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Severity of COVID-19 manifestations in HIV patients: a systematic review and meta-analysis. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2024; 28:2569-2583. [PMID: 38567616 DOI: 10.26355/eurrev_202403_35763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE The incidence of coronavirus disease 2019 (COVID-19) pandemic among people living with HIV (PLWH) is experiencing major increases. This demographic is vulnerable due to compromised immune function, but the individuals are subjected to antiretroviral therapy (ART), which shows potential as a treatment for the pandemic. Therefore, this study aimed to investigate the severity of various forms of COVID-19 in PLWH as opposed to the general population. MATERIALS AND METHODS The study followed PRISMA guidelines and included a systematic review of literature from Pubmed, Science Direct, and Cochrane Library, comprising English-language articles from 2019 to 2022. This study included articles discussing HIV and COVID-19 case prevalence data by severity. A random effect model was used to demonstrate the pooled prevalence of COVID-19 among PLWH, as well as the prevalence of moderate and critical severity of COVID-19 among PLWH. The Joanna Briggs Institute checklist was used to assess the quality of studies. This study is registered in INPLASY No. INPLASY2023100063. RESULTS Out of a total of 1,965 articles relevant to the specified keyword combination, 13 articles conformed with inclusion and exclusion criteria. For HIV and non-HIV COVID-19 patients, the mean age was 52.98 ± 6.45 years and 55.84 ± 9.73 years, respectively. Approximately 73% of HIV COVID-19 patients were male. Symptoms among PLWH included fever (57%), cough (48.9%), and shortness of breath (37%). The pooled prevalence of COVID-19 among PLWH was 3.0% (95% CI, 1.0 - 8.5%), with critical, moderate, and mild severity in 4.8% (95% CI, 1.6 - 13.3%), 24.4% (95% CI, 1.9 - 29.8%), and 9.9% (95% CI, 1.9 - 38%), respectively. CONCLUSIONS PLWHs and HIV-negative individuals showed comparable rates and intensity of COVID-19. ART users exhibited immunological health comparable to immunocompetent people, demonstrating the essential role of ART in reducing the severity and mortality of PLWH with COVID-19.
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Epidemiology and clinical features of cutaneous leishmaniasis in Khyber Pakhtunkhwa, Pakistan. BRAZ J BIOL 2024; 84:e249124. [DOI: 10.1590/1519-6984.249124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/22/2021] [Indexed: 12/23/2022] Open
Abstract
Abstract Current cross-sectional study was carried out between September 2019 to January 2020 at the Department of Pathology, Mardan Medical Complex (MMC), Mardan, and District Headquarter Hospital North Waziristan, Khyber Pakhtunkhwa (KP), Pakistan. The objectives of the current study were to determine the prevalence of leishmaniasis and its associated risk factors in selected districts of KP province, Pakistan. Altogether, three hundred and seventy-four (n=374) leishmaniosis patients were included in the current study. Skin specimen from the ulcer border were collected. The slides were stained by Giemsa stain and examined for the presence of amastigote. The prevalence of leishmania infected patients in different region of KP were as follows: North Waziristan region 53.7 (n=201) District Mardan 34.7% (n=130); District Nowshera 6.7% (n=25), District Swabi 1.1% (n=4) and other Districts i.e. Dir, Malakand, Buner and Bajawarr were 3.7% (n=14). The frequency of leishmaniasis were more in male and majority of the infected patients were in the age group of <10 years. Among n=374 patients 95.7% (n= 358) had cutaneous leishmaniasis while 3% (n= 11) had mucocutaneous type of infection and 1.3% (n= 5) patients had both cutaneous and mucocutaneous infection. Upon treatment by Sodium stibogluconate (SSG) 97% (n=362) showed clinical signs of complete or partial recovery of their skin lesions. Conclusively, highest incidence of leishmania infection occurred during short study period and majority of the cases showed positive response to treatment.
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Deep remission improves the quality of life of patients with Crohn's disease and anoperineal fistula treated with darvadstrocel: results of a French pilot study. Tech Coloproctol 2023; 27:1201-1210. [PMID: 36811811 DOI: 10.1007/s10151-023-02765-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/31/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND The injection of allogeneic adipose tissue-derived mesenchymal stem cells (MSC) into anal fistulas in patients with Crohn's disease has never been evaluated in "real-life" conditions in France. METHODS We prospectively studied the first patients receiving MSC injections at our center and undergoing 12 months of follow-up. The primary endpoint was the clinical and radiological response rate. The secondary endpoints were symptomatic efficacy, safety, anal continence, quality of life (Crohn's anal fistula-quality of life scale, CAF-QoL), and predictive factors of success. RESULTS We included 27 consecutive patients. The complete clinical and radiological response rates at M12 were 51.9% and 50%, respectively. The combined complete clinical-radiological response (deep remission) rate was 34.6%. No major adverse effects or changes in anal continence were reported. The perianal disease activity index decreased from 6.4 to 1.6 (p < 0.001) for all patients. The CAF-QoL score also decreased from 54.0 to 25.5 (p < 0.001). At the end of the study, M12, the CAF-QoL score was significantly lower only in patients with a complete combined clinical-radiological response relative to those without a complete clinical-radiological response (15.0 versus 32.8, p = 0.01). Having a multibranching fistula and infliximab treatment were associated with a combined complete clinical-radiological response. CONCLUSIONS This study confirms reported efficacy data for the injection of MSC for complex anal fistulas in Crohn's disease. It also shows a positive impact on the quality of life of patients, particularly those for whom a combined clinical-radiological response was achieved.
