Facial Assessment and Cosmetic Enhancement Quality of Life Questionnaire (FACE-Q) Arabic Validation.

Background  Rhinoplasty, a common cosmetic surgery, improves aesthetic appearance and nasal function. Outcomes are typically measured by patient satisfaction and quality of life impact. However, a gap exists in validated non-English assessment tools, especially in Arabic, which hinders accurately capturing patient experiences in Arabic-speaking populations. To fill this gap, this study aims to translate and validate the "Rhinoplasty" module of the Facial Assessment and Cosmetic Enhancement Quality of Life Questionnaire (FACE-Q) self-questionnaire into Arabic. Methods A cross-sectional study was conducted at the Otorhinolaryngology Department of the National Guard Health Affairs in Riyadh, Saudi Arabia. Adults who underwent rhinoplasty from 2017 to 2021 were included if they had at least one year of follow-up and were contactable. A sample size of 109 was determined, and the participants were selected using probability cluster sampling. A 33-item FACE-Q scale was administered via telephone, with scores converted to a 0-100 scale for analysis. Translation involved a two-way process with independent translations and back-translations, followed by review and pilot testing. Results The study included 137 participants (mean age, 32.5 years; 53 men, 84 women), predominantly electing cosmetic surgery, with an average of four years post-surgery. The internal consistency of the scales varied, with the self-acceptance/love scale showing acceptable reliability (Cronbach's alpha = 0.73) and other scales suggesting item redundancy (Cronbach's alpha for aesthetic scales > 0.94). The self-rated complications scale did not meet the acceptability threshold, indicating a need for scale revision. Conclusions The Arabic translation of the FACE-Q Rhinoplasty module shows potential as a reliable tool for evaluating patient satisfaction and quality of life after rhinoplasty in Arabic-speaking patients. Further refinement is necessary to address item redundancy and enhance cultural specificity. This work underscores the importance of culturally sensitive tools for global applicability in cosmetic surgery outcomes research.

Unravelling the utility of modern sulfonylureas from cardiovascular outcome trials and landmark trials: expert opinion from an international panel.

AIM: The primary objective of this review is to develop practice-based expert group opinions on the cardiovascular (CV) safety and utility of modern sulfonylureas (SUs) in cardiovascular outcome trials (CVOTs). BACKGROUND: The United States Food and Drug Administration issued new guidance to the pharmaceutical industry in 2008 regarding the development of new antihyperglycemic drugs. The guidance expanded the scope for the approval of novel antihyperglycemic drugs by mandating CVOTs for safety. A few long-term CVOTs on dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, and sodium-glucose cotransporter 2 inhibitors have been completed, while others are ongoing. SUs, which constitute one of the key antihyperglycemic agents used for the management of type 2 diabetes mellitus (T2DM), have been used as comparator agents in several CVOTs. However, the need for CVOTs on modern SUs remains debatable. In this context, a multinational group of endocrinologists convened for a meeting and discussed the need for CVOTs of modern SUs to evaluate their utility in the management of patients with T2DM. At the meeting, CVOTs of modern SUs conducted to date and the hypotheses derived from the results of these trials were discussed. REVIEW RESULTS: The expert group analyzed the key trials emphasizing the CV safety of modern SUs and also reviewed the results of various CVOTs in which modern SUs were used as comparators. Based on literature evidence and individual clinical insights, the expert group opined that modern SUs are cardiosafe and that since they have been used as comparators in other CVOTs, CVOTs of SUs are not required. CONCLUSION: Modern SUs can be considered a cardiosafe option for the management of patients with diabetes mellitus and CV disease; thus CVOTs among individuals with T2DM are not required.

Fixed-dose combination in management of type 2 diabetes mellitus: Expert opinion from an international panel.

