. An ISG formulation containing 22% poloxamer loaded with optimized SLNs exhibited better mucoadhesion and ex vivo drug permeation, and was able to penetrate deeper into the nasal tissue when compared to the same formulation loaded with pure drug. No signs of inflammation or necrosis were observed upon histopathological study. In summary, this thermosensitive ISG formulation containing SMV SLNs can be considered as an alternative to currently available oral drug formulations, however, further pre/clinical studies are needed.

Noncoding RNAs are emerging biomarkers for many diseases including diabetic retinopathy (DR). This study aimed to measure the expression levels of serum miR-20b, miR-17-3p, HOTAIR, and MALAT1 in DR patients. A total of 80 patients diagnosed as type 2 diabetes (T2D) and 81 healthy subjects were recruited in this study. T2D patients were divided into three groups: nondiabetic retinopathy (NDR) group (30 patients), nonproliferative diabetic retinopathy (NPDR) group (30 patients), and proliferative diabetic retinopathy (PDR) group (20 patients). Quantitative real-time polymerase chain reaction (PCR) was used to assess the expression of serum miR-20b, miR-17-3p, HOTAIR, and MALAT1. We found a significant decrease in serum miR-20b and a significant increase in serum HOTAIR and MALAT1 in NDR patients compared to healthy subjects. Also, we revealed a significant decrease in serum miR-20b and miR-17-3p and a significant increase in serum HOTAIR and MALAT1 in each of NPDR and PDR groups when compared with healthy subjects. Furthermore, we reported a significant decrease in miR-20b and miR-17-3p and a significant increase in HOTAIR and MALAT1in DR as well as in PDR patients when compared with NDR patients. However, on comparing NPDR with NDR patients, no significant difference was observed regarding the expression levels of miR-20b and miR-17-3p, in contrast, significant elevation of serum HOTAIR and MALAT1 was found in NPDR. Moreover, we observed a significant decrease in serum miR-20b and miR-17-3p and a significant increase in serum HOTAIR and MALAT1 in PDR group relative to NPDR group. Receiver operating characteristic (ROC) curve was used for evaluating the diagnostic value of the examined serum noncoding RNAs as novel biochemical indicators detecting severity of DR. Our analyses suggested that the examined serum noncoding RNAs may discriminate DR (PDR and NPDR) from NDR. Furthermore, these noncoding RNAs (less importantly miR-17) can be used as promising novel biomarkers for prediction DR severity, distinguishing PDR from NPDR patients. We can conclude that serum miR-20b, miR-17-3p, HOTAIR, and MALAT1 may be used as noninvasive biomarkers for screening of DR and early diagnosis of PDR. © 2018 IUBMB Life, 71(3):310-320, 2019.

Helicobacter pylori is a ubiquitous Gram-negative bacterium, that is responsible for gastric mucosal inflammation. It is the most common risk factor for gastric cancer (GC). The current study aimed...

Aim: This study aimed to propose a protocol for health needs management among patients having day case laparoscopic cholecystectomy (LC) surgery . Subjects and Method : A descriptive exploratory design was utilized for the conduction of this study in the Outpatients` Clinics and Surgical Departments at El- Demerdash Hospital affiliated to Ain Shams University and Naser Institute Hospital affiliated to Health Insurance . A purposive sample of 120 adult and old age patients involved from both genders having laparoscopic cholecystectomy surgery and were taken from the above mentioned settings . Tools of data collection: 1) Patients, interviewing questionnaire (pre surgery ) to determine patients’ health needs regarding day case laparoscopic cholecystectomy surgery . 2) An observation checklist (pre surgery) to evaluate studied patients' practices in relation to care activities of laparoscopic cholecystectomy surgery and care given for them morning of the surgery. 3) Numerical pain scale (pre surgery) to assess pain severity level. 4) Hamilton’s anxiety rating scale (pre surgery) to determine patients’ levels of anxiety. Results: More than half of the studied patients were female, married and with secondary education. Moreover, they had higher health needs added to elevated pain and anxiety levels pre surgery at both hospitals . Conclusion : On light of the current study results , it can be concluded that more than two thirds of the studied patients had physical, psychological, social, spiritual and educational health needs pre surgery with a statistically insignificant differences between both studied hospitals . Furthermore, less than one third of them had satisfactory level of practices in care activities of LC surgery added to , lower level of care given morning of the surgery . Recommendations : Further research study should be done to implement and investigate effect of such proposed protocol for LC surgery on reducing incidence of complications post surgical technique .

Abrasive waterjet (AWJ) cutting is considered one of the optimum machining processes for cutting a reflective, conductive, or heat sensitive materials like aluminum alloys. The aim of this work is to understand the effect of abrasive waterjet cutting parameters (traverse speed, water pressure and standoff distance) on surface roughness quality of the cutting process. The material under study is aluminum alloy 7075 which is used widely in space applications. Design of experiments and statistical modelling techniques are employed to establish a relationship between the control factors and output responses. Response Surface Method (RSM) is used for surface roughness modeling. The results showed that an improvement of the surface roughness can be achieved by increasing the water pressure at low traverse speed or decreasing the pressure at high traverse speed, or decreasing the standoff distance at low traverse speed and low pressure in the investigating range.

Background and Objective: Cognitive impairment is one of the consequencesof substance abuse. Tramadol abuse is a public health problemin Egypt. The objective of this study was to study the effect of tramadol addiction on cognitive functions, determine if cognitive impairment caused by tramadol is reversible or not and to study the impact of other related factors as duration of intake and dose of tramadol on cognition. Methods: This study included 30 patients with active tramadol abuse, 30 patients abstinent from tramadol for 3 to 6 months and 30 control subjects (matched for age, sex, and education) who were recruited from Kasr Al-Aini psychiatric and addiction hospital (from outpatient clinic and inpatient admitted patients), Egypt.The participants were interviewed using Montreal Cognitive Assessmenttest (MoCA), Trail making test A and B and had urine screening for drugs. Results: 53.33%(n=16) of active group had impaired total MoCA scores compared to 10 % (n=3) in control group.This was statistically significant with P value

This article aims to study the mixed convection heat transfer in non-Newtonian nanofluids over an infinite vertical plate. Mixed convection is caused due to buoyancy force and sudden plate motion. Sodium alginate (SA-NaAlg) is considered as non-Newtonian base fluid and molybdenum disulphide (MoS2) as nanoparticles are suspended in it. The effective thermal conductivity and viscosity of nanofluid are calculated using the Maxwell–Garnetts (MG) and Brinkman models, respectively. The flow is modeled in the form of partial differential equations with imposed physical conditions. Exact solutions for velocity and temperature fields are developed by means of the Laplace transform technique. Numerical computations are performed for different governing parameters such as non-Newtonian parameter, Grashof number and nanoparticle volume fraction and the results are plotted in various graphs. Results for skin friction and Nusselt number are presented in tabular form which show that increasing nanoparticle volume fraction leads to heat transfer enhancement and increasing skin friction. Keywords: Molybdenum disulphide, Sodium alginate, Enhanced heat transfer, Mixed convection, Exact solutions

