Search

Background: The global increasing prevalence of obsessive-compulsive disorders and symptoms among various age groups and nationalities is considered a great clinical challenge. However, limited data are available on this topic in the Middle East and Gulf Council Countries. This study aimed to raise awareness of obsessive-compulsive symptoms among adults in Bahrain by determining its prevalence and risk factors among patients attending primary healthcare centers Materials and Methods: A cross-sectional study was conducted among adult patients attending primary healthcare centers in Bahrain. A self-administered online questionnaire using Google form, a free online survey-creating website, was distributed through WhatsApp messages. A snowball sampling technique was used. The questionnaire consisted of three parts: the socio-demographic data of participants, the Maudsley Obsessional-Compulsive Inventory, and the Yale-Brown Obsessive-Compulsive Scale. Descriptive and inferential analyses were conducted. Results: A total of 614 participants were included with a mean age of 30.04 ± 13.04 years. Most participants were females (82.5%) and single (n = 347, 56.5%). The estimated prevalence of obsessive-compulsive symptoms among the participants was 15%; most of them reported mild symptoms (85%). Significantly higher obsession and compulsion symptoms were found among non-Bahraini (P < 0.001 and P < 0.002), single (P < 0.001 and P < 0.033), and student participants (P < 0.001 and P = 0.002) compared to their counterparts, respectively. In addition, undergraduates reported higher obsessions compared to other participants (P = 0.005). Conclusions: Approximately, one in every eight people in Bahrain were found to suffer from obsessive-compulsive symptoms, especially single, students, and non-Bahraini participants. These findings highlight the need for raising awareness of obsessive-compulsive disorder and its symptoms as well as the importance of early detection and management of obsessive-compulsive disorder.

Abstract Objectives Lifetime DSM‐5 diagnoses generated by the lay‐administered Composite International Diagnostic Interview for DSM‐5 (CIDI) in the World Mental Health Qatar (WMHQ) study were compared to diagnoses based on blinded clinician‐administered reappraisal interviews. Methods Telephone follow‐up interviews used the non‐patient edition of the Structured Clinician Interview for DSM‐5 (SCID) oversampling respondents who screened positive for five diagnoses in the CIDI: major depressive episode, mania/hypomania, panic disorder, generalized anxiety disorder, and obsessive‐compulsive disorder. Concordance was also examined for a diagnoses of post‐traumatic stress disorder based on a short‐form versus full version of the PTSD Checklist for DSM‐5 (PCL‐5). Results Initial CIDI prevalence estimates differed significantly from the SCID for most diagnoses ( χ 1 2 = 6.6–31.4, p = 0.010

Objectives: To determine the prevalence of primary dentition malocclusion and its linked risk indicators among a group of Saudi preschool children. Methods: A cross-sectional study was carried out on preschool children aged 3 to 5 years residing in Riyadh City, the capital of Saudi Arabia. The study sample included 709 Saudi children of both genders with complete primary dentition. Oral examination was conducted for children to assess the anteroposterior, transverse, and vertical dimensions, arch spacings, and oral habits. Results: The prevalence of malocclusion was 59.1% among the study participants. A deep overbite and increased overjet were found in 26.23 % and 25.11%, respectively. Arch space problems were reported, including missing primate spaces in 24.12%, missing developmental spacing in 27.93%, and crowding in 14.1%. An association between mothers aged 25 years and younger at childbirth was linked with their child's malocclusion in the primary dentition (p-value of 0.03). Conclusion: The prevalence of primary dentition malocclusion among a specific group of Saudi preschool children was significantly high. Increased overbite and overjet were the most prevalent occlusal discrepancies, followed by arch spacing problems. The younger mother's age at childbirth is significantly associated with her child's malocclusion. The study results can serve as a baseline for future investigations.

Background: Late in pregnancy or soon after delivery, peripartum cardiomyopathy (PPCM) which is an uncommon type of cardiomyopathy, can develop. To assess the association between the level of irisin expression and (FNDC5) (rs3480) gene polymorphism with peripartum cardiomyopathy. Methods: This is a case control study included a thirty female patients with new-onset PPCM and sixty healthy females at the at the peripartum period in same time window for PPCM as a control. For each patient, comprehensive medical history was taken, full clinical assessment was done, ECHO., FNDC5 (rs3480) & Irisin assay. Results: The left ventricle end diastolic dimensions &left atrium diameters were statistically significant higher in patients’ group than controls’ group (P=0.000 for all), Also left ventricular ejection fraction (%) was statistically significant lower in patients than controls and as regards irisin, its Mean ±SD was lower in patient group than control group (8.44±1.1 vs 10.65±2.31) with (p

Helicobacter pylori (H. pylori) infection is a significant global health concern, affecting approximately 50% of the world’s population and leading to gastric ulcers, gastritis, and gastric cancer. The increase in antibiotic resistance has compromised the efficacy of existing therapeutic regimens, necessitating novel approaches for effective eradication. This study aimed to develop a targeted liposomal drug delivery system incorporating furazolidone and N-acetylcysteine (NAC) to enhance mucopenetration and improve Helicobacter pylori eradication. Liposomes were formulated with furazolidone, NAC, and Pluronic F-127 using a modified reverse-phase evaporation technique. The formulations were categorized based on charge as neutral, negative, and positive and tested for mucopenetration using a modified silicon tube method with coumarin-6 as a fluorescent marker. The encapsulation efficiency and particle size were analyzed using HPLC and an Izon q-nano particle size analyzer. The results indicated that charged liposomes showed a higher encapsulation efficiency than neutral liposomes with Pluronic F-127. Notably, combining furazolidone with 1% NAC achieved complete eradication of H. pylori in 2.5 h, compared to six hours without NAC. The findings of this study suggest that incorporating NAC and Pluronic F-127 into liposomal formulations significantly enhances mucopenetration and antimicrobial efficacy.

Pharmaceutical contaminants are difficult to remove with standard treatment techniques and are one of the current problems in wastewater treatment. These bioactive substances are considered emerging pollutants due to their persistence and potential impact on aquatic ecosystems. Even in small amounts, they will continue to function. Efficient wastewater treatment methods are needed to address this issue. As a result, efforts to develop more efficient wastewater treatment methods have recently intensified. Fluidized bed reactors offer a special opportunity for efficient treatment of wastewater containing recalcitrant pollutants. This article discusses FBBR and covers its advantages, disadvantages, modifications, and applications. Additionally, the FBBR design is briefly discussed.