Type 2 diabetes mellitus (T2DM) is a progressive disease with multifactorial etiology. The first-line therapy includes monotherapy (with metformin), which often fails to provide effective glycemic control, necessitating the addition of add-on therapy. In this regard, multiple single-dose agents formulated as a single-dose form called fixed-dose combinations (FDCs) have been evaluated for their safety, efficacy, and tolerability. The primary objective of this review is to develop practice-based expert group opinion on the current status and the causes of concern regarding the irrational use of FDCs, in Indian settings. After due discussions, the expert group analyzed the results from several clinical evidence in which various fixed combinations were used in T2DM management. The panel opined that FDCs (double or triple) improve patient adherence, reduce cost, and provide effective glycemic control and, thereby, play an important role in the management of T2DM. The expert group strongly recommended that the irrational metformin FDC's, banned by Indian government, should be stopped and could be achieved through active participation from the government, regulatory bodies, and health ministry, and through continuous education of primary care physicians and pharmacists. In T2DM management, FDCs play a crucial role in achieving glycemic targets effectively. However, understanding the difference between rational and irrational FDC combinations is necessary from the safety, efficacy, and tolerability perspective. In this regard, primary care physicians will have to use a multistep approach so that they can take informed decisions.

Systematic review of non-surgical therapies for osteoarthritis of the hand: an update.

OBJECTIVE: To update our earlier systematic reviews which evaluated all published randomized controlled trials (RCTs) evaluating pharmacological and non-pharmacological therapies in patients with hand osteoarthritis (OA). Surgical therapies were not evaluated. DESIGN: RCTs published between March 2008 and December 2015 were added to the previous systematic reviews. RESULTS: A total of 95 RCTs evaluating various pharmacological and non-pharmacological therapies in hand OA were analyzed in this update. Generally, the methodological quality of these RCTs has improved since the last update, with more studies describing their methods for randomization, blinding, and allocation concealment. However, RCTs continue to be weakened by a lack of consistent case definition and a lack of standardized outcome assessments specific to hand OA. The number and location of evaluated hand joints continues to be underreported, and only 25% of RCTs adequately described the method used to ensure allocation concealment. These remain major weaknesses of published RCTs. A meta-analysis could not be performed because of marked study heterogeneity, insufficient statistical data available in the published RCTs, and a small number of identical comparators. CONCLUSION: Hand OA is a complex area in which to study the efficacy of therapies. There has been an improvement in the overall design and conduct of RCTs, however, additional large RCTs with a more robust methodological approach specific to hand OA are needed in order to make clinically relevant conclusions about the efficacy of the diverse treatment options available.

Novel Use of an Orbital Atherectomy Device for In-Stent Restenosis: Lessons Learned.

We present a case of a 67-year-old man with stage III chronic kidney disease, uncontrolled diabetes mellitus, coronary artery disease, and high surgical risk who presented with two episodes of acute coronary syndrome attributed to in-stent restenosis (ISR) associated with heavily calcified lesions. In this case, we were able to improve luminal patency with orbital atherectomy system (OAS); however, withdrawal of the device resulted in a device/stent interaction, causing failure of the device. Given limitations in current evidence and therapies, managing ISR can be a technical and cognitive challenge. Balloon expansion of the affected region often provides unsatisfactory results, possibly related to significant calcium burden. OAS could be an efficacious way of reestablishing luminal patency in ISR lesions, as these lesions are often heavily calcified.

Role of free radicals and antioxidant status in childhood nephrotic syndrome.

Nephrotic syndrome (NS) is characterized by heavy proteinuria and hypoalbuminuria. Reactive oxygen species (ROS) seem to play an important role in the etiopathogenesis of proteinuria in NS. This study aims to evaluate the potential role of reactive oxygen species in pathogenesis of NS by estimating the levels of oxidants and antioxidants in children with NS. Thirty patients of NS and thirty age, sex-matched healthy subjects, were selected for the study. As compared to healthy controls, the levels of serum lipid peroxide were significantly elevated while levels of nitric oxide, erythrocyte-superoxide dismutase activity, levels of vitamin C, albumin and total antioxidant capacity were significantly reduced in nephrotic patients. The levels of uric acid and bilirubin were significantly increased in children with NS as compared to controls. There was no significant difference in vitamin E level between patients and controls. It can be concluded that increased ROS generation and decreased antioxidant defense may be related to the pathogenesis of proteinuria in NS.

