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Abstract Twelve spiro thiazolidinone compounds (A–L) were synthesized via either conventional thermal or ultrasonication techniques using Fe2O3 nanoparticles. The modification of the traditional procedure by using Fe2O3 nanoparticles led to enhancement of the yield of the desired candidates to 78–93% in approximately half reaction time compared with 58–79% without catalyst. The products were fully characterized using different analytical and spectroscopic techniques. The structure of the two derivatives 4-phenyl-1-thia-4-azaspirodecan-3-one (A) and 4-(p-tolyl)-1-thia-4-azaspirodecan-3-one (B) were also determined using single crystal X-ray diffraction and Hirshfeld surface analysis. The two compounds (A and B) were crystallized in the orthorhombic system with Pbca and P2 1 2 1 2 1 space groups, respectively. In addition, the crystal packing of compounds revealed the formation of supramolecular array with a net of intermolecular hydrogen bonding interactions. The energy optimized geometries of some selected derivatives were performed by density functional theory (DFT/B3LYP). The reactivity descriptors were also calculated and correlated with their biological properties. All the reported compounds were screened for antimicrobial inhibitions. The two derivatives, F and J, exhibited the highest levels of bacterial inhibition with an inhibition zone of 10–17 mm. Also, the two derivatives, F and J, displayed the most potent fungal inhibition with an inhibition zone of 15–23 mm. Molecular docking investigations of some selected derivatives were performed using a B-DNA (PDB: 1BNA) as a macromolecular target. Structure and activity relationship of the reported compounds were correlated with the data of antimicrobial activities and the computed reactivity parameters.

Botox treatment has become a popular method for reducing facial lines and wrinkles and rejuvenating the signs of aging. However, like any procedure, Botox can lead to temporary and minor complications. In the presence of certain systemic diseases such as diabetes mellitus, it is essential to take additional precautionary measures that should not be ignored, as it could turn into a life-threatening situation which may need to surgical intervention. Therefore, the key to success lies in ensuring that the procedure is carried out by skilled professionals, conducting a comprehensive medical history assessment, despite the simplicity of the procedure. Thus, we present a case of A 52-year-old diabetic woman came with a severe facial phlegmon persisting for 7 days and mentioned a previous Botox treatment 8 days ago. Drainage of the phlegmon was performed under general anesthesia using an intraoral vestibular approach.

Background:. Patient-specific implants (PSIs) have been presented as an effective solution for diseases that require reconstruction. PSIs are designed to precisely fit anatomical defects or deformities in terms of shape and size. In addition to the possibility of predicting the results of surgery regarding soft tissue changes. Methods:. A research sample consisting of 10 patients with facial deformities underwent maxillofacial reconstructive surgery between 2020 and 2021 in the Tishreen University Hospital, Syria. All patients underwent computed tomography scans; then, the design of the required facial implant was carried out, and the three-dimensional soft tissues were reconstructed using the ExoCad 3.0 program based on the computed tomography. The final form of the facial implant was printed from polyether ether ketone, and then surgical work was performed. The patients were followed up after 6 months. Then, a comparison was made between the virtual design and the real result. Results:. The absolute difference between the expected soft tissue changes result and the actual result did not exceed three-tenths for all patients, and only two of 10 patients had measurements higher than 20%. Conclusions:. This technique can be relied upon with the placement of implants to predict the outcome of the surgical procedure in terms of morphological changes in the facial soft tissues covering PSI polyether ether ketone. Therefore, it is possible to make a virtual design based on the cosmetic requirements of the patient.

Abstract The exponential development of resistance to conventional chemical insecticides adds another important motive for the creation of novel insecticidal active agents. One of the keys to meeting this challenge is the exploration of novel classes of insecticidal molecules with different modes of action. Herein, a novel series of spiro pyrimidine derivatives was prepared using some green synthetic methodologies such as microwave irradiation, and sonication under ultrasound waves. Spiro pyrimidine aminonitrile 1 is a key starting material for the synthesis of targets 2–9 by reaction with different carbon electrophiles and nitrogen nucleophiles. The structures of all the newly synthesized compounds were approved using spectral data. The toxicological efficiency and biological impacts of the synthesized spiro pyrimidine derivatives were assessed against Culex pipiens L. larvae. The toxicity of synthesized compounds showed remarkable variations against the C. pipiens larvae. Where, 3, 4 and 2 were the most efficient compounds with LC50 values of 12.43, 16.29 and 21.73 µg/mL, respectively. While 1 was the least potent compound with an LC50 value of 95.18 µg/mL. As well, other compounds were arranged according to LC50 values as follows 5 > 7 > 6 > 9 > 8. In addition, 3 and 4 exhibited significant prolongation of the developmental duration and greatly inhibited adult emergence. Moreover, many morphological deformities were observed in all developmental stages. Furthermore, cytotoxicity of the most effective compounds was assessed against the normal human cells (WI-38) as non-target organisms, where compounds 2, 4 and 3 showed weak to non-toxic effects. The study of binding affinity and correlation between chemical structure and reactivity was carried out using molecular docking study and DFT calculations to investigate their mode of action. This study shed light on promising compounds with larvicidal activity and biological impacts on the C. pipiens life cycle.

هدف الدراسة : تقييم نتائج استخدام الموسعة التقويمية المثبتة بالبراغي في إعادة بناء العظم السنخي المتخرب والضامر في الفك السفلي. المواد والطرق: تألفت عينة الدراسة من 6 مرضى( 5 ذكور، 1 إناث، بمعدل أعمار تتراوح بين 20-36) ممن يعانون من فقد وضمور في العظم السنخي للفك السفلي. تم علاج هؤلاء المرضى استخدام الموسعات التقويمية وفق مبدأ التطويل العظمي بالشد بالمشاركة. تألف الجهاز المستخدم من جزئين: الجزء الأول هو الموسعة التقويمية والجزء الآخر الحلقات المصممة لتوضع البراغي. تم تركيب الموسعات التقويمية في مكان القطع العظمي في المنطقة المجاور لمنطقة الفقد العظمي وتثبيتها على القطع العظمية بواسطة البراغي.تم إجراء صورة cbct للمرضى قبل العلاج وبعد 4 أشهر من أجل قياس كمية الكسب العظمي. النتائج: متوسط الكسب العظمي الأفقي في نهاية مرحلة النضج كانت 7.55 مم (5.5 -10 مم) متوسط الكسب العظمي العمودي في نهاية مرحلة النضج كانت 6.91 مم (3.5-9 مم) الاستنتاج: تضمن حدود هذه الدراسة يمكن الاستناج بأن عملية التطويل العظمي باستخدام الموسعات التقويمية تساهم في إعادة بناء العظم السنخي المتخرب والضامر في الفك السفلي

This meta-analysis compares the efficacy and safety of inhaled versus systemic corticosteroids for COPD exacerbations. Following a pre-registered protocol, we appraised eligible randomised controlled trials (RCTs) according to Cochrane methodology, performed random-effects meta-analyses for all outcomes prioritised in the European Respiratory Society COPD core outcome set and rated the certainty of evidence as per Grading of Recommendations Assessment, Development and Evaluation methodology. We included 20 RCTs totalling 2140 participants with moderate or severe exacerbations. All trials were at high risk of methodological bias. Low-certainty evidence did not reveal significant differences between inhaled and systemic corticosteroids for treatment failure rate (relative risk 1.75, 95% CI 0.76–4.02, n=569 participants); breathlessness (mean change: standardised mean difference (SMD) −0.11, 95% CI −0.36–0.15, n=239; post-treatment scores: SMD −0.18, 95% CI −0.41–0.05, n=293); serious adverse events (relative risk 1.47, 95% CI 0.56–3.88, n=246); or any other efficacy outcomes. Moderate-certainty evidence implied a tendency for fewer adverse events with inhaled compared to systemic corticosteroids (relative risk 0.80, 95% CI 0.64–1.0, n=480). Hyperglycaemia and oral fungal infections were observed more frequently with systemic and inhaled corticosteroids, respectively. Limited available evidence suggests potential noninferiority of inhaled to systemic corticosteroids in COPD exacerbations. Appropriately designed and powered RCTs are warranted to confirm these findings.

