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Feasibility of 199Au production from neutron activated platinum and gold targets at the Egyptian Second Research Reactor was studied. A comparison between theoretical calculations and experimental measurements for the two targets was carried out. A radiochemical separation of 199Au from irradiated Pt target was achieved using chromatographic column packed with modified chabazite material with elution efficiency of 90 ± 0.54% based on the high separation factor between Au and other produced undesired radionuclides. Three quality control tests; radionuclidic, radiochemical and chemical purities were carried out on the eluted 199Au to ensure its safe application in nuclear medicine.

The ideal treatment of non-united and neglected fracture neck femur in the young adult still remains unclear and is characterized by many biological and biomechanical challenges. Twenty-one patients with non-united or neglected fracture neck femur aged between 19 and 50 years were treated by a novel subtrochanteric valgus osteotomy and were followed up for a mean of 26.7 months. Patients were assessed by radiological parameters, the Harris Hip Score, Oxford Knee Score, and Askin Bryan Criteria to categorize the overall outcome of the patients at 24 months. Other outcome measures included the occurrence of AVN, adductor lever arm, leg length discrepancy, and mechanical implant failure. All patients treated with the SALVA osteotomy consolidated and displayed a marked improvement of functional and radiological outcome measures. Nevertheless, there were 2 mechanical failures in patients with marked osteopenia and three developed AVN. In patients with un-united/neglected fracture neck femur, SALVA osteotomy appears to be reliable and reproducible. It also restores the abductor lever arm and improves the leg length discrepancy. Technically less demanding conversion to arthroplasty remains still possible prospectively.

Seasonal influenza viruses constitute a major global concern. Currently, H3N2 and H1N1pdm09 are the commonly circulating influenza A viruses. The haemagglutin and neuraminidase genes of influenza A(H3N2) and A(H1N1)pdm09 viruses from Egyptian paediatric patients with respiratory distress were sequenced. Mutational analysis of all published sequences from Egypt was evolutionary tracked for both HA and NA genes. Phylogenetic analysis of H3N2 HA showed that the Egyptian strains belong to 3C2 subclade while Egyptian A(H1N1)pdm09 strains belong to 6B1 subclade. Some Egyptian A(H1N1)pdm09, 2013-2014, strains form a new subclade; 6B3. High score of mutations were recorded in HA of H1N1pdm09 but higher was recorded in H3N2 strains. These findings confirmed a high mutation rate of influenza A subtypes specially H3N2 strains.

Orthostatic intolerance (OI) is a group of disorders characterized by symptoms that occur upon standing and resolve with recumbence. Although well established but not widely recognized, these diagnoses may create uncertainty for clinicians dealing with a patient affected by OI and requiring a surgical procedure. To determine the rate of intra- and postoperative major adverse events in patients with OI undergoing surgery with general anesthesia. The study was a retrospective study of patients with orthostatic intolerance who underwent surgery requiring general anesthesia from 1 January 2000 to 31 December 2018. A total 171 patients with OI underwent 190 surgeries. In patients with POTS and orthostatic-induced VVS, there were no major significant adverse events. There was one episode of AVNRT in a patient with POTS and one episode of bradycardia secondary to vasovagal reflex in a patient with orthostatic-induced VVS. Moreover, there were 13 (6.8%) episodes of postoperative hypotension. However, the majority of these episodes were related to bleeding, volume depletion or sepsis. All cases of hypotension responded well to appropriate therapy. In patients with OH, the rate of postoperative major adverse cardiac events was 4.7%, and the 30-day mortality rate was 6.1%. This is not significantly different from the calculated risk for patients without OH. There were no myocardial infarctions or deaths at 30 days in patients with POTS or orthostatic-induced VVS. Patients with OI may not experience higher rates of perioperative complications compared with patients without OI syndromes.

This work is concerned with the development of a simple and accurate procedure for trace elements determination in infusion of medicinal plants using neutron activation analysis. The developed scheme involves irradiation of herb (tea in the present work) before immersion into boiled water and then analyzing the induced radioactivity in the infusion using HPGe detector to determine the concentration levels of the extracted elements. Results were corrected for geometry and γ-ray attenuation effects using Monte Carlo simulation. The effects of irradiation dose and infusion period on the extraction process were also evaluated. The developed method proved its efficiency and capability for evaluation of the daily intake of elements reach our body through consumption of medicinal plants.