Sensitive and selective method for the analysis of menthol from pharmaceutical products by RP-HPLC with refractive index detector.

OBJECTIVE: Liquid chromatography with refractive index (RI) detection has been found to be very useful for the determination of menthol from pharmaceutical products. A simple and rapid HPLC method has been developed for this purpose compared to conventional GC methods, requiring no special sample pretreatment for the determination of menthol from pharmaceutical products. MATERIALS AND METHODS: A chromatographic separation was achieved on a Inertsil ODS 3V (4.6mm×250mm, 5µm) column using water : methanol (30:70 v/v) as a mobile phase, at a flow rate of 1.0 ml/min. RESULTS: Method was validated as per ICH guidelines for various parameters such as precision, linearity, accuracy, solution stability, robustness, limit of detection and quantification. Results were found to be within acceptable limits. CONCLUSION: The method has been successfully applied for the quantification of menthol from syrup formulations. The developed method can be conveniently used by the quality control department to determine assay of menthol from pharmaceutical preparations.

Role of reactive oxygen species in pathogenesis of nephrotic syndrome.

Nephrotic syndrome is the common chronic disorder characterized by alteration of permeability of the glomerular capillary wall, resulting in its inability to restrict the urinary loss of proteins. Nephrotic syndrome is characterized by heavy proteinuria, hypoalbuminemia, hyperlipidemia associated with peripheral edema. The molecular basis of glomerular permselectivity remains largely unknown. In recent years it has been proposed that Nephrotic syndrome is a consequence of an imbalance between oxidant and antioxidant activity. The present study was aimed to test that the reactive oxygen species are the mediators of excessive protein permeability and other complications of Nephrotic syndrome. For this 30 adults with Nephrotic syndrome were studied. The control group comprised 30 healthy adults matched for age. Serum levels of lipid peroxides, nitric oxide (NO⊙), α- tocopherol, ascorbic acid, erythrocyte superoxide dismutase activity, serum albumin, uric acid, cholesterol and plasma total antioxidant capacity were measured. Student's 't' test was applied for statistical analysis. There was a significant increase in lipid peroxide (1.58 ± 0.42 in controls, 3.64 ±1.3 in patients) (P<0.001) levels in study group as compared with controls. α-tocopherol (12.95 ± 1.04 in controls, 9.93 ± 1.43 in patients) (P<0.001), erythrocyte SOD activity(1.88 ± 0.9 in controls 1.07 ± 0.5 in patients) (P=0.01), serum albumin(4.06 ± 0.50 in controls, 3.04 ± 0.11 in patients) (P<0.001), and plasma total antioxidant capacity (847.33 ± 126.83 in controls, 684.00±102.94 in patients) (P<0.001) were significantly decreased. There was non-significant increase in uric acid (P>0.05), a non-significant decrease in NO⊙ (38.48 ± 15.47 in controls 37.47 ± 14.27 in patients) (P>0.05) and ascorbic acid levels ascorbic acid,( 0.95 ± 0.31in controls 0.79 ± 0.30 in patients) (P>0.05) in study group as compared with controls. Imbalance between oxidants and antioxidants may contribute to pathogenesis of proteinuria and related complications in nephrotic syndrome.

Development and validation of a reversed-phase HPLC method for simultaneous estimation of ambroxol hydrochloride and azithromycin in tablet dosage form.

