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The analysis of the possibilities and directions of Russian-Hungarian bilateral cooperation in the field of pharmaceuticals carried out by the authors allowed us to assert that in the conditions of anti-Russian Western sanctions, the situation in the domestic pharmaceutical industry in terms of demand and supply of medicines has significantly worsened. The pharmaceutical industry remains important both from the point of view of ensuring public health and national security in this area, and high innovation. The authors conclude that it is necessary to strengthen international cooperation in this area, especially with states that traditionally have high achievements in it and a long history of interaction with Russian structures. One of these countries is Hungary. The article emphasizes that both countries are interested in cooperation in this area, relying on the ties traditionally formed during the socialist period and a certain complementarity. It is also noted that under the conditions of sanctions, the Russian pharmaceutical industry maintains both positive dynamics and maintains a high level of competitiveness of manufacturers in the domestic market.

During the COVID-19 pandemic, major challenges are facing pediatric cancer centers regarding access to cancer centers, continuity of the anti-cancer therapy, hospital admission, and infection protection precautions. Pediatric oncologists actively treating children with cancer from 29 cancer centers at 11 countries were asked to answer a survey from May 2020 to August 2020 either directly or through the internet. COVID-19 pandemic affected the access to pediatric cancer care in the form of difficulty in reaching the center in 22 (75.9%) centers and affection of patients' flow in 21 (72.4%) centers. Health care professionals (HCP) were infected with COVID-19 in 20 (69%) surveyed centers. Eighteen centers (62%) modified the treatment guidelines. Care of follow-up patients was provided in-hospital in 8(27.6%) centers, through telemedicine in 10 (34.5%) centers, and just delayed in 11 (38%) centers. Pediatric oncologists had different expectations about the future effects of COVID-19 on pediatric cancer care. Seventy-six percent of pediatric oncologists think the COVID-19 pandemic will increase the use of telemedicine. Fifty-five percent of pediatric oncologists think if the COVID-19 pandemic persists, we will need to change chemotherapy protocols to less myelosuppressive ones. Collaborative studies are required to prioritize pediatric cancer management during COVID-19 era.

Diabetes mellitus is a chronic disease that affects many body systems, including the nervous and auditory systems. It is noted that there is a scarcity of research on the effect of diabetes on cognitive functions in particular and auditory functions in general in children with type 1 diabetes. Therefore, this study was designed to assess cognitive and auditory functions in children with type 1 diabetes mellitus and to correlate the reflection of diabetes control on cognitive functions.This study is a case-control study that included 100 children divided into two groups, the patient group, which includes 50 children with type 1 diabetes, and the control group, which consists of 50 healthy children. Subjects in the current study were submitted to pure tone audiometry, speech recognition threshold test, immittancemetry study, and measurement of cortical auditory evoked and P300 potentials (CAEPs and P300). These audiometric measures were statistically analyzed and correlated with the clinical characteristics of the study group.The latency of P300 and CAEPs was significantly increased while the amplitude of P300 and CAEPs was significantly decreased in the patient group compared to the control group (p 0.001). P300 and CAEPs latency has a positive correlation with HbA1c levels (r = 0.460). In addition, there was significant differences between the two groups regarding the hearing threshold at 8000 Hz, and 28% of patients had bilateral sensorineural hearing loss (SNHL) at 8 kHz.The prolonged P300 and CAEPs latency and decreased amplitude in patients indicate a cognitive decline in individuals with type 1 diabetes compared to healthy individuals. HbA1c levels may increase the risk of cognitive impairment in children. In addition, the risk of bilateral SNHL increased at 8 kHz in children with type 1 diabetes mellitus.

Background: Improving recovery after exercise is vital for decreasing cardiac mortality by dominance of parasympathetic nervous system control in recovery time. Objective: To determine the influence of coronary artery disease on heart rate recovery after exercise in patients with diabetes mellitus. Patients and Methods: The ethical approval was obtained from the hospital ethical research committee, in cardiology department in Al-Hussein university hospital from March 2019 to November 2019 and each patient signed an informed consent. Fifty patients were included in this study divided in 4 groups, all with no evident history of ischemic heart disease. Detailed history, physical examination, resting ECG, trans thoracic echocardiography, and finally treadmill exercise stress test was done. In this study we assessed heart rate recovery in 1st, 2nd& 3rd minute and also basal heart rate included. Results: Significant delay in heart rate recovery time was detected in diabetic patients with positive stress ECG test for myocardial included ischemia. Conclusion: Delayed recovery and reduced heart rate recovery after treadmill exercise stress test is an available and important index for detecting and revealing the extent of ischemic burden.