To assess the capability of Kyoto University Research Reactor to supply the domestic needs of medical isotopes, its neutron flux has been fully characterized. The production rates of theranostics radionuclides 177Lu (from 176Lu (n, γ) 177Lu), 176Lu (n, γ) 177mLu/177Lu and 176Yb (n, γ) $$^{177} {\text{Yb}}\mathop{\longrightarrow}\limits{{\beta^{ - } (1.88\;{\text{hr}})}}^{177} {\text{Lu}}$$ reactions), and 47Sc (from 46Ca (n, γ) $${^{47} {\text{Ca}}} \mathop{\longrightarrow}\limits^{{\beta^{ - } (4.54\;{\text{d}})}} {^{47} {\text{Sc}}}$$ and Ti (n, p) 47Sc) were evaluated. The activity (per gram of target) of 47Sc produced from Ti was found to be 10 times higher than that produced from Ca. Production of 177Lu from the decay of its isomer 177mLu was found to be produce less radioactive wastes than Yb route and can be used as a generator for long-time use.

A novel series of 3-, 4-substituted, and 3,4-di substituted quinazoline derivatives were prepared via various cyclized regents and most of the newly prepared compounds evaluated for their antimicrobial activities in vitro against Gram-positive, Gram-negative bacterial strains and fungi strains. The structures of the quinazoline derivatives have been confirmed using spectroscopic analyses (IR, NMR, and EI-MS). Some of the synthesized derivatives displayed a moderate antimicrobial activity in comparison with reference drugs, for example compounds 13d, 15a, 17b, 18b, 18d, 25, and 29a-c. Among the synthesized compounds, the pyrimidoqunazoline derivative 6c elicited the highest activity.

The Egyptian Second Research Reactor (ETRR-2) is a pool-type reactor, 22 MW thermal, with 27 fuel elements loaded with 60Co production facility in the most relative highest flux position for the pr...

Introduction: Femoral neck fractures can complicate by non-union and/or hip avascular necrosis (AVN); moreover, the incidence of AVN remains obscure when it is accompanied by an ipsilateral acetabular fracture. Measures to reduce non-union or hip AVN with this complex injury pattern are not well addressed in the literature. Case Report: We report a case of a young male patient who sustained ipsilateral acetabular, femoral neck, and shaft fractures in addition to a contralateral floating knee injury following a motor vehicle collision. To the best of our knowledge, this is the first report that describes the simultaneous occurrence of these fractures and their management. The patient attained an excellent functional outcome with union of all his fractures. We, therefore, propose a management flowchart for this rare case scenario. Conclusion: The acute management of ipsilateral femoral shaft and neck fractures in such cases has to be prioritized. The use of a retrograde nail in addition to dynamic hip screw (DHS) with two cannulated anti-rotation screws and locking the DHS to the nail is likely to increase the healing potential of femoral neck fracture in these cases. Acetabular fixation is better to be performed in a second stage after the hyper-inflammation phase ends. The definitive management for the contralateral floating knee can be delayed to a third stage but should be completed within the 10-day limit of immunosuppression.

Abdominal surgery and chemotherapy are well-established risk factors for venous thromboembolism (VTE) in patients with cancer, but their specific contribution in patients with esophageal and gastric cancer is unclear. We aim to quantify the risk of VTE, identify risk factors associated with VTE, and determine the association between VTE and survival in patients undergoing surgery for esophageal or gastric cancer.A retrospective, population-based cohort study was conducted using linked administrative healthcare databases. We used the Ontario Cancer Registry to identify patients with esophageal or gastric cancer between January 1, 2007 and December 31, 2016 who underwent surgical resection. Incidence of first VTE event was identified using International Classification of Diseases 9 and 10 codes. VTE incidence was calculated at clinically relevant time points 180 days before and after surgery. Logistic regression was used to identify factors associated with VTE with odds ratios (OR) and 95% confidence intervals (CI) reported. Cox proportional hazards regression models were used to estimate associations between covariates and survival. Kaplan-Meier method was used to compare overall (OS) and cancer-specific survival (CSS) by VTE status.A total of 4894 patients had esophagectomy or gastrectomy, of which 8% (n = 383/4894) had VTE. VTE risk was 2.5% (n = 123/4894) 180 days before surgery, 2.8% (n = 138/4894) within 30 days of surgery, and 2.5% (n = 122/4894) from 31 to ≤ 180 days after surgery. Of the patients with VTE within 30 days of surgery, 34% (n = 47/138) were diagnosed after discharge from hospital. Receipt of preoperative chemotherapy was associated with VTE 180 days before surgery (odds ratio [OR] 3.84, 95% confidence interval [CI] 2.41, 6.11). Increased hospital length of stay (LOS) was associated with VTE 30 days after surgery (OR 1.08, 95% CI 1.02, 1.14, per week). Patients with VTE had inferior median OS and CSS (2.2 vs. 3.7 years; 2.3 vs. 4.4 years, respectively). In adjusted models VTE was associated with inferior OS (HR 1.36, 95% CI 1.13, 1.63) and CSS (HR 1.42, 95% CI 1.16, 1.75).The highest risk of VTE is within 30 days of surgery with one third of patients diagnosed after discharge from hospital. Longer hospital LOS and receipt of preoperative chemotherapy are associated with increased risk of VTE. VTE is an independent risk factor for inferior survival in patients with esophageal or gastric cancer.