In this study, the effect of organic pollutants dissolved in water, which was extracted with normal hexane (HEM) on the physical properties of groundwater in the Azzab Al-Asfal district - Kirkuk, was studied, represented by viscosity, surface tension. And chemical properties: pH, basicity, acidity, chlorides, nitrates, sulfates, and chromium. The results showed that the organic pollutants are sourced from the oil wells in the (Bai Hassan) region of the North Oil Company. Oil spills and crude oil processing operations lead to contamination of groundwater in nearby areas with organic matter that has a direct impact on the physical and chemical properties of that water. As the viscosity and surface tension decreased as a result of the dissolution of some organic substances in the groundwater, these solutes acted as surface tension and viscosity reducers. Other chemical properties were also affected by human activities, as the alkalinity and acidity increased significantly while the pH remained within the medium limits. Concentrations of chlorides, chromium, and nutrients represented in nitrates and sulfates were also affected, as their levels rose beyond the normal values. The data were treated statistically using the (SPSS) software, and Pearson's correlation coefficient was used as a function to find out the correlations and their size between HEM and other variables.

Ciprofloxacin (Cip) and hydrocortisone (Hyd) were simultaneously measured as hydrochloride and sodium succinate, respectively, using the H-point standard addition method (HPSAM). The approach can precisely identify Cip in the presence of Hyd with various analyte-to-interference ratios (5:5, 5:10, 10:5, 10:10) µg.mL-1, in mixed samples containing (1-5µg.ml-1) of Cip, at the wavelengths of (236 and 257) nm. In the same way, Hyd was analyzed in the presence of Cip in different analytes with an interference ratio of (5:5, 5:10, 10:5, 10:10) µg.mL-1, in mixed samples containing (1-5 µg.mL-1) of Hyd, at wavelengths of (266 and 278) nm. The satisfactory results show good reproducibility of the developed method (RSD equals 0.9735-1.6825 and 0.9692-1.7671 for Cip and Hyd, respectively). The results also show that the excipients had no influence on the assaying of the above drugs (Recovery, 98.87–101.73). The recommended technique has successfully been used to determine the Cip and Hyd in pharmaceutical composites simultaneously with an RSD range of (0.972 to 1.671) and (0.898 to 1.820) for Cip and Hyd, respectively.

هدف الدراسة: تقييم فعالية تقنية التطويل العظمي باستخدام الموسعات التقويمية المثبتة بالبراغي في سياق معالجة العيوب والتشوهات في عظام الفكين العلوي والسفلي. المواد والطرق: تألفت عينة الدراسة من 9 مرضى( 7 ذكور، 2 إناث، بمعدل أعمار تتراوح بين 20-50) ممن يعانون من فقد وضمور في العظم السنخي للفكين. تم علاج هؤلاء المرضى وفق مبدأ التطويل العظمي بالشد. تألف الجهاز المستخدم من جزئين: الجزء الأول هو الموسعة التقويمية والجزء الآخر الحلقات المصممة لتوضع البراغي. تم تركيب الموسعات التقويمية في مكان القطع العظمي وتثبيتها على القطع العظمية بواسطة البراغي. تغيرات النسج الرخوة والعظمية تم تقييمها عن طريق الصور الشعاعية cbct والصور الفوتوغرافية خلال 4أشهر . النتائج: حدث تفزر الجرح في حالة واحدة و حدث انحسار لثوي بسيط على الأسنان الموجودة ضمن القطعة العظمية المنقولة في حالتين. بلغ متوسط الكثافة العظمية لمنطقة فجوة التطويل العظمي بعد 4 أشهر من عملية التطويل العظمي 497,9. بلغ متوسط الكثافة العظمية لمنطقة الفقد العظمي بعد 4 أشهر من عملية التطويل العظمي 513,29 الاستنتاجات: ضمن حدود هذه الدراسة يمكن الاستنتاج أن عملية التطويل العظمي باستخدام الموسعات التقويمية تساهم في تشكيل نسيج عظمي بكثافة عظمية جيدة وبأقل الاختلاطات.

An accurate and sensitive determination procedure has been established for the quantification of cefdinir in pure and pharmacological formulas. The approach was dependent on derivatizing cefdinir with sodium anthraquinone-2-sulfonate (SAS) in an alkaline medium to produce a magenta-colored derivative with a maximum absorbance at 517 nm against the reagent blank. Different factors affecting the interaction of cefdinir with SAS were studied carefully and optimized, such as the buffer value, medium acidity, the duration of hydrolysis, and the reagent percentage. Under optimized conditions, a linear calibration curve with a correlation coefficient of R2 = 0.9995 was obtained over the concentration range of cefdinir 0.5–100 μg/mL. The values of the parameters that represented the sensitivity of the method were satisfactory, i.e., the limit of detection, the limit of quantification, as well as Sandell's sensitivity (л) were 0.1 μg/mL, 0.5 μg/mL, and 0.064 μg/cm2/0.001 Au, respectively. The relative standard deviation was below 1.35%, while the percentage recovery was 99.930%–102.257%. The mole ratio of the colored complex was estimated by following Job's method of continuous variation, which indicated that the cefdinir-SAS ratio was 1:1. The suggested approach was proven to be adequately accurate, precise, and without interfering with common excipients and additives. Thus, it could be implemented successfully for the standard determination of cefdinir in its pure and pharmaceutical forms.

The research aims to be an attempt by the researchers to apply improving the model of the digital rise, thus opening the way for researchers who are interested in developing and expanding this idea in the future. The development of the improved digital elevation model within the boundaries of Al-Tharthar Lake its elevation levels means the unimproved digital elevation model within the lake boundaries of Mozaic topographic maps, in order to avoid the limitations of the unimproved digital elevation model that shows the entire lake at a level of 44 meters above sea level, so the improved digital elevation model shows its morphological, hydrological, topographic and topographic properties within the lake's various elevations within the lake's various elevations within the boundaries of the lake.These proposed steps in the research have proven to be efficient in improving digital elevation models, and the improved digital elevation model has proven to be highly effective in giving a high-level geo-reality perception of the lake greater credibility than it does: the unimproved digital elevation model as well as the old topographic maps. One of the recommendations of the research, recommends the Ministry of Water Resources and General directorate of Survey do accurate field survey principally hydrographic survey for lakes and rivers of the country through the marine area devices which are the best way to represent the topography of the lake with very high accuracy on two levels: horizontal topographic morphometric, vertical interval and elevation levels from both local and national geodesic reference. Consequently, the possibility of updating topographic maps which belong to 20th century

هدف البحث: هدفت هذه الدراسة إلى مقارنة مقدار الانطباق الحفافي وتحمل قوى القص بين الدعامات الجاهزة الدعامات المصنعة بطريقة CAD\CAM من الزيركونيا والدعامات المصنعة بطريقة التشميع من خليطة الكروم-كوبالت. المواد والطرائق: تألفت عينة الدراسة من 30 دعامة، تم تقسيمها بحسب طريقة الصنع إلى ثلاث مجموعات متساوية (10 دعامات جاهزة من الشركة المصنعة للزرعات، و10 دعامات مصنوعة من الزيركونيا بواسطة CAD\CAM، و10 دعامات مصنعة بطريقة الشمع الضائع من خليطة كروم-كوبالت)، حيث تم في كل مجموعة قياس دقة الانطباق الحفافي ومقدار تحمل قوى القص. ومن ثم تمت المقارنة بين المجموعات الثلاث باستخدام اختبار Anova أحادي التباين، كما تم استخدام اختبار Tukey كاختبار للمقارنة بين كل مجموعتين من مجموعات الدراسة. النتائج: تبين وجود فروق جوهرية عند مقارنة مقدار دقة الانطباق الحفافي بين مجموعات الدراسة الثلاث (p

This research aimed to study the availability of extension services that are provided to the coffee small-scale farmers in the Al-Udein district of Yemen. In addition, it outlines the other extension sources that farmers might depend on for the improvement of their knowledge and skills. The researchers found that the majority of respondents (70.8%) do not have access to any public institutions that provide extension services. Furthermore, the whole respondents (100%) stated that they are highly dependent on their experiences gained from the traditional practices. Moreover, more than (90%) of the respondents moderately depend on their friends and neighbors as a source of knowledge and skills. Furthermore, the researchers pointed out that (100%) of the respondents never depend on classical organizations as sources of agricultural extension knowledge. Additionally, (90%) of the respondents do not, at all, depend on agriculture exhibitions, agriculture films, printed materials, radio or TV programs as sources of knowledge and skills. However, (6.3%) of the respondents said that they are highly dependent on ‘WhatsApp’ as a source of knowledge. Finally, the researchers recommended that it is necessary to enhance the role of public extension services and encourage farmers to use the social media platforms and mobile phones in order to support the exchange of knowledge between extension services in one hand and between farmers themselves in the other hand which will led to enhancing the knowledge exchange process effectively and efficiently.