A simple, precise and accurate reversed-phase liquid chromatographic method has been developed for the simultaneous estimation of ambroxol hydrochloride and azithromycin in tablet formulations. The chromatographic separation was achieved on a Xterra RP18 (250 mm x 4.6 mm, 5 microm) analytical column. A Mixture of acetonitrile-dipotassium phosphate (30 mM) (50:50, v/v) (pH 9.0) was used as the mobile phase, at a flow rate of 1.7 ml/min and detector wavelength at 215 nm. The retention time of ambroxol and azithromycin was found to be 5.0 and 11.5 min, respectively. The validation of the proposed method was carried out for specificity, linearity, accuracy, precision, limit of detection, limit of quantitation and robustness. The linear dynamic ranges were from 30-180 to 250-1500 microg/ml for ambroxol hydrochloride and azithromycin, respectively. The percentage recovery obtained for ambroxol hydrochloride and azithromycin were 99.40 and 99.90%, respectively. Limit of detection and quantification for azithromycin were 0.8 and 2.3 microg/ml, for ambroxol hydrochloride 0.004 and 0.01 microg/ml, respectively. The developed method can be used for routine quality control analysis of titled drugs in combination in tablet formulation.

Simultaneous determination of aceclofenac, paracetamol, and chlorzoxazone by RP-HPLC in pharmaceutical dosage form.

A simple, rapid, and precise reversed-phase liquid chromatographic method is developed for simultaneous determination of paracetamol, aceclofenac, and chlorzoxazone in their ternary mixtures of commercial pharmaceutical preparation. This method uses a Zorbax SB C18, 250 x 4.6 mm, 5 microm analytical column. Mobile phase is acetonitrile and buffer (40:60, v/v), buffer containing 50 mM orthophosporic acid; pH of the buffer is adjusted to 6 with 10% w/v sodium hydroxide solution. The instrumental settings are at a flow rate of 1 mL/min; the column temperature is 25 degrees C, and detector wavelength is 270 nm. The sample concentrations are measured on weight basis to avoid the internal standard. The method is validated and shown to be linear. The correlation coefficients for paracetamol, aceclofenac, and chlorzoxazone are 0.9981, 0.9990, and 0.9986, respectively. The recovery values for paracetamol, aceclofenac, and chlorzoxazone ranged from 100.7-101.4%, 100.4-101.0%, and 100.5-101.3%, respectively. The relative standard deviation for six replicates is always less than 2%. This HPLC method is successfully applied to the simultaneous quantitative analysis of the title drugs in tablets and can be applied for assay and dissolution test of tablets for the estimation of paracetamol, aceclofenac, and chlorozoxazone in their commercial samples.

The anti-tumor effect of bee honey in Ehrlich ascite tumor model of mice is coincided with stimulation of the immune cells.

Honey is thought to exhibit a broad spectrum of therapeutic properties including antibacterial, antifungal, cytostatic and anti-inflammatory activity and has been used for the treatment of gastric ulcers, burns, and for storage of skin grafts. The present study investigated the antitumor effect of bee honey against Ehrlich ascites tumor in mice and the possible mode of antitumor action. Peroral administration of mice with honey (10, 100 or 1000 mg/ 100 g BW) every other day for 4 weeks before intraperitoneal inoculation with Ehrlich ascites tumor (EAT, 1 x 10(6) cells) increased the number bone marrow cells as well as peritoneal macrophages, but not peripheral blood leukocytes nor splenocytes. The phagocytic function of macrophages as well as the T- and B-cell functions were also increased. Honey pre-treatment also recovered the total lipids, total proteins, as well as liver and kidney enzyme activities in EAT-bearing mice. In vitro studies on EAT cells demonstrated inhibitory effect of honey on tumor cell proliferation, viability % of tumor cells as well as the size of solid tumor. The present results indicate that the preventive treatment with honey is considerably effective against EAT in mice both in vivo and in vitro. The antitumor activity of honey may occur through the activation of macrophages, T-cells and B-cells.

Epilepsy: public knowledge and attitude in a slum area of Karachi, Pakistan.