To enhance the poor bioavailability and extensive liver metabolism of atorvastatin calcium (ATC), we have developed an oleic acid–reinforced PEGylated polymethacrylate (OLA–PEG–E-RLPO) transdermal film as a convenient and alternative delivery system. The effect of varying levels of Eudragit RLPO, PEG 400, and oleic acid on the target product profile was optimized through Quality by Design (QbD) approach. The ATC–loaded OLA–PEG–E-RLPO transdermal films were evaluated in ex-vivo experiments using full thickness skin, utilizing Franz cell studies, and undergone in-vivo pharmacokinetics/pharmacodynamics (PK/PD) assessment, using poloxamer-induced dyslipidemic Sprague-Dawley rats. At 2 and 12 h, the optimized ATC films with a thickness of 0.79 mm showed permeation of 37.34% and 97.23% into the receptor compartment, respectively. Steady-state flux was 0.172 mg/cm2h, with 7.01 × 10−4 cm/h permeability coefficient, and 0.713 × 10−3 cm2/h diffusion coefficient. In-vivo PK results indicated that the absorption profiles (AUC0-∞) of the optimized film in pre-treated group of animals were 8.6-fold and 2.8-fold greater than controls pre-treated with non-PEGylated non-oleic acid film and orally administered ATC, respectively. PD assessment of the lipid panel indicated that the lipid profile of the optimized film pre-treated group reached normal levels after 12 h, along with the significant enhancement over the non–PEGylated non-oleic acid film and the oral marketed tablet groups. The histopathological findings revealed near-normal hepatocyte structure for the optimized film pre-treated animal group. Our results further indicate that transdermal delivery films based on an optimized ATC–loaded OLA–PEG–E-RLPO were successfully developed and their assessment in both ex-vivo and in-vivo suggests enhanced permeability and improvement in bioavailability and antidyslipidemic activity of ATC. This approach can provide several advantages, especially during chronic administration of ATC, including improvement in patient compliance, therapeutic benefits, bioavailability, and feasibility for commercialization and as a platform for other drug classes.

Implementation of a new pharmaceutical technique to improve aqueous solubility and thus dissolution, enhancement of drug permeation, and finally formulation of a controlled release tablet loaded with glimepiride (GLMP).Improve GLMP bioavailability and pharmacokinetics in type II diabetic patients.Different polymers were used to enhance aqueous GLMP solubility of which a saturated polymeric drug solution was prepared and physically adsorbed onto silica. An experimental design was employed to optimize the formulation parameters affecting the preparation of GLMP matrix tablets. A compatibility study was conducted to study components interactions. Scanning electron microscope (SEM) was performed before and after the tablets were placed in the dissolution medium. An in vivo study in human volunteers was performed with the optimized GLMP tablets, which were compared to pure and marketed drug products.Enhancement of GLMP aqueous solubility, using the polymeric drug solution technique, by more than 6-7 times when compared with the binary system. All the studied formulation factors significantly affected the studied variables. No significant interaction was detected among components. SEM illustrated the surface and inner tablet structure, and confirmed the drug release which was attributed to diffusion mechanism. The volunteer group administered the optimized GLMP tablet exhibited higher drug plasma concentration (147.4 ng/mL), longer time to reach maximum plasma concentration (4 h) and longer tMatrix tablet loaded with a physically modified drug form could represent a key solution for drugs with inconsistent dissolution and absorption profiles.

Curcumin derivatives have been well-documented due to their natural antioxidant, antimicrobial and anti-inflammatory activities. Curcuminoids have also gained widespread recognition due to their wide range of other activities which include anti-infective, anti-mutagenic, anticancer, anti-coagulant, antiarthrititc, and wound healing potential. Despite of having a wide range of activities, the inherent physicochemical characteristics (poor water solubility, low bioavailability, chemical instability, photodegradation, rapid metabolism and short half-life) of curcumin derivatives limit their pharmaceutical significance. Aiming to overcome these pharmaceutical issues and improving therapeutic efficacy of curcuminoids, newer strategies have been attempted in recent years. These advanced techniques include polymeric nanoparticles, nanocomposite hydrogels, nanovesicles, nanofibers, nanohybrid scaffolds, nanoconjugates, nanostructured lipid carriers (NLCs), nanoemulsion, polymeric micelles and polymeric blend films. Incorporation of curcumin in these delivery systems has shown improved solubility, transmembrane permeability, long-term stability, improved bioavailability, longer plasma half-life, target-specific delivery, and upgraded therapeutic efficacy. In this review, a range of in vitro and in vivo studies have been critically discussed to explore the pharmaceutical significance and therapeutic viability of the advanced delivery systems to improve antioxidant, anti-inflammatory and antimicrobial efficacies of curcumin and its derivatives.

Background Data: Muscle dissection associated with posterior approach to cervical spine usually results in local pain, muscle wasting and temporarily restricted neck movement. Use of muscle sparing spinous process splitting approach for cervical laminectomy allows decompression of the spinal cord and neural foramen if needed. Meanwhile, it does not require instrumentation, fusion and it preserves cervical spine stability. Purpose: To assess the effectiveness of spinous process splitting approach for cervical laminectomy in cervical spondylotic myelopathy. Study Design: Prospective clinical case study. Patients and Methods: Patient Sample: Fifteen patients with cervical spondylotic myelopathy, eleven males and 4 females with mean age 66.4±6.6 (Range 44-71) years. All patients underwent muscle sparing spinous process splitting cervical laminectomy. Outcome Measures: Operative time and blood loss were recorded. Clinical outcome was assessed by the JOA score and VAS. MRI was done 6 months postoperative to assess decompression. Spinal stability and curvature index were assessed on plain cervical radiographs. Results: No case of wound dehiscence was recorded. There was significant improvement of JOA scores and brachialgia and neck pain VAS scores at 6 months, the mean JOA recovery rate was 56.2%. No patient had postoperative kyphosis or instability and 66.6% of patients had improved modified Ishihara cervical curvature index. No neurological deterioration was recorded in the follow-up. No patient had newly developed axial pain. MRI revealed adequate decompression of the spinal cord in all patients. Conclusion: The spinous process splitting cervical laminectomy allows good spinal cord decompression and preserves spine curvature and stability. The mini open approach and preservation of interspinous ligaments could play a role in wound dehiscence prevention. (2017ESJ133)