A mRNA vaccine is a type of vaccine that induces an immune response. Antigen-encoding mRNA is delivered via vaccine carriers into the immune cells, which are produced because of antigen-encoding mRNA translation, a protein. For example, COVID-19 mRNA vaccines produce the spike protein of the COVID-19 virus, whereas for influenza virus, mRNA vaccines target the haemagglutinin protein to treat the flu, and it requires modifications depending on the pandemic or seasonal viruses as it is capable of adapting the immune response, which makes the development of vaccines arduous. The protein molecule promotes an adaptive immune response that eliminates and terminates the corresponding virus or pathogen. There are many challenges to delivering an mRNA vaccine into the body; hence, the encapsulation of the mRNA (usually within lipid nanoparticles) is necessary to protect the mRNA from the body’s surrounding environment. In this review article, we focus mainly on the production, formulation, and stabilization of mRNA vaccines in general, elaborating more on and focusing more on SARS-CoV-2, or COVID-19, and influenza viruses, which have become a major concern as these viruses have turned into life-threatening diseases.

Abstract Chyluria is an uncommon medical condition resulting from an abnormal communication between the abdominal lymphatic system and the urinary tract, which results in the presence of chyle in the urine, making it appear milky white. Proper diagnosis is demonstrated by the concentration of urinary lipids. Worldwide, chyluria is most commonly associated with the parasite Wuchereria bancrofti. However, in Europe and North America, where the condition is rare, non-parasitic etiologies predominate. Identifying the cause and location of the uro-lymphatic communication is essential in guiding therapeutic management, but imaging the lymphatic channels remains a challenge. Magnetic resonance (MR) lymphography, a non-invasive free-breathing 3D high-resolution fast-recovery fast spin-echo sequence similar to that used for 3D MR cholangiopancreatography, may demonstrate the cause and location of an abnormal communication between the lymphatic system and urinary tract. In parasitic causes of chyluria, dilated lymphatics vessels communicating with the lymphatic system are demonstrated. In non-parasitic causes of chyluria channel type lymphatic malformations are the most common. Markedly dilated and dysplastic lymphatic vessels communicating with the urinary tract are demonstrated. In addition, other cystic or channel type lymphatic malformations such as thoracic, soft tissue or bone abnormalities may be observed. This review describes the abdominal lymphatic diseases leading to chyluria and presents the technique and images obtained with non-enhanced MR lymphography to enable radiologists in identifying and classifying uro-lymphatic fistulae. Critical relevance statement: Non-enhanced MR lymphography enables the identification and categorization of uro-lymphatic fistulae. Graphical abstract

Three-dimensional printing is getting a great deal of interest in recent years because of what it can offer to personalize medication in general and personalize polypill specifically. Fused deposition modelling (FDM) is one of the most studied technologies in 3dp because of its low cost and simplicity. However, this technique has some limitations among which is the high printing temperature and low drug load. In this work, an analgesic polypill with flexible design that can be tailored according to patient needs after printing, will be formulated. This polypill will contain paracetamol, ibuprofen and caffeine. Paracetamol formulation in addition to having taste masking property it will have high drug load and printed at relatively low temperature. While the ibuprofen formulation will be entric properties decreasing the gastric irritation it usually causes.

The aim of the study is to examine the effect of the molecular weight of Polyethylene glycol (PEG) on the properties of nanoparticles. PEGlyation of nanoparticles is a promising approach to extend the circulation time and protect nanoparticles from opsonisation and macrophage. However, PEG molecular weight has a significant effect on key parameters of nanoparticles such as Size and encapsulation efficiency. In this study, PLGA-PEG nanoparticles with Pimozide were prepared using a microfluidic technique using two different molecular weights of PEG. Physicochemical characterizations were undertaken including Encapsulation efficiency and Fourier transform infrared spectroscopy (FTIR). Results were compared for these two formulations to understand how the weight variation of PEG impacts on physicochemical properties of nanoparticles.

Three-dimensional printing is becoming more appealing to pharmaceutical research in recent years, especially after the approval of Spritam by the FDA. However, its role in personalized medication is still hindered by quality control barriers among other development barriers. In this work, a novel design is suggested to offer a middle ground to solve regulatory barriers. This design was printed into four units that can be attached through hinges like a jigsaw puzzle. This work will showcase the capability of this design to control the release of the model drug theophylline. Two formulations were prepared one immediate release using PVP 40K and one sustained release using Eudragit EPO. Using the principles of the surface response method, the experiment was designed where three variables -drug load, infill density, and number of immediate release units- were adjusted to study their effect on theophylline release in the dissolution test. Both the drug load and number of units had a significant effect on both the level and the shape of the drug release curve in 24 hours dissolution study.

Abstract Background It is crucial to differentiate between benign and malignant pleural effusions while making a diagnosis. The purpose of this research was to investigate the diagnostic significance of GSDMD and VEGF in discriminating between different kinds of pleural effusion and their correlation with both progression-free and overall survivals in the malignant type. Methods Ninety-one pleural fluid samples, which were classified as transudates or exudates (tuberculous, para-infectious, or malignant) by pleural fluid classifications, were tested for GSDMD using sandwich ELIZA kits, and 41 of the exudative samples were randomly selected for VEGF testing. Both markers' diagnostic accuracy was assessed. Results The lowest level of GSDMD was associated with the transudate group (mean and SD of 2.35 ± 0.44 ng/mL) and the highest in the malignant effusion group (mean and SD of 4.38 ± 1.67 ng/mL). The specificity and sensitivity of GSDMD in the diagnosis of exudative PE were 97% and 98%, respectively (p = 0.001) with the cutoff point = 2.89). Regarding VEGF, its level was 222.3 ± 53.4 pg/ml for all studied samples where MPE (n = 21) was 261.2 ± 48.2 pg/ ml (mean ± SD), TBPE (n = 7) was 185.4 ± 6.96 pg/ml (mean ± SD), and PIPE (n = 13) was 179.3 ± 13.9 pg/ml (mean ± SD). The diagnostic accuracy of VEGF for the detection of MPE was 90% with a sensitivity of 100% and specificity of 80% and the cutoff point was 191.5 pg/ml. There were highly significant inverse correlations between progression-free survival and both GSDMD (r =− 0.531, p = 0.009) and VEGF (r = − 0.582, p = 0.006) in MPE. Conclusion Pleural effusion GSDMD can be an effective marker for differentiating the different kinds of PE, and VEGF levels can be a useful adjuvant marker in screening out MPE as a possible diagnosis, leading to the proper selection of patients who may benefit from more invasive procedures.

