Massive repeated nose bleeding after bimaxillary osteotomy

In LeFort I surgery, the separation of the pterygomaxillary junction is done by osteotomy. Although the osteotome is positioned too close to the maxillary artery and its branches during pterygomaxillary separation, postoperative complications from vascular injuries are uncommon. We describe an unusual occurrence of a maxillary artery pseudoaneurysm after LeFort I and bilateral sagittal split osteotomies for maxillary advancement and mandibular setback as well as (anterior sliding) genioplasty. In a patient with class III occlusion and midface retrusion, the significant bleeding began 10 days postoperatively, which was controlled by anterior and posterior nasal packing. The bleeding recurred 28 days after surgery; thus, vascular anatomy in the pterygomaxillary area is reviewed, pseudoaneurysm was diagnosed on selective carotid angiography and successfully treated by embolization; and 2-year follow up was uneventful.     

The Effect of Type of Femoral Component Fixation on Mortality and Morbidity after Hip Hemiarthroplasty: A Systematic Review and Meta-Analysis

HSS Journal ® - Hip hemiarthroplasty is a well-established treatment of displaced femoral neck fracture, although debate exists over whether cemented or uncemented fixation is superior....     

Community pharmacists’ knowledge,behaviors and experiences about adverse drug reaction reporting in Saudi Arabia

Objective

To assess community pharmacists’ knowledge, behaviors and experiences relating to Adverse Drug Reaction (ADR) reporting in Saudi Arabia.

Methods

A cross-sectional study was conducted using a validated self-administered questionnaire. A convenience sample of 147 community pharmacists working in community pharmacies in Riyadh, Saudi Arabia.

Results

The questionnaire was distributed to 147 pharmacists, of whom 104 responded to the survey, a 70.7% response rate. The mean age of participants was 29 years. The majority (n = 101, 98.1%) had graduated with a bachelorette degree and worked in chain pharmacies (n = 68, 66.7%). Only 23 (22.1%) said they were familiar with the ADR reporting process, and only 21 (20.2%) knew that pharmacists can submit ADR reports online. The majority of the participants (n = 90, 86.5%) had never reported ADRs. Reasons for not reporting ADRs most importantly included lack of awareness about the method of reporting (n = 22, 45.9%), misconception that reporting ADRs is the duty of physician and hospital pharmacist (n = 8, 16.6%) and ADRs in community pharmacies are simple and should not be reported (n = 8, 16.6%). The most common approach perceived by community pharmacists for managing patients suffering from ADRs was to refer him/her to a physician (n = 80, 76.9%).

Conclusion

The majority of community pharmacists in Riyadh have poor knowledge of the ADR reporting process. Pharmacovigilance authorities should take necessary steps to urgently design interventional programs in order to increase the knowledge and awareness of pharmacists regarding the ADR reporting process.     

Structure modeling and docking study of HCV NS5B-3a RNA polymerase for the identification of potent inhibitors

Homology modeling in combination with molecular docking studies has been applied to predict the binding modes of the Hepatitis C virus (HCV) NS5B-3a inhibitors within the pocket of NS5B polymerase of HCV genotype 3a. Structure modeling and docking using Genetic Optimization for Ligand Docking (GOLD) were carried out to understand the ligand binding properties of NS5B-3a and to identify a potent inhibitor against it. The three-dimensional homology model of Pakistani strain is not available and was built based on the HCV-J4 NS5B polymerase structure. Compound 1 possessing high GOLD fitness score of 62.17 with IC50 value of 0.04 μM was selected as the potent inhibitor. The docking analysis depicted that hydrogen bonding, ionic and hydrophobic interactions contributed significantly for its ligand binding and the amino acid residues Arg442 and His403 seemed to be the anchor residues for receptor recognition. For developing a connection between the experimental bioactivities and GOLD fitness scores, a squared correlation coefficient was calculated and found as acceptable with the value of r ² = 0.67. These findings may act as potent lead in designing effective NS5B-3a inhibitors.     

Antioxidant effect of manganese on the testis structure and sperm parameters of formalin‐treated mice

Manganese inhibits oxidative stress damage. The aim of this study was to investigate the protective role of manganese on testis structure and sperm parameters in adult mice exposed to formaldehyde (FA). Twenty adult male NMRI mice were selected and randomly divided into four groups: (i) control; (ii) sham; (iii) ‘FA’‐exposed group; and (iv) ‘FA and manganese chloride’‐exposed group. The FA‐exposed groups received 10 mg kg^?1 FA daily for 14 days, and manganese chloride was just injected intraperitoneally 5 mg kg^?1 on 2nd weeks. Mice were sacrificed, and spermatozoa were collected from the cauda of the right epididymis and analysed for count, motility, morphology and viability. The other testicular tissues were weighed and prepared for histological examination upon removal. Seminiferous tubules, lumen diameters and epithelium thickness were also measured. The findings revealed that FA significantly reduced the testicular weight, sperm count, motility, viability and normal morphology compared with control group (P ≤ 0.05). In addition, seminiferous tubules atrophied and seminiferous epithelial cells disintegrated in the FA group in comparison with the control group (P ≤ 0.05). However, manganese improved the testicular structure and sperm parameters in FA‐treated mice testes (P ≤ 0.05). According to the results, manganese may improve and protect mice epididymal sperm parameters and testis structure treated with FA respectively.     

Important Synthesis Parameters Affecting Crystallization of Zeolite T: A Review

Synthesis of zeolite T with a variety of desired characteristics necessitates extensive work in formulation and practical experiments, either by conventional hydrothermal methods or aided with different approaches and synthesis techniques, such as secondary growth or microwave irradiation. The objectives of this review are to adduce the potential work in zeolite T (Offretite-Erionite) synthesis, evaluating determining factors affecting the synthesis and quality of zeolite T crystals. Attention is given to extensive studies that interconnect with other significant findings.     

Characterisation at the Bonding Zone between Fly Ash Based Geopolymer Repair Materials (GRM) and Ordinary Portland Cement Concrete (OPCC)

In recent years, research and development of geopolymers has gained significant interest in the fields of repairs and restoration. This paper investigates the application of a geopolymer as a repair material by implementation of high-calcium fly ash (FA) as a main precursor, activated by a sodium hydroxide and sodium silicate solution. Three methods of concrete substrate surface preparation were cast and patched: as-cast against ordinary Portland cement concrete (OPCC), with drilled holes, wire-brushed, and left as-cast against the OPCC grade 30. This study indicated that FA-based geopolymer repair materials (GRMs) possessed very high bonding strength at early stages and that the behavior was not affected significantly by high surface treatment roughness. In addition, the investigations using scanning electron microscopy (SEM) and energy-dispersive X-ray (EDX) spectroscopy have revealed that the geopolymer repair material became chemically bonded to the OPC concrete substrate, due to the formation of a C–A–S–H gel. Fundamentally, the geopolymer network is composed of tetrahedral anions (SiO₄)⁴⁻ and (AlO₄)⁵⁻ sharing the oxygen, which requires positive ions such as Na⁺, K⁺, Li⁺, Ca²⁺, Na⁺, Ba²⁺, NH⁴⁺, and H₃O⁺. The availability of calcium hydroxide (Ca(OH)₂) at the surface of the OPCC substrate, which was rich in calcium ions (Ca²⁺), reacted with the geopolymer; this compensated the electron vacancies of the framework cavities at the bonding zone between the GRM and the OPCC substrate.