Purpose The main aim of the study was to report visual, refractive, topographic, and aberrometric results of accelerated CXL in patients with keratoconus who were followed for 12 months and to highlight the important parameters that can be used in follow-up. Settings It was a prospective interventional non-randomized case series study, in which 40 keratoconus eyes of 40 patients were studied in the period between April 2016 and July 2018. Methods All eyes were examined preoperatively and post-accelerated CXL to evaluate visual acuity, refractive state, keratometric values, keratoconus indices, and corneal higher order aberrations (HOAs). Results The mean age of the studied patients was 28.4 ± 8.6 years (18-37years). One year after cross-linking, 11.6% of the eyes gained two lines of the UCVA, 26.4% of the eyes gained one line, 49.8% showed no change, 7.1% lost one line, and 5.1% lost two lines. Postoperative BCVA showed 13.7% of the eyes gained at least two lines, 32.5% gained one line, 49.9% had no change, and 3.9% lost one line. The keratometric values changed significantly after CXL; K1 decreased by a mean of 0.41D, K2 by 0.62D while Kmax by 1.57 D. The significant changes in keratoconus indices were in index of vertical asymmetry (IVA), index of surface variance (ISV), and keratoconus index (KI). Vertical coma, spherical aberrations, and trefoil decreased significantly at 12 months compared to baseline values (p = 0.04, 0.017, 0.025, respectively). Conclusion Keratoconus indices especially ISV, IVA, and KI along with HOAsparticularly vertical coma, spherical aberrations, and trefoil can add value beside keratometric readings in the follow-up of eyes treated with accelerated CXL.

Background Patients with schizophrenia suffer from diffuse cognitive impairment and high prevalence of cardiovascular metabolic risks, associated with poor clinical outcomes. We aimed in this study to test the presence of cognitive impairment in a sample of patients with schizophrenia, and evaluate its possible relations to patients’ metabolic profile. We recruited forty patients diagnosed with schizophrenia and their matched controls from the inpatient departments and outpatient services from January to December 2016. Schizophrenia diagnosis was confirmed by the ICD10 criteria checklist. Symptoms profile and severity were assessed by the Positive and Negative Syndrome Scale. Cognitive profile was assessed through (1) Trail Making Test, Parts A and B and (2) Wechsler Memory Scale-Revised Visual Reproduction Test. Metabolic profile was assessed by measuring the body mass index, fasting blood glucose, and lipid profile. SPSS (V. 22.0, IBM Corp., USA, 2013) was used for data analysis. Results The patients group had a significantly higher means in the speed of processing, executive function, attention, and working memory scores on TMT-A (p = 0.0), TMT-B (p = 0.00), and WMS-R (p = 0.029) and significantly higher FBG levels (p = 0.00). Correlation studies showed that the increase in patients’ age, illness duration, treatments, number of hospitalizations, number of episodes and of ECT sessions received, symptoms severity, and deficits in cognitive function scores was associated with higher BMI and FBG. Conclusions Patients with schizophrenia have a higher prevalence of cognitive impairment and vascular risk factors than the general population. Close monitoring and early management of these risk factors can promote better cognitive abilities and overall functions.

