Tuberculosis is one of the most widespread disease in the world, and can be deadly in patientswith AIDS worldwide. The course of treatment is long (3-9) months, often need combinationtherapy to decrease microbial resistance, some of these drugs have serious side effects andundesirable physicochemical properties like, gastric irritation, short T1/2 (pas), hepatic toxicity andextensive metabolism by the liver (INH), through N-acetyl transferase enzyme.So by using this approach we hope reduction of gastrointestinal toxicity of PAS and reductionof intestinal acetylation of Isoniazid. This drug was synthesized by amidation of free amine groupof INH with free carboxyl group of glycine from one side and amidation of carboxyl group of PASafter protection of it, and amino group of glycine from other side, here amidation was done by usingcoupling agent (DCC) using conventional solution method and it was identified by the followingmethods: melting point, thin layer chromatography (TLC), infrared spectroscopy (IR) and theelemental analysis(CHN). The synthesized compound showed better partition coefficient comparedwith the original apromoiety (PAS,INH).

أن مرض التدرن هو احد الأمراض المنتشرة عالميا وباستطاعته أن يفتك بالأشخاص المصابين بمرض العوزالمناعي أن مدة العلاج غالبا ما تكون طويلة تتراوح من3 اشهر إلى 9 أشهر و تحتاج إلى مزيج من العلاجاتلتقليل مقاومة البكتريا.أن البعض من هذه العلاجات تحملتأثيرات جانبية خطرة و خواص فيزوكمياوية غير مرغوبفيها مثل حامض الباراامينوسالسلك يعمل على تخدش جدارالمعدة والمثال الأخر هو الايزونيازيد الذي يعمل على تسممالكبد وتأثره السريع بعمليات الايض بواسطة أنزيم(إن-استيل ترانسفريس). لذلك باستخدام هذه الطريقة نتوقعالتقليل من تأثير الباراامينوسالسلك أسد على جدار المعدةواختزال عمليات الايض السريع للايزونيازايد.ان المركب المخلق صنع على شكل مركب امايدبواسطة ربط مجموعة ألامين الحرة للايزونيازايد معمجموعة الكاربوكسيل من الطرف الأول للحمض الكلايسينوربط مجموعة الكاربوكسيل لحامض الباراامينوسالسلك معمجموعة ألامين للطرف الثاني للكلايسين.ان عملية صنع(DCC) مركب الامايد تمت بواسطة استخدام عامل الرابطبواسطة طريقة الطور السائل وتم استخدام التقنيات التاليةللتعرف على المركب الناتج مثل:قياس درجة الانصهار،كروماتوغلرافيا الطبقة الرقيقة، مطياف الأشعة تحت(P.C) الحمراء، التحليل الدقيق للعناصر أن معامل الانتشارللعقار المصنع هو أفضل أصلا من المواد المكونة له

Mutual prodrug --- PAS --- INH

Background:Children with acute abdominal pain represent most of the admitted cases to the pediatric surgical department, one third of these cases are acute appendicitis. Early diagnosis of “no appendicitis” or “appendicitis” on the basis of pediatric appendicitis score could potentially save emergency department's time and resource use and could avoid time cost and risks for further evaluation.Objective:Evaluation of Samuel scoring system in diagnosing children with acute appendicitis and their need for surgery.Methods:One hundred and twelve patients aged between 5 to 15 years who presented with abdominal pain suggestive of acute appendicitis were studied. A complete data from patients were analyzed by using Samuel score. The clinical findings used by previously mentioned scoring system were analyzed to determine reliability of pediatric appendicitis score (PAS). The Final diagnosis was determined by histopathological report for patients' undergone appendicectomy.Results:The mean (median, SD) score for children with acute appendicitis and non-acute appendicitis were 4.9 (5, 1.8) and 4.6 (5, 1.7) respectively. No variable (of the known signs and symptoms regarded as pathognomonic for acute appendicitis) shows a significant value in the diagnosis of acute appendicitis. A PAS of ≥ 4 had a sensitivity, specificity, Positive predictive value (PPV), and Negative predictive value (NPV) of 0.78, 0.27, 0.87, and 0.16 respectively.Conclusion:The diagnosis of acute appendicitis and the need for surgery is still a matter of clinical judgment which can be built with practice, and although the PAS could provide useful diagnostic information in children with suspected acute appendicitis, it cannot be used as sole method for determining the need for surgery.Key words:Pediatric Appendicitis Score (PAS), acute appendicitis, appendicectomy.