Tarek Abdelnapy Ahmed,1,2 Bader M Aljaeid1 1Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; 2Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Cairo,Egypt Abstract: Oral ketoconazole therapy is commonly associated with serious hepatotoxicity. Improving ocular drug delivery could be sufficient to treat eye fungal infections. The purpose of this study was to develop optimized ketoconazole poly(lactide-co-glycolide) nanoparticles (NPs) with subsequent loading into in situ gel (ISG) formulation for ophthalmic drug delivery. Three formulation factors were optimized for their effect on particle size (Y1) and entrapment efficiency (Y2) utilizing central composite experimental design. Interaction among components was studied using differential scanning calorimetry (DSC) and Fourier transform infrared (FTIR) spectroscopy. Ketoconazole crystalline state was studied using X-ray powder diffraction. Six different polymeric ISG formulations were prepared and loaded with either optimized NPs or a pure drug. The prepared ISG formulations were characterized for invitro gelation, drug release and antifungal activity. The permeation through human epithelial cell line was also investigated. The results revealed that all the studied formulation parameters significantly affected Y1 and Y2 of the developed NPs. DSC and FTIR studies illustrated compatibility among NP components, while there was a change from the crystalline state to the amorphous state of the NPs. The in vitro release from the ISG formulations loaded with drug NPs showed sustained and enhanced drug release compared to pure drug formulations. In addition, ISG loaded with NPs showed enhanced anti-fungal activity compared to pure drug formulations. Alginate–chitosan ISG formulation loaded with optimized ketoconazole NPs illustrated higher drug permeation through epithelial cell lines and is considered as an effective ophthalmic drug delivery in the treatment of fungal eye infections. Keywords: ketoconazole, PLGA, nanoparticles, ISG, ophthalmic delivery

For any pair of ordinals $\alpha, Comment: arXiv admin note: text overlap with arXiv:1503.02189, arXiv:1408.3282, arXiv:1608.03513, arXiv:1502.07701

Background Injectable in situ gel (ISG) systems suffer from high initial drug release that may result in toxic effects. Objective This work aimed to develop an injectable sustained release rosuvastatin (RSV) ISG formulation with minimum initial drug burst and improved hyperlipidemic efficacy. Methods Six formulation factors that affect RSV release after 0.5, 2 and 24 hrs have been screened and the significant ones were optimized utilizing an experimental design tool. The optimum ISG formulation components were physicochemically characterized. Kinetic treatment, dissolution efficiency and mean dissolution time were investigated for the developed ISG formulations. Pharmacodynamic effects of the optimized ISG formulation were studied and compared to ISG formulation loaded with free RSV and to a marketed oral drug product. Results The concentration polylactide-co-ε-caprolactone (25: 75), the surfactant hydrophilic lipophilic balance (HLB) and the ratio of surfactant to polyethylene glycol 400 were significantly affecting the release of RSV during the first 24 h. Physicochemical characterization demonstrated complete dispersion of RSV in the polymeric matrix with slight changes in the drug crystalline structure. The optimized formulation demonstrated acceptable syringeability, good flow rate and was able to extend the in vitro drug release for 34 days. The ISG formulations complied with Weibull model. Pharmacodynamic study revealed a sustained reduction in the lipid profile that lasted for 21 days with a marked decrease in the lipid level during the first 24 hrs from the ISG system loaded with free RSV. Conclusion The optimized RSV ISG formulation could be considered a promising strategy due to a reduction in dosing frequency and enhancement in hypolipidemic efficacy.

Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disease. We aimed to measure the level of miR-155 and its genetic variant rs767649 in patients with RA and to evaluate their relationship with ischemia-modified albumin (IMA). The study was performed on 79 patients with RA (group I) and 78 healthy control participants (group II). Quantitative real-time polymerase chain reaction was used to assess the expression of serum miR-155 in addition to its functional variant rs767649. IMA levels were measured by enzyme-linked immunosorbent assay. Significant overexpression of miR-155 and higher levels of IMA were detected in patients with RA compared with those in controls (

Background: Vinpocetine (VPN) is a synthetic derivative of the Vinca minor alkaloids. The drug is characterized by a short half-life, limited water solubility and high hepatic first-pass effect. The objective was to develop different lipid-based nanocarriers (NCs) loaded into a thermosensitive in situ gelling (ISG) system to improve VPN bioavailability and brain targeting via intranasal (IN) delivery. Methods: Different lipid-based NCs were developed and characterized for vesicle size, zeta potential, VPN entrapment efficiency (EE) and morphological characterization using transmission electron microscope (TEM). The prepared NCs were loaded into ISG formulations and characterized for their mucoadhesive properties. Ex-vivo permeation and histological study of the nasal mucosa were conducted. Pharmacokinetic and brain tissue distribution were investigated and compared to a marketed VPN product following administration of a single dose to rats. Results: VPN-D-α-Tocopherol polyethylene glycol 1000 succinate (TPGS) micelles nano-formulation showed the smallest particle size, highest EE among the studied NCs. TEM images revealed an almost spherical shape for all the prepared NCs. Among the NCs studied, VPN-loaded TPGS micelles demonstrated the highest percent cumulative VPN ex vivo permeation. All the prepared ISG formulations revealed the presence of mucoadhesive properties and showed no signs of inflammation or necrosis upon histological examination. Rats administered IN VPN-loaded TPGS-micelles ISG showed superior VPN concentration in the brain tissue and significant high relative bioavailability when compared to that received raw VPN-loaded ISG and marketed drug oral tablets. VPN-D-α-Tocopherol polyethylene glycol 1000 succinate (TPGS) micelles nano-formulation showed the smallest particle size, highest EE among the studied NCs. TEM images revealed an almost spherical shape for all the prepared NCs. Among the NCs studied, VPN-loaded TPGS micelles demonstrated the highest percent cumulative VPN ex vivo permeation. All the prepared ISG formulations revealed the presence of mucoadhesive properties and showed no signs of inflammation or necrosis upon histological examination. Rats administered IN VPN-loaded TPGS-micelles ISG showed superior VPN concentration in the brain tissue and significant high relative bioavailability when compared to that received raw VPN-loaded ISG and marketed drug oral tablets. Conclusion: VPN-loaded TPGS-micelles ISG formulation is a successful brain drug delivery system with enhanced bioavailability for drugs with poor bioavailability and those that are frequently administered.