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Patient safety in radiology: Our experience. Med J Armed Forces India 2023; 79:373-377. [PMID: 37441298 PMCID: PMC10334132 DOI: 10.1016/j.mjafi.2020.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 09/22/2020] [Indexed: 11/15/2022] Open
Abstract
Background Present-day radiology departments have very high footfall of patients and are prone to patient safety errors. This study analyses such errors in our hospital. Methods Observational cross-sectional analysis of errors over the last 30 months was performed. These were classified using the Eindhoven classification model into technical, organizational, and human errors. Technical errors focused on equipment safety. Organizational errors related to policies. Human errors were subclassified as per the skill rule knowledge model. Root cause analysis was performed wherever necessary, and possible mitigation strategies for ensuring safety were suggested. Errors peculiar to the Armed Forces environment were specifically addressed. Results Seventy-seven errors were analyzed. Two were equipment based including faulty pressure injector syringes and radiation leakage from the computed tomography gantry. Of 44 skill-based errors, 09 involved dispatch of wrong reports to dependents owing to identifying patients with serving personnel's name. Four were due to scanning wrong sites. Eleven involved reporting abnormality on the wrong side. Six involved underreporting due to not viewing specific images. The rest were due to failure to omit conflicting elements in the report. Rule-based errors included wrong protocol selection (9 errors), omitting a particular sequence due to individual preference (6 errors), and so on. Knowledge-based errors were due to misinterpretation of findings (4 errors), reporting an abnormality as normal (3 errors), and selection of wrong modality (3 errors). Conclusion The findings of this study highlights the importance of voluntary reporting, diligent recording, and in-depth analysis of errors for understanding the causes and formulating possible mitigation strategies.
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Impella 5.5 Use as a Bridge to Transplant in Hereditary Transthyretin Amyloidosis. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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An increasingly frequent rash to be aware of…. Tech Coloproctol 2023; 27:165-166. [PMID: 35996043 DOI: 10.1007/s10151-022-02692-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/12/2022] [Indexed: 01/18/2023]
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Clinical Outcome of 0.2% Glyceryl Trinitrate Topical Ointment Compared to Lateral Internal Sphincterotomy in the Treatment of Patient with Chronic Anal Fissure: A Randomized Control Trial. Mymensingh Med J 2022; 31:1034-1039. [PMID: 36189549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The objective of study was to evaluate the clinical outcome of topical 0.2% Glyceryl trinitrate topical (GTN) ointment in the treatment of chronic anal fissure. This randomized control trial was carried out in the Colorectal Surgery Unit, Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from May 2015 to April 2016. Total 94 patients were included in this trial, where 47(50.0%) patients were treated by 0.2% GTN ointment as Trial group 12 hourly for 8 weeks and 47(50.0%) patients by lateral internal sphincterotomy (LIS) as Control group in this study. Patients were randomized in two groups by lottery following purposive sampling. Post-procedural outcome variables with 6 months follow up were evaluated. Majority of the patients were found in between 20 to 40 years of age in both groups. The mean age was 34.6±10.4 years and 33.2±8.6 years in GTN and LIS respectively. Overall male female ratio was 0.88:1. All (100.0%) patients presented with pain in anus and 86.15% patients presented with per rectal bleeding. Pain relief in GTN arm versus LIS arm in 2nd and 6th week was 55.31% vs. 76.6%, 74.5% vs. 87.23% with no significant difference between two groups. But at 6 month it was 57.44% vs. 93.6% respectively. The fall in pain relief at 6th month in GTN arm was due to recurrence of fissure. At the end of 2nd, 6th week and 6month, cessation of bleeding improved gradually in both groups after treatment but the improvement was significantly better in LIS group than in GTN group indicating sphincterotomy stops bleeding better. Healing after 2nd week in both groups was minimum but equal 2(4.26%) patients. After 6 weeks LIS group had significant better healing than GTN 40(85.1%) versus 26(55.3%) with p value <0.001. In 6 month time GTN group had increased healing but LIS group had significant better healing than GTN group 42(89.36) vs. 32(68.08) with p value 0.004. Transient flatus and liquid incontinence were 8.51% and 6.4% respectively in LIS group with 0.0% in GTN group. Headache and recurrence were significantly higher in GTN group 61.7% and 34.04% with p<0.001. Lateral internal anal sphincterotomy is superior to the topical application of 0.2% nitroglycerin ointment in the treatment of chronic anal fissure with the advantages of good symptomatic relief, high rate of healing and a very low rate of transient continence disturbances.
