Abstract Purpose: This study aimed to evaluate the role of 18F-FDG PET/CT scans in staging breast carcinoma. Materials and Methods: A descriptive study on 46 patients who were diagnosed with breast carcinoma in Hanoi Oncology Hospital, Vietnam from June 2019 to June 2021. Those patients underwent 18F-FDG PET/CT scans for pre-treatment staging. Results: There was a posi tive correlation between the size of primary tumors and their SUV (p < 0.0001, r = 0.759). The mean SUV was reported to be 2.5 for tumors under 2 cm, 5.89 for tumors from 2 - 5 cm, 13.6 for tumors above 5 cm, and 8.23 for skin invasive lesions. In terms of regional lymph node metastasis detection, the sensitivity and specificity of 18F-FDG PET/CT were 75% and 100%, re spectively. The rate of distant metastasis detection was 15.2% (7/46 patients).Metastatic lesions were found in bone, lungs, liver, and lymph nodes. There was a significant difference in SUV among organs (p < 0.001), with the high est SUV found in bone metastasis. The rates of stage I, II, III and IV diag nosed after PET/CT are 8.7%; 45.7%; 30.4% and 15.2% respectively, com pared to 10.9%; 54.3%; 32.6%; 2.2% before taking 18F-FDG PET/CT. After PET/CT, 17.4% patients (8/46) had their treatment plan changed. Conclu sions: 18F-FDG PET/CT plays an important role in staging breast carcinoma. Determining accurately the breast carcinoma stage by 18F-FDG PET/CT could help alter treatment strategy to best suit with patients, and avoid unnecessary surgery.

Abstract Pharmacokinetic compartment models are the only models that can extract pharmacokinetic parameters from data collected in clinical studies but their estimates lack accuracy, explanations and physiological significance. The ob jective of this work was to develop particular solutions to drug concentration and AUC in the form of mathematical series and Heaviside functions for re petitive intermittent infusions in the one- and two-compartment models, as a function of dose number and total time using differential calculus. It was demonstrated that the central and peripheral compartment volumes deter mined from regression analysis of the aminoglycoside antibiotic Sisomicin concentration in plasma represent the actual physiological body fluid vo lumes accessible by the drug. The drug peak time and peak concentration in the peripheral compartment were also calculated as a function of dose num ber. It is also shown that the time of intercompartmental momentary distri bution equilibrium can be used to determine the drug’s apparent volume of distribution within any dosing interval in multi-compartment models. These estimates were used to carry out simulations of plasma drug concentration with time in the one-compartment model. In conclusion, the two-compartment open mammillary pharmacokinetic model was fully explained for the ami noglycoside antibiotic sisomicin through the new concept of the apparent volume of distribution.

Abstract Haemoglobinopathies are very serious clinical conditions caused by genetic mutations. They belong to autosomal recessive disorders and the most fre quent genetic inherited diseases seen, specifically and above all among Medi terranean countries. Thalassaemia syndromes (included Beta Thalassaemia and Sickle Cell Disease) have been the first diagnosed diseases since in intra uterine life using reccombinant DNA techniques. So, the better understand ing of their pathophysiology has given a spectacolar improvement and a con siderable impact on these conditional managements. Every year there are nearly 300,000 children born with haemoglobinopathies globally, and there are 60,000 - 70,000 children with Beta Thalassemia among them. Nowadays in Albania like everywhere, there is a significant increase of survival in these patients. As a result of life longevity and improvement of patients life quality,we can see that these patients may suffer from other concomitant illnesses. In our country, there are registered approximately 500 patients with haemoglo binopathies. We studied 50 pediatric patients at random ranging from age 2until 18 years old. We excluded other pathologies among them. We found high values of biochemical indicators in blood (Ca 15-3 was found elevated in 75% of our patients, Lactate Dehydrogenases was found elevated in 70% of cases, Indirect Bilirubin was found elevated in 66% of cases). All three para meters are indicators of hemolysis. We found a correlation between high val ues of Ca 15-3 marker and high levels of LDH, Indirect Bilirubin and low lev el of hemoglobin (p < 0.05). Ca 15-3 is much elevated among patients non regularly transfused and in those who take an unsufficient amount of blood.Continuous monitoring of these biochemical parameters is going to help in the more effective follow up of patients with haemoglobinopathies.

