Background and Objectives: Accurately estimating fetal weight is critical for optimal obstetric management. This study aimed to evaluate the efficacy of using fetal liver length, measured via ultrasonography, to predict estimated fetal weight (EFWG). The specific objectives were to assess fetal weight using fetal liver length, establish predictive mathematical formulas, correlate liver length with EFWG, and quantify the strength of the association between fetal liver parameters and fetal weight. Methods: A cross-sectional study was conducted on a sample of 173 pregnant women with confirmed normal pregnancies at Ultrasound Department of Al-Auda Medical Center in Hafr Al-Batin, KSA; Pregnancies with suspected congenital abnormalities were excluded. Sonographic evaluations were performed using a real-time grayscale scanner (Mindray and Fujifilm) equipped with a 3.5 MHz curvilinear array transducer. Data collection involved measuring fetal liver length, and the data were analyzed using bivariate correlation and multiple linear regression methods. Results: The proposed simple linear regression analysis revealed that fetal liver length demonstrated a strong positive linear correlation with estimated fetal weight (R = 0.766). The coefficient of determination (R2 = 0.587) confirms that approximately 58.7 % of the total variance in fetal weight can be directly explained by liver length alone. The adjusted R2 (0.585) further substantiates the stability and reliability of the model. The analysis of variance yielded an F-statistic of 243.082 (p < 0.001), verifying that the regression model is highly significant and that the relationship is robust rather than a result of random chance. The derived unstandardized model provides a direct mathematical formula for clinical application: EFW G = -1637.782 + 492.151 X (Liver Length). The unstandardized coefficient for liver length (B = 492.151, t = 15.591, p < 0.001) confirms its critical role in assessing fetal growth parameters. Overall, these findings validate fetal liver length as a dependable, highly accurate metric for clinical estimation of fetal weight in routine obstetrical evaluations. This equation specifies that for every 1 cm increase in fetal liver length, the estimated fetal weight increases by approximately 492.15 g. Conclusion: The findings demonstrate that fetal liver length is a robust and statistically significant predictor of estimated fetal weight, offering a reliable, alternative parameter for comprehensive fetal growth assessment in clinical practice.

This work is about finding probable new anti-Ebola drugs. A formula [1] is used for that purpose- (Log A/Log B) =64.5/C-H-N-O. Where, C-H-N-O is molecular weight of the Ebola virus antigens. This formula was used to identify probable new anti-HIV drugs [2] and the cause of dementia [3]. Use of the formula [1] -(Log A/Log B) =64.5/C-H-N-O, to identify the constitution of probable anti Ebola drugs. “Log A is Logarithm of molecular weight (elemental atomic weight multiplied by number of molecules of that element) of individual element(s) of drug. Log B is Logarithm of molecular weight of similar element(s) of Deoxy Ribose Nucleic Acid (DNA). C-H-N-O is basic effector. 64.5 Kda is the molecular weight of a complex effector molecule-Haemoglobin. Atomic weight of the element x number of molecules of the same molecule = Molecular weight of that element in either DNA or Drug” [1].

Objective: To evaluate the association and discriminatory performance of diffusion MRI-derived apparent diffusion coefficient (ADC) values for ¹⁸F-FDOPA PET-defined metabolic activity in newly diagnosed glioma. Methods: This was a retrospective study of 87 treatment-naïve adults, who were initially evaluated for newly diagnosed or radiologically suspected glioma at Baghdad Teaching Hospital, Medical City, Baghdad from January 2026 to July 2026. Pretreatment diffusion MRI and ¹⁸F-FDOPA PET/CT results were evaluated. PET activity was determined a priori as TBRmax ≥1.60 as an approximated operational application of PET RANO 1.0. The mean ADC was compared across PET groups, associated with SUVmax and TBRmax and assessed by ROC analysis. WHO grade analyses were done in 80 individuals with histological confirmation. Results: Forty-six tumors were PET-active and 41 were PET-inactive. Mean ADC was lower in PET-active tumors (1.04 ± 0.24 vs 1.16 ± 0.23 ×10⁻³ mm²/s; p=0.029), whereas SUVmax was higher (3.73 ± 0.98 vs 2.06 ± 0.45; p<0.001). ADC correlated inversely with TBRmax (Spearman rho=−0.32; p=0.003) and SUVmax (rho=−0.29; p=0.006). The AUC was 0.62 (95% CI, 0.50–0.74). At ADC ≤1.20 ×10⁻³ mm²/s, sensitivity was 84.8%, specificity 41.5%, and accuracy 64.4%. Conclusion: ADC was moderately inversely correlated with 18F-FDOPA uptake but was poor in discriminative ability alone. The lower bound of the AUC confidence interval was near chance performance. The cutoff from this cohort is experimental and should not be used for guiding clinical choices without external confirmation.

Istradefylline, a selective adenosine A2A receptor antagonist used as an add-on therapy to levodopa therapy for Parkinson’s disease, requires reliable impurity profiling to ensure pharmaceutical quality and safety. In this study, a novel, stability-indicating, Quality by Design (QbD)-based and eco-friendly RP-HPLC method was developed and validated for the determination of Istradefylline and its related impurities in tablet dosage forms. Method robustness was systematically evaluated using a three-level, two-factor factorial design. Chromatographic separation was achieved on an XBridge C18 column (250 × 4.6 mm, 5 µm) using 0.01M ammonium formate buffer (pH 4.0) and acetonitrile at a flow rate of 0.8mL min⁻¹, with detection at 280 and 360nm. The method demonstrated excellent specificity, effectively separating Istradefylline from its impurities (IST-4, IST-5, IST-CIS, IST-10, and IST-40) without interference from excipients and degradation products. Linearity was established over the concentration range of 0.200–4.000µgmL⁻¹ (R² > 0.999), while accuracy, precision, and sensitivity met ICH acceptance criteria. Forced degradation studies confirmed the stability-indicating capability of the method. The method also complies with Green Analytical Chemistry principles through reduced solvent consumption and efficient chromatographic performance. Validation results demonstrated that the method is robust, reliable, and suitable for routine quality control, impurity profiling, and stability assessment of Istradefylline tablet formulations.