Hepatocellular carcinoma (HCC) is one of the most prevalent form of cancer. Various long non coding RNA (lncRNAs) and micro RNA have been confirmed to have a role in the progression of HCC. Our aim was to investigate for the first time the expression profile of serum level of LNC NEAT (nuclear enrich abundant transcript) and MiR-129-5p in HCC patients and their relations with patient's clinical and biochemical investigations rather than previous studies on tissue cell lines. Our study includes 72 subjects divided into 36 as control subjects and 36 patients with HCC. Complete physical and laboratory investigations were done on all subjects. RNAs were extracted from sera of all subjects. RNAs were reversed transcribed into cDNAs using Qiagen, Valenica, CA. Quantitative PCR (qPCR) was performed using Rotor gene Q System (Qiagen). Relative NEAT1 expression level was significantly increased in serum of HCC patients 4.7 (1.31-6.82) (p < .0001). Meanwhile MiR-129-5p relative expression level was significantly decreased in serum of HCC patients 0.17 (0.14-20) (p < .0001). Also there was negative significant correlation between the expression level of LNC NEAT and MiR-129-5p in HCC group (p < .0001). ROC curve analysis revealed that LNC NEAT; AUC = 0.981, p < .0001, cutoff value (1.02), sensitivity 100%, specificity 88.9%. MiR-129-5p; AUC = 0.997, p < .0001, cutoff value (0.43), sensitivity 100%, specificity 97.2%. Serum LNC NEAT and MiR-129-5p could be used as potential biomarkers for HCC cancer diagnosis and prognosis.

Rosuvastatin is a hepato-selective statin of limited water solubility and poor oral bioavailability. The rationale behind this work was to develop pullulan based freeze-dried orodispersible tablets containing rosuvastatin flexible lipid-based nanoparticles (transfersomes) to enhance rosuvastatin bioavailability and hypolipidemic activity. Drug loaded transfersomes were prepared, characterized, and loaded into pullulan based freeze-dried orodispersible tablets. The prepared tablets were evaluated for their quality attributes and in vivo disintegration time. The pharmacokinetic behavior of the prepared tablets was studied on male Wistar rats and compared to commercial drug tablets. The hypolipidemic, hepatic enzyme and antioxidant activities were also assessed in poloxamer-induced hyperlipidemic rats. Hepatotoxicity was also investigated. The developed transfersomes showed oval irregular shape vesicles and illustrated an average vesicle size of about 230.34 ± 8.73 nm, a polydispersity index value of 0.508 ± 0.075, a zeta potential value of −10.29 ± 0.46 mV and an entrapment efficiency of 78.13 ± 0.54%. The prepared tablets were complying with the pharmacopeial standards for orodispersible tablets specification. The relative bioavailability of the orodispersible tablets was found to be 133.59%. The prepared orodispersible tablets were more effective than the commercial drug product in reducing the serum lipids, and improving the hepatic enzyme and serum antioxidant levels. No remarkable histopathological changes were observed. So, pullulan based freeze-dried orodispersible tablets loaded with rosuvastatin transfersomes are an effective and safe therapeutic dosage form in treatment of hyperlipidemia, but more preclinical and clinical investigations are required.

INTRODUCTION & AIM OF THE WORK : Depression and anxiety are common psychiatric comorbidities of epilepsy. This work aimed to assess the relationship between psychological disorders (depression and anxiety) and epilepsy and to explore the different factors involved in such relationship. SUBJECTS AND METHODS: We studied 100 patients with epilepsy in the neuropsychiatry department in Qena South Valley University Hospital for comorbid depression and anxiety. Hamilton questionnaire for depression and anxiety (HAMD and HAMA), EEG and brain Imaging were carried out.. RESULTS: Demographic data of the studied population show that the mean ± SD of age is 25.08±13.81, male (64%), age of onset of epilepsy (19.18± 12.597), duration of treatment (4.82± 4.546). HAMD score (9.31±5.74), HAMA score (13.80±7.16). Depression was diagnosed in 48% and anxiety in 36% of patients. Among epileptic patients with depression or anxiety, no significant relation was detected regarding age, sex, educational level, age of onset nor duration of illness Depression was more in those with postictal drowsiness and GTC type of seizures.

Background Data: Ligamentum flavum cysts have rarely been reported, it is believed to be a result of degenerative process. Complete excision of the cyst leads to excellent results. Ligamentum flavum cysts have rarely been reported worldwide and never published as an Egyptian case. Purpose: To report a case of ligamentum flavum cysts in the lumbar spine. Study Design: Case Report. Patients and Methods: We reported a case of ligamentum flavum cyst at the level of L4-5 in a 45 year old Egyptian woman, meticulous complete excision of the cyst without any durotomy or CSF leakage. Histopathological examination reported myxoid degeneration of the ligamentum flavum with no synovial cells. Results: the patient was satisfied and all her symptoms were completely resolved with 1 year follow up. Conclusion: ligamentum flavum cyst should be put in mind when reading the MRI. Complete surgical excision should be carried meticulously. (2016ESJ123)

The goal was to develop an optimized transdermal finasteride (FNS) film loaded with drug microplates (MIC), utilizing two-step optimization, to decrease the dosing schedule and inconsistency in gastrointestinal absorption. First; 3-level factorial design was implemented to prepare optimized FNS-MIC of minimum particle size. Second; Box-Behnken design matrix was used to develop optimized transdermal FNS-MIC film. Interaction among MIC components was studied using physicochemical characterization tools. Film components namely; hydroxypropyl methyl cellulose (X1), dimethyl sulfoxide (X2) and propylene glycol (X3) were optimized for their effects on the film thickness (Y1) and elongation percent (Y2), and for FNS steady state flux (Y3), permeability coefficient (Y4), and diffusion coefficient (Y5) following ex-vivo permeation through the rat skin. Morphological study of the optimized MIC and transdermal film was also investigated. Results revealed that stabilizer concentration and anti-solvent percent were significantly affecting MIC formulation. Optimized FNS-MIC of particle size 0.93μm was successfully prepared in which there was no interaction observed among their components. An enhancement in the aqueous solubility of FNS-MIC by more than 23% was achieved. All the studied variables, most of their interaction and quadratic effects were significantly affecting the studied variables (Y1-Y5). Morphological observation illustrated non-spherical, short rods, flakes like small plates that were homogeneously distributed in the optimized transdermal film. Ex-vivo study showed enhanced FNS permeation from film loaded MIC when compared to that contains pure drug. So, MIC is a successful technique to enhance aqueous solubility and skin permeation of poor water soluble drug especially when loaded into transdermal films.