Abstract Published clinical data of Prazosin were reevaluated pharmacokinetically us ing explicit solutions to drug concentration as a function of total time for IV bolus injection, intermittent intravenous infusion and oral routes of adminis tration in an open two-ompartment model. In a novel way, the apparent vo lume of distribution was estimated from a two-compartment model and found to be close to the total body water suggesting that Prazosin is distri buted in all tissues both extracellularly and intracellularly. In addition, ex tracting the value of the apparent volume of distribution from a two-com partment model allowed comparative simulations in the one-compartment model. It is shown that dosage calculations of Prazosin intermittent infusion can be safely performed using the simpler one-compartment model equa tions. Lastly, several additional time-dependent pharmacokinetic parameters e.g., the peak time in the central and peripheral compartment and non steady state and steady state peak concentration and AUC were determined using series equations for all three routes of administration, as a function of dose number and total time upon multiple drug administrations in the two-compartment model. It is also the first time that steady-state plasma drug concentration equations were derived in a two-compartment mammillary model

Abstract Insulin, an old but still actual molecule, has many roles in various cellular processes including bone formation and also angiogenesis. Insulin effects on different cell types were investigated, and we intended to check its effect on dental pulp cells (DPC) during osteoblast differentiation. First, bone differen tiation ability of isolated dental pulp cells was assessed by alizarin red (AR)staining. Insulin increased dental pulp cell proliferation after 25 hours of cul ture. It increased mRNA expression of osteogenic markers such as Col1, RunX2, ALP, Osc, Mef2C and expression of genes involved in TGF b pathway such as Smad3, TSP1, VEGF at different time points.

Abstract The apparent volume of distribution was defined for the first time as the phase volume that can hold the total amount of a substance at the measured phase substance concentration, in a system composed of two immiscible me dia that are in contact under conditions of constant phase volumes, at equili brium. Its value is not affected by the total system solute mass and it only de pends on the total system volume, the phase volumes and the affinity of the solute for the two phases in the system. Using this new concept of the appar ent volume of distribution, we were able to demonstrate that under certain conditions compartment volumes in multi-compartment and multi-phasic pharmacokinetic models represent the actual physiological volumes of body fluids accessible by drugs. The classical pharmacokinetic models are now fully explained and can be used to provide accurate estimation of the pharmacoki netic parameters for hydrophilic drugs. In contrast, in the absence of tis sue-plasma partition coefficients, lipophilic drugs that do not follow a one compartment model are unlikely to be adequately described with classical multi-compartment pharmacokinetic models.

Abstract Purpose: Since the mRNA technology used to manufacture Pfizer-BioNTech COVID-19 Vaccine is new, it is still difficult to predict its consequences. However, many young people, especially in developing countries, think that they are less susceptible to severe infection with the Coronavirus 2 (SARS CoV-2), Therefore, they do not prefer to take the COVID-19 vaccines. Ac cordingly, studies in this aspect are necessary to increase people’s awareness of the acceptance of vaccination, especially for the youth. Patients and Me thods: This study was conducted on healthy young adults of both sexes. Par ticipants (n = 81) were received two doses of the Pfizer-BioNTech COVID-19 Vaccine. A paper questionnaire was prepared, the survey asks about the side effects related to receiving the Vaccine. All participants completed the ques tionnaire twice, once after the first dose and again after the second dose. Data were collected and statistically analyzed. Results: The most common side ef fects were Muscle pain, Tiredness, Headache, and Fever. Less common side effects were Chills, Fainted, Breathlessness, and Coughing. Rare side effects include nausea and vomiting, Diarrhea, Anaphylactic Reaction, and Swollen Lymph Nodes. Side effects that are strongly associated with females are Headache, and Joint pain, for males, Anaphylactic reaction. The study re vealed a significant difference between the number of females (96.5%) and males (85%) who suffered from the side effects of the Pfizer-BioNTech COVID-19 Vaccine (P = 0.033). Conclusion: Most of the side effects reported in our study were consistent with Pfizer’s fact sheet for recipients and caregivers. Through our follow-up to the participants in the study, we noticed that the reported side effects were not too bad, and they were able to carry out their daily activities, so we recommend taking the vaccine, especially for young people.