Mahmoud Mohamed Genaidy, Hosny Ahmed Zein, Ahmed Mostafa Eid Department of Ophthalmology, Faculty of Medicine, Minia University, Minia, Egypt Purpose of the study: To evaluate efficacy, safety, and success rates of canaloplasty combined with phacoemulsification and intraocular lens implantation in patients with open-angle glaucoma (OAG) and visually significant cataract.Patients and methods: A prospective interventional noncomparative case series carried out in Minia University Hospital from April 2015 to October 2016 on 20 eyes of 18 patients who had visually significant cataract and primary OAG. All the cases had combined phacocanaloplasty. Preoperative best-corrected visual acuity, intraocular pressure (IOP), and number of antiglaucoma medications were collected and compared to postoperative levels, and complications rates were recorded.Results: 20 eyes of 18 patients (5 males and 15 females), with a mean age 57.6 years (range 48–69years), underwent phacocanaloplasty. Preoperative mean IOP was 25.20 ±1.009mmHg. Postoperative IOP decreased to a mean of 14.20±0.9, 14.85±0.8, and 15.85±0.7 mmHG at 3, 6, and 12months, respectively, with 37% reduction from preoperative IOP level at one year follow-up visit (P=0.0005). The number of antiglaucoma medications dropped from mean of 1.55 preoperatively to 0.35 postoperatively. LogMAR of best-corrected visual acuity improved from 0.6950±0.07 preoperatively to 0.3670±0.056, 0.3460±0.056, and 0.03370±0.052 at 3, 6, and 12months postoperatively (P=0.0005). Complications were limited to mild hyphemia (one case), mild corneal edema (one case), and mild inflammatory membrane (one case) that resolved in the first week after surgery.Conclusion: Canaloplasty combined with clear corneal phacoemulsification and intraocular lens implantation may be a safe and effective procedure to lower IOP in adult patients with OAG and visually significant cataract. Keywords: cataract, glaucoma, phacoemulsification, canaloplasty

Bier’s block is a simple, safe, cheap, and trustable technique of regional anesthesia for operations performed on extremities but it has some obstacles such as pain of tourniquet, poor postoperativ...

The Arab States of the Gulf Cooperation Council (GCC) host one of the fastest developing, yet one of the most closed groups of securities markets in the EMEA region. This study provides an analysis of the regional securities market and compares it with global securities’ market trends for the period 2000 to 2014. The study refers to regional IPO activity as a reflection of the level of maturity of the local economy. An IPO Market Ratio is introduced in this study as an instrument for measuring the national economy so as to be able to further compare it to other economies. The study provides descriptions of the financial markets of all GCC economies, outlines their developmental history, and develops a ranking of GCC countries based upon weighted normalized IPO Market Ratio data. The collected information and the results of the analysis are presented both in table and graphical formats.

Calix[4]azulene 1 is shown to be an effective molecular receptor for tetraalkylammonium halide and BF4− salts. The respective binding constants were determined using global-fit analyses of the spectral data from UV-vis absorption titration studies. A DFT study of the putative complexes formed with 1, and the X-ray structure of 1 itself is also reported.

Background Middle East respiratory syndrome (MERS) is caused by a coronavirus (MERS‐CoV) and is characterized by hypoxemic respiratory failure. The objective of this study is to compare the outcomes of MERS-CoV patients before and after the availability of extracorporeal membrane oxygenation (ECMO) as a rescue therapy in severely hypoxemic patients who failed conventional strategies. Methods We collected data retrospectively on MERS-CoV patients with refractory respiratory failure from April 2014 to December 2015 in 5 intensive care units (ICUs) in Saudi Arabia. Patients were classified into two groups: ECMO versus conventional therapy. Our primary outcome was in-hospital mortality; secondary outcomes included ICU and hospital length of stay. Results Thirty-five patients were included; 17 received ECMO and 18 received conventional therapy. Both groups had similar baseline characteristics. The ECMO group had lower in-hospital mortality (65 vs. 100%, P = 0.02), longer ICU stay (median 25 vs. 8 days, respectively, P

A morbidity interoiew-survey was conducted in Addis Zemen, North-Western Ethiopia. Four hundred (20%) of the households (1710 people) were randomly selected to praticipate in the survey, to test the recall of recent health problems during a four week period. 310 people (18%) of the sample reported health problems, particularly of the digestive, visual, musculoskeletal and respiratory systems. Morbidity varied with age and sex. There were relatively higher reports of morbidity in the preschoolage as well as during later life. There was also a preponderence of females ( 12%) versus males (6%) reporting illnesses as a consequence of which adults lost 0.65 days of work per month per person, estimated at 8.0 days per year. Only 7.9% of persons reporting illnesses were disabled for three or more days, while over half of those reporting illness utilized medical care, with a preference for modem medicine, 40% failed to utilize any fonn of medical care. The major reason given was cost.