Introduction Many factors determine the outcomes of renal transplant, including characteristics of both donors and recipients. Antihuman leukocyte antigen donor-specific antibodies are strongly linked to antibody-mediated rejection and late allograft loss. Aim The aim was to determine the effect of recipient and donor characteristics on kidney transplant graft survival, with special stress on panel-reactive antibodies. Participants and methods This study included 168 adult recipient and donor couples. The authors analyzed data of kidney transplants performed between the years of 2008 and 2018 at National Institute of Urology and Nephrology. Results The authors found a significant increase in renal failure in recipients transplanted with unrelated donor kidney and in positive hepatitis C virus antibodies (HCV Abs) recipients (P = 0.002 and 0.001, respectively) and renal complications (P ≤ 0.001). There was also a significant increase in panel-reactive antibody-positive recipients to get renal complications (P = 0.03). There was a significant increase in renal failure with old-aged recipients (P = 0.008) and with increased duration of transplant (P = 0.003). By multivariate regression, the authors deduced that young age decreases graft loss risk (hazard ratio (HR): 0.88; 95% confidence interval (95% CI): 0.79–0.97; P = 0.017). Recipients of unrelated donor graft and HCV infection were associated with higher hazard ratio graft loss (HR: 13.56; 95% CI: 2.58–71.22; P = 0.002, and HR: 7.96; 95% CI: 1.04–60.44; P = 0.45). Unrelated donors graft were associated with 4 times higher hazard ratio renal complication (HR: 4.18; 95% CI: 2.01–8.72; P = 0.003). HCV infection increases risk three times (HR: 3.24; 95% CI: 1.31–7.99; P = 0.010). Unrelated donor was a significant independent predictor for recipient graft loss risk in a period of more than 5 years after transplantation. Conclusion The authors concluded that recipient and donor characteristics have important roles on kidney transplant graft survival and also on renal complications.

Colorectal cancer (CRC) represented the second cause of mortality among cancer patients. Long noncoding RNAs and microRNAs (miRNAs) serve as noninvasive biomarkers for CRC surveillance and introduce new therapeutic approaches. LINC00657 and miR-106a expression levels play a pivotal role in CRC. This study included 190 Egyptian subjects, and the expression levels of LINC00657 and miR-106a in serum were measured by using quantitative real-time polymerase chain reaction. We found that upregulation of LINC00657 and downregulation of miR-106a are significantly associated with the development of CRC. Also, a positive correlation was detected between their serum levels. In addition, serum LINC00657 can distinguish adenomatous polyposis (AP) patients and/or ulcerative colitis (UC) patients from controls. Also the miRNA-106a expression level discriminates AP but not UC from healthy individuals. Our study cited new diagnostic biomarkers for CRC, AP, and UC among Egyptians in addition to be noninvasive screening tools for CRC in both healthy subjects and those having precancerous lesions. © 2019 IUBMB Life, 71(9):1322-1335, 2019.

The original version of this Article contained an error in the author affiliations. The affiliation of Marjan Enayati with ‘Ludwig Boltzmann Cluster for Cardiovascular Research at the Center for Biomedical Research, Medical University of Vienna, Austria' was inadvertently omitted. This has now been corrected in both the PDF and HTML versions of the Article.

The microenvironment characteristics of solid tumors, renowned as barriers that harshly impeded many drug-delivery approaches, were precisely studied, investigated, categorized, divided, and subdivided into a complex diverse of barriers. These categories were further studied with a particular perspective, which makes all barriers found in solid-tumor micromilieu turn into different types of stimuli, and were considered triggers that can increase and hasten drug-release targeting efficacy. This review gathers data concerning the nature of solid-tumor micromilieu. Past research focused on the treatment of such tumors, the recent efforts employed for engineering smart nanoarchitectures with the utilization of the specified stimuli categories, the possibility of combining more than one stimuli for much-greater targeting enhancement, examples of the approved nanoarchitectures that already translated clinically as well as the obstacles faced by the use of these nanostructures, and, finally, an overview of the possible future implementations of smart-chemical engineering for the design of more-efficient drug delivery and theranostic systems and for making nanosystems with a much-higher level of specificity and penetrability features.

Long non-coding RNAs (lncRNAs) play an important role in gene regulation and show greater tissue specificity and complexity of biological functions. There is on-going research in their contribution in autoimmune diseases like multiple sclerosis (MS). Our study aimed at the evaluation of serum levels of lncRNAs, MALAT1 and lnc-DC in MS patients and the investigation of the association between these lncRNAs and the disease activity. Serum from 45 MS patients and 45 healthy controls was separated. MALAT1 and lnc-DC expression levels were assayed by qRT-PCR. MALAT1 and lnc-DC were significantly increased in MS patients (P=0.004 and P=0.006, respectively) in comparison with controls. There was a significant increase in expression of MALAT1 in secondary progressive MS (SPMS) subgroup compared with controls (P

Background Different combinations of Direct Antiviral Agents (DAAs) have been used against different Hepatitis C Virus (HCV) genotypes and in different types of patients. Despite being effective and characterized by a very low rate of adverse effects in clinical trials, few data are available on adverse events in real life studies. Objectives The aim of this study was to identify the incidence and pattern of Adverse Drug Reactions (ADRs) caused by DAAs; daclatasvir and sofosbuvir and their combination with ribavirin and to assess the causality and the severity of the reported ADRs. Methods A prospective observational study was conducted over six months at treatment HCV center of Health Insurance Hospital in Fayoum Governorate, Egypt. A pre-tested, interviewed structured questionnaire was used by authors to gather required data from 345 enrolled patients regarding demographics, co-morbidity and ADRs. Causality and severity of ADRs were assessed. Results According to our data. we have found that 75.7% (261out of 345) patients reported 36 different ADRs involving different systems, of these 1.2% experienced Serious Adverse Events (SAEs), including three deaths (0.9%). A majority of ADRs were more significantly reported with ribavirin-containing regimen. Out of 345 patients, 23.5% have comorbidities. Among them, 92.6% reported ADRs. Causality assessment of ADRs by WHO-UMC criteria revealed that 38.89% were probable while 61.11% were possible. Conclusion New antiviral drugs require careful follow-up of any significant adverse event that may occur and can affect adherence. Special population as the elderly and those with comorbidities should always be managed with caution to avoid development of serious side effects.