Abstract Background: Studies have shown that long non-coding RNA (LncRNA)plays a critical role in maintaining genomic instability. The correlation be tween lncRNA and genomic instability is still worth exploring in bladder cancer as a new tumour marker. Methods: Therefore, combined with the lncRNA expression profile and somatic mutation profile of bladder cancer, we established a computing framework of lncRNA related to genomic insta bility and identified 58 new lncRNA related to genomic instability. Next, we identified a lncRNA signature (GILncSig), based on these 58 new genes, which divided patients into high-risk and low-risk groups. The clinical prog nosis was significantly different and was further verified in an independent cohort of patients. Results: We confirmed that GILncSig is related to the ge nomic mutation rate of bladder cancer, suggesting that GILncSig can be used as an indicator of genomic instability. The results show that GILncSig has prognostic value independent of age, sex, grade, and stage and is vital in eva luating clinical prognosis. To sum up, this study provides a vital research ba sis and methods for further exploring the role of lncRNA in the genomic in stability of bladder cancer and provides a theoretical basis for the identifica tion of bladder cancer biomarkers related to genomic instability.

Abstract Urgent urologic interventions create a challenging scenario when they occur in patients suffering from concurrent acute coronary syndrome. Herewith we report two patients with this scenario. Case 1, a male patient was admitted with non-ST elevation myocardial infarction in which dual antiplatelet ther apy was initiated. He developed symptomatic right obstructive uropathy.Case 2, a male patient developed non-ST elevation myocardial infarction and was commenced on dual antiplatelet therapy. Subsequently, he developed gross hematuria unresponsive to conservative measures. Urgent urological intervention was carried out while on aspirin in both cases with uneventful recovery. Upon coronary angiography, both cases were found to have mul ti-vessel disease requiring coronary artery by-pass graft later. Due to their concurrent urologic problems the patients described were not optimized fully to undergo coronary angiography. In close collaboration with cardiology, pa tients with acute coronary syndrome can be carefully selected to undergo ur gent urologic interventions prior to coronary angiography/primary coronary intervention.

Abstract "Cryofrequence is the combination of cryotherapy with radiofrequency, which promotes a “thermal shock” to the tissue, working simultaneously to skin flaccidity and localized adiposity. The efficacy of dermatological and hypo dermic cryofrequency treatment was evaluated. This study reports the case of a 45-year-old woman with complaints of flaccidity and fat located in the in fra-umbilical region in the preoperative period of abdominoplasty. The evaluation was performed before and after treatment through evaluation protocols, ultrasound examinations and histological findings through optic microscopy, microfocal and immunohistochemical analysis. The treatment was performed in 4 sessions, with a weekly application, using the BHS 156 FULL®—BODY HEALTH BRASIL® apparatus, the parameters were tem perature of −10˚C, power in 70%, duration of 8 minutes. After the surgical procedure, parts of treated and untreated abdominal tissues were removed for evaluation. In the tests performed, significant destruction of adipocytes was detected, with consequent reduction of fat and greater expression of caspase-3 in the treated tissue, being constated the macrophage increase by CD68 ex pression. There was improvement in flaccidity, evidenced by the significant increase in the number of fibroblasts and inflammatory cells positive for Ki67, bringing more quantity and better quality to the collagen."

Abstract Background: Hydrolysis improves the sensitivity of drug detection for drug classes such as opiates/opioids and benzodiazepines, which are highly me tabolized by glucuronidation and sulfation and should be implemented in analytical procedures to convert conjugated metabolites into the free or un bound form. This study was aimed to compare different enzymes to make an informed decision. Methods: In this study, the CEDIA Benzodiazepine assay was compared with the LC-MS-MS method using 150 positive urine samples and 50 negative urine samples. The samples were analysed without adding any enzyme and then by adding different enzymes to compare their per formance. Results: The Kura Escherichia coli enzyme performed better than the Roche Escherichia coli enzyme which had 20% false-positive results. Kura BG-100 enzyme performed well but Kura B-One enzyme performed better The Kura B-One enzyme had only 11.5% false-positive results. When double the volume of Kura B-One enzyme was used to test to see if it will have any impact on reducing the number of false negatives, it performed worse. Kura Turbo enzyme behaved similarly to Kura BG-100. Conclusions: The β-glucu ronidase enzymes comparison allowed us to identify the Kura B-One enzyme as the enzyme of choice for our operation because it reduces the false posi tives from 20% to 11.5% when compared with the Roche enzyme. It also im proved the detection of oxazepam. The Kura B-One enzyme has a short in cubation time for hydrolysis when used with the LC-MS-MS method. As a result, we improved the overall turn-around time and reduced the number of false positives that needed confirmation.

