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Hypolipidemic agents have been shown to be helpful in the primary and secondary prevention of cardiovascular disease. Statins are frequently administered to treat hyperlipidemia. Although there are many statins on the market today, atorvastatin is the one that is most frequently recommended. The medications must meet the required physical qualities and contain the right quantity of active medicinal components. The primary goal of the study was to assess the value of several brands of atorvastatin calcium tablets sold in Iraq.Methods: In this study, the in vitro dissolving test, disintegration, friability, and hardness tests of the innovator product coded as (AT-1) and the generic brands (coded as AT-2) of atorvastatin tablets 20 mg available in Iraq were assessed. Drug analysis was done using a spectrophotometric technique. At a 240 nm wavelength, atorvastatin was found. The researched products released more than 90% of the atorvastatin in 30 minutes, per the findings of the dissolving testing. In under 30 minutes, the brands AT-1 and AT-2 showed a release of atorvastatin of over 95% and 86%, respectively. Our research revealed that the generic brand AT-2 and the innovator atorvastatin (AT-1) were of high pharmaceutical grade. In vitro dissolution, friability, disintegration, and hardness tests required by the pharmacopoeia were all passed by generic and innovator of atorvastatin tablets sold in the Iraqi market. Therefore, it was concluded that these generics might be utilized interchangeably by focusing on their in vitro release characteristics.

Data availability: Data will be made available on request. Copyright © 2023 The Authors. Polyvinyl chloride plastic (PVC) and glass waste have proven to be significant environmental concerns considering their restricted reuse and complicated recycling procedures. Glass and PVC waste materials form a substantial portion of total solid wastes that negatively influence the environment. This study aims to fully replace natural sand with recycled PVC and waste glass aggregates in alkali-activated materials (AAMs). A comprehensive testing programme was employed to investigate the effect of 100 % aggregate replacement on the composites’ mechanical performance, water absorption, impact resistance, thermal conductivity, resistance to harsh environments, and microstructural changes. Results revealed that AAMs containing recycled PVC and glass aggregates outperformed their ordinary Portland cement (OPC)-based composite counterparts in terms of mechanical properties, energy absorption, thermal conductivity, and carbon footprint estimation. Although mixtures containing recycled aggregates cannot be deemed for load-bearing applications, these composites exhibited a promising capacity to be used in insulating applications. AAMs containing 100 vol-% PVC aggregates with flexural and compressive strengths of 9 and 11 MPa, respectively, registered the highest energy absorption of about 6 J, three times higher than the AAM control sample, and the lowest thermal conductivity of about 0.5 W/mK, with about 80 % reduction of thermal conductivity compared to the AAM control sample. With the full replacement of PVC and glass aggregates, the most significant decrease in the carbon footprint is achieved for AAM (−352.25 kg CO2-eq) and OPC (−353.94 kg CO2-eq), respectively. DigiMat project, which has received funding from the European Union's Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement ID: 101029471.

Background Remote triage for suspected head and neck cancer (HNC) referrals was adopted by many institutions during the initial peak of the coronavirus disease 2019 pandemic. Its safety in this population has not been established. Methods A 16-week, prospective, multicenter national service evaluation was started on March 23, 2020. Suspected HNC referrals undergoing remote triage in UK secondary care centers were identified and followed up for a minimum of 6 months to record the cancer status. Triage was supported by risk stratification using a validated calculator. Results Data for 4568 cases were submitted by 41 centers serving a population of approximately 26 million. These represented 14.1% of the predicted maximum referrals for this population outside of pandemic times, and this gave the study a margin of error of 1.34% at 95% confidence. Completed 6-month follow-up data were available for 99.8% with an overall cancer rate of 5.6% (254 of 4557). The rates of triage were as follows: urgent imaging investigation, 25.4% (n = 1156); urgent face-to-face review, 27.8%; (n = 1268); assessment deferral, 30.3% (n = 1382); and discharge, 16.4% (n = 749). The corresponding missed cancers rates were 0.5% (5 of 1048), 0.3% (3 of 1149), 0.9% (12 of 1382), and 0.9% (7 of 747; P = .15). The negative predictive value for a nonurgent triage outcome and no cancer diagnosis was 99.1%. Overall harm was reported in 0.24% (11 of 4557) and was highest for deferred assessments (0.58%; 8 of 1382). Conclusions Remote triage, incorporating risk stratification, may facilitate targeted investigations for higher risk patients and prevent unnecessary hospital attendance for lower risk patients. The risk of harm is low and may be reduced further with appropriate safety netting of deferred appointments. Lay summary This large national study observed the widespread adoption of telephone assessment (supported by a risk calculator) of patients referred to hospital specialists with suspected head and neck cancer during the initial peak of the coronavirus disease 2019 pandemic. The authors identified 4568 patients from 41 UK centers (serving a population of more than 26 million people) who were followed up for a minimum of 6 months. Late cancers were identified, whether reviewed or investigated urgently (0.4%) or nonurgently (0.9%), but the overall rate of harm was low (0.2%), with the highest rate being seen with deferred appointments (0.6%).