Despite the positive impact of corporate governance on corporate performance has been widely recognized and many academic and practitioners considered it as a prerequisite for sustainable development and effective resources management, few works empirically addressed this phenomenon and academic literature has paid limited attention towards factors influencing corporate governance applications in the developing economics context. It focused mainly on governance regulation. In responding to this call, the current study aimed at helping to narrow the existing research gap in the literature and contribute to the accumulated knowledge through achieving the following interrelated objectives. (a) Provide further insights into the current state of relevant literature (B) investigate empirically the critical factors influencing applying corporate governance for achieving sustainable development(C) developing a structural equation model (SEM) for predicting these factors in the developing economics context and provide empirical evidence on its validity and relevance. A multi-stage research methodology was utilized, combining quantitative and qualitative methods to validate the research model and empirically test the hypothesized relationships. The developed questionnaire was pretested and feedback from the pre-test and the panel of experts used to revise the survey instrument. The reliability was assessed using Cronbach’s alpha coefficients and the results showed an acceptable level for each construct. The hypothesized relationships have been tested using structural equation modeling. The evidence of a good fit, reliability and validity indicated that the measurement model deemed appropriate for testing the structural model that demonstrated highly explanatory power. The current study provided empirical evidences and validation for the existing specialized literature concerning corporate governance and added empirical weight to research addressing developing countries.

Finasteride (FSD), a specific competitive inhibitor of the steroid type-II 5α-reductase enzyme, is used in treatment of benign prostate hyperplasia (BPH) and male pattern baldness. The drug is of limited solubility that affect its dissolution and bioavailability. The aim was to study the effect of FSD particle size reduction on the pharmacokinetic, tissue distribution and cellular permeation. An optimized drug micro- and nano-particles were developed, characterized, administered to group of rats, and systemic pharmacokinetic and tissue distribution within target and not-target organs were determined using near-infrared (NIR) spectroscopy technique. Moreover, the cellular permeation of the prepared formulations through normal prostate epithelial cells was assessed and compared to pure FSD. The developed micro- and nano-particles were of 930 and 645 nm, respectively. Plasma maximum drug levels (Cmax) and overall exposure (AUC) of both formulations were not significantly higher than unformulated drug. However, micronized FSD achieved significant higher concentration within the target tissue (prostate) within the current study compared to pure drug and nano-sized formulation as well. Yet, this is explained by the higher sequestration ability of spleen tissue to the nano-sized formula compared to micro-sized FSD. At the cellular level, permeation of nano-sized FSD through prostate epithelial cells was superior to the unformulated FSD as well as the micro-sized drug formulation. FSD particle size reduction significantly influences its cellular permeation and to a lesser extend affect its systemic pharmacokinetics and tissue distribution after oral administration.

Avanafil (AVA) is used in the treatment of erectile dysfunction, but is reported for its poor aqueous solubility. Solid lipid nanoparticles (SLNs) are lipid carriers that can greatly enhance drug solubility and bioavailability.This work was aimed to formulate and optimize AVA SLNs with subsequent loading into hydrogel films for AVA transdermal delivery.AVA SLNs were prepared utilizing homogenization followed by ultra-sonication technique. The prepared SLNs were characterized for particle size, charge, surface morphology and drug content. The optimized SLNs formulation was incorporated into transdermal films prepared using HPMC and chitosan. Hydrogel films were evaluated for ex-vivo rat skin permeation using automated Franz diffusion cells. The permeation parameters and the release mechanism were evaluated. The transdermal permeation of the prepared AVA SLNs through the skin layers was studied using confocal laser scanning microscope.Lipid concentration and % of oil in lipid had a pronounced effect on particle size while, entrapment efficiency was significantly affected by lipid concentration and % of cholesterol. The optimized AVA SLNs showed particle size and entrapment efficiency of 86 nm and 85.01%, respectively. TEM images revealed spherecity of the particles. High permeation parameters were observed from HPMC films loaded with AVA SLNs. The release data were in favor of Higuchi diffusion model. The prepared AVA SLNs were able to penetrate deeper in skin layers.HPMC transdermal film-loaded AVA SLNs is an effective and alternative to per-oral drug administration.

This study was aimed at developing risperidone oral disintegrating mini-tablets (OD-mini-tablets) as age-appropriate formulations and to assess their suitability for infants and pediatric use. An experimental Box-Behnken design was applied to assure high quality of the OD-mini-tablets and reduce product variability. The design was employed to understand the influence of the critical excipient combinations on the production of OD-mini-tablets and thus guarantee the feasibility of obtaining products with dosage form uniformity. The variables selected were mannitol percent in Avicel (X1), swelling pressure of the superdisintegrant (X2), and the surface area of Aerosil as a glidant (X3). Risperidone-excipient compatibilities were investigated using FTIR and the spectra did not display any interaction. Fifteen formulations were prepared and evaluated for preand post-compression characteristics. The prepared ODmini- tablet batches were also assessed for disintegration in simulated salivary fluid (SSF, pH 6.2) and in reconstituted skimmed milk. The optimized formula fulfilled the requirements for crushing strength of 5 kN with minimal friability, disintegration times of 8.4 and 53.7 s in SSF and skimmed milk, respectively. This study therefore proposes the risperidone OD-mini-tablet formula having robust mechanical properties, uniform and precise dosing of medication with short disintegration time suitable for pediatric use.

Currently, many pharmacologically active compounds are formulated as sterile dosage forms. These include parenteral, nasal, pulmonary, and ocular preparations. Different nanosystems have been successfully formulated and loaded into these dosage forms. Delivery of these nanosystems via invasive and noninvasive routes offers many advantages. Despite being invasive, parenteral administration of nanosystems remains the route of choice, owing to the overcoming absorption barriers and rapidity of action, while noninvasive routes such as pulmonary, ocular and nasal are widely investigated due to the advantages of localizing drug action and minimizing adverse events. In this chapter, the composition, characteristic and different types of these sterile dosage forms were outlined. In-process and release specifications of these preparations were also generally mentioned. Delivery of nanoformulation and their applications via invasive and noninvasive routes were discussed.

Preparation of an optimized finasteride (FSD) lyophilized tablets loaded with self-nanoemulsifying drug delivery system (SNEDDS).Enhance FSD bioavailability in male pattern baldness and benign prostatic hyperplasia.Two-step optimization was implemented to achieve the study goals. First; the mixture design was used to develop an optimized SNEDDS through which the effect of cosurfactant number of carbon atoms on SNEDDS particle size and thermodynamic stability has been tested. Second; the different tablet excipients have been used to develop an optimized self-nanoemulsifying lyophilized tablets (SNELTs). The prepared tablets have been fully characterized. Interaction among tablet components has been studied. Finally, FSD clinical pharmacokinetic has been investigated on human volunteers.Anise oil and tween 80 were selected as oily phase and surfactant, respectively while different aliphatic alcohols were studied as cosurfactants. Percentages of oil, surfactant, and cosurfactants were significantly affecting SNEDDS particle size. Increasing cosurfactant number of carbon atoms achieved smaller particle size and higher stability. The optimized SNEDDS was found to contain 10.3455, 45.8972, and 43.7573% of anise oil, tween 80, and butanol, respectively. Variations in FSD cumulative release and disintegration time, from the prepared tablets, were attributed to change in the percent of plasdone XL, Avicel and silica. No interaction among components was noticed. Clinical pharmacokinetics illustrated significant enhancement in the studied parameters from the optimized lyophilized tablets loaded with drug SNEDDS when compared to marketed FSD product.Lyophilized tablets could be considered as a good alternative for conventional solid dosage forms especially when loaded with drug nanosystems.