Abstract Background Women with inverted nipples may struggle with breastfeeding and may stop exclusive breastfeeding before six months. The use of an inverted syringe to evert the nipples was successful in achieving high rates of infant latching and exclusive breastfeeding in case series but has not been tested in clinical trials. This open label, parallel group, randomized clinical trial investigated whether the use of the inverted syringe technique in women with inverted nipples would increase exclusive breastfeeding rate at one month, as compared to standard care. Methods/Design Between June 2018 and January 2020, healthy pregnant women (N=54) with grades 1 or 2 inverted nipples were randomly allocated to standard care or to an experimental group that used the inverted syringe technique to evert the inverted nipple prior to every breastfeeding. The primary outcome measure was the rate of exclusive breastfeeding at one month. Secondary outcomes included the rates of exclusive breastfeeding at three and six months, any breastfeeding at one, three, and six months, nipple eversion, successful infant latching, breastfeeding-associated complications, maternal satisfaction with breastfeeding, maternal quality of life, and adverse events. Descriptive and bivariate analyses were conducted according to the intention to treat principle. Results Participants in the experimental group were less likely to be exclusively breastfeeding at one (RR = 0.65, 95% CI: 0.44, 0.95; n = 47), and at three months (RR = 0.66, 95% CI: 0.47, 0.91; n = 45), or to practice any breastfeeding at six months (RR = 0.54, 95% CI: 0.34, 0.87; n = 44). Only 14.3% of women in the experimental group complied with the use of the inverted syringe during the first month. Breast pump and breastfeeding-associated complications were more commonly reported in the control group (p < 0.05 for both). Both groups had similar rates of nipple eversion, successful infant latching, and similar satisfaction with breastfeeding and quality of life issues. Conclusion The inverted syringe technique was not associated with improvement in breastfeeding outcomes of women with inverted nipples. Larger clinical trials are needed to confirm our findings. Trial registration ClinicalTrials.gov NCT03529630 ; Registered May 8, 2018.

Chloroquine and Hydroxychloroquine drugs are widely prescribed for malaria disease. Since the end of 2019, humans have been under threat due to a disease called (COVID-19), which was first reported in China. Many methodical approaches have been reported to quantify chloroquine and hydroxychloroquine in blood, urine, plasma, serum, and pharmaceutical dosage form. Some of these techniques are spectrophotometry, liquid chromatography with a mass detector, gas chromatography, and ultra-performance, high-performance liquid chromatography (HPLC), in addition to electrochemical methods. This literature review discusses various analytical methods for the determining hydroxychloroquine and chloroquine.

تم في هذا البحث دراسة الشروط المثلى لتحضير المركب الحيوي هيدروكسي أباتيت ذو الصيغة الكيميائية:Ca10(PO4)6(OH)2 (HA) في الجملة ثلاثية المكون: Ca(NO3)2-(NH4)2HPO4-NH3.H2O حيث تم تحضير مركب نترات الكالسيوم اعتماداً على تكليس قشر البيض الأبيض للحصول على أكسيد الكالسيوم CaO والذي يعالج بحمض الآزوت, بينما فوسفات الأمونيوم أحادية الهيدروجين ومحلول الأمونيوم فأخذت من عبوتها النقية. تمت عملية تحضير المركب الحيوي هيدروكسي أباتيت Ca10(PO4)6(OH)2] [ ضمن شروط محددة أهمها: تركيز المحاليل المستخدمة, سرعة إضافة الكواشف, درجة حرارة المزيج التفاعلي, سرعة التحريك الدوراني, درجة نقاوة المواد المستخدمة, ودرجة حموضة المحلول pH. أظهرت الدراسة أنَّ المركب الصلب المحضر في الجملة ثلاثية المكون والذي فصل عن الطور السائل وجفف وحلل كيميائياً يملك الصيغة الكيميائية المجملة: Ca10(PO4)6(OH)2 وذو نسبة مولية 1.666= Ca/P , وأن عملية التحضير كانت أفضل في النموذج المحروق من النموذج المجفف وهذا ما أكدته دراسة العينات للنموذجين المجفف والمحروق بمطيافية الأشعة تحت الحمراء IR ومطيافية انعراج الأشعة السينية XRD حيث كان الناتج في النموذج المحروق بلورياً أما في النموذج المجفف فكان الناتج مختلطاً بلوري وغير بلوري.

تهدف هذه التجربة السريرية المضبوطة المعشاة الى تقييم مستويات الألم وعدم الراحة عند استخدام تقنية الشق القرصي بهدف تسريع المعالجة التقويمية مواد البحث وطرائقه : دراسة سريرية مضبوطة معشاة تم تطبيق تصميم ثنائي الجانب (هناك ذراع لجهة القطع القرصي والذراع المقابل للمعالجة التقليدية.( شملت 12 مريض (7 إناث و 5ذكور) , لتقييم التقبل والرضا ومستويات الألم والانزعاج والانتباج وصعوبات الأكل المرافقة للقطع القشري المحافظ المنجز باستخدام قرص المنشار تم استخدام استبيان يعتمد على مجموعة من الأسئلة تتم الإجابة عليها من قبل المرضى تم منحهم إياها بعد 1 يوم 7 أيام 14 يوم 28 يوم , من خلال استخدام مقاييس VAS , تم استخدام اختبار ويلكوكسن لتحليل البيانات النتائج : وجود فرق جوهري احصائيا بين الجهة الشاهدة وجهة الشق القرصي بالنسبة للمتغيرات الأربعة المدروسة ( الألم – الانزعاج – الانتباج) خلال زمن التقييم الأول فقط ( بعد 24 ساغة من اجراء الشق القرصي ) حيث بلغت قيمة الاحتمالية (0.003 -0.014-0.018) على الترتيب ,بينما لم بكن الفرق بين الجهتين جوهريا في أزمنة التقييم الثلاثة المتبقية , حيث كانت القيمة الاحتمالية أكبر من 0.05 عند مستوى ثقة 95% الاستنتاجات: ترافقت تقنية الشق القرصي مع مستويات مرتفعة ا من الألم والانزعاج والانتباج فقط بعد يوم من تطبيقها و مستويات مرتفعة من الرضا والتقبل بعد شهر من تطبيقها

أهداف البحث: يهدف البحث إلى تقييم فعالية المكثفات العظمية الآلية في رفع قاع الجيب الفكي عبر دراسة مقدار الكسب العظمي العمودي. المواد والطرق: تألفت عينة البحث من 10 مرضى أجري لديهم 12 عملية لرفع قاع الجيب الفكي بالمدخل السنخي باستخدام المكثفات العظمية الآلية بالتزامن مع وضع الغرسات السنية. تم دراسة مقدار الكسب العظمي تحت قاع الجيب بعد 6 أشهر باستخدام التصوير الطبقي المحوري ذو الحزمة المخروطية. النتائج: حدثت حالة إنثقاب لغشاء شنايدر من أصل 12 حالة أي ما نسبته 8.33%. وكان معدل بقاء الغرسات خلال فترة المتابعة 100%. بلغ متوسط ارتفاع العظم المتبقي قبل العمل الجراحي 6.5 ملم في حين بلغ متوسط ارتفاع العظم بعد 6 أشهر من العمل الجراحي 8.32 ملم. وكان متوسط الكسب العظمي العمودي 1.82 ملم (دال إحصائيا). أظهرت النتائج علاقة طردية دالة إحصائيا بين طول الجزء المندخل من الغرسة مع الكسب العظمي العمودي, في حين لم نجد علاقة ذو دلالة إحصائية بين ارتفاع العظم المتبقي وهذا الكسب. الاستنتاجات: إن المكثفات العظمية الآلية فعالة لرفع قاع الجيب الفكي بالمدخل السنخي بالتزامن مع وضع الغرسات السنية عبر تأمين كسب عظمي جيد.