BACKGROUND: Epilepsy is a common but widely misunderstood illness. Consequently, epileptics suffer from considerable stigmatization in society. Since no studies have detailed the misperceptions about epilepsy in our community, it is not possible to provide focused intervention aimed at eliminating this prejudice. PURPOSE: To assess the knowledge and attitude regarding epilepsy in an adult population of a Karachi slum area. METHODS: A face-to-face interview was conducted on 487 consenting adult non-epileptics (305 males; 182 females) who were conveniently sampled. Chi-square test was employed to calculate the variability in knowledge and attitude with demographic and other variables. RESULTS: In all, 12.5% had never heard about epilepsy. Among the rest, 66.7% identified epilepsy as being non-infectious, while 28.2% were unaware of any treatment available for it. Among the other 71.8%, 62.7% were aware of the existence of anti-epileptic drugs. Religious/spiritual treatment was chosen as the most effective treatment by 33.1%. Males were more likely to identify epilepsy as being non-infectious (p=0.02). Nearly 18% of the respondents would not object to their child marrying an epileptic, 69.5% did not want to socially isolate the epileptics, 83.1% said epileptics could receive academic education, 85.6% said they could perform activities of daily life and 62.4% said they could become useful members of the society. Those who considered epilepsy to be infectious were more likely to carry negative attitudes towards epilepsy (p<0.01 with four attitudes). CONCLUSIONS: Considerable gaps exist in the community's knowledge about epilepsy. Some of these may explain the prevalence of negative attitudes towards this ailment.

Recovery of age-dependent immunological deterioration in old mice by thyroxine treatment.

On the basis that multiple interactions exist between thyroid hormones and immune system, and ageing is accompanied by changes in thyroid hormone secretion, it seems possible that thyroid hormones may be involved in the age-related immune dysfunction. The present study was conducted to evaluate in vivo and in vitro effects of thyroxine (T(4)) treatment on both cell-mediated and humoral immune responses of aged mice. In a trial to improve age-associated immune dysfunction, T(4) (0.2, 1.0 and 5.0 microg) was subcutaneously supplemented to BALB/c mice (over 18 months old) for 30 consecutive days. The present results showed that exogenous treatment of aged mice with T(4) was associated with a marked increase in serum T(4) level, and the total number of peripheral blood leukocytes as well as the total cellularity of thymus, spleen, peripheral lymph nodes (PLNs), mesenteric lymph nodes (MLNs) and bone marrow (BM). T(4) treatment also caused a significant increase in the total and differential numbers of peritoneal exudate cells (PECs), while it caused a slight increase in macrophages' phagocytic activity of PEC. Moreover, T(4) treatment elicited a statistically significant increase in both plaque-forming cell and rosette-forming cell responses. In vitro results showed that the addition of T(4) at concentrations of 0.001, 0.005 and 0.025 microg/well substantially potentiated the ability of splenocytes from aged mice to proliferate in the presence of concanavalin-A mitogen. Histological examination of thymuses from T(4)-treated aged mice revealed that the cortex was preferentially enlarged and repopulated with immature thymocytes. The present study postulates that thyroid hormones may be involved in the observed decrease in the immune responsiveness during ageing, and that T(4) treatment to aged mice is able to restore the age-related decline of the immune efficiency.

Synthesis and properties of halogenated 7-deaza-2'-deoxyxanthosine and protected derivatives for oligonucleotide synthesis.

The 7-bromo- (4a) and 7-iodo- (4b) derivatives of 7-deaza-2'-deoxyxanthosine (5) are prepared. Furthermore, the building blocks 6-8 of 7-deaza-2'-deoxyxanthosine (5) are synthesized and tested for their usage in oligonucleotide synthesis.

[Tests and criteria in diagnosis of chronic hypotension--a systematic review]. / Tests und Kriterien in der Diagnostik der chronischen Hypotonie--Ein Systematic Review.