The purpose of this study was to document the distribution of blood pressures and the prevalence of hypertension in two rural communities located in the northwestern Gondar Region of Ethiopia. Based upon a systematic random sampling, 226 households (724 persons) were selected. Mean systolic and diastolic blood pressures (SBP and DBP) were calculated separately for male and female children (5 -15 years) and adults. Among male and female children the mean SBP's were 110.0 +/- 9.5 and 113.4 =/- 10.0, while the mean DBP's were 73.8 +/- 8.2 and 73.8 +/- 7.9, respectively. The difference in mean SBP's was statistically significant (p

Sheep and goat pox Outbreaks occurred in different geographic areas of Sudan and most strikingly, were highly species specific. Two outbreaks in Gedarif State in June. 2013 affected no goats and outbreak in Khartoum state in March. 2015 affected no sheep despite communal herding; affected goats were vaccinated with 0240 strain. Clinically, the disease was characterized by fever, depression and eruption of generalized pox lesions. Mortality rate ranged between 5.2 and 6.7% with a mean of 6.1%. Isolation of viruses succeed on Lamb testes cell culture at passage four, the diseases were diagnosed using virus neutralisation test and polymerase chain reaction. Sheeppox and goatpox isolates grew well in lamb testes and Vero cells. In MDBK however, both viruses induced slight CPE that reached 60% in 9 days. On the other hand, both isolates induced no CPE in chick embryo fibroblast cells. Virus isolation attempts failed on chorioallantoic membrane of embryonated chicken eggs.

Enantioselective total syntheses and X-ray structures of both (S)-tetrahydropalmatrubine (2) and (S)-corytenchine (3) are reported for the first time. They were both derived from (S)-N-norlaudanidine, a benzyltetrahydroisoquinoline that was synthesized with high (>95% ee) enantioselectivity using a chiral auxiliary-assisted Bischler-Napieralski cyclization/reduction approach.

Objective To compare between two doses of ondansetron (2 mg, 4 mg) and ephedrine in prevention of maternal hypotension and bradycardia induced by spinal anesthesia, their effects on specifications of spinal blockade, neonatal outcome, and their side effects. Patients and methods One hundred twenty parturients ASA І or ІІ aged between 18 and 40 years, scheduled for elective cesarean section under spinal anesthesia. They were randomly divided into four equal groups. First group received intravenous I.V. 2 mg ondansetron, second group received I.V. 4 mg ondansetron, third group received 10 mg ephedrine, and the fourth group received normal saline. All the test drugs were administered as bolus dose five minutes before intrathecal injection. Mean blood pressure, heart rate, vasopressor use, spinal anesthesia specifications, neonatal outcome, and side effects were assessed. Results The fall in mean blood pressure after spinal anesthesia in ondansetron 4 mg group was the least and the greatest was in the control group. There was dropping in heart rate values after spinal anesthesia started from 5 minutes value with significance to the control group only. No significant difference between the four groups in the spinal anesthesia characters. Slight acidosis was noticed in the ephedrine group which doesn’t affect the clinical neonatal outcome. Conclusion Prophylactic bolus intravenous ondansetron 4 mg and to less extent 2 mg could decrease the fall in mean blood pressure of parturients following spinal anesthesia as well as intravenous ephedrine 10 mg with added advantage that it could decrease neonatal acidosis associated with ephedrine use.

Purpose The aim was to investigate the effect of ablation depth on the incidence and severity of the dry eye after laser-assisted in-situ keratomileusis (LASIK) treatment of myopia. Patients and methods This was a prospective, noncomparative, interventional case series study that included myopic patients who underwent LASIK treatment for myopia ranging from −1.75 to −12.00 D. All patients had a comprehensive preoperative ophthalmologic evaluation. Tear breakup time (TBUT) and Schirmer 1 tests were undertaken for all patients preoperatively and at 1, 3, and 6 months postoperatively. The main outcome measures included the incidence and severity of the dry eye and their correlation with ablation depth at 1, 3, and 6 months postoperatively. Results 104 eyes of 53 myopic patients (14 males and 39 females) with a mean age of 27.4±6.06 years (range: 21–45 years). At the baseline, the mean spherical equivalent was −6.38±2.82 D (range: −1.5 to −12 D), mean TBUT was 12.93±1.60 s (range: 10–17 s), and the mean Schirmer 1 score was 17.9±62.52 mm (range: 14–30 mm). Mean post-LASIK TBUT was 7.58±4.32, 10.22±5.38, and 12.07±4.02 s at 1, 3, and 6 months, respectively (P