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EP16.03-024 Cellworks Singula™ Therapy Response Index (TRI) Identifies Superior OS Outcomes for NSCLC Patients: myCare-203A. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Impact on Donor Derived Cell Free DNA (dd-cfDNA) of Procurement Using Paragonix SherpaPak™ (SP) Cardiac Transport System versus ICE Transportation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Body Composition After Cardiac Transplantation via Bioimpedance Spectroscopy. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Predictors of Malignancy in Thyroid Nodules. Mymensingh Med J 2022; 31:372-378. [PMID: 35383753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Thyroid swellings are common clinical problem throughout the world and also in Bangladesh. Most of thyroid swellings are multinodular, but a good percentage is solitary thyroid nodule. There is no robust, feasible method for malignancy differentiation has not been well established. The study evaluated thyroid nodules for risk of malignancy and compared history, clinical, sonographic features and FNAC findings with histopathology. This was a cross sectional study on 160 consecutive subjects of thyroid nodules done in the department of ENT and Head Neck Surgery of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh during from July 2018 to December 2019. All patients were admitted and diagnosed by detail history, clinical examination, investigations and underwent thyroidectomy. Detailed history, clinical examination, ultrasonographic finding and FNAC variables were documented retrospectively and a mathematical model was established for malignancy prediction. In this study mean age of the patients of thyroid nodules was 37.54±11.49 years and majority of the patients were within 21-40 years of age. Frequency of thyroid nodules is more in female with male female ratio 1:7. Most of the thyroid nodules appeared in this study within 0-2 years (61.9%). In this series of thyroid nodules constituted 88.1% firm, 8.8% hard, 3.1% cystic. Among the patients 89(55.6%) cases have solitary thyroid nodule and 71(44.4%) cases have multinodular goitre Majority of the nodules were warm 57.5% followed by cold 42.5%. FNAC showed nodular goitre 72.5%, Follicular neoplasm 1.3%, Papillary carcinoma of thyroid 7.5%, colloid goitre 9.4%, suspicious papillary carcinoma 3.8% and lymphocytic thyroiditis 1.3%. In this study out of 85 solid nodule, 69(81.18%) were benign and 16(18.82%) was malignant and out of 3 cystic nodule 3(100%) were benign. In this study most of the benign and malignant nodules were predominantly solid. Study showed the malignancy is significantly (p=0.001) more in solid than cystic nodules. Final diagnosis in this study was done on the basis of histopathological reports. Out of 160 patients, histopathologically benign lesion was 120(75%) and malignant was 40(25%). Among malignant cases 36(22.5%) cases were papillary carcinoma, 1 case was medullary carcinoma and 3 cases were follicular carcinoma.
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Managing Infectious Complications in the Immunocompromised Stage D Heart Failure Patient: A Case of Left Ventricular Assist Device Placement in a Patient with Chronic Lymphocytic Leukemia. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Abnormal Surveillance Echo Parameters Following Orthotopic Heart Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Impact of Donor Characteristics on AlloSure Scores. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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164 Testicular Torsion: A Race to Beat the Golden Hours. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Testicular torsion is a condition requiring immediate attention and the golden time period for its management is 6 hours at which rate of salvageability of the testes is 90 percent (NICE). This decreases considerably with passing time. Imaging has minimal value.
Method
The electronic data of 36 patients from June 2020 to May 2021 were reviewed and analysed. Majority of patients were between the age of 11–20 i.e., 21. We analysed the mode of admission of these patients, the time between the A&E triage and surgical clerking and A&E triage and induction of anaesthesia.
Results
Majority (70 percent) patients were admitted through Emergency A&E. The time between the A&E triage and surgical clerking was less than 30 minutes for 10 patients while 11 patients had no proper documentation of time. The time between the A&E triage and the induction of anaesthesia was less than 6 hours in 23 patients, and more than 6 hours for 7 of them. 14 underwent Scrotal Exploration and Bilateral orchidopexy and 13 orchidectomies. Out of 13 orchidectomies, 6 had crossed the golden time period at the time of induction. Out of 10 patients booked for USS testis, 8 underwent Orchidectomy and 6 had crossed the golden hour (6 Hours).
Conclusions
Early presentation, diagnosis and exploration of testicular torsion improves the salvable rate of testes. 6 patients who underwent USS testis passed the golden timeframe which shows that there is a scope for faster and appropriate management of testicular torsion.
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Sutureless Manual Extracapsular Cataract Extraction with Club. PAKISTAN JOURNAL OF OPHTHALMOLOGY 2021. [DOI: 10.36351/pjo.v38i1.1252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Purpose: To evaluate the efficacy and safety of cataract extraction through small pupil with the help of a specially designed instrument called club.
