BACKGROUND: Minimally invasive endoscopic hematoma evacuation is a promising treatment option for intracerebral hemorrhage (ICH). However, the technique still needs improvement.

METHODS: We report our early clinical experience of using this technique to evacuate supratentorial spontaneous intracerebral hematomas and evaluate its short-term outcomes.

RESULTS: The study included 15 patients, basal ganglia hematoma was the most common location 62.5%, mean preoperative hematoma volume was 61.07 cc, mean ICH score was 3, and mean rate of hematoma evacuation was 89.27%. Factors that could be related to mortality were Glasgow Coma Score (GCS) on admission ( = 0.001), ICH score ( = 0.004); postoperative GCS ( < 0.001), postoperative hematoma volume ( = 0.006); intraventricular extension ( = 0.001), and rate of evacuation ( = 0.001).

CONCLUSION: Endoscopic technique is a safe surgical option for evacuation of spontaneous supratentorial ICH. This minimally invasive technique could be helpful to provide better short-term outcomes for selected patients. However, in our experience, this minimally invasive technique did not change the outcome for cases presented with poor GCS on admission 4/15. Our results warrant a future prospective, randomized, controlled efficacy trial.

Blastocystis is an opportunistic parasite causes gastro-intestinal symptoms including irrita-
ble bowel syndrome (IBS). This study evaluated the effect of probiotics and silver nanopar-
ticles on Blastocystis hominis in mice and compared between both probiotics (Lactobacillus)
and silver nanoparticles as compared to metronidazole. A cross-sectional study was done in
which stool samples were collected from patients suffering from IBS.The stool samples
were examined microscopically to detect B. hominis and any co-parasitism. All positive
stool samples were cultured on Modified Jones' media. BALB/C mice were infected by iso-
lated Blastocystis. The effect of probiotics and silver nanoparticles on blastocystosis was
tested in experimentally infected mice. Cysts' mean count in stool of infected mice markedly
decreased; with a decrease in serum levels of nitric oxide and glutathione antioxidants com-
pared to drug control one. There wasintestinal villi improvement of infected groups treated
with probiotics and silver nanoparticles,with mild inflammation and decrease of Blastocystis
at the intestinal surface as compared to theinfected group metronidazole treated.
Keywords: Blastocystis hominis, Irritable bowel syndrome, Nanoparticles, Probiotics.

Assessment of soil loss and understanding its major drivers are essential to implement targeted management interventions. We have proposed and developed a Revised Universal Soil Loss Equation framework fully implemented in the Google Earth Engine cloud platform (RUSLE-GEE) for high spatial resolution (90 m) soil erosion assessment. Using RUSLE-GEE, we analyzed the soil loss rate for different erosion levels, land cover types, and slopes in the Blue Nile Basin. The results showed that the mean soil loss rate is 39.73, 57.98, and 6.40 t ha−1 yr−1 for the entire Blue Nile, Upper Blue Nile, and Lower Blue Nile Basins, respectively. Our results also indicated that soil protection measures should be implemented in approximately 27% of the Blue Nile Basin, as these areas face a moderate to high risk of erosion (>10 t ha−1 yr−1). In addition, downscaling the Tropical Rainfall Measuring Mission (TRMM) precipitation data from 25 km to 1 km spatial resolution significantly impacts rainfall erosivity and soil loss rate. In terms of soil erosion assessment, the study showed the rapid characterization of soil loss rates that could be used to prioritize erosion mitigation plans to support sustainable land resources and tackle land degradation in the Blue Nile Basin.

Three ratio spectra manipulating spectrophotometric methods have been developed for determination of Paracetamol (PAR) and Phenylephrine HCl (PHE) in bulk powder and in pharmaceutical formulation. Linear correlations were obtained over the concentration range of 1.0-25.0 µg/mL and 5.0-50.0 µg/mL for PAR and PHE, respectively. The first method is the ratio subtraction method (RS) coupled with constant multiplication (CM) in which PHE was determined by ratio subtraction and PAR was determined by constant multiplication. The second method is the ratio difference method (RD) which depends on measuring the difference between the amplitudes of the ratio spectra at two selected wavelengths. The third method is the first derivative of the ratio spectra (DD), which allows the determination of PAR at 238.8 and 243 nm and PHE at 213.2, 222.2, 271.8 and 286 nm. The proposed methods are simple, accurate and precise (RSD does not exceed 2%). The applicability of the proposed methods was successfully verified by the analysis of PAR and PHE in pharmaceutical formulation without interference of the dosage form additives. Furthermore, the developed methods were validated according to ICH guidelines, so they are considered to be potential competitors for the analysis of the mixture in quality control labs and pharmaceutical factories.

Spironolactone (SP) is a potassium sparing diuretic with antiandrogenic properties. This study aimed at formulating SP into hyaluronic acid enriched cerosomes (HAECs) for topical management of hirsutism. HAECs were prepared by ethanol injection method, according to D-optimal design, after a proper study. HAECs were evaluated by measuring their entrapment efficiency (EE%), particle size (PS), and polydispersity index (PDI). Optimal hyaluronic acid enriched cerosomes (OHAECs) were subjected to further and and studies. The study concluded better interactions between SP and phosphatidyl choline in presence of hyaluronic acid (HA) and high stability of their binding in water. The prepared HAECs had acceptable EE%, PS, and PDI values. The statistical optimization process suggested OHAEC containing 10.5 mg ceramide III and 15 mg HA, utilizing Kolliphor RH40. OHAEC had EE% and PS of 89.3 ± 0.3% and 261.8 ± 7.0 nm, respectively. OHAEC was stable for up to 3 months. It also showed a mixed tubular and vesicular appearance under transmission electron microscope. The and studies concluded better skin deposition and accumulation of SP from OHAEC. The histopathological study demonstrated the safety of OHAEC for topical application. Therefore, OHAEC could be considered as effective system for topical application of SP to manage hirsutism, with prolonged action, coupled with minimized side effects.

BACKGROUND: Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization-World Health Organization- Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries.

METHODS: Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019.

RESULTS: Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p < 0.001). Acute stroke treatments were offered in ∼ 60% of high-income countries compared to 26% of low-income countries (p = 0.009). Compared to high-income countries, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol.

CONCLUSIONS: There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.