Rheumatic mitral stenosis, atrial fibrillation, and marked left atrial remodeling create a strong substrate for intracardiac thrombosis and systemic embolism. We report a 67-year-old woman with a previous ischemic stroke who had not received long-term anticoagulation or cardiological follow-up and presented with progressive exertional dyspnea, lower-limb edema, and signs of right-sided heart failure. Electrocardiography showed atrial fibrillation. Transthoracic and transesophageal echocardiography demonstrated rheumatic mitral stenosis with a mitral valve area of 1.5 cm² and a mean transmitral gradient of 8 mmHg, massive left atrial enlargement, dense spontaneous echo contrast with sludge, and multiple thrombi; the largest measured 60 × 40 mm. Therapeutic anticoagulation was initiated. Because of symptomatic valvular disease and the extensive thrombus burden, the patient underwent mitral valve replacement with left atrial thrombectomy. An organized 60 × 40 mm thrombus was removed, and postoperative recovery was uneventful. This case illustrates that thromboembolic risk in rheumatic mitral stenosis may be driven as much by atrial fibrillation, atrial remodeling, and blood stasis as by the transmitral gradient itself, and highlights the central role of transesophageal echocardiography in defining thrombus burden and guiding treatment.

Background: Medication adherence and health-related quality of life (HRQoL) serve as key determinants of therapeutic success in type 2 diabetes mellitus (T2DM). While sodium–glucose cotransporter-2 (SGLT-2) inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors continue to be widely recommended as add-on therapies, comparative real-world evidence on adherence and QoL outcomes remains limited. Objective: To evaluate and compare medication adherence and QoL in T2DM patients receiving SGLT-2 inhibitors versus DPP-4 inhibitors administered as adjunct therapies. Methods: A prospective, observational cohort study was undertaken for a period of 12 months at a tertiary hospital and affiliated clinics. In total, 200 individuals with T2DM (100 per group) were followed after initiating either SGLT-2 inhibitors (empagliflozin/dapagliflozin) or DPP-4 inhibitors (sitagliptin/linagliptin). Medication adherence assessment was conducted by means of 8-item Morisky Medication Adherence Scale (MMAS-8) and pill counts, whereas HRQoL underwent evaluation with the Diabetes-39 (D-39) questionnaire at baseline, 6 months, and 12 months. Statistical analyses involved repeated measures ANOVA and logistic regression. Results: Both groups demonstrated significant improvements in adherence and QoL from baseline (p < 0.001). Adherence scores increased from 5.0 ± 0.82 to 8.0 ± 0.82 in the SGLT-2 group and from 6.0 ± 0.82 to 9.67 ± 0.47 in the DPP-4 group, with consistently higher adherence in the DPP-4 cohort (p < 0.001). QoL improved more markedly in the SGLT-2 group (5.5 ± 1.51 to 7.96 ± 1.04; Δ = +2.46) compared to the DPP-4 group (4.95 ± 0.81 to 6.35 ± 0.48; Δ = +1.4; p < 0.001). Conclusion: Significant enhancements in adherence and QoL were observed with SGLT-2 and DPP-4 inhibitors in T2DM patients. DPP-4 inhibitors were associated with superior adherence, while SGLT-2 inhibitors conferred greater QoL improvements. These findings underscore the importance of tailoring therapy to optimize both clinical and patient-reported outcomes in long-term diabetes management.

Even though there have been major scientific developments in the fields of pharmaceutical analytical chemistry, manufacturing science, and regulatory science over the last twenty years, the incorporation of validated innovations into routine industrial practice remains slow, irregular, and incomplete. Although Quality by Design (QbD), Process Analytical Technology (PAT), continuous manufacturing (CM), Real-Time Release Testing (RTRT), and artificial intelligence (AI) are backed by strong scientific bases and have clear regulatory routes, their adoption differs greatly from product to product, facility to facility, and region to region. This structured narrative review uses implementation science, a field that systematically examines methods for integrating evidence into everyday practice, to examine innovations in pharmaceutical analytical and manufacturing processes. The review brings together the regulatory environments in the United States (21 CFR Parts 210/211, the FDA Emerging Technology Program, Quality Management Maturity), in the European Union (EudraLex Volume 4, Annex 1 on sterile manufacturing, the reform of EU pharmaceutical legislation), and in international frameworks (ICH Q8–Q14, M7, Q3D; WHO GMP; PIC/S Annex 11). Based on the Consolidated Framework for Implementation Research (CFIR), the RE-AIM evaluation model, and the Expert Recommendations for Implementing Change (ERIC) compilation, the review links implementation strategies to the various domains of pharmaceutical innovation. It examines FDA drug shortage reporting, analyzes 1,766 FDA Warning Letters (from 2016 to 2023), examines biosimilar uptake, and reviews regulatory submissions for continuous manufacturing. The review concludes with an implementation science framework tailored to the pharmaceutical industry, an example KPI dashboard, and 12 evidence-based recommendations. The main point is that, for a number of well-established innovations, the ability to implement them is now the main barrier to their routine adoption.