Study Design: Interventional case series.
Place and Duration of Study: Euro eye clinic from January 2019 to December 2019.
Methods: Seventeen consecutive patients with pupil diameter of <4mm after maximal pharmacological dilatation were recruited for study. Inclusion criteria was patients with less than 4mm pupil size after maximum pharmacological dilation. Patient with previous anterior segment surgery and small pupil with posterior synechea were excluded. The instrument (club) was originally designed for breaking posterior synechae. Sutureless Manual Extracapsular Cataract Extraction (SMECE), more commonly known as MSICS, was performed in all cases. After tunnel formation and capsulotomy, club was used to bring lens edge out in pupillary margin. Lens was then maneuvered into anterior chamber and expressed out.
Results: All 17 patients had successful SMECE. In one patient pupil was stretched before applying instrument. None of the patients had posterior capsular rupture or hyphaema.
Conclusion: This instrument designed in Center of Ophthalmic Instrument and Equipment Designing (COIED) is very useful, safe and cost effective. In Extra Capsular Cataract Extraction (ECCE) or SMECE, surgeons usually do keyhole iridotomy, mechanical stretching or multiple sphincterotomies for managing small pupil. With this new instrument, cataract extraction can be done without surgical trauma to the pupil, thus preserving pupil shape.
Key Words: Sutureless Manual Extra capsular Cataract Extraction (SMECE), Manual Small Incision Cataract Surgery (MSICS), Miosis.
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Advance care planning in dementia: a qualitative study of Australian general practitioners. Aust J Prim Health 2021; 28:69-75. [PMID: 34844662 DOI: 10.1071/py20307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 07/19/2021] [Indexed: 11/23/2022]
Abstract
As the population ages, so does the prevalence of dementia, a condition in which timely advance care planning (ACP) is recommended. This study explored the barriers and enablers of ACP for Australian GPs caring for people with dementia. Semi-structured qualitative telephone interviews informed by the theoretical domains framework (TDF) were conducted with 16 GPs from the south-east region of metropolitan Melbourne. The most prevalent domains of the TDF were: (1) environmental context and resources; (2) beliefs about consequences; and (3) social/professional role and identity. Further thematic analysis found that: (1) ACP was felt to be within the scope of general practice, but more so before the onset of dementia because lack of confidence in capacity assessment acted as a barrier once a diagnosis was made; (2) beliefs about the perceived benefits of ACP motivated GPs to engage patients in ACP; and (3) doctors felt that patients were often reluctant to discuss ACP, especially in the time-pressured context of the standard consultation. This study's use of the TDF provides direction for potential interventions to alleviate challenges faced by Australian GPs with ACP in dementia. Improving ACP in general practice may require a focus on public health campaigns to educate patients about the benefits of ACP before the onset of dementia. GPs' difficulty assessing a patient's decisional capacity may be addressed through skills development workshops.
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Synthesis, characterization and urease inhibitory activities of Zn(II) complexes bearing C1-symmetric ligands derived from (R)-phenylethanamine. B CHEM SOC ETHIOPIA 2021. [DOI: 10.4314/bcse.v35i2.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
ABSTRACT. A series of Zn(II) complexes, supported with N-substituted phenylethanamine derivatives, [LnZnCl2] (where Ln = LA ((R)-1-phenyl-N-(thiophene-2-ylmethyl)ethanamine; LB (R)-N-(5-meyhylthiophene-2-yl)methyl-1-phenylethanamine; LC ((R)-N-(furan-2-ylmeththyl)-1-phenylethanamine and LD (R)-N-((5-methylfuran-2-yl)methyl)-1-phenylethanamine) were synthesized and characterized. The urease inhibitory activities of these complexes were determined against selected urease inhibitors where [LBZnCl2] was found to be the most prominent inhibitor of Jack bean urease (J. B. urease) (IC50 = 10.39±0.78 μM), whereas the activity of Bacillus pasteurii urease (B. P. urease) was predominantly inhibited by [LAZnCl2] (IC50 = 8.68±0.7 μM). Additionally, MOE-Dock program was used to affirm the probable binding modes of these complexes into the crystal structure of J. B. urease which certainly verified the inhibitory mechanism of these novel complexes.
KEY WORDS: Zn(II) complexes, (R)-Phenylethanamine, Urease inhibition, Molecular docking
Bull. Chem. Soc. Ethiop. 2021, 35(2), 301-314.