Background Diabetes mellitus (DM), a chronic metabolic disease, is a rising global concern with significant social, economic, and health implications. Proper glycemic control is crucial to guarantee protection against these implications such as micro and macrovascular complications. To achieve proper glycemic control, patients' self-management is probably the most essential component, and the development of appropriate self-management behaviors which include medication adherence and lifestyle modifications improves the prognosis and the incidence of DM complications. Objective The aim of the study is to examine diabetes self-management and control of diabetic healthcare providers from different specialties working at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. Design and setting This is a cross-sectional pilot study carried out in King Abdulaziz Medical City, Riyadh, Saudi Arabia, using a pre-validated self-administered questionnaire that was “Diabetes Self-Management Questionnaire” (DSMQ), which examined diabetes management and control within the last two months. The questionnaire was distributed to the healthcare providers of all specialties at the site of the study. Correlations and descriptive analyses were carried out using the Statistical Package for Social Science (SPSS) software version 23 (IBM Corp, Armonk, USA). Results The total number of participants was 370 healthcare providers (100% response rate). It was found that 26 (7%) of them had diabetes (92.3% of them with type 2 diabetes). The diabetic participants’ mean age was 48.58±7.3 years old. 42.3% were applied medical sciences specialists, with 38.5% having years of experience between 16 to 20 years old. 26.3% were Saudi nationals. The mean HbA1c levels among diabetic patients were 6±1.03%, ranging between (5.1%-9%). There was a significant inverse relationship between each section's scores and total scores with the HbA1c levels (p-value

Introduction: Peer-assisted learning (PAL) is a teaching method that develops new knowledge and skills through active learning support from peers. Objectives: To assess the impact of PAL in medical education, by collecting quantitative data that explore its effectiveness. To evaluate students’ perception of and satisfaction with PAL. Methods: A 5-point Likert scale survey was developed for students participating in the PAL program either as tutors or learners. Data were compared and statistically analyzed according to gender, GPA, and year of study. Moreover, follow up of peer tutors and peer learner’s achievement was done through comparing their grades with those that not shared in PAL and with their GPA of previous year. Results: Statistical analysis of questionnaire data revealed that medical students regarded voluntary peer-teaching similarly to faculty teaching and have a generally positive perception of PAL. Most of the respondents reported that they benefited both professionally and personally from PAL activities. They recommended expanding the role of PAL and officially incorporating PAL sessions into the curriculum. Students’ achievement was significantly increased for those who acted as peer learners and peer tutors. Conclusions: Using PAL in conjunction with other teaching and learning methods provides additional value by fostering cooperation and social interaction among medical students and further prepares them for their future role as medical science educators. Additional research into the impact of PAL on academic achievement, both short- and long-term learning outcomes, in medical programs is warranted., Introducción: El aprendizaje asistido por pares (AAP) es un método de enseñanza que desarrolla nuevos conocimientos y habilidades a través del apoyo activo del aprendizaje por parte de los compañeros. Objetivos: Evaluar el impacto del AAP en la educación médica, mediante la recopilación de datos cuantitativos que exploran su eficacia. Evaluar la percepción y la satisfacción de los estudiantes con el AAP. Métodos: Se elaboró una encuesta con una escala de Likert de 5 puntos para los estudiantes que participaban en el programa AAP como tutores o como alumnos. Los datos se compararon y analizaron estadísticamente en función del género, el promedio académico y el año de estudio. Además, se realizó un seguimiento del rendimiento de los compañeros tutores y de los compañeros alumnos mediante la comparación de sus notas con las de los que no compartían el AAP y con su GPA del año anterior. Resultados: El análisis estadístico de los datos del cuestionario reveló que los estudiantes de medicina consideraban la enseñanza voluntaria entre pares de forma similar a la enseñanza en la facultad y tienen una percepción generalmente positiva de la AAP. La mayoría de los encuestados afirmaron haberse beneficiado tanto profesional como personalmente de las actividades de AAP. Recomendaron ampliar el papel de la AAP e incorporar oficialmente las sesiones de AAP en el plan de estudios. El rendimiento de los estudiantes aumentó significativamente en el caso de los que actuaron como alumnos y tutores de sus compañeros. Conclusiones: El uso de AAP junto con otros métodos de enseñanza y aprendizaje proporciona un valor adicional al fomentar la cooperación y la interacción social entre los estudiantes de medicina y los prepara aún más para su futuro papel como educadores de ciencias médicas. Se justifica la realización de más investigaciones sobre el impacto de la AAP en el rendimiento académico, tanto a corto como a largo plazo, en los programas de medicina., Introdução: A Aprendizagem Assistida por Pares (AAP) é um método de ensino que desenvolve novos conhecimentos e competências através do apoio ativo à aprendizagem por pares. Objetivos: Avaliar o impacto do AAP na educação médica, recolhendo dados quantitativos que exploram a sua eficácia. Avaliar a perceção e a satisfação dos estudantes com AAP. Métodos: Foi desenvolvido um inquérito à escala Likert de 5 pontos para estudantes participantes no programa AAP, quer como tutores, quer como alunos. Os dados foram comparados e analisados estatisticamente de acordo com o género, GPA, e ano de estudo. Além disso, o acompanhamento dos tutores e dos alunos foi feito através da comparação das suas notas com as que não foram partilhadas no AAP e com o seu GPA do ano anterior. Resultados: A análise estatística dos dados do questionário revelou que os estudantes de medicina consideraram o ensino voluntário por pares semelhante ao ensino docente e têm uma perceção geralmente positiva do AAP. A maioria dos inquiridos relatou ter beneficiado tanto profissionalmente como pessoalmente das atividades de AAP. Recomendaram a expansão do papel do AAP e a incorporação oficial das sessões AAP no currículo. A realização dos estudantes foi significativamente aumentada para aqueles que atuaram como alunos e tutores de pares. Conclusões: A utilização do AAP em conjunto com outros métodos de ensino e aprendizagem proporciona um valor adicional ao promover a cooperação e interação social entre estudantes de medicina e prepara-os ainda mais para o seu futuro papel como educadores de ciências médicas. É necessária investigação adicional sobre o impacto do AAP nos resultados académicos, tanto a curto como a longo prazo, em programas médicos.