Background Context Cerebrolysin is a mixture containing 85% free amino acids and 15% biologically active low–molecular weight peptides that is believed to mimic the effects of endogenous neurotrophic factors to interact with the pathologic process cascade of neurodegenerative diseases. No study has examined the effect of Cerebrolysin on cervical myelopathic patients. Purpose The objective of this study was to evaluate the effect of Cerebrolysin as a conservative modality on cervical spondylotic myelopathic patients. Study Design This is a prospective randomized study. Patient Sample A total of 192 patients with cervical spondylotic myelopathy (CSM) were subdivided blindly into two equal groups. Outcome Measures Followed-up was performed at 1, 3, and 6 months comparing the recovery rate Japanese Orthopaedic Association (JOA) score for cervical myelopathy between the two groups. Methods Group I received Cerebrolysin and Group II received placebo for 4 weeks; both groups received celecoxib 200 mg for 4 weeks. Results Myelopathy improved in 92% and 52% of patients at 1 month in Groups I and II, respectively; these changed at 6 months to 87% and 33%; the remaining 13% in Group I neither improved nor deteriorated, whereas 60% in Group II neither improved nor deteriorated and 7% deteriorated with statistically significant differences when comparing the mean JOA recovery rate between the 2 groups at 1, 3, and 6 months. Conclusions Cerebrolysin over 4 weeks is safe and effective for the improvement of CSM as compared with placebo, with no reported cases of neurologic deterioration over 6 months of follow-up.

Rotifers Brachionus plicatilis are being used worldwide to feed early developmental stages of marine finfish and crustaceans. Further, rotifer transmits adequate supplies of micro and macro-nutrients, vitamins, probiotic, and even antibodies to fish larvae. Food type is regarded as the most important criterion that could affect growth and quality of rotifers. There fore, the present work was performed to study the effect of food type, salinity, water temperature, and initial stocking density on the population growth of rotifers. The first experiment was conducted to during the first phase of the present study investigate the effect of four different algal diets: (1) Nannochloropsis oculata life (N), (2) Spirulina platensis powder (S), (3) 50% N. oculata + 50% beaker yeast (NY), and (4) 50% S. platensis + 50% beaker yeast, on rotifer population (as final number/ml) and fatty acid profile of rotifer batch cultured (72 h) was employed. Rotifer culture treatments were conducted in jars (30 liters) with three replicates for each treatment.The results of the firts phase of the study clearly illustrated that NY diet possessed the highest population growth, Eicosapentaenoic acid (EPA), and Docosahexaenoic acid DHA percentage. Depending on the results of the first phase, the diet NY was candidate to investigate the effect of different salinities (25, 27, and 29 ppt), temperatures (26, 28, 30, 32 oC), and initial rotifer stocking densities (50, 100, 150, and 200 Ind./ml) on rotifer population. The results showed that salinity 25 ppt, temperature 28oC, and initial rotifer density 150 pcs/ml possessed the highest rotifer population growth during a 72-hrs batch culture system of rotifer when fed on 50% N. oculata + 50% beaker yeast (NY) food type

تواجه مصر فى الوقت الراهن بمجموعة کبيرة من التحديات ويعتبر تحدى التنمية من أهم هذه التحديات وحيث أن الريف کان دائما ولا يزال هو عصب المجتمع المصري فان التنمية الريفية المتکاملة هى الأساس للتنمية الاقتصادية والاجتماعية لمصر. ولقرون طويلة من الزمن کان الاهتمام مرکزا على المدن حيث يسکن اهل الحضر، وکانت خدمات الحکومة ومشروعاتها تنفذ اساسا في المدن والفتات فقط من الاموال المخصصة لهذه المشروعات تذهب الى القرى. ولذلک عمرت المدن بالطرق المرصوفة ومياه الشرب والصرف الصحي والکهرباء ووسائل الاتصال وبالمدارس والمستشفيات ومنافذ الترويج، والى جانبهم جميعا اقام اصحاب المشروعات الاقتصادية مصانعهم وتجارتهم واسواقهم الکبيرة ومراکز خدماتهم المتنوعة، وانتعشت دخول اهل المدن وهاجر اليها اهل الريف بحثا عن فرص عمل افضل ومستوى حياة أعلى. ولم تتغير هذه الاحوال بقوة إلا فى السنوات الخمسين الماضية وخاصة بعد ثورة يوليو۲٥۱۹. ووضعت برامج وخططت مشروعات لتحسين أحوال القرى کان هناک دائما اولويات اکثر اهمية من وجهه نظر الحکومة تخصص لها الاموال بوفرة لإقامة المشروعات والخدمات لأحداث تنمية محلية للمجتمعات الريفية. واستهدفت مشروعات التنمية المحلية، من خلال مجالاتها المتعددة ( العمرانية - الخدمية – بنية اساسية – الاقتصادية - الاجتماعية -...)، تهيئة حياة افضل للسکان، وتعتبر المجالات سابقة الذکر ذات صلة رئيسية بالتنمية العمرانية وتأثر علي توجهاتها المختلفة سواء سلبا أو ايجابا أن لم توضع تلک المشروعات في أطر البعد المکاني ويرجع ذلک الي أن التنمية العمرانية تهدف الي تهيئة البيئة العمرانية بمختلف مستوياتها لتوفر مناخ ملائم لنجاح المشروعات المحلية، بحيث تکون هناک موائمة بين هيکل المشروعات المحلية وتوزيعها المکاني بخصائص البيئة العمرانية المحلية، بجانب ايضا الأخذ في الاعتبار المحددات والامکانيات العمرانية التي تصيغها البيئة العمرانية المحلية کأساس لتوزيع تلک المشروعات علي التجمعات العمرانية، وتمثل مشروعات المياه والطاقة أحد المجالات الأساسية الداعمة لأحداث تنمية فعالة للمجتمعات المحلية علي کافة المستويات التخطيطية. يهدف البحث إلي مناقشة وقياس الإرتباط بين خصائص البعد المکاني علي المستوي المحلي الريفي وإختيار وتوزيع مشروعات المياه والطاقة بذلک المستوي وعرض وتحليل منظومة إتخاذ قرار التوزيع المکاني لتلک المشروعات وعلاقته بالخصائص العمرانية والمکانية (المحلية والإقليمية). يتمثل التساؤل الرئيسي للبحث في هل يؤثر البعد المکاني من المنظور التنموي في إختيار وتوزيع مشرعات المياه والطاقة لإحداث تنمية ريفية متکاملة للتجمعات؟ ويعتمد منهج البحث على المنهج التحليلى لتوزيع المشروعات المتعاقبة فى مجالات البنية الاساسية وبخاصة المياه والطاقة لبعض المناطق والقرى الريفية فى المحافظات المصرية وقياس مدى إرتباطها بالبعد المکانى لتحقيق التنمية الريفية، للخروج بأهمية الأخذ فى الإعتبار المعايير المکانية لتوزيع المشروعات التنموية او مشروعات البنية الأساسية کرکيزة لتحقيق التنمية الريفية المتکاملة والمستدامة. The big and mega cities witness several challenges that affect their urban growth and development. These cities can be considered as economical, social and cultural development poles which in turn enhance the urban and demographic growth rates at the national level. As per the pressures of market forces and the real sate development that recently recorded high growth rates, many problems have been appeared. The high speed of informal urban growth is one among these problems. According to the planning concepts of the relationships between the urban centers and periphery at the big cities, a fusion between the center and periphery is existed and formulated another new big center. This phenomenon is famous in literature by the megapolis. This indeed lead to cities' inflation as occurred in Greater Cairo Region (GCR). Recently, the assets of New Cairo city have been sold out for the private enterprises and investors to develop large areas for high income and elite. This in turn affects the values and prices of lands at the new city and also at the city outskirts. This accordingly affected the growth of existing city to the extent that Cairo city boundary extended remotely on the regional external roads in the west and east. It extends on the west at Ismalia and Suez regional roads and also at Alexandria regional road in the west. All of this affected the new-city urban growth for particular types of housing and for informal uncontrolled growth of the existing cities for low income. The paper therefore aims to identify the way in directing the investments projects to meet the requirements of future urban development of these cities. The study makes a critical analysis for the growth of real sate development at the different eras of GCR development. Then it reviews the case of New Cairo city as a recent example representing the supply –demand forces in the western of Cairo. Through these studies it can be recommended some tips to direct the investment projects at the regional and national levels.