Dentine adhesives have demonstrated great success with permanent teeth. Though the results in primary teeth are not well documented, some studies have demonstrated lower values of bond strength in primary teeth than those found in permanent teeth. The aim of this study was to compare and evaluate the effect of grape seed extract (6.5%) (Herbal Bio Solutions, Delhi, India), glutaraldehyde (5%) (Loba Chemie PVT. LTD., Mumbai), hesperidin (0.5%) (Herbal Bio Solutions, Delhi, India), and casein phosphopeptide-amorphous calcium phosphate (tooth mousse) (GC Corporation, Alsip, IL, USA) on the shear bond strength of dentine of primary teeth and to evaluate the resin tags at the resin tooth interface. Seventy-five caries-free human primary molars were collected, and their occlusal surfaces were ground flat. Dentin surfaces were etched using phosphoric acid. Then teeth were randomly assigned in sequential order to five groups according to the dentinal treatment method: Group I (Control group) (no treatment), Group II (5% glutaraldehyde), Group III (6.5% grape seed extract), Group IV (0.5% hesperidin), and Group V (CPP-ACP). Ten teeth from each group were assigned for Shear Bond Strength and five for SEM analysis. ANOVA and a post hoc least significant difference test (p < 0.05) were used for statistical analysis of the collected data. The grape seed extract group showed significantly increased shear bond strength than the control group (p < 0.05), and the mean length of resin tags in different dentine bio modifiers groups was also statistically significant (p < 0.05). The use of dentin bio modifiers such as 5% glutaraldehyde, 6.5% grape seed extract, 0.5% hesperidin, and CPP-ACP in the bonding process for primary teeth did not improve the dentinal bond strength.

Abstract Background The Composite International Diagnostic Interview (CIDI) has been clinically reappraised in several studies conducted mainly in the US and Europe. This report describes the methodology used to conduct one of the Middle East's largest clinical reappraisal studies. The study was carried out in conjunction with the World Mental Health Qatar—the first national psychiatric epidemiological study of common mental disorders in the country. This study aimed to evaluate the diagnostic consistency of core modules of the newly translated and adapted Arabic version of the CIDI 5.0 against the independent clinical diagnoses based on the Structured Clinical Interview for DSM‐5 (SCID‐5). Methods Telephone follow‐up interviews were administered by trained clinicians using the latest research edition of the SCID for DSM‐5. Telephone administered interviews were key in the data collection, as the study took place during the COVID‐19 pandemic. Results Overall, within 12 months, 485 interviews were completed. The response rate was 52%. Quality control monitoring documented excellent adherence of clinical interviews to the rating protocol. Conclusions The overall methods used in this study proved to be efficient and effective. For future research, instrument cultural adaptation within the cultural context is highly recommended.

Abstract Background Maintaining good oral hygiene is key to preventing dental caries and periodontal disease. Children and adolescents with good oral hygiene behaviours are likely to grow into adults with the same behaviours. This study assessed the frequency of using various oral hygiene methods among children and adolescents from different countries and individual, familial and country-level factors associated with the use of these methods. Methods A multi-country online survey collected data from caregivers of children in 2020–21 about children’s use of oral hygiene methods including toothbrush, fluoridated toothpaste, mouthwash, dental floss and miswak using self-administered, close-ended questions. Adjusted multilevel logistic regression models were used to assess the relationship between each of the five oral hygiene methods (dependent variables) and the independent factors: sex, age, and history of dental visits (individual factors), mother's education and area of residence (familial factors) as well as country income and region (country-level factors). Results A total of 4766 parents/caregivers were included from 20 countries (77.4% Eastern Mediterranean-region and 41.6% lower middle income countries). The most frequent oral hygiene methods were using toothbrush and toothpaste (90% and 60.3%). The use of oral hygiene methods differed by age, sex and history of dental visits as well as mother’s education and area of residence (P

Parkinson’s disease (PD) is a progressive neurodegenerative disease that is characterized by the loss of dopamine. Since dopamine has trouble entering the blood–brain barrier, the utilization of dendrimers and other nanomaterials is considered for conjugating the neurotransmitter and other PD drugs. Dendrimers are three-dimensional, hyper-branched structures that are categorized into several generations. Alpha-synuclein (ASN) is the protein involved in regulating dopaminergic functions and is the main aggregate found inside Lewy bodies. Different types of dendrimers have shown efficacy in disrupting the formation of unstable beta structures of ASN and fibrillation. The conjugation of PD drugs into nanomaterials has elicited a prolonged duration of action and sustained release of the drugs inside the BBB. The objectives of this study are to review the applications of a dendrimer-based drug delivery system in addressing the root cause of Parkinson’s disease and to emphasize the delivery of anti-Parkinson’s drugs such as rotigotine, pramipexole and dopamine using routes of administration other than oral and intravenous.