Introduction: Peer-assisted learning (PAL) is a teaching method that develops new knowledge and skills through active learning support from peers. Objectives: To assess the impact of PAL in medical education, by collecting quantitative data that explore its effectiveness. To evaluate students’ perception of and satisfaction with PAL. Methods: A 5-point Likert scale survey was developed for students participating in the PAL program either as tutors or learners. Data were compared and statistically analyzed according to gender, GPA, and year of study. Moreover, follow up of peer tutors and peer learner’s achievement was done through comparing their grades with those that not shared in PAL and with their GPA of previous year. Results: Statistical analysis of questionnaire data revealed that medical students regarded voluntary peer-teaching similarly to faculty teaching and have a generally positive perception of PAL. Most of the respondents reported that they benefited both professionally and personally from PAL activities. They recommended expanding the role of PAL and officially incorporating PAL sessions into the curriculum. Students’ achievement was significantly increased for those who acted as peer learners and peer tutors. Conclusions: Using PAL in conjunction with other teaching and learning methods provides additional value by fostering cooperation and social interaction among medical students and further prepares them for their future role as medical science educators. Additional research into the impact of PAL on academic achievement, both short- and long-term learning outcomes, in medical programs is warranted.

Ghazwa B Korayem,1 Raghad Alkanhal,1 Raghad Almass,1 Sarah Alkhunaizan,1 Ghada Alharthi,1 Nader Bin Sheraim,2 Sara Alqahtani,2 Hadeel Alkofide3 1Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 2Pharmaceutical Care Services, King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia; 3Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Ghazwa B KorayemPharmacy Practice Department, College of Pharmacy, Princess Nourah bint Abdulrahman University, Al Imam Abdullah Ibn Saud Ibn Abdul Aziz Road, Riyadh, Saudi ArabiaTel +966 504161649Email Gbkorayem@pnu.edu.saPurpose: To identify factors associated with inappropriate acid-suppressive therapy (AST) use in hospitalized medical ward patients.Patients and Methods: This was a combined retrospective cohort study reviewing the electronic medical records of medical ward in a secondary university hospital between January 2018 and July 2019, in addition to prescriber surveys about AST knowledge. We included adult patients (≥ 18 years old) admitted to the medical ward who received at least one dose of AST during their hospitalization. Statistical analyses included descriptive statistics and logistic regression.Results: A total of 335 patients were included. Most of the patients were female (66.6%), with a mean age of 42.37 ± 17.72 years; 76% (n=256) of the study subjects were prescribed AST for an inappropriate indication. Patients who were not receiving any home medications associated with high bleeding risk had higher odds of being prescribed AST inappropriately (OR, 4.06; 95% CI, 1.09– 13.8). A total of 27 physicians completed the prescriber survey, and the average prescriber’s knowledge score was 46.8 ± 15.6%. This score did not differ by the prescriber’s position.Conclusion: This study demonstrated the overuse of AST in the medical ward. Therefore, improving providers’ awareness about AST and implementing an AST stewardship program in institutions is necessary to limit this long-lasting issue.Keywords: acid suppressive therapy, overuse, hospital practice, medical ward