الهدف : تهدف هذه الدراسة الى تقييم الانتان المبكر و المتأخر لاستخدام الزرعات الوجهية المصنعة خصيصا للمريض بتقنية الطباعة ثلاثية الابعاد في ترميم تشوهات الوجه و الفكين . مواد و طرائق البحث : تألفت عينة البحث من 10 مرضى يعانون من تشوهات على مستوى الوجه (مرضى الرضوض في المنطقة الفكية الوجهية الذين يعانون من عيوب نقص مادي بالنسج الصلبة ,مرضى الأورام الذين تعرضوا لاجراء جراحي سابق في منطقة منطقة الحجاج و الفك العلوي و الذقن و نتج عنه نقص مادي في العظم ,حالات تراجع الذقن الشديدة ,مرضى التشوهات الولادية ,مرضى متلازمة نقص نمو نصف الوجه ) و ذلك بين عامي 2020 و 2021 في قسم جراحة الفم والوجه والفكين في مشفى تشرين الجامعي – اللاذقية – سوريا .خضع جميع المرضى للتصوير المقطعي المحوسب باستخدام جهاز بشرط توفر عدد كبير من المقاطع )اكثر من 200 مقطع في كل محور) و سماكة المقطع اقل من 1 ملم بدقة 64 bit , ثم تم اجراء تصميم للزرعة الوجهية المطلوبة بالتنسيق بين المصمم و الفريق الجراحي بعد ذلك تم طباعة الزرعة الوجهية النهائية من مادة peek ثم إجراء الاعمال الجراحية للمرضى للمرضى تحت التخدير العام وفق المدخل الجراحي المناسب و تثبيت الزرعات بواسطة براغي التيتانيوم مع تغطيتهم بالصادات الحيوية وتمت متابعتهم بانتظام بعد الجراحة باسبوع و شهر و ثلاث أشهر للتأكد من وجود علامات انتان . النتائج : لوحظ وجود انتان متاخر في حالة واحدة فقط ضمن منطقة الذقن دون استجابة للمعالجة الدوائية من دفعنا لاجراء عمل جراحي لازالة الزرعة الوجهية بنسبة انتان 10%.

Medicines comprising fosfomycin are prescribed for urinary tract infections. These drugs are available for oral use as tromethamine and calcium, while fosfomycin-sodium and disodium are given for intravenous (IV) and intramuscular (IM). Many quantitative analytical methods have been reported to estimate Fosfomycin in blood, urine, plasma, serum, and pharmaceutical dosage formulations. Some techniques were spectrophotometric, mass spectrometry, gas chromatography, high-performance liquid chromatography, and electrochemical methods. Here we perform a rapid narrative review that discusses and comparison between them of various analytical methods for the determination of Fosfomycin-containing drugs.

نفذ البحث في الريف التابع لمحافظة طرطوس خلال موسمي النمو 2019-2020م، على أشجار التفاح صنف Starking delicious بعمر 16 عاماً، والمطعمة على الأصل Malus domistica، والمزروعة وفق المسافات 5×5م، وذلك باستخدام الرش الورقي للأشجار المدروسة باستخدام مستخلصات الطحالب البحرية الصلبة ألجا600 بتراكيز (6-4-2 غ/ل) ومسخلصات بحرية سائلة إنكوسيويد بتراكيز(6-4-2 مل/ل)، ومستخلص العرق سوس بتراكيز (8-4-2 مل/ل)، إلى جانب التسميد الأرضي الأساسي، وكانت النتائج التالية: حسنت معاملات الرش الورقي من جودة الثمار(الصفات الفيزيائية والكيميائية) للأشجار المدروسة بشكل عام، حيث تفوقت المعاملة بمستخلص الإنكوسيويد تركيز 6مل/ل على باقي المعاملات من حيث وزن الثمرة (173.2 غ)، ومحور الثمرة (6.93 سم)، وقطر الثمرة (6.23 سم) مقارنة مع الشاهد (5.72, 6.08, 158.7 سم) على التوالي، بينما تفوقت المعاملة بمستخلص ألجا600 تركيز 6غ/ل من حيث نسبة المواد الصلبة الذائبة الكلية (13.17%)، ومن حيث نسبة السكريات الكلية (12.7%)، ومن حيث نسبة الحموضة (0.25%)، ونسبة المادة الجافة في الثمار (25.43%)، ونسبة المادة الجافة في الأوراق (45.88%) مقارنة مع الشاهد (39.72,16.28, 0.45, 9.8, 10.37%) على التوالي، وتفوقت المعاملة بمستخلص العرق سوس تركيز 8مل/ل من حيث حجم الثمرة على باقي المعاملات (180.3 سم3)، وقطر الثمرة (6.33 سم) مقارنة مع الشاهد (168.8سم3، 5.72 سم) على التوالي.

Abstract Background Patients with schizophrenia are at least twice as likely to develop diabetes mellitus compared to the general population. This is of significance in Qatar given the high prevalence of obesity and diabetes. Furthermore, the lifespan of people with schizophrenia is shortened by approximately 15 years, partly due to long-term microvascular and macrovascular complications. High quality diabetes care can significantly reduce morbidity and mortality. We assessed the level of diabetes care delivered to patients in Qatar with schizophrenia and diabetes compared to those with diabetes alone. Methods We performed a retrospective chart review of patients with diabetes mellitus with (n = 73) and without (n = 73) schizophrenia. Demographic information and electronic medical records were reviewed to determine adherence to American Diabetes Association standards of diabetes care in the last 6 and 12 months. Optimal diabetes care was defined as having completed glycated hemoglobin (HbA1c), lipid profile and retinal examination within 12 months. Results Optimal diabetes care was significantly lower in patients with schizophrenia and diabetes compared to diabetes alone [26.0% (n = 19/73) vs 52.1% (n = 38/73), p = 0.002]. Patients with diabetes and schizophrenia were also significantly less likely to have had body mass index recorded within 6 months (p = 0.008) and HbA1c (p = 0.006), lipid profile (p = 0.015), estimated glomerular filtration rate (eGFR) (p = 0.001) and order for retinal examination (p = 0.004) over 12 months. After adjusting for multiple comparisons, only assessment of eGFR (p = 0.01) and order for retinal examination (p = 0.04) remained significant. Conclusion Patients in Qatar with schizophrenia and diabetes, receive sub-optimal diabetes care compared to those with diabetes alone.

Objectives: To determine if the origin of article published in Gynecologic Oncology (“Journal”) is correlated with quality of the article when measured per US institution and per country, using an index of citation (IOC) metric as a stand-in for article quality. Methods: PubMed was used to query the Journal from 2005 to 2020. Articles not deemed original research were excluded. A US-only cohort (“US-Only”) was evaluated separately from the entire cohort (“Whole”). The IOC for each article was calculated by dividing the number of citations listed in PubMed by the days from the publication date to 9/1/2021. The IOC per US institution was summarized by the median value. All articles were hand reviewed for correctness. The Whole cohort included all countries with 3 or more publications (including all of the US-Only cohort) and underwent similar analysis. Correlation coefficients were estimated using Pearson’s correlation after log-transformation. Results: In the US-only cohort, 2733 articles from 276 institutions within the US contributed original articles to the Journal. The association between the number of publications per institution and the median IOC was not well correlated (Pearson’s Correlation coeffeicient r = 0.16, p = 0.009). In the Whole cohort, 5,848 original research articles were published from 40 countries. There was no difference between median IOC for articles from US compared to non-US institutions was (0.0026 vs 0.0027, p = 0.287). The US median IOC was ranked 17/40. The US accounted for just over half (51.2%) of publications, and there was a trend of decreasing Non-US publications over time (p = 0.0004). Conclusions: The Journal was fairly consistent in the quality of articles published over the 15-year study period when using the IOC as a surrogate for quality, regardless of the article’s country or US institution of origin.