Background: Mobile phones have become part of everyday life with a potential risk for microbial transmission. Makkah is a mass gathering city that may act as hotspots of disease transmission. The contact between public and both visitors and pilgrims to Makkah can't be overlooked, and any small outbreak within the public can be transmitted rapidly to them. Aim: We aimed to assess knowledge, attitudes, and practices (KAP) of general population towards infection transmission via mobile phones in Makkah and different characteristics relevant to KAP scores. Methods: A cross-sectional web-based survey was conducted on general population in Makkah city using a snowballing sampling method. Participants answered questions about their KAP towards infection transmission via mobile phone. The overall KAP scores were graded as good, fair, and poor and explored against different population characteristics using suitable statistical methods. Results: The study included 385 participants aged 15–64 years. About 88.8% owned personal mobile phone, 3.9% encountering a patient with infections transmitted via mobile phones, and 60.5% know nothing about potential role of mobile phones in infection transmission. Only 16.6% had good knowledge, 64.1% with positive attitudes, and 55.3% reported poor practices. The mean knowledge score was significantly higher among young adults (p = 0.002) and those with higher education (p = 0.005). Their mean attitude and practice scores were significantly higher among older adults (p

Pallister–Hall syndrome (PHS) is a rare, autosomal dominant genetic disorder. The phenotypic features of the syndrome include hypothalamic hamartoma, polydactyly, craniofacial anomalies, and other malformations. This case report describes a 5-year-old girl with Central precocious puberty (CPP) due to the presence of suprasellar hypothalamic hamartoma. With a history of polydactyl, suspicion of PHS was made, and the genetic test showed a novel GLI3 gene mutation. CPP is treated with gonadotropin-releasing hormone agonist. In addition to CPP, an extensive endocrine evaluation revealed central hypothyroidism while other pituitary functions were intact. The variable clinical phenotype of PHS makes it challenging to diagnose early, especially in the sporadic form. However, suspicion of these cases and early diagnosis leads to a better outcome as many endocrine features may evolve during follow-up, which necessitates interventions.

Occupational health and safety (OHS) is an essential area concerned with the protection, health, and safety plus the welfare of individuals involved in any kind of occupation. This study aimed at assessing the occupational health and safety awareness and practices among the healthcare workers in the pediatric hospital in Benghazi city, Libya. The study adopted descriptive survey research in the Benghazi pediatric hospital. The study randomly selected 246 healthcare workers and the response rate was 96%. A questionnaire was used as the main data collection instrument. The data were coded and analyzed using descriptive statistics; frequencies and percentages and inferential analysis of correlation. Around 50% of the participants reported a lower level of awareness regarding occupational health and safety (OHS). The study proposes that the ministry of health should conduct specialist training in occupational health and safety for their staff, they also should confirm provisions of this policy and technical guidelines apply to all health institutions and administrative units within the health sector. Further hospital risk management should put in place a regular monitoring team who will certify that workers notice in firm terms safety measures put in place to avoid any accidents/injuries. Lastly, the study recommends that further research on the factors determining the implementation of occupational health and safety awareness and practices at public health care facilities in Libya.

Abstract Background Symplastic hemangioma is a benign superficial abnormal buildup of blood vessels, with morphological features which can mimic a pseudo malignancy. A few cases have been reported in the literature. We report here, a unique case of calvarial symplastic hemangioma, which is the first case in the calvarial region. Case presentation A 29-year-old male patient, with a left occipital calvarial mass since childhood, that gradually increased in size with age, was associated with recurrent epileptic fits controlled by Levetiracetam (Keppra), with no history of trauma. He presented to the emergency room with a recent headache, vomiting, frequent epileptic fits and a decrease in the level of consciousness 1 day prior to admission. A CT scan showed three diploic, expansile, variable sized lytic lesions with a sunburst appearance; two that were biparietal, and one that was left occipital, which were all suggestive of calvarial hemangiomas. However, the large intracranial soft tissue content, within the hemorrhage of the occipital lesion was concerning. The patient had refused surgery over the years; however, after the last severe presentation, he finally agreed to treatment. The two adjacent, left parietal and occipital lesions were treated satisfactorily using preoperative embolization, surgical resection, and cranioplasty. Histopathology revealed cavernous hemangiomas, in addition to symplastic hemangioma (pseudo malignancy features) on top at the occipital lesion. The right parietal lesion was not within the surgical field; therefore, it was left untouched for follow-up. Conclusions Histopathology and radiology examinations confirmed the diagnosis as symplastic hemangioma, on top of a pre-existing cavernous hemangioma. To the best of our knowledge, this is the first case of a calvarial symplastic hemangioma, which we report here.

Beta-ketothiolase (BKT) deficiency is a disorder of ketone body metabolism and isoleucine catabolism. Patients with BKT deficiency have intermittent ketoacidosis attacks. In this report, we describe an unusual case that mimicked type 1 diabetes presentation. The patient is a 1-year-old boy who presented with clinical and biochemical evidence of diabetes ketoacidosis (DKA). After the resolution of DKA, he was commenced on subcutaneous insulin regimen. Insulin requirements decline over few weeks to 0.3 U/kg/day, and due to normalization of blood glucose coupled with frequent hypoglycemic episodes, insulin was stopped for few months. Later, he developed two additional DKA episodes with intermittent period of no insulin requirement. At 2 years of age, he presented with ketoacidosis and hypoglycemia. The unusual presentation of ketoacidosis accompanied with hypoglycemia prompted genetic testing. Genetic testing revealed a novel homozygous mutation in the ACAT1 gene. The patient was advised to avoid prolonged fasting and started on a low-protein diet. Since then, he had developed mild episodes of ketosis with illness required intravenous hydration. In conclusion, the pediatrician should maintain a high index of clinical suspicion when dealing with children presenting with unusual diabetic ketoacidosis. Delayed diagnosis of BKT, failure of management of acute crisis, and the unnecessary use of insulin can lead to high morbidity and mortality.

The aim of this paper, the synthesis of new series of substituted 1,3,4-thaidiazole and 1,2,4-triazol from reaction of the carboxylic acid (2-naphthoic acid,4-methyl benzoic acid) with absolute ethanol in the presence of concentrated sulfuric acid to give esters. the above synthesis ester were converted to acid hydrazide by their reaction with hydrazine hydrate in ethanol, which then reacted with ammonium thiocyanate and hydrochloric acid in ethanol or with phenylisothiocyanate in absolute ethanol to give substituted thiosemicarbazides compounds. the substituted thiosemicarbazides then uses to synthesis of many hyterocyclic compounds like substituted 1,3,4-thiadiazole and 1,2,4-triazole by its reaction with concentrated sulfuric acid and sodium hydroxide respectively. the substituted thiosemicarbazides then cyclization to substituted 3,4-diamine-1,2,4-triazole when treated with hydrazine hydrate. And finally the N- acetyl-N-substituted hydrazide compounds synthesis by treated hydrazide with acetyl chloride in anhydrous tetrahydrofuran which then cyclized to 2-methyl substituted-1,2,4-thiadiazole by their reaction with diphosphorus pentoxide in xylene. The structure of the synthesized compounds were confirmed By physcical & spectroscopic techniques infrared (IR) and (1H-NMR) data.