Abstract Objective: To investigate the concentration and clinical significance of serum ferritin (SF) in patients diagnosed with advanced gastric cancer before and after treatment. Methods: Forty patients with advanced gastric cancer diag nosed by cytology or pathology in our hospital were selected, including 25 males and 15 females, aged from 48 to 85 years, and the median age was 61.0 years. 40 healthy volunteers matched with age and education were selected as the control group. In order to study the changes of SF level in the treatment of advanced gastric cancer, we divided the patients into effective group (effi cacy evaluation as partial remission or complete remission), ineffective group (efficacy evaluation as no remission) and recurrence group according to the efficacy after treatment. Then the difference of SF level between different groups and the relationship between SF level and curative effect were ana lyzed. There was no significant difference in gender and age among all groups. Results: The SF levels in the newly diagnosed group, stage III patient group and stage IV patient group were significantly higher than those in the control group. The level of SF in stage IV patients was significantly higher than that in stage III patients. There were significant differences in SF level be tween the effective treatment group, the newly diagnosed group and the inef fective treatment group, but there was no significant difference in SF level between the newly diagnosed group and the ineffective treatment group. Conclusion: SF level has a certain value in the auxiliary diagnosis of gastric cancer, and it also has a certain guiding significance for the evaluation of cur ative effect and prognosis after treatment.

Abstract Objective: To explore the mechanism of Chuanxiong in alleviating hypoxic pulmonary hypertension in rats by inhibiting pulmonary vascular remode ling. Methods: Thirty healthy and clean male SD rats weighing (180 - 220) g were randomly divided into three groups (n = 10): normoxia group (n), hy poxia group (H) and Chuanxiong group (L). Group N was fed in normoxic environment, and the other two groups were fed in hypoxic (9% 11% O2) en vironment for 4 weeks, 8 h/D, 6 days a week. Rats in group L were gavaged with Ligusticum chuanxiong solution diluted with normal saline at the con centration of 300 mg/kg, and rats in group H were gavaged with equal vo lume of normal saline. After 4 weeks, the mean pulmonary artery pressure was measured. After pulmonary perfusion, the right ventricular free wall and left ventricle plus ventricular septum were taken to measure the right ventri cular hypertrophy index. The changes of pulmonary morphology and ultra structure were observed under light microscope. Results: Compared with group n, the average pulmonary artery pressure and right ventricular hypertrophy index in the other two groups increased, and the thickening of pulmonary vascular wall was obvious under microscope (P < 0.01); compared with group H, the above changes in group L were reduced (P < 0.05). Conclusion: Ligus ticum chuanxiong can relieve pulmonary artery pressure in rats by inhibiting pulmonary vascular remodeling.

Abstract Assessment of Active Case Search of COVID-19 in Healthcare Facilities during the Third Wave of the Pandemic in Ekiti State, Nigeria Early case detection and isolation of patients infected with highly infectious diseases through active case search (ACS) are important for early commence ment of treatment and control of the disease within a population. This study aimed to assess the ACS of COVID-19 in healthcare facilities during the third wave of the pandemic in Ekiti State, Nigeria. This cross-sectional study was conducted in all healthcare facilities in Ekiti State. All cadres of local govern ment primary healthcare workers were trained to carry out the ACS using semi-structured interviewer-administered questionnaire uploaded on android phone software open data kit (ODK). ACS was conducted between June and September (epidemiological week 23 to 36), 2021 and the collected data were analyzed using IBM SPSS version 23.0. P-value < 0.05 was taken as signifi cant. The number of ACS visits for COVID-19 increases with epidemiological week progression, but the highest was in week 32 (9.9%). Cases of suspected COVID-19 in the healthcare facilities in the last one week were reported in more than half (58%) of the visits and 57.8% of those reported, documented between 1 - 4 cases. Also, out of those that were reported, 42% of them missed (not line listed) at least one suspected case of COVID-19. The private health facilities missed more cases of COVID-19 (54.3%) than other catego ries of health facilities (p < 0.001). The health educators and local government immunization officers (LIO) than other cadre of healthcare workers found most missed cases (57.1% and 51.4% respectively) in their visits (p < 0.001). The health educator as well as the LIO detected the highest proportion of missed suspected cases which shows that disease surveillance officers alone may not be adequate for ACS, there is a need to involve other local govern ment team member.