تهدف هذه الدراسة لتقييم فعالية استخدام مادة هرمون النمو somatropin الدوائية في حفظ أبعاد العظم السنخي بعد القلع السني بدأت تقنيات حفظ أبعاد العظم السنخي بعد قلع الأسنان تصبح جزءاً من الممارسة السريرية النمطية لأطباء جراحة الفم والفكين بهدف تقليل الامتصاص العظمي التالي للقلع السني لأقل درجة ممكنة والمتابعة اللاحقة بالتعويض بزرع الأسنان. تألفت عينة الدراسة من 10 مرضى لديهم استطباب قلع سني متناظر ثنائي الجانب حيث تم اتباع تقنية الفم المجزأ تم تطبيق المادة في سنخ السن بعد قلعه بواسطة الجلفوم وإجراء المتابعة الشعاعية باستخدام الـتصوير المقطعي المحوسب ذو الحزمة المخروطية لتقييم التغييرات في أبعاد العظم السنخي في منطقة القلع قبل وبعد ثلاثة أشهر من الإجراء الجراحي. أظهرت النتائج حفظ أفضل للأبعاد العظمية للحافة السنخية في منطقة تطبيق المادة لدى كل مريض مع أفضلية للكثافة العظمية .

Background The aim of this retrospective study is to investigate the cumulative live birth rate (CLBR) following one or more completed in vitro fertilization (IVF) cycles (up to 6 cycles) stratified by maternal age and type of infertility. Materials and Methods In this retrospective study, five hundred forty-seven women who received 736 fresh ovarian stimulation/embryo transfer cycles between January 2016 and December 2016 were included in the study at a tertiary care center located in Lebanon. Results In all women, the live birth rate for the first cycle was 33.0% [95% confidence interval (CI): 27.8-38.2]. The CLBR showed an increase with each successive fresh cycle to reach 56.9% (95% CI: 51.2-62.4) after 3 cycles and 67.9% (95% CI: of 62.5-73.0) after 6 cycles. The CLBR following 6 cycles reached 69.9% (95% CI: 63.8-75.6) in women younger than 35 years. In women older than 40 years, however, the live birth rate for the first cycle was signifi- cantly low at 3.1% (95% CI: 0.3-9.5) with a plateau in success rates after 4 cycles reaching 21.9% (95% CI: 9.2-40.0). Couples with different types of infertility had CLBRs ranging from 65% to 72%, with the exception of women with low ovarian reserve, where CLBRs reached 29.4% (95% CI: 10.3-56.0). Conclusion The CLBR at a referral center in a Middle Eastern country reached 67.9 % after 6 cycles, with variations by age and type of infertility treatment. These findings are encouraging for patients insisting to extend their treatment beyond 4 to 5 cycles.

Abstract Background Laparoscopic surgery has become a standard of care for many gynecological surgeries due to its lower morbidity, pain and cost compared to open techniques. Unfortunately, the use of carbon dioxide (CO2) to insufflate the abdomen is the main contributor to post-operative shoulder pain. Methods We aim to assess the effect of postoperative Trendelenburg position on shoulder pain after gynecological laparoscopic procedures. We hypothesize that maintaining the patient in Trendelenburg for 24 h postoperatively will significantly decrease postoperative shoulder pain and analgesic consumption. After obtaining written informed consent, 108 patients were prospectively randomized into two groups. In the control group, patients underwent standard gynecologic laparoscopic procedures; then after passive deflation of the pneumoperitoneum at the end of the surgery, the patients were placed in supine head up position in the post anesthesia care unit (PACU) and received our institution’s common postoperative care. Patients in the intervention group were subjected to the same maneuver but were positioned in a Trendelenburg position (20 °) once fully awake and cooperative in the PACU and retained this position for the first 24 h. Numerical rating scale (NRS) was used to assess shoulder pain and nausea upon patient arrival to the PACU, at 4, 6, 12 (primary outcome) and 24 h postoperatively. Time to first rescue pain medication, total rescue pain medications and overall satisfaction with pain control were recorded. 101 patients were included in the final data analysis. Results Both groups were comparable in terms of baseline characteristics. NRS pain scores were significantly lower in the intervention group at 12 h compared to the control group (0 [0–1] versus 5 [1–4], p

يسبب القلع الجراحي للأرحاء الثالثة السفلية المنطمرة ألماَ شديداَ وتوذم وازعاجاَ للمريض حيث يعد العلاج الشائع للألم هو استخدام مضادات الالتهاب غير الستيروئيدية. لكن تترافق هذه الأدوية بآثار جانبية غيرمرغوبة. يمكن ان يوفر العلاج الفيزيائي بالإبر الصينية تسكيناَ فعالا للألم بدون آثار جانبية. هدف البحث : تقييم فعالية الإبر الصينية في السيطرة على الألم التالي للقلع الجراحي للأرحاء الثالثة السفلية المنطمرة مواد وطرق البحث: بلغ عدد أفراد العينة 10 مرضى من مراجعي قسم جراحة الفم والفكين بكلية طب الأسنان جامعة تشرين لديهم أرحاء ثالثة سفلية منطمرة في كلا الجهتين وتم التقسيم الى مجموعتين. مجموعة التجربة حيث طبقت فيها المعالجة بالوخز لمدة 30 دقيقة قبل البدء بالقلع الجراحي للأرحاء الثالثة السفلية المنطمرة حيث تم اعتماد طريقة النرد حيث يمثل العدد الزوجي الرحى المراد تطبيق الإبر الصينية بعد قلعها بينما يمثل العدد الفردي الرحى في المجموعة الشاهدة. تم تقييم الألم باستخدام استبيان موحد يحتوي على معلومات حول المريض. طلب من المرضى تقييم شدة الألم على الفترات التالية : بعد 4 و 6 ساعات و12 ساعة وفي الأيام الثاني والثالث والرابع والخامس والسادس والسابع النتائج: كانت قيم شدة الألم عند مجموعة الوخز أقل وذات دلالة إحصائية في الفترات بعد 4 ساعات وفي اليوم الثاني حتى السادس الخلاصة: يمكن أن يخفف العلاج الفيزيائي بالوخز بالإبر الصينية الألم التالي للقلع الجراحي للأرحاء الثالثة السفلية المنطرة.

Objectives. The study aims to report on the feasibility and associated adverse events of HPV-Vaccination (HPVV) in a private clinic setting in Lebanon and, when available, the results of subsequent cervical cancer screening. Methods. Opportunistic HPV vaccination is offered at the Women’s Health Center of the AUBMC. We retrospectively reviewed the patients’ demographic data, the incidence of adverse events, and their cytological screening. Results. A cohort of healthy women (n = 1013) aged 26.2 years (12–54 years) were opportunistically vaccinated with one of two HPV vaccines; 845 (83.4%) received the quadrivalent vaccine (Q4V), and 151 (14.1%) received the bivalent vaccine (B2V). The majority (75.8%) received three doses while 16% received two doses. Out of these women, 26.3% (267) became sexually active postvaccination (NS2), whereas 17% (174) were sexually active prior to vaccination (SA) and the rest 57% (572) reported no sexual activity (NS1). Among the SA group, 26% (46/147) presented with abnormal cytology at time of vaccination. As for the NS2 women, 5% (14/267) had subsequently abnormal screening within 37 (12–103) months following vaccination. Conclusions. In this observational study, we report the successful introduction of HPVV with negligible adverse events. The incidence of abnormal cervical cytology was low among our patients.