Device-to-Device communication (D2D) is a promising technique for improving fifth-generation cellular network (5G) spectrum and energy efficiency. However, limited user power and co-channel interference make designing an energy efficient D2D communication a difficult task. In this paper, a novel framework is proposed to optimize the energy efficiency of D2D communication coexisting with a heterogeneous network (HetNet) in downlink transmission. This optimization problem is mathematically formulated in terms of mode selection, power control, and resources allocation (i.e., NP-hard problem). The optimization fraction problem is simplified based on network load and is solved using different optimization methods. An innovative dynamic mode selection based on Fuzzy clustering is introduced. Proposed scheme performance is evaluated and compared to the standard algorithm. Simulation demonstrated the advantage of the proposed framework in terms of gain performance in both energy efficiency and number of successfully connected D2D users. Moreover, D2D communication improves energy efficiency of the heterogeneous network of Downlink transmission.

Atherosclerosis is a chronic, lipid-driven disease of medium sized arteries which causes myocardial infarction and stroke. Recently, an adaptive immune response against the plaque-associated autoantigen Apolipoprotein B100 (ApoB), the structural protein component of low-density lipoprotein, has been implicated in atherogenesis. In healthy individuals, CD4+ T cells responding to ApoB mainly comprised regulatory T cells, which confer immune tolerance and atheroprotection. Mice and patients with atherosclerosis harbor increased numbers of proatherogenic ApoB-reactive T-helper cell subsets. Given the lack of therapies targeting proatherogenic immunity, clarification of the underlying mechanisms is of high clinical relevance. T cells develop in the thymus, where strong autoreactive T cells are eliminated in the process of negative selection. Herein, we investigated whether the transcription factor autoimmune regulator (AIRE), which controls expression of numerous tissue-restricted self-antigens in the thymus, is involved in mediating tolerance to ApoB and whether Aire deficiency might contribute to atherogenesis. Mice deficient for Aire were crossbred to apolipoprotein E-deficient mice to obtain atherosclerosis-prone Aire−/−Apoe−/− mice, which were fed a regular chow diet (CD) or western-type diet (WD). CD4+ T cells responding to the ApoB peptide p6 were analyzed by flow cytometry. We demonstrate that Aire deficiency influences neither generation nor activation of ApoB-reactive T cells and has only minor and overall inconsistent impacts on their phenotype. Furthermore, we show that atherosclerotic plaque size is not affected in Aire−/−Apoe−/− compared to Aire+/+Apoe−/−, irrespective of diet and gender. In conclusion, our data suggests that AIRE is not involved in regulating thymic expression of ApoB or atherosclerosis. Alternative mechanisms how ApoB-reactive CD4 T cells are selected in the thymus will have to be investigated.

Liposome-based drug delivery systems are nanosized spherical lipid bilayer carriers that can encapsulate a broad range of small drug molecules (hydrophilic and hydrophobic drugs) and large drug molecules (peptides, proteins, and nucleic acids). They have unique characteristics, such as a self-assembling bilayer vesicular structure. There are several FDA-approved liposomal-based medicines for treatment of cancer, bacterial, and viral infections. Most of the FDA-approved liposomal-based therapies are in the form of conventional “symmetric” liposomes and they are administered mainly by injection. Arikace® is the first and only FDA-approved liposomal-based inhalable therapy (amikacin liposome inhalation suspension) to treat only adults with difficult-to-treat Mycobacterium avium complex (MAC) lung disease as a combinational antibacterial treatment. To date, no “asymmetric liposomes” are yet to be approved, although asymmetric liposomes have many advantages due to the asymmetric distribution of lipids through the liposome’s membrane (which is similar to the biological membranes). There are many challenges for the formulation and stability of asymmetric liposomes. This review will focus on asymmetric liposomes in contrast to conventional liposomes as a potential clinical intervention drug delivery system as well as the formulation techniques available for symmetric and asymmetric liposomes. The review aims to renew the research in liposomal nanovesicle delivery systems with particular emphasis on asymmetric liposomes as future potential carriers for enhancing drug delivery including pulmonary nanotherapeutics.

Background: The Golden Proportion (GP) has been considered by many as the most harmonious recurrent tooth-to-tooth ratio and has long been proposed as an aesthetic guideline for restoring/replacing maxillary anterior teeth. Researchers investigated GP in various populations. Purpose: The aim of the current study was to investigate the occurrence and prevalence of the GP between the perceived widths of maxillary anterior teeth in a Saudi population with natural smiles. Materials and Methods: A total of 360 Saudi dental students (180 males and 180 females) with natural smiles and who met the inclusion criteria were included in the study. Frontal photographs were captured for all participants while maximally smiling using a digital camera with standardized settings. Photo-editing software was used to measure the perceived mesiodistal width of each anterior maxillary tooth in all digital images. Paired and student t-tests were performed to detect side and/or gender differences respectively. Calculated ratios of the perceived mesiodistal widths of the teeth were compared with their respective GP values using a one sample t-test. Statistical significance was set at 5%. Results: For both genders, there were significant differences (P

Background: Shivering is an undesirable, unpleasant experience after spinal anesthesia. Injecting cold bupivacaine has been incriminated as a contributory factor. Aims and Objective: In this prospective study we evaluated the efficacy of warming the heavy bupivacaine to body temperature for prevention of shivering and if it influences analgesic quality of spinal anesthesia. Materials and Methods: In this double blind, randomized controlled study, 100 patients aged 20-35 years of American Society of Anesthesiologist physical status I and II undergoing elective or emergency Caesarean sections were included and allocated to either Room temperature group (RT Group, n= 50), or Body temperature group (BT group, n = 50). A standard spinal anesthetic of 2ml of 0.5 % heavy bupivacaine plus 20 microgram of fentanyl was administered using 25G pencil point spinal needle in the sitting position. Besides the incidence and intensity of shivering and effect on intraoperative analgesia, effect on hemodynamics, nausea, vomiting, blood loss, pruritis and Apgar scores were recorded. Data was analyzed using SPSS (The Statistical Package for Social Sciences) version 22.0 software (International Business Machines Corporation, Armonk, New York, USA). P < 0.05 was considered significant. Results: The patients were comparable in terms of demographic variables. Shivering was present in 31 (62%) and 7 (14%) patients respectively in RT and BT Groups, which was statistically significant (P = 0.0001). Intensity of shivering ≥3 was observed in 15 (30%) patients of RT group and 5 (10%) patient in BT group. We did not note any difference in the analgesic status intraoperatively nor any difference in the duration of analgesia. Surprisingly, the incidence of pruritis was significantly reduced in the BT group as compared to RT group (P = 0.037). Conclusions: Warming the heavy bupivacaine to body temperature is effective in preventing shivering and reducing pruritis secondary to spinal anesthesia without affecting analgesia.