The aim of this work was to study the effect of different processing and formulation parameters on the preparation of sildenafil (SD) transfersomes utilizing the Plackett-Burman design. The drug to phospholipid molar ratio (X1), phospholipid to surfactant ratio (X2), hydrophilic-lipophilic balance of the surfactant (X3), hydration medium pH (X4), hydration time (X5) and the temperature of hydration (X6) were investigated to study their effect on the vesicle size (Y1) and entrapment efficiency (EE) of the drug (Y2). The preparation conditions were optimized to minimize the vesicle size and maximize the EE. The prepared transfersomes were also subjected to zeta potential measurements, morphological and physicochemical characterization. The combinations of factors that achieve the optimum desirability were identified. An optimized formulation was prepared and characterized once more for its vesicle size, EE, in vitro permeation and deformability index. The results revealed that both X3 and X6 had a pronounced effect on Y1, while X1 and X4 showed a significant effect on Y2. Morphological and physicochemical study confirmed the transfersomes spherical shape and compatibility of the formulation ingredients. The formulation with optimum desirability showed EE and vesicle size of 97.21% and 610 nm, respectively. In vitro permeation of the drug-loaded transfersome showed more than 5-fold higher permeation rate compared with drug suspension. Deformability index verified elasticity of the preparation. The significant variables could be optimized again to produce smaller vesicle size that could increase SD permeation from transdermal delivery systems loaded drug optimized transfersomes.

Background: In recent years laparoscopic splenectomy (LS) has gained acceptance as a viable alternative to open splenectomy. Laparoscopic splenectomy is evolving and may become the standard operative method for the treatment of the problem spleen. Patients and methods: From July 2012 till December 2013, 20 patients with clinical immune thrombocytopenic purpura (ITP) were referred as surgical candidates. Two ofthem (10%) were converted to open, and the other 18 underwent successful LS. The operative approach was performed with the patient in the right lateral decubitus position, with extensive use of the ultrasonic dissecting shears. Results: There were 20 patients in the study, twelve women and eight men with a mean age of28 years (18-38). Immune thrombocytopenic purpura (ITP) was the indication for surgery. Laparoscopic splenectomy was intended in all patients and successfully completed in 18 patients (90%). Two cases (10%) required conversion to open splenectomy, due to intraoperative hemorrhage which could not be controlled laparoscopically. Length of hospital stay (LOS) was 2.3 ± 0.8 days. The two major complications (10%) were intraoperative hemorrhage which required conversion to open splenectomy The two minor complications were trocar site infection and hernia. The average operative times (150 ± 48 min) improved as the study progressed. This improvement was believed to be due to the learning curve. Conclusion: Laparoscopic splenectomy (LS) may be considered the standard of care for patients who require splenectomy for ITP Laparoscopic splenectomy results in less patient disability, shorter hospitalization, and probably less perioperative morbidity

The purpose was to improve the encapsulation efficiency of cetirizine hydrochloride (CTZ) microspheres as a model for water soluble drugs and control its release by applying response surface methodology. A 3(3) Box-Behnken design was used to determine the effect of drug/polymer ratio (X1), surfactant concentration (X2) and stirring speed (X3), on the mean particle size (Y1), percentage encapsulation efficiency (Y2) and cumulative percent drug released for 12 h (Y3). Emulsion solvent evaporation (ESE) technique was applied utilizing Eudragit RS100 as coating polymer and span 80 as surfactant. All formulations were evaluated for micromeritic properties and morphologically characterized by scanning electron microscopy (SEM). The relative bioavailability of the optimized microspheres was compared with CTZ marketed product after oral administration on healthy human volunteers using a double blind, randomized, cross-over design. The results revealed that the mean particle sizes of the microspheres ranged from 62 to 348 µm and the efficiency of entrapment ranged from 36.3% to 70.1%. The optimized CTZ microspheres exhibited a slow and controlled release over 12 h. The pharmacokinetic data of optimized CTZ microspheres showed prolonged tmax, decreased Cmax and AUC0-∞ value of 3309 ± 211 ng h/ml indicating improved relative bioavailability by 169.4% compared with marketed tablets.