Abstract Background Breastfeeding provides ideal infant nutrition, conferring several health benefits to children and their mothers. Women with inverted nipples, however, face difficulties that force them to prematurely terminate breastfeeding. Whereas available conservative measures for the correction of inverted nipples are of limited success, the use of an inverted syringe may be effective in achieving high rates of infant latching and exclusive breastfeeding. This technique, however, has not been investigated in a clinical trial. Methods/design This open-label randomized controlled trial aims to investigate whether, in women with inverted nipples, the use of an inverted syringe increases the rate of exclusive breastfeeding at one month compared to standard care. One-hundred healthy women with grade 1 or 2 inverted nipples will be recruited as of 37 weeks of gestation. They will be randomly allocated to standard care (control group) or to an intervention group. The intervention consists of using an inverted syringe to evert the nipple before every breastfeed, starting with the first feed after delivery. The primary outcome measure is the rate of exclusive breastfeeding at 1 month. Secondary outcome measures include exclusive breastfeeding rates at 3 and 6 months, nipple eversion rate, successful latching rate, rates of any breastfeeding at 1, 3, and 6 months, breastfeeding-associated complications, maternal satisfaction with breastfeeding, maternal quality of life, and adverse events. Descriptive and regression analysis will be conducted under the intention to treat basis. Discussion The use of the inverted syringe to evert inverted nipples is a simple, inexpensive, and safe technique that can be performed by mothers with inverted nipples. Findings of this trial, if positive, will provide much needed evidence for a safe, affordable, readily available, and simple intervention to treat inverted nipples, and improve breastfeeding practice among affected women. Trial registration ClinicalTrials.gov, NCT03529630. Registered May 8, 2018.

جاء انعقاد مؤتمر مدريد للسلام في ظل متغيرات دولية أهمها سقوط الاتحاد السوفيتي وتحول السياسة العالمية إلى سياسة أحادية القطب بقيادة الولايات المتحدة الأمريكية ، فضلاً عن المتغيرات التي شهدتها المنطقة العربية كحدوث الانتفاضة الفلسطينية 1987م ، والحرب العراقية _الكويتية 1990م وما خلفته من آثار سلبية على العلاقات العربية_العربية بشكل عام والعربية_ الفلسطينية بشكل خاص، والتي أدت إلى وقوع المنطقة العربية تحت السيطرة الأمريكية. تطرق البحث إلى الأسباب والظروف التي مهدت لانعقاد مؤتمر مدريد للسلام، ويوضح الأسس التي قام عليها المؤتمر، وموقف الأطراف المعنية من الدعوة لانعقاده ، كما يسلط الضوء على طبيعة المفاوضات التي جرت بين تلك الأطراف، بالإضافة إلى إظهاره الآثار المترتبة عنه على القضية الفلسطينية، وقد خلص البحث إلى نتيجة مفادها بأن انعقاد هذا المؤتمر كان لخدمة المصالح الإسرائيلية وتصفية القضية الفلسطينية.

Abstract Background The Lebanese public perceives the physician-patient relationship as flawed. The objectives of this study are to assess factors associated with the public’s trust in physicians in the context of the Lebanese healthcare system and to explore potential ways to enhance it. Methods We conducted a qualitative study based on a grounded theory methodology using semi-structured interviews with members of the Lebanese public (not restricted to patients). We selected participants through convenience and maximum variation sampling approaches. The constant comparative analysis resulted in a theoretical framework that describes the factors influencing trust in physicians. Results Participants trusted an experienced, up-to-date, graduate of a North American or Western European school, working in a reputable hospital, with a high level of diagnostic skills. The personal characteristics that improved trust were physicians who are ‘non-materialistic’, have a good rapport, and have sufficient encounter time with patients. Social factors that enhance trust in the physician include: being a family member, recommended by a family member, featured in mainstream media, and/or having a good reputation. Trust increased compliance, loyalty despite occasional mistakes committed, high consultation fees, and negative attitudes towards the physician’s institution. Conversely, no trust led to severed therapeutic relationship and seeking second opinions. Conclusion The level of trust of members of the Lebanese public in physicians was affected by the personal characteristics of physicians, their practice or clinical skills, their interactions with the patient, finances, in addition to a number of social factors. Moreover, the level of trust had major implications on patients’ interactions with their physicians.

A 43-year-old woman treated with radical hysterectomy 1 year ago for cervical cancer presented with a suprapubic abdominal mass. A 15 cm necrotic mass from the abdominal wall along with 2 small bowel loops and the dome of the bladder were resected. The peritoneal defect was reconstructed with a pedicled anterolateral thigh and Vastus Lateralis muscle composite flap. Pathology showed invasive non-keratinizing moderately differentiated squamous cell carcinoma, consistent with metastatic cervical cancer, involving urinary bladder, bowel and soft tissue. With advancement in reconstructive surgery, extensive resection with defect closure in properly selected cases of metastatic cervical cancer to the abdominal wall may be considered in an attempt at improving quality of life and overall survival. Keywords: Abdominal wall lesion, Cervical cancer, Metastasis of cervical cancer, Resection of lesion

Objective: to study and evaluate esthetic outcomes and cure in the management of Basel cell carcinoma of face skin by using continuous wave Laser CO2. Materials and methods: a total of 12 patients (8 males and 4 females) with mean age 62 years، and diagnosed with basel cell carcinoma on face skin, were treated by traditional scalpel and vaporization of the wound by using CO2 Laser in Tishreen university hospital. The postoperative cosmetic and cure outcomes were recorded after 1 year of surgery. Results: 12 Tumors had been treated: 2(17%) nodular، 7(85%) superfacial and 3(25%) pigmented. The tumors locations: 6 on zygomatic skin, 3 on temporal skin, 1 on forehead skin and 2 on upper lip. Tumors diameters are between 5.5 – 11 with average 7.7. After 1year, the cosmetic results was: 2 tumors ( 16%) bad, 7 tumors (58%) good, 3 tumors (25%) excellent. Tow tumors had been recurred. No statistically significant differences between CO2 laser surgery and cosmetic\recurrence outcomes in accord with Tumor diameter, but it is statistically significant differences in accord with Tumor type. Conclusion: CO2 Laser is effective method in management of Basel cell carcinoma of face skin, because of his good esthetic outcomes without needing of any flaps to close the wounds. هدف البحث: دراسة وتقييم الناحية الجمالية والشفاء اثناء تدبير الورم القاعدي الخلايا لجلد المنطقة الوجهية باستخدام الموجة المستمرة لليزر CO2 المواد والطرق: تتألف العينة من 12 مريض (8 ذكور و 4 اناث) متوسط العمر 62 سنة، تم تشخيص وجود ورم قاعدي الخلايا على جلد الوجه، العلاج باستئصال الورم بالمشرط بهامش أمان 2-3 مم و تبخير الجرح الناتج باستخدام الليزر CO2. تم متابعة الحالة لمدة سنة لمعرفة النتائج التجميلية الحاصلة بعد العلاج، و للتأكد من الشفاء الكامل. النتائج: عدد الأورام 12 ورم توزعت حسب نمط الورم بين 2 (17%) ورم عقدي ، 7 (58%) ورم سطحي، 3 (25%) ورم مصطبغ ، و قد توزعت الآفات كما يلي:6 على جلد الوجنة، 3 على جلد الصدغ ،1 على جلد الجبهة ،2على الشفة العلوية. تراوح حجم الاورام بين 5.5 – 11 مم بمتوسط 7.7 مم. بعد سنة من المراقبة توزعت النتائج من حيث الناحية الجمالية بين2 ورم( 16%) سيئة، 7 ورم (58%) جيدة، 3 أورام ( 25%) ممتازة. تعرض ورمين للنكس (16%) بعد سنة. اعتمادا على حجم الورم لم تشاهد فروق ذات أهمية من الناحية الاحصائية فيما يخص الناحية التجميلية و النكس ، بينما ظهرت الفروق الاحصائية اعتمادا على نوع الورم. الخلاصة: يعتبر الليزر CO2 أداة فعالة في تدبير الورم قاعدي الخلايا على جلد الوجه، لما له من نتائج تجميلية جيدة تعمل على تقليص الحاجة الى تسليخ النسج المجاورة من أجل الحصول على شرائح تغطي الجرح الحاصل.