Vaccination is the most effective means of preventing infectious diseases and saving lives. Modern biotechnology largely enabled vaccine development. In the meantime, recent advances in pharmaceutical technology have resulted in the emergence of nanoparticles that are extensively investigated as promising miniaturized drug delivery systems. Scientists are particularly interested in liposomes as an important carrier for vaccine development. Wide acceptability of liposomes lies in their flexibility and versatility. Due to their unique vesicular structure with alternating aqueous and lipid compartments, liposomes can enclose both hydrophilic and lipophilic compounds, including antigens. Liposome composition can be tailored to obtain the desired immune response and adjuvant characteristics. During the current pandemic of COVID-19, many liposome-based vaccines have been developed with great success. This review covers a liposome-based vaccine designed particularly to combat viral infection of the lower respiratory tract (LRT), i.e., infection of the lung, specifically in the lower airways. Viruses such as influenza, respiratory syncytial virus (RSV), severe acute respiratory syndrome (SARS-CoV-1 and SARS-CoV-2) are common causes of LRT infections, hence this review mainly focuses on this category of viruses.

The main objective of this work was to formulate novel amphiphilic PLGA nanoparticles with improved physicochemical properties for the delivery of the novel peptide (CK-10) to be used for targeting of the cancerous/tumour tissue. This was achieved by blending of various amphiphilic polymers with PLGA, especially by using a novel microfluidic technique which can overcome several problems of the conventional techniques like the double emulsion technique e.g. low peptide loading efficiencies, large sizes, and high PDI. Loading efficiency was measured by modified Lowry assay; size and zeta potential were characterized by dynamic light scattering and tuneable pore resistive sensing techniques; images were scanned by scanning and transmission electron microscopes; stability and interaction were confirmed by HPLC-MS, FTIR, DSC and CZE. PLGA/Poloxamer nanoparticles exhibited higher peptide loading than the other types of PLGA nanoparticles [56.13 %m/m for the novel microfluidic technique]. PLGA/Poloxamer prepared by the microfluidics technique had the smallest size with the lowest PDI (208.90 nm, 0.11) which is a vital parameter for targeting. The successful development of better physicochemical properties for the CK-10 loaded PLGA nanoparticles can improve the RAN blocking by CK-10.

Ran is a small RAS-related GTPase and is overexpressed in breast carcinoma to induce malignant transformation and metastatic growth. A novel series of antiRan-GTPase peptide (CK-10), which inhibits Ran hydrolysis and activation, have suboptimal activity in vitro due to low bioavailability and poor delivery. To overcome these disadvantages, we delivered the CK-10 peptide by encapsulating it in PLGA-based nanoparticles (NP). The successful delivery of CK-10 can prevent Ran activation by blocking a regulator of chromosome condensation 1 (RCC1) following peptide release directly in the cytoplasm after endocytosis of the novel NP(s). A novel hydrodynamic flow technique is designed to avoid the drawbacks with a double emulsion solvent evaporation technique. Loading efficiency and in vitro release were measured by modified Lowry assay, size was characterized by dynamic light scattering, tuneable pore resistive sensing and laser obscuration time, zeta potential was measured by laser anemometry, morphology was scanned by electron microscopes and laser obscuration time. Water absorption and its associated changes in the physicochemical properties were measured by various color indicator and potentiometric titration techniques to understand the fundamental biodegradation process. PLGA/β-cyclodextrin nanoparticles showed the highest peptide loading (53.92%m/m) for the novel microfluidic technique with the highest cumulative release of 91.38%.

Cationic lipid-mediated gene transfer is one of the most commonly used non-viral vectors. It has been shown to be a safe and effective carrier. However, its use in gene delivery was hampered by its low transfection efficiency and stability. DOTAP, DOPE, cholesterol (CHO) and carboxymethyl-β-cyclodextrin (CD) were used to prepare cationic liposomes. Cationic liposomes were prepared using both, thin film hydration and a microfluidic method. Formulation stability was evaluated using liposome size, zeta potential and polydispersity index (PDI).Promega QuantiFluor® ONE dsDNA System was used to investigate the encapsulation efficiency. COS7 and SH-SY5Y cell lines were used to determine transfection efficiency. Results show that carboxymethyl-β-cyclodextrin increased encapsulation efficiency by 15.5% and 8% using NanoAssemblr® and rotary evaporator, respectively compared to liposomes without CD. The addition of carboxymethyl-β-cyclodextrin to cationic liposomes resulted in an increase in transfection efficiency in both cell lines. B

Cancer has always been a big concern for human health. There is always an increased need for fabrication of newer drugs or repurposing the existing drugs to treat cancer. Apart from being an antipsychotic agent, pimozide has already shown its anticancer activity against various cancers in several studies. The aim of the present study was to fabricate pimozide loaded PLGA nanoparticles and hence characterize them. Single emulsion and microfluidic techniques were used to prepare nanoparticles. Physicochemical properties such as particles size, shape, surface charge, and encapsulation efficiency were investigated. Results showed that the nanoparticles were in average size distribution of 200-300 nm, spherical in shape and negatively charged. Additionally, high encapsulation efficiency (50-89%) makes these nanoparticles potential drug delivery systems to target cancer cells.