DOI: https://dx.doi.org/10.4314/bcse.v35i2.7
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Hemorrhoidal surgery in patients with IBD: caution is the parent of safety. Tech Coloproctol 2021; 25:1319-1321. [PMID: 34609635 DOI: 10.1007/s10151-021-02531-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 09/14/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the outcome of hemorrhoidal surgery in patients with inflammatory bowel disease (IBD) undergoing surgery at our center. METHODS All adult patients with IBD undergoing hemorrhoidal surgery in our department between November 1, 2013 and July 7, 2020 were included in the study. At the time of surgery, the patients' IBD was in clinical, biological and endoscopic remission, and none of the patients had specific primary anoperineal lesions. RESULTS We included 25 patients (48% female) with a mean age 48 years (± 13.1 years). There were 13 cases of CD (52%) and 12 of ulcerative colitis (UC). Pharmacological and instrumental hemorrhoidal treatment had failed in all patients. The CD lesions were exclusively ileal (77%) or ileocolic (23%). The surgical procedures performed for CD were mono-hemorrhoidectomy in three patients (21.4%), tripedicular hemorrhoidectomy in six patients (42.9%), and artery ligations with mucopexy in five patients (35.7%). UC was rectal (16.7%), rectosigmoid (66.7%), or pancolic (16.6%). The surgical procedures performed for UC were a tripedicular hemorrhoidectomy in ten patients (83.3%) and artery ligations with mucopexy in two patients (16.7%). The mean duration of postoperative follow-up was 15.1 months. None of the patients was lost to follow-up. The mean time to wound healing after resection was 71.1 days (± 21 days) for patients with CD and 56.9 days (± 6.7 days) for patients with UC (p = 0.05). Postoperative complications were reported for four patients with CD (28.8%) and two patients with UC (16.7%). There was no suppuration, stenosis, or anal incontinence sequelae. CONCLUSIONS Hemorrhoidal surgery resulted in a non-negligible frequency of complications in our series of IBD patients, especially in those with CD. Caution is, therefore, still necessary in this patient population.
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Plasma convalescent decrease mortality in COVID-19 patients: a systematic review and meta-analysis. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2021; 25:4841-4853. [PMID: 34337734 DOI: 10.26355/eurrev_202107_26398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the role of Convalescent Plasma (CP) in reducing mortality of COVID-19 patients. MATERIALS AND METHODS A systematic literature search was conducted from PubMed, Embase, Medrxiv, and Google Scholar from April and finalized in December 2020 using the following terms: covid-19, convalescent plasma, cp, ccp, copla. The studies were screened, extracted, and evaluated by two authors independently. Comparative retrospective or prospective studies with a control group were included. Mortality was defined as the outcome of interest. Research articles not published in the English language, not available in full text, review articles, no measured outcome of interest were excluded from this study. RESULTS Eighteen studies were included in this meta-analysis. There were 5658 patients with 2092 patients treated with CP and 3536 patients as a control group. Forest plot showed CP use was associated with decreased mortality with OR = 0.64 (95% CI 0.49 to 0.84, p<0.001) and heterogeneity (I2)= 27.62%. Few patients experienced an adverse event, but no fatal case was reported. CONCLUSIONS Convalescent plasma is effective in reducing mortality of severe and critical COVID-19 with tolerable adverse effects.
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Abstract
AbstractCardiac MRI is a valuable and an accurate modality used in the evaluation of structure and function of the heart. It is increasingly considered as a useful non invasive examination in management of cardiovascular conditions, a situation resulting from significant advances in MR technologies. Evaluation of congenital heart disease is an important application of Cardiac MRI since the morphological details of chambers, septum, defects and anomalous connections are depicted accurately. Additionally, flow information across valves, chambers, outflow tracts and shunts are also provided. Its utility is further increased especially during follow up of patients after corrective surgery. This article reviews current state-of-the-art MRI application in common congenital heart diseases.
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Biodiversity of orb-web spiders (family: araneidae) of buner valley, Pakistan. BRAZ J BIOL 2021; 82:e238339. [PMID: 34161423 DOI: 10.1590/1519-6984.238339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/28/2020] [Indexed: 11/21/2022] Open
Abstract
The present research was carried out to explore the spider fauna of Buner valley with taxonomic study from February 2018 to January 2019. For this purpose samples were collected, four times at each month from 4 tehsils: Daggar, Gagra, Mandan and Totalai. Two methods were used, hand picking and sweep net for collection of samples. During day and night, three habitats, arid area, agriculture land and building area were search for collection. A total of 534 samples of spider were collected from four sampling sites, in which 379 were belonging to family Araniedae. After confirmation, the identified species were belonging to 8 genera (Neoscona, Argiope, Cyclosa, Araneus, Cyrtophora, Larinia, Erivoxia and Poltys) and 19 species. 18 of them were identified to specie level while a single specie to its generic level. The genus Neoscona was the dominant genus 26.31% having 5 species while the genus Argiope 21.05% is the second dominant having 4 species followed by Cyclosa 15.78% having 3 species followed by Cyrtophora and Araneus 10.52% having two species both. The Poltys and Larinia 5.26% are the rarest genera represent single-single specie both. Statistical analysis show that specie richness (D) = 5.77, Simpson index (1-D) = 0.87, Shannon index (H) = 2.33. Diversity of spiders was evenly distributed and calculated Evenness value was H/InS = 0.5408. There is also few atypical species and Fisher alpha estimate high value (Fisher α) = 4.42. Chao-1 estimated we have reported 22 species.