نفذت الدراسة في قرية بلوطة التابعة لمدينة الحفة في محافظة اللاذقية في بستان تفاح صنف ستاركينغ ديليشس، مساحته الإجمالية / 5 / دونم خلال العام 2019 م, على أشجار بعمر 20 سنة, مزروعة بمسافات (5×5) م ومطعمة على الأصل البذري (Malus domestica Borkh). صممت التجربة بالطريقة العشوائية الكاملة؛ إذ تضمنت أربع معاملات وخمس مكررات للمعاملة وشجرة لكل مكرر: - 1 (T1): الشاهد: الرش بالماء فقط. -2 (T2): الرش بالبورون بتركيز 170 ppm. -3 (T3): الرش بمستخلص الطحالب سبرينتال بتركيز 0.5 سم3/ل (ppm 117 كربون عضوي, 52.5 ppm آزوت). -4 (T4): الرش بالبورون بتركيز 170 ppm والرش بمستخلص الطحالب سبرينتال بتركيز0.5 سم3/ل (ppm 117 كربون عضوي, 52.5 ppm آزوت). أظهرت الدراسة النتائج الآتية: • زادت معاملات الرش بالبورون بتركيز 170 ppm ومستخلص الطحالب بتركيز5 سم3/ل (117 ppm كربون عضوي, 52.5 ppm آزوت) بشكل مفرد أو متداخل من نسبة العقد, وقللت من تساقط الثمار في شهر حزيران, كما زادت الإنتاج, وزادت نسبة المواد الصلبة الذائبة الكلية والسكريات الكلية. • أعطت معاملة الرش بالبورون بتركيز 170 ppm ومستخلص الطحالب بتركيز5 سم3/ل (117 ppm كربون عضوي, 52.5 ppm آزوت) معاً أكبر وزن وحجم للثمار.

The aim of this study was to evaluate the efficacy of Mucabrasion and refreshment of mucousal opening of the fistula technique, based on the principle of skin dermabrasion, in the treatment of small oroantral and oronasal fistulas with a diameter ≤ 3 mm. The method is the refreshment of the edges of the fistula opening with a surgical spike loaded on the microtor grip, and repeating the refreshment process after a week until the fistula opening is closed. Cases where the fistula opening did not close after the third refreshment (after three weeks) were considered to have failed The research sample consisted of 19 cases of patients attending the Department of Oral and Maxillofacial Surgery at the Faculty of Dentistry at Tishreen University during the period 2012 - 2018. The sample was divided into two groups; Group 1: 12 patient with oroantral fistula, ranging in age from 22 to 70 years. Group 2: 7 patients with oronasal fistula (3 in the hard palate, 4 in the soft palate), ranging in age from 12 to 40 years. The results showed that the rate of complete closure of the fistula opening (healing) 75% of cases of oroantral fistula after the third refreshment , while the failure rate was 25%. In the cases of oronasal fistula (soft and hard palate), the rate of complete closure of the fistula opening (healing) was 71.43%, while the failure rate was 28.57%. CONCLUSION: This technique is simple, easy to apply, inexpensive and effective in the closure of oroantral and oronasal fistulas. هدفت هذه الدراسة إلى تقييم فعالية تقنية تسحيج وتنضير مخاطية الفتحة الناسورية – اعتماداً على مبدأ تسحيج الجلد- في معالجة النواسير الغارية الفموية والأنفية الفموية الصغيرة والتي يبلغ قطر الفتحة الناسورية فيها ≤ 3 ملم. تعتمد هذه الطريقة على تنضير حواف الفتحة الناسورية بواسطة سنبلة جراحية محملة على قبضة المكروتور، وتكرار عملية التنضير بعد أسبوع حتى انغلاق الفتحة الناسورية. اعتبرت الحالات التي لم يحدث فيها إنغلاق الفتحة بعد التنضير الثالث (بعد انقضاء ثلاثة أسابيع) حالات فاشلة. تألفت عينة البحث من 19 حالة من المرضى المراجعين لقسم جراحة الفم والفكين في كلية طب الأسنان في جامعة تشرين خلال الفترة 2012 – 2018. تم تقسيم العينة إلى مجموعتين؛ المجموعة الأولى: 12 مريض يعانون من وجود ناسور غاري فموي تراوحت اعمارهم من 22 حتى 70 سنة، والمجموعة الثانية: 7 مرضى ناسور أنفي فموي ( 3 في قبة الحنك الصلب، 4 في قبة الحنك الرخو) تراوحت اعمارهم من 12 حتى 40 سنة. أظهرت النتائج أن نسبة الإنغلاق الكامل للفتحة الناسورية (الشفاء) 75% من حالات الناسور الغاري الفموي بعد التنضير الثالث، بينما نسبة الفشل فكانت 25%. أما في حالات الناسور الأنفي الفموي (الحنك الرخو والصلب)؛ كانت نسبة الإنغلاق الكامل للفتحة الناسورية (الشفاء) 71,43% ، بينما كانت نسبة الفشل 28,57%. الخلاصة: هذه التقنية بسيطة، سهلة التطبيق،غير مكلفة وفعالة في إغلاق النواسير الغارية الفموية والأنفية الفموية.

We report here selective Tsuji-Trost type allylation of Ugi adducts using a strategy based on the enhanced nucleophilicity of amide dianions. Ugi adducts derived from aromatic aldehydes were easily allylated at their peptidyl position with allyl acetate in the presence of palladium catalysts. These substitutions were compared to more classical transition metal free allylations using allyl bromides.

Hydrophobic and amphiphilic derivatives of the biocompatible and biodegradable poly(dimethylmalic acid) (PdiMeMLA), varying by the nature of the lateral chains and the length of each block, respectively, have been synthesized by anionic ring-opening polymerization (aROP) of the corresponding monomers using an initiator/base system, which allowed for very good control over the (co)polymers’ characteristics (molar masses, dispersity, nature of end-chains). Hydrophobic and core-shell nanoparticles (NPs) were then prepared by nanoprecipitation of hydrophobic homopolymers and amphiphilic block copolymers, respectively. Negatively charged NPs, showing hydrodynamic diameters (Dh) between 50 and 130 nm and narrow size distributions (0.08 < PDI < 0.22) depending on the (co)polymers nature, were obtained and characterized by dynamic light scattering (DLS), zetametry, and transmission electron microscopy (TEM). Finally, the cytotoxicity and cellular uptake of the obtained NPs were evaluated in vitro using the hepatoma HepaRG cell line. Our results showed that both cytotoxicity and cellular uptake were influenced by the nature of the (co)polymer constituting the NPs.

The aim of this research is to study the optimal conditions for the preparation of hydroxyapatite , Chemical formula: Ca10(PO4)6(OH)2 (HA). In the three-component system: Ca(NO3)2-(NH4)2HPO4-NH3.H2O , Calcium Nitrate was prepared based on the calcification of the white eggshell . to obtain calcium oxide (CaO), which is treated with nitrogen acid, while ammonium phosphate Mono hydrogen and ammonium solution was taken from its pure packaging. Hydroxyapatite (HA) Ca10 (PO4) 6 (OH)2was prepared under specific conditions, mainly: concentration of solutions used, speed of addition of reagents, reaction mix temperature, rotational speed, purity of materials used, and pH of the solution. The study showed that the solid compound recorded in the three-component system, which was separated from the liquid phase and dried and chemically analyzed, has the total chemical formula Ca10 (PO4) 6 (OH)2 and has a Molar ratio of Ca / P= 1.666 . and the preparation process was better in the model burned from the dried model and confirmed by the study of samples of the models dried and burned by IR infrared spectroscopy and XRD X ray diffraction spectroscopy, The burner model was a crystalline product, but in the dried model the output was mixed crystalline and not crystalline.