Pediatric Appendicitis Score --- PAS --- acute appendicitis --- appendicectomy

ABSTRACT:BACKGROUND: The diagnosis of acute appendicitis carries significant difficulties, particularly in very young ages on which the history and physical examination are difficult. The clinical challenge is to diagnose appendicitis early enough to prevent perforation, while minimizing the number of negative appendicitis that are performed. The diagnosis of acute appendicitis is primarily clinical and the clinical scoring systems have been investigated as alternatives or adjuncts to diagnostic imaging. OBJECTIVE: Is to establish the accuracy and applicability of using pediatric appendicitis scoring system (PAS) in evaluating acute appendicitis in pediatric age group.METHODS: A prospective cohort study was conducted in Al-Khansaa Teaching Hospital and Children Welfare Teaching Hospital, from January 2014 till November 2015. The study includes 143 patients aged from (3-13) years old referred from pediatric emergency unit or outpatient clinic with suspicion of acute appendicitis. All the obtained data were analyzed using pediatric appendicitis score (PAS) system which classifies the patients into 3 groups: Group (1): Patients with scoring (1-3) includes 38 patients, Group (2): Patients with scoring (4-6) includes 20 patients, while Group (3): Patients with scoring (7-10) includes 85 patients. Surgery was done to all patients of group 3 and thirteen patients of group 2. All removed appendices were sent for histopathological study.RESULTS: The median age of the 98 operated on patients was (8.9 years ± 2.6). The histopathological results of appendicitis were confirmed in 89 patients underwent surgery (five patients of group 2 and 84 patients of group 3), while negative histopathological result of appendicitis is seen in nine (9.2%) patients. There is significant association of positive histopathological findings with high PAS (≥7) scoring (p<0.0001). The 8 parameters of PAS system shows accuracy as following: the right lower quadrant tenderness, anorexia and hop tenderness shows accuracy of 90.8%, 87.8% and 86.7% respectively, while leukocytosis, fever and nausea/vomiting shows accuracy of 83.7%, 80.6% and 63.3% respectively. Migration of pain and PMN neutrophilia shows the lowest accuracy rate. The sensitivity of PAS system was 94.4%, the specificity was 88.9%, the PPV was 98.8%, the NPV was 61.5% with overall accuracy of PAS system was 93.9%.CONCLUSION: PAS system is easy, simple and useful tool in pre-operative diagnosis of acute appendicitis and can be used by pediatricians to reduce the number of admission to the hospital. Patients with scores of ≥ 7 show high probability of appendicitis and early operation is indicated, while patients with score of ≤3 rule out this disease. The CT scan and diagnostic laparoscopy is advocated for patients with score of (4-6).

KEYWORD: appendicitis --- pediatric appendicitis scores --- PAS.

Summary:Background: Nitre I la sativa Linn is a well known herb that is used by different societies, as food additive and as a medicinal herb: it used as a galactagouge for lactating women, and has long been described as an abortifacient-emmenagouge.Aim of the work: is to investigate the effect of crude black seeds on the endometrium and the pattern of it’s mucins, during the different phases of the Estrus cycle, making use of some special stains for the histochemical demonstration of mucins.Materials <6 Methods.'Crude Nieella sativa Linn, seeds were administrated for ten days, by an orogastric tube, on single regular daily dosage to properly selected mature Norway albino female rats. Animats were subdivided into subgroups, according to phases of the estrus cycle. Utera of these animals were routinely processed for carbohydrate histochemical (d-PAS, d AB2.5-PAS & A li 1.0) studies using carnoy's fixative, paraffin embedded sections. Experimental specimens were compared with that of control subgroups.Results: Results showed marked production of diastase fast-PAS reactive non-alcianophilic neutral mucins, with inhibited production of sulphated highly acidic mucins among the surface lining and the glandular epithelial cells, at Estrus. Effects of such changes in the pattern of endometrial mucins on the state of fertility, was discussed.Keywords: Nigella Sativa, Linn., Metrial gland, Endometrial Histochemistry. Sialomucins, Fucomucins, Sulphated mucins. d-PAS, AB2.5PAS, AB1.0.Introduction

Nigella Sativa --- Linn. --- Metrial gland --- Endometrial Histochemistry. Sialomucins --- Fucomucins --- Sulphated mucins. d-PAS --- AB2.5PAS --- AB1.0.