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Description of Lutziella swatensis sp.n. (Trematoda: Dicrocoelidae) from Rattus rattus in Swat, Pakistan. BRAZ J BIOL 2021; 82:e225092. [PMID: 34037073 DOI: 10.1590/1519-6984.225092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 04/13/2020] [Indexed: 11/21/2022] Open
Abstract
A new species of the genus Lutziella (Rohde, 1966) Yamaguti, 1971 is described here and named Lutziella swatensis sp.nov. from the liver of rat (Rattus rattus L.). The new species is characterized by having body flat, smooth, longer than broad with maximum width at the level of the ovary, oral sucker with weak musculature, pharynx small; eosophagus long; caeca of irregular shape which bifurcate on the anterior border of the ovary in to unequal portions, acetabulum weakly muscular, post-testicular, testes lobed, cirrus pouch somewhat median, small in size containing winding seminal vesicle, prostatic complex and short ejaculatory duct. Genital pore median. Ovary post testicular, submedian; seminal receptacle overlapping ovary, laurer's canal present. Vitellaria follicular extending on each side from almost the level of testes to anterior portion of posterior half of the body. Uterus filled with eggs occupying most of the body, eggs oval rather small, numerous, brownish in colour, excretory vesicle tubular with terminal pore. Lutziella swatensis n. sp. is the second species of the genus known from Pakistan as well as the second species described from murid rodents in the world.
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Euphlyctis Cyanophlyctis Schneider, 1799 (Amphibia: Dicroglossidae) in district Lower Dir, Pakistan. BRAZ J BIOL 2021; 82:e236496. [PMID: 34037074 DOI: 10.1590/1519-6984.236496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 08/10/2020] [Indexed: 11/21/2022] Open
Abstract
Euphlyctis cyanophlyctis (the skittering frog) is one of the most widespread species in Pakistan. Present study was aimed to know the presence of Euphlyctis cyanophlyctis in urban and rural areas of Lower Dir, the North-western Pakistan. A total of 33 frogs were collected, including 15 from rural and 18 from urban areas. The frogs were caught by hands covered with gloves instead of using nets. The collection was managed from August to October 2016 and from April to May 2018. Morphometric analysis, coloration as well as photographs of the frogs have been provided in detail. Skittering frogs were seen frequent in swampy areas near the water bodies. These frogs were mostly seen after sunset.
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Systematic analysis of leisler's bat Nyctalus leisleri (Kuhl, 1817) captured from FATA region, Pakistan. BRAZ J BIOL 2021; 82:e238337. [PMID: 33978080 DOI: 10.1590/1519-6984.238337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/28/2020] [Indexed: 11/21/2022] Open
Abstract
Extensive field surveys were carried out to explore the distribution of Leisler's Bat Nyctalus leisleri (Kuhl, 1819) in selected area of FATA regions, Pakistan. Specimens of Leisler's Bat Nyctalus leisleri (Kuhl, 1819) (n5) were collected from Kurram Agency (Shublan) (N33.8229788 E70.1634414) at elevation 1427m and Khyber Agency (Landi Kotel) (N34.0909899 E71.1457517) at elevation 1091m for two years survey extending from May 2013 through August 2015. The mean head and body length, hind foot length, ear length and tail length the Nyctalus leisleri specimens captured from the study area was 65.08 ± 1.58 mm, 44.06 ± 0.52 mm, 8.38 ± 0.60 mm, 13.20 ± 0.99 mm and 39.46 ± 1.46 mm, respectively. For molecular analysis the sequences of COI gene were obtained and analyzed. The mean intraspecific divergences of Nyctalus leisleri was 0.04%. The mean interspecific divergences of Nyctalus noctula and Nyctalus leisleri was 0.2%. The mean concentration of each nucleotides was A = (26.3%), T = (32.8%), G = (15.9%) and C = (25.0%). The mean A+T contents were 59.2%and C+G were 40.9%. In the phylogenetic tree Nyctalus leisleri and Nyctalus noctula clustered with significant bootstrap support value.
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Re: UK undergraduate aspirations and attitudes survey: do we have a perception problem in clinical radiology? Clin Radiol 2021; 76:547. [PMID: 33962780 DOI: 10.1016/j.crad.2021.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 02/11/2021] [Indexed: 11/28/2022]
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Drugs, Bugs, and the ECMO Unplugged: A Case of a 61-year-old with Cardiogenic Shock and Utility of Palliative Bedside ECMO De-Escalation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Procedural Safety Profile of Cardiomems Heart Failure Sensor Implantation in a Veterans Association Patient Population. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Pandemic Now and Then: A Historical Perspective of Non-Pharmaceutical Interventions Adopted In Covid-19. Mymensingh Med J 2021; 30:562-569. [PMID: 33830144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The coronavirus disease 2019 (COVID-19), first reported in Wuhan, China is now a major global health threat - a pandemic. Public health control measures are the cornerstones in the fight against COVID-19 in the absence of an effective vaccine or proven treatment. The aim of this review was to explore the historical use case of various public health measures adopted today to tackle COVID-19 spread. Although our knowledge about this novel coronavirus transmission is evolving over time, the fundamental non-pharmaceutical interventions e.g., handwashing, wearing a mask, physical distancing, isolation, quarantine and border control which are adopted globally at present are not new. This review highlighted that historically and religiously similar approaches were practised in the medieval past for controlling disease outbreaks. The successful implementation of the public health control measures largely depends on health systems resilience, community engagement and changes in population behaviour. Combined global efforts are essential to strengthen health systems, improve the capability of research and transparent information sharing with both public and international bodies to combat the pandemic.