Niosomes are colloidal vesicles that capable of encapsulating drugs as a carrier for drug delivery system. They are formed by self-assembly of a non-ionic surfactant with cholesterol and co-surfactant. In this work, cinnarizine-containing niosomes comprised of sorbitan monostearate (Span® 60), cholesterol and co-surfactant (Cremophor® ELP, Cremophor® RH40 or Solutol® HS15) were prepared using conventional thin film hydration and microfluidic methods. Effects on characteristics of niosomes with the presence of poorly water-soluble drug, cinnarizine in the niosomal formulations prepared using different methods and incorporation of different co-surfactants were studied and compared for their particle size, polydispersity index (PDI) and encapsulation efficiency. Dynamic light scattering was employed for particle size measurements and drug loading studies were analysed using high performance liquid chromatography (HPLC). The morphology of niosomes was characterized using optical light microscopy.

Antioxidants are known to minimize oxidative stress by interacting with free radicals produced as a result of cell aerobic reactions. Oxidative stress has long been linked to many diseases, especially tumours. Therefore, antioxidants play a crucial role in the prevention or management of free radical-related diseases. However, most of these antioxidants have anticancer effects only if taken in large doses. Others show inadequate bioavailability due to their instability in the blood or having a hydrophilic nature that limits their permeation through the cell membrane. Therefore, entrapping antioxidants in liposomes may overcome these drawbacks as liposomes have the capability to accommodate both hydrophilic and hydrophobic compounds with a considerable stability. Additionally, liposomes have the capability to accumulate at the cancer tissue passively, due to their small sizes, with enhanced drug delivery. Additionally, liposomes can be engineered with targeting moieties to increase the delivery of chemotherapeutic agents to specific tumour cells with decreased accumulation in healthy tissues. Therefore, combined use of liposomes and antioxidants, with or without chemotherapeutic agents, is an attractive strategy to combat varies tumours. This mini review focuses on the liposomal delivery of selected antioxidants, namely ascorbic acid (AA) and alpha-lipoic acid (ALA). The contribution of these nanocarriers in enhancing the antioxidant effect of AA and ALA and consequently their anticancer potentials will be demonstrated.

Objective The aim of this study was to compare the validity of MRI in the early detection of sacroiliitis with laboratory findings of human leukocyte antigen-B27 (HLA-B27), conventional radiography, and clinical assessment. Participants and methods Sixty patients with spondyloarthropathy (group II) with duration of illness less than 2 years and 20 healthy controls (group I) were included in this study. Both groups were subjected to assessment of history, clinical examination, and laboratory investigations (erythrocyte sedimentation rate, C-reactive protein titer, rheumatoid factor, HLA-B27). Conventional radiography and MRI of the sacroiliac joints were performed. Spondyloarthropathic patients were divided according to MRI as follows: group IIA, which included patients with sacroiliitis, and group IIB, which included patients without sacroiliitis. Results In our study, ankylosing spondylitis was diagnosed in 22 (36.6%) patients, followed by undifferentiated spondyloarthropathy in 12 (20%) patients, reactive arthritis in 10 (16.7%) patients, psoriatic arthropathy in 10 (16.7%) patients, and enteropathic arthropathy in six (10%) patients. Evidence of sacroiliitis was found in 66.6% (40/60) of patients by MRI, which was higher than the result obtained by plain radiography 20% (12/60). HLA-B27 positivity found in 53.3% (32/60) of patients. There was a significant difference between the two groups in HLA-B27 and radiological sacroiliitis; there was no sacroiliitis in the control group. MRI showed sacroiliitis even in patients with no inflammatory back pain. There was a highly statistically significant difference between patient subgroups in disease duration (P = 0.001) and primary complaints and clinical sacroiliitis (P = 0.001). Conclusion MRI is the preferred modality in the detection of early sacroiliitis in spondyloarthropathy and HLA-B27 positivity is a highly useful predictor of early sacroiliitis

BACKGROUND:The Na-H exchanger [NHE] performs an electroneutral uptake of NaCl and water from the lumen of the gastrointestinal tract. There are several distinct NHE isoforms, some of which show an altered expression in the inflammatory bowel diseases (IBD). In this study, we examined a role of NHE-2 in experimental colitis. METHODS:Colitis was induced in male Sprague-Dawley rats by intra-rectal administration of trinitrobenzenesulphonic acid (TNBS). On day 6 post-TNBS, the animals were sacrificed, colonic and ileal segments were taken out, cleaned with phosphate buffered saline and used in this study. RESULTS:There was a significant decrease in the level of NHE-2 protein as measured by ECL western blot analysis and confocal immunofluorescence microscopy. The levels of NHE-2 mRNA and heteronuclear RNA measured by an end-point RT-PCR and a real time PCR were also decreased significantly in the inflamed colon. However, there was no change in the level of NHE-2 protein in response to in vitro TNF-α treatment of uninflamed rat colonic segment. These changes were selective and localized to the colon as actin, an internal control, remained unchanged. Confocal immunofluorescence microscopy revealed co-localization of NHE-2 and NHE-3 in the brush borders of colonic epithelial cells. Inflamed colon showed a significant increase in myeloperoxidase activity and colon hypertrophy. In addition, there was a significant decrease in body weight and goblet cells' mucin staining in the TNBS treated colon. These changes were not conspicuous in the non-inflamed ileum. CONCLUSIONS:These findings demonstrate suppression of NHE-2 expression on the brush borders in the colonic epithelial cells which is regulated transcriptionally. However a role of TNF-α in the regulation of NHE-2 is discounted in the present model of colitis. This decrease in the NHE-2 expression will lead to a loss of electrolyte and water uptake thus contributing to the symptoms associated with IBD.

This work aimed to investigate and optimise the effects of co-surfactants, hydration volume, and time on the entrapment of methylene blue (MB) within niosomes and the vesicle sizes of MB-loaded niosomes upon different storage temperatures. Niosomes were prepared by the thin film hydration method followed by gel permeation chromatography to obtain purified niosome suspensions. The probe sonication method was used to reduce the niosome vesicle size and distribution. Highest entrapment efficiencies (%EE) were determined for niosomal formulations containing Span® 60, cholesterol, and Cremophor® ELP (E2 and E3), which were prepared with a hydration volume of 5 mL. The hydration time was 15 min for E2 and 60 min for E3 (%EE = 40.1 ± 7.9% and 32.9 ± 10.1% for E3 and E2, respectively). The final lipid contents in the formulations were shown to have an impact on %EE.