The displacement of inferior alveolar nerve, is a surgical procedure aims to reposition the inferior alveolar nerve outside the mandibular canal in order to secure enough elevation of bone to place the dental implants. Nevertheless, carrying out the surgery by conventional techniques, and using reusable tools has many hazards due to the damage, that could happen to the nerve; which could potentially lead to paresthesia of the mental nerve and irreversible sensation loss of telo branches. And in some cases; this could cause a cut to the neurectomy, leading to a complete loss of sensation in the related region. The hazards of these techniques could be minimized by using the new techniques of mown Piezosurgery and under local anesthesia. The Piezosurgery has been used in a special clinical case in young female 22 age year who has been suffering of congenial loss bilateral of mandibular molars and second premolars. Using this technique resulted in redusing post-surgery complications. إزاحة العصب السنخي السفلي باستخدام تقنية الأمواج فوق الصوتية بالتزامن مع وضع الزرعات السنية لدى مريضة شابة تعاني من درد خَلقي ثنائي الجانب للضواحك الثانية والأرحاء السفلية (حالة سريرية) إزاحة العصب السنخي السفلي هو إجراء جراحي يهدف إلى إعادة تموضع العصب السنخي السفلي خارج القناة السنخية السفلية، بهدف تأمين ارتفاع عظمي كافي لوضع الزرعات السنية. غير أن هذه الجراحة بالطريقة التقليدية وباستخدام الأدوات الدوارة تحمل مخاطر كثيرة بسبب الاضرار التي يمكن أن تلحق بالعصب والتي تؤدي إلى اضطرابات حسية في العصب الذقني وفقدان الإحساس بالفروع الانتهائية وفي بعض الحالات قطع العصب مما يؤدي إلى فقدان كامل وغير ردود للحس في المنطقة الموافقة. يمكن تقليل مخاطر هذه التقنية إلى الحد الأدنى بفضل تقنية حديثة هي الجراحة بالأمواج فوق الصوتية (Piezosurgery) وإجراء الجراحة تحت التخدير الموضعي. تم استخدام تقنية الجراحة بالأمواج فوق الصوتية في إزاحة العصب السنخي السفلي في حالة سريرية خاصة لدى مريضة شابة بعمر 22 سنة، تعاني من فقد خَلقي للأرحاء والضواحك الثانية السفلية من كلا الجانبين. أدى استخدام هذه التقنية إلى التقليل من الاختلاطات التالية للجراحة.

Objective: This study aimed to determine the prevalence and predictors of undiagnosed and uncontrolled hypertension (HTN) in a local community in Lebanon. Design and methods: In this cross-sectional study, we interviewed 911 adults in the local community of Byblos, Lebanon, and 691 were enrolled in the study. Blood pressure (BP), height, and weight were measured. The diagnosis of HTN was based on the 2013 European Society of Hypertension (ESH)/ European Society of Cardiology (ESC) guidelines (systolic BP ⩾140 mm Hg and/or diastolic BP ⩾90 mm Hg). The data collected were analyzed using “Statistical Package for the Social Sciences” software (SPSS). Results: A total of 260 participants were found to be hypertensive, either previously diagnosed or undiagnosed, yielding an overall prevalence of HTN of 37.62%. Of these participants, 149 (57.31%) were previously diagnosed and had controlled BP, and 111 (42.69%) had undiagnosed or uncontrolled HTN. Of these 111 participants, 44 had undiagnosed HTN and 67 were previously documented as hypertensive but had uncontrolled BP. Younger age and the absence of associated cardiovascular comorbidities were found to be associated with undiagnosed HTN, whereas high body mass index, smoking, and nonadherence to therapy were found to be associated with uncontrolled HTN. Conclusion and implications: This study revealed a relatively high prevalence of HTN in the studied population, along with a high prevalence of undiagnosed and uncontrolled HTN. These findings emphasize the need for wider and more efficient screening strategies to better diagnose and control HTN in the general population.

A simple, fast and sensitive spectrophotometric method has been applied for the determination of tetracycline hydrochloride in its pure form and in pharmaceutical preparations. The method based on coupling reaction of the antibiotic with diazotized anthranilic acid to form a stable yellow azo dye which shows a maximum absorption at 419 nm. Uni- and multivariate approaches were followed in optimizing the experimental conditions. Under optimum experimental conditions obtained via multivariate (Central Composite Design), the linearity of the constructed calibration curve was in the range of 0.560 μg.mL-1 with molar absorptivity of 14619 L.mol-1.cm-1 and the value of detection limit was 0.2813μg.mL-1. The capability of the method for the analysis of real tetracycline samples was evaluated. The results show that the method could successfully be applied with no significant interference from the common excipients.

Throughout the past few decades, Dubai City has witnessed massive growth in its urban area and infrastructure facilities. The discovery of oil and gas in the Emirate significantly played a role for such a rapid growth. Given this fact and the short time-period for such an expansion, it is crucial to develop an understanding of the patterns of the development in the City, where policy-makers, researchers, and concerned authorities would gain better vision and strategy for the future. Recent advances in satellite imagery in terms of improved spatial and temporal resolutions are allowing for efficient identification of change patterns and the prediction of areas of growth. This study aims to quantify and analyse the spatial–temporal urbanization that took place in Dubai City throughout the past decades (specifically from early 1970’s until 2015). Multi temporal satellite images with various geometric and radiometric resolutions will be utilized for this purpose. The suggested methodology consists of a sequence of image processing techniques that include supervised and unsupervised classification. Subsequently, the classified images were utilized to quantify the urbanization of the City. The results show that since 1970, the urbanization and population have been dramatically increased by 5 and 12 times respectively. The resulting trend can be potentially used to evaluate the consequences of massive urban development, such as City infrastructure, water, environmental and the social impact.

Background: It is still difficult to give a final diagnosis in chronic myeloproliferative disorders (CMPDs) because of the overlap of the common pathological and clinical features of these disorders like bone marrow fibrosis which is considered important because it affects the normal function of the bone marrow. The collagen fibers are of different types, but in the bone marrow, the two main types are: collagen I, which is the most abundant type and collagen III (reticular) which is often associated with type I. Objectives:To study bone marrow fibrosis (BMF) in samples of bone marrow biopsies (BMB) of chronic myeloid leukemia (CML) and other chronic myeloproliferative disorders using histochemical stains to establish the grade of fibrosis and enabling a correct differentiation between chronic myeloid leukemia, essential thrombocythemia (ET), polycythemia rubra vera (PRV), and idiopathic marrow fibrosis (IMF) as subtypes of myeloproliferative disorders. Patients and methods: This retrospective study included collection of previously preserved formalin fixed- paraffin embedded bone marrow trephine biopsies of patients with chronic myeloproliferative disorders from January 2003 through December 2008 .The relevant clinical data of patients were retrieved from the stored case sheets. Applied histochemical stains (Reticulin stain, Van Gieson stain, and trichrome stain) with Haematoxylin and Eosin (H&E) stain on sections from these specimens. These stains were used to detect the presence and the degree of pathological marrow fibrosis by the most recent grading system, the European Consensus 2005(EC2005) originally described by Thiele at 2003. Using Trichrome stain for collagen type I and reticulin stain for reticulin fibers (collagen type III) and by using a special marrow fibrosis grading system as a routine work with H&E is valuable in determining the degree of marrow fibrosis on bone marrow biopsy examination and simplifies the diagnosis. Results: Sixty eight percent of chronic myeloproliferative disorders patients had no marrow fibrosis when diagnosed by H&E, while only 30% of chronic myeloproliferative disorders patients had no marrow fibrosis when the diagnosis was made by special stains and marrow fibrosis grading system. There is rare marrow fibrosis in essential thrombocythemia, polycythemia rubra vera, but present in chronic myeloid leukemia and almost always in marrow fibrosis. Some patients really have myelofibrosis of different grades and the histological findings by using histochemical stains are crucial to distinguish between myeloproliferative diseases Conclusion: Patients with chronic myeloid leukemia and other chronic myeloproliferative disorders had marrow fibrosis of different grades, which is confirmed by using histochemical stains for different collagen fibers and special grading system for marrow fibrosis (EC2005) that has to be applied. It can be used routinely to avoid misdiagnosis of the primary disease or its conversion and transition to another chronic myeloproliferative disorders type, in which the clinical and laboratory features overlap, but the prognosis and therapeutic implications are significantly different.