Background: Hypertensive disorders of pregnancy are used as an umbrella term that includes chronic and gestational hypertension, preeclampsia and eclampsia, representing a major cause of maternal and perinatal morbidity and mortality, considered to be the most common medical problem encoun-tered during pregnancy, and so this study was done to find the prevalence and types and the proper methods of treatment of each type of hypertension in pregnant women admitted to Department of Obstetrics, Tanta University Hospital.Aim of Study: The aim of this study is to find the prevalence and types of hypertension in pregnant women admitted to Department of Obstetrics, Tanta University Hospital.Patients and Methods: This prospective, randomized, comparative study included Seven hundred and fifty (750) pregnant women in the Department of Obstetrics and Gyne-cology in Tanta University Hospital during the period between December 2016 and December 2017. In this study, hypertensive pregnant females were categorized in to 4 major groups: Chronic hypertension, gestational hypertension, pre-eclampsia, eclampsia and no cases of superimposed pre-eclampsia on top of chronic hypertension were encountered. Informed consents were obtained from all study participants.Results: Number of patients examined in this study was 750 pregnant women, 179 were hypertensive (23.86%). Chron-ic hypertension 15 cases (8.37%), gestational hypertension 61 cases (34.07%), pre-eclampsia 90 cases (50.27%) and eclampsia 13 cases (7.26%), according to the clinical charac-teristics, the mean age was significally higher in chronic hypertensive group (40.53±5.3 years), and was significally lower in eclamptic patients (23.31±4.33 years), the highest gravidity was recorded in chronic hypertension (3.20±0). The body mass index was similar in all the studied groups. Blood pressure was highest in preeclampsia, according to methods of delivery in different studied groups, assisted and spontaneous vaginal delivery were highest in gestational hypertension (23%) and (13.1%) respectively and Caesarian section was highest in eclampsia (84.6%) and lowest in chronic hyperten-sion (60%), the gestational age of the studied groups was showing that prematurity was encountered in 61.54% of cases of eclampsia and was lowest (0%) in chronic hypertension; this was due to induction of labor, the main cause of death in this study is prematurity. The mean APGAR score in the present study was highest in chronic hypertension group (7.40 ±1.88) and lowest in eclamptic group (5.08±1.19) after one minute of delivery and after 5 minutes APGAR score was highest in pre-eclamptic (8.80±1.52) and lowest in eclamptic group (7.23±1.88). The respiratory distress syndrome, Neonatal Intensive Care Unit and neonatal mortality were highest in eclampsia group (3 8.5%, 30.8% and 23.1% respectively) and lowest in chronic hypertension group (0% in all), a comparison between 2 forms of pre-eclampsia (mild and severe) showed that all the parameters including blood pressure, hematocrit value, creatinine, uric acid levels and liver enzymes were higher in severe preeclampsia compared to the mild form. C.S was 100% in severe pre-eclampcia and 73.01% in mild pre-eclampcia, the respiratory distress syndrome, Neonatal Intensive Care Unit and neonatal mortality were significally higher in severe pre-eclampcia than mild pre-eclampcia, gestational age and birth weight were significally higher in severe pre-eclampcia than mild pre-eclampcia, Intra Uterine Growth Restrictions (I.U.G.R) were found only among the severe pre-eclampcia group (18.52%).Conclusions: From this study we can reach the following conclusions:1-High blood pressure complicates 23.9% of all pregnant women.2-The incidence of chronic hypertension in the present study is 8.37%, gestational hypertension is 34.1%, pre-eclampsia is 50.3% and eclampsia is 7.3%.3-The worst prognosis was found among the eclamptic group.4-Chronic hypertension when perfectly managed doesn't develop into superimposed pre-eclampsia.5-No cases of secondary chronic hypertension were encoun-tered in the study denoting that it is rare with pregnancy. The cause of secondary hypertension may compromise her fertility.6-Neonatal complications were most common with pre-eclampsia and eclampsia.

Thioureas, often contained within neoprene to provide water resistance, are an important cause of allergic contact dermatitis (ACD) in those who use neoprene products. We wish to present three cases of thiourea-induced ACD from three different orthopaedic supports containing neoprene. The first case was a 67-year-old woman who developed an itchy rash on her heel three weeks after using a neoprene insole for plantar fasciitis. The second case was a 47-year-old man who developed an itchy rash on his wrist after wearing neoprene wrist splints for psoriatic arthropathy. The third case was a 77-year-old woman who experienced a severe erythematous rash with blistering from a neoprene elbow brace she received following a humeral fracture. All patients were patch tested to the British Society of Cutaneous Allergy Standard and rubber series and a cut piece from all the relevant supports. At 96 hours, all patients had a + reaction to mixed dialkylthiourea, diethylthiourea, and the supports’ material. No other positive patch test reactions were identified. As neoprene is fast becoming one of the most popular materials used for orthopaedic supports, awareness of this reaction and close liaison between dermatologists and orthopaedic surgeons are therefore essential to allow for early recognition of this complication.

The role of homocysteine as an independent risk factor for vascular endothelial damage, and the possible link between homocysteine and tumour necrosis factor-alpha [TNF-alpha] as two synergistic risk factors for beta-cell apoptosis in type 1 diabetes mellitus was studied. Plasma homocysteine levels were significantly elevated in all diabetic patients compared with controls and diabetic patients with vascular complications showed higher elevations. Furthermore, homocysteine levels showed significant positive correlation with the degree of microalbuminuria. TNF-alpha levels were elevated in all diabetic patients compared with controls. These results may have therapeutic implications.