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Variation in CardioMEMS Pressure Measurements Due to Frequent Changes in Altitude in a Patient with HeartMate III LVAD. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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POS-690 Outcomes of Malignancy in Kidney Transplant Recipients. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Distribution of commensal rodents in rain-fed and irrigated areas of Swat district, Khyber Pakhtunkhwa, Pakistan. BRAZ J BIOL 2021; 82:e236499. [PMID: 33729383 DOI: 10.1590/1519-6984.236499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 07/28/2020] [Indexed: 11/22/2022] Open
Abstract
Distribution pattern and relative abundance of the agricultural rodent pests of rain-fed and irrigated areas of district Swat Khyber Pakhtunkhwa, Pakistan were recorded from April 2011 to November 2013 using wire mesh live traps. A total of 350 rodents (269 Rattus rattus and 81 Mus musculus) were captured under 2268 trap nights (trap success: 0.15). Regression of daily captures on cumulative captures revealed an estimate of 350 rodents from all the sampled structures with an average of 21.8 rodents per crop field. House rats (R. rattus; 76.8% of captures) were numerically dominant in almost all types of agricultural fields, and were significantly different from the mice (Mus musculus; 23.1% of captures). Both species were found together in some fields. The sex ratio revealed that males outnumbered the females in both of the reported species.
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Expression of stress responsive β-1,3-glucanase and chitinase genes in Arachis hypogaea seedlings against Macrophomina phaseolina. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100693] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cystoid Macular Edema after Extracapsular Cataract Extraction Performed by Residents. PAKISTAN JOURNAL OF OPHTHALMOLOGY 2020. [DOI: 10.36351/pjo.v36i3.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Purpose: To determine the frequency and outcome of management of cystoid macular edema after extracapsular cataract extraction performed by residents.Study Design: Interventional case series.Place and Duration of Study: Lady Reading Hospital, MTI, Peshawar from Oct 2018 to Oct 2019.Material and Methods: Total 400 patients with mature cataract were included in our study. Patients having preexistingdisease such as uveitis, hypertensive retinopathy, diabetic retinopathy and retinal degenerations wereexcluded. All surgeries were performed by 4th year residents under supervision. Complicated cases before orduring surgery were excluded from the study. Cystoid macular edema cases were classified as follows; acuteoccurring within three months of cataract extraction and with duration fewer than 6 months, chronic persistingmore than 6 months. Patients were either managed conservatively or with anti-VEGF. All cases were followed for3 months or longer until resolution of cystoid macular edema.Results: Twenty patients developed cystoid macular edema out of which 16 patients (80%) improved withconservative treatment and 4 patients (20%) developed resistant cystoid macular edema. All four patients weregiven intravitreal bevacizumab injection monthly for three months. Our findings showed that best corrected visualacuity (BCVA) before injection ranged from 6/60 to 6/24. After three injections BCVA improved between 6/18 to6/6. Pre injection central subfield thickness (CSFT) was between 611 to 480 micron which improved to 272 -260micron after injections.Conclusion: Cystoid macular edema responds well to conservative treatment but resistant cases need repeatedinj of anti VEGF.