Rational goals for denture construction are basically directed at the restoration of esthetics and masticatory function and the healthy preservation of the remaining natural tissues. Little concern has been given to the perfection and optimization of the phonetic quality of denture users. However, insertion of prosthodontic restorations may lead to speech defects. Most such defects are mild but, nevertheless, can be a source of concern to the patient. For the dental practitioner, there are few guidelines for designing a prosthetic restoration with maximum phonetic success. One of these guidelines involves the setting up of teeth within the neutral zone. The aim of this study was to evaluate, subjectively and objectively, the effect on speech of setting up teeth in the neutral zone. Three groups were examined: group I (control) included 10 completely dentulous subjects, group II included 10 completely edentulous patients with conventional dentures, and group III included the same 10 edentulous patients with neutral zone dentures. Subjective assessment included patient satisfaction. Objective assessment included duration taken for recitation of Al-Fateha and acoustic analysis. Subjectively, patients were more satisfied with their neutral zone dentures. Objectively, speech produced with the neutral zone dentures was closer to normal than speech with conventional dentures. Keywords: Neutral zone, Speech, Complete dentures, Patient satisfaction, Consonants, Vowels

Novel niosomal formulations containing cinnarizine were developed to enhance its drug characteristics. In this work, niosomes (non-ionic surfactant vesicles) were prepared by conventional thin-film hydration (TFH) and microfluidic (MF) methods with sorbitan monostearate (Span® 60), cholesterol, and co-surfactants (Cremophor® ELP, Cremophor® RH40 and Solutol® HS15) as key excipients. The aim was to study the effect of cinnarizine on the characteristics of different niosomal formulations manufactured by using different methods. For effective targeted oral drug delivery, the efficacy of niosomes for therapeutic applications is correlated to their physiochemical properties. Niosome vesicles prepared were characterised using dynamic light scattering technique and the morphology of niosomes dispersion was characterised using optical microscopy. Dialysis was carried out to purify niosome suspensions to determine drug loading and drug release studies was performed to study the potential use of niosomal systems for cinnarizine.

Cancer is a life-threatening disease contributing to ~3.4 million deaths worldwide. There are various causes of cancer, such as smoking, being overweight or obese, intake of processed meat, radiation, family history, stress, environmental factors, and chance. The first-line treatment of cancer is the surgical removal of solid tumours, radiation therapy, and chemotherapy. The systemic administration of the free drug is considered to be the main clinical failure of chemotherapy in cancer treatment, as limited drug concentration reaches the tumour site. Most of the active pharmaceutical ingredients (APIs) used in chemotherapy are highly cytotoxic to both cancer and normal cells. Accordingly, targeting the tumour vasculatures is essential for tumour treatment. In this context, encapsulation of anti-cancer drugs within the liposomal system offers secure platforms for the targeted delivery of anti-cancer drugs for the treatment of cancer. This, in turn, can be helpful for reducing the cytotoxic side effects of anti-cancer drugs on normal cells. This short-review focuses on the use of liposomes in anti-cancer drug delivery.

Purpose: Hydrophobic drugs are facing a major challenge in dissolution rate enhancement and solubility in aqueous solutions; therefore, a variety of methods have been used to improve dissolution rate and/or solubility of bendroflumethiazide as a model hydrophobic drug. Methods: In this study, two main methods (physical mixing and lyophilisation) were used with gluconolactone, hydroxyl propyl γ-ccyclodextrin, and trehalose to explore this challenge. Bendroflumethiazide, practically insoluble in water, was mixed with one of the three excipients gluconolactone, hydroxyl propyl γ-cyclodextrin, and trehalose in three different ratios 1:1, 1:2, 1:5. To the best of our knowledge, the dissolution of the drug has not been previously enhanced by using either these methods or any of the used excipients. Samples containing drug and each of the excipients were characterized via dissolution testing, Fourier Transform infra-red spectroscopy, differential scanning calorimetry, and scanning electron microscopy. Results: The used methods showed a significant enhancement in dug dissolution rate; physical mixing significantly, p < 0.05, increased the percentage of the drug released with time; for example, bendroflumethiazide dissolution in distilled water was improved from less than 20% to 99.79% within 90 min for physically mixed drug-cyclodextrin 1:5. The lyophilisation process was enhanced and the drug dissolution rate and the highest drug dissolution was achieved for (drug-gluconolactone 1:1) with 98.98% drug release within 90 min. Conclusions: the physical mixing and freeze drying processes significantly increased the percentage of drug release with time.

ABSTRACT In this paper the synthesis of some 2-(3-pyridyl)-5-aryl-1,3,4-oxadiazoles from hydrazones is reported. Nicotinic acid was converted to ethyl nicotinate (1) by its reaction with thionyl chloride and the resultant acid chloride was treated with absolute ethanol, the ethyl nicotinates was treated with hydrazine hydrate in ethanol to give the corresponding acid hydrazide (2). The acid hydrazide was treated with benzaldehyde or substituted benzaldehyde to give the hydrazones (3-8). The hydrazones were cyclized to 2-(3-pyridyl)-5-aryl-1,3,4-oxadiazoles (4-14) by their reaction with lead oxide. The structure of the synthesised compounds were confirmed by physical and spectral methods.

Aim. To detect the frequency of subclinical atherosclerosis in rheumatoid arthritis patients without clinically evident atherosclerosis and to correlate its presence with the disease activity. Patients and Methods. Our study includes 112 RA patients (group 1) and 40 healthy controls (group 11). All patients and controls were subjected to full history taking, clinical examination, and laboratory investigations. Carotid intima media wall thickness (IMT) and carotid plaques were measured in both groups by B-mode ultrasonography; also color duplex Doppler ultrasound of the brachial artery was done to detect endothelial function. Results. There is atherosclerosis in 31.3% of asymptomatic RA patients compared with only 5% in controls P=0.003**. A significant difference was detected in patients with and without atherosclerosis regarding duration of the disease P=0.0001*** and patient’s age P=0.01*. There is highly statistical significant correlation between atherosclerosis and disease activity index. Conclusion. The frequency of subclinical atherosclerosis was high in long-term active RA patients.