The diagnosis of hypotensive circulatory disorders is based on a variety of criteria and classifications. This paper aims to provide a systematic review of published definitions and diagnostic criteria for hypotensive disorders. Searches for relevant papers were undertaken in Medline, Winspirs version (January 1966 to December 1999) and in textbooks of internal medicine. References of all identified articles were also searched. Publications in English, French, German and Italian were included. In 47 articles, 56 different reference were made to definitions and diagnostic criteria for hypotension. At present there is no uniform definition of hypotension and there are no clear, standardized criteria on which to base a diagnosis. Basically, one distinguishes between two schools of thought. The Anglo-American literature describes hypotensive disorders in terms of orthostatic dysregulation in the presence of an underlying primary condition, whereas the German-speaking countries use mixed approaches. On the one hand, the questionable pathological value of essential/primary hypotension is discussed; on the other hand, tests for orthostatic circulatory function, like the Schellong test, appear to have become established. Neither resting blood pressure limits nor a drop in blood pressure during orthostatic challenge can be used to diagnose hypotension. The orthostatic test is a better diagnostic tool than resting blood pressure. Hypotension is probably difficult to classify in simple terms because it is usually a symptom of numerous disorders hallmarked by a variety of pathophysiological mechanisms. Hypotension should indeed be understood as a secondary symptom of a primary disease. Accordingly, the primary aim of diagnostic efforts should be to uncover the underlying condition. The studies included were of insufficient methodological quality. Moreover, the heterogeneity among the individual studies made pooled analysis impossible. This systematic review revealed a marked lack of studies with valid results.

SDS-PAGE-separated tissue proteins of Biomphalaria alexandrina snails in the presence and absence of Schistosoma mansoni.

SDS-PAGE was used to separate tissue proteins of control and trematode-infected Biomphalaria alexandrina snails. The separated profiles demonstrate the occasional appearance of protein fractions and the remarkable increase of concentration of certain molecular masses in infected snails at one week interval over four weeks post exposure to Schistosoma mansoni. Proteins of molecular masses of 44, 56, 65 and 144 KDa were among these occasionally appeared protein masses. Post exposure to S. mansoni larval infection, a protein mass of 36 KDa was predominant giving a markedely higher absorbance (> 1) compared to control (0.0166). This was identified as lactate dehydrogenase enzyme. Moreover, a protein of 56 KDa mass was identified as Pyruvate kinase. The predicted induction of these two enzymes could be either of host and/or parasitic origin. This study revealed that S. mansoni- B. alexandrina complex has a completely different protein pattern compared to control with very low similarity coefficient "S" value. A correlation between the snail tissue protein or separation patterns and the metabolic redirection of the snail host by the developing sporocyst was discussed.

The social and demographic correlates of divorce in rural Bangladesh.

"This article examines the rate of divorce by age, sex and duration of marital life at the time of divorce in rural Bangladesh for a period of 18 years from 1975 to 1992. An attempt has also been made to investigate the extent to which the incidence of divorce changes with the various socio-economic and demographic characteristics. The overall divorce rates per thousand married males and females declined from 16.1 to 11.5 and 11.8 to 8.4, respectively, during the study periods 1975-1979 and 1989-1992."

Recent changes in marriage patterns in rural Bangladesh.

"This article considers age at marriage and other aspects of nuptiality in Bangladesh in the context of opportunities to accelerate national development. It suggests that concerted efforts to increase the female age at marriage could produce a number of beneficial effects ranging from reduction in the incidence of divorce and widowhood to a lowering of fertility. It suggests a number of policy and programme measures that could be employed to foster such an increase."

Comparative study of diclofenac sodium and flurbiprofen in osteoarthritis.

A comparative study was conducted to evaluate the therapeutic efficacy of diclofenac sodium and flurbiprofen both non-steroidal anti-inflammatory drugs (NSAIDS) in osteoarthritis. Forty patients of either sex between the ages of 35-60 years suffering from osteoarthritis of at least one knee joint minimum of eight weeks duration were included in the study. Diclofenac sodium exhibited better results by improving the signs and symptoms of osteoarthritis in both high and low doses compared to flurbiprofen. The adverse effects observed were similar in both groups.