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Use of small intestinal submucosa for corporal body grafting in cases of epispadias and epispadias/exstrophy complex. J Pediatr Urol 2019; 15:406.e1-406.e6. [PMID: 31221598 DOI: 10.1016/j.jpurol.2019.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 05/18/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Male epispadias is a rare congenital urogenital anomaly in which the meatus is ectopically located along the dorsal midline of the penile shaft. In cases associated with severe curvature, functional and cosmetic outcomes could be accomplished by lengthening the shorter dorsal surface with the use of corporal grafting. Various graft materials have been used in the past for hypospadias repair including tunica vaginalis, dermis, and small intestinal submucosa (SIS). The use of SIS grafting for corporoplasty during epispadias repair has rarely been described in the literature. OBJECTIVE To report the experience in the management of dorsal corporal body grafting using SIS in children with severe penile curvature due to epispadias. STUDY DESIGN The authors retrospectively reviewed the charts of all patients with epispadias or bladder exstrophy/epispadias complex and severe dorsal chordee (>40°) who underwent epispadias repair with single-layer SIS for corporal body grafting. Clinical variables, surgical technique, and outcomes were analyzed. RESULTS A total of nine consecutive patients underwent staged epispadias repair with dorsal corporal single-layer SIS grafting (summary figure). Of these, four (44.4%) had primary penopubic epispadias, one (11.1%) had mid-shaft epispadias, and four (44.4%) had bladder exstrophy/epispadias complex. The mean age at surgery was 13.4 ± 6 months. After phalloplasty with SIS grafting, there were no reported complications related to the graft during the post-operative period or follow-up visits. DISCUSSION Although traditional techniques for epispadias repair allow some degree of corporal lengthening, they also result in abrupt medial rotation of the corporal bodies leading to torqueing and potential unsatisfactory cosmetic results. In contrast, the authors use single-layer SIS for corporal body grafting, and this study technique results in a more gradual inward rotation thus allowing more anatomical accuracy. Furthermore, an advantage of the use of SIS over other grafting materials is that there is no need to harvest an autologous graft such as tunica vaginalis or dermis. CONCLUSION Epispadias repair using single-layer SIS corporal body grafting is an effective, safe, and feasible method, which provides satisfactory cosmesis and correction of dorsal curvature in congenital epispadias in children. Furthermore, a more normal penis appearance, without a decrease in the corporal length or diameter, is achieved with this technique.
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Validating the Newly Reported ASA Score. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Efficacy and Safety of Short-Term Universal Prophylaxis for Invasive Aspergillosis after Heart Transplantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Artificial intelligence in radiology: how will we be affected? Eur Radiol 2018; 29:141-143. [DOI: 10.1007/s00330-018-5644-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/24/2018] [Accepted: 07/02/2018] [Indexed: 02/06/2023]
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Isolation and genome analysis of a lytic Pasteurella multocida Bacteriophage PMP-GAD-IND. Lett Appl Microbiol 2018; 67:244-253. [PMID: 29808940 DOI: 10.1111/lam.13010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 04/10/2018] [Accepted: 04/25/2018] [Indexed: 11/28/2022]
Abstract
Currently used alum precipitated and oil adjuvant vaccines against HS caused by Pasteurella multocida B:2, have side effects and short-lived immunity, leading to regular catastrophic outbreaks in bovines in Asian subcontinent. The need for the development of an improved vaccine with longer immunity and the ability to differentiate between vaccinated and infected is essential. Pasteurella phage isolated in present study belongs to family Siphoviridae. PMP-GAD-IND phage exhibited lytic activity against vaccine strain (P52) as well as several field strains of P. multocida (B:2), and fowl cholera agent (P. multocida A:1).The phage has a double stranded DNA (dsDNA) with a genome of 46 335 bp. The complete genome sequence of the Pasteurella multocida phage has been deposited in Gen Bank with accession no: KY203335. PMP-GAD-IND being a lytic phage with broad activity range has a potential to be used in therapy against multidrug resistant P. multocida infections. SIGNIFICANCE AND IMPACT OF THE STUDY The present work is a part of research for the development of an improved phage lysate marker vaccine and a companion DIVA assay against haemorhagic septicaemia. This study describes the isolation and genome analysis of PMP-GAD-IND a lytic Pasteurella multocida bacteriophage.
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The GBA p.Trp378Gly mutation is a probable French-Canadian founder mutation causing Gaucher disease and synucleinopathies. Clin Genet 2018; 94:339-345. [PMID: 29920646 DOI: 10.1111/cge.13405] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/08/2018] [Accepted: 06/12/2018] [Indexed: 12/30/2022]
Abstract
Biallelic GBA mutations cause Gaucher disease (GD), and heterozygous carriers are at risk for synucleinopathies. No founder GBA mutations in French-Canadians are known. GBA was fully sequenced using targeted next generation and Sanger sequencing in French-Canadian Parkinson disease (PD) patients (n = 436), rapid eye movement (REM)-sleep behavior disorder (RBD) patients (n = 189) and controls (n = 891). Haplotype, identity-by-descent (IBD) and principal component analyses (PCA) were performed using single nucleotide polymorphism-chip data. Data on GD patients from Toronto and Montreal were collected from patients' files. A GBA p.Trp378Gly mutation was identified in two RBD and four PD patients (1% of all patients combined), and not in controls. The two RBD patients had converted to DLB within 3 years of their diagnosis. Haplotype, IBD and PCA analysis demonstrated that this mutation is from a single founder. Out of 167 GD patients screened, 15 (9.0%) carried the p.Trp378Gly mutation, all in trans with p.Asn370Ser. Three (20%) of the GD patients with the p.Trp378Gly mutation had developed Parkinsonism, and 11 patients had family history of PD. The p.Trp378Gly mutation is the first French-Canadian founder GBA mutation to be described, which leads to synucleinopathies and to GD type 1 when in compound heterozygosity with p.Asn370Ser.
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0284 Sleep-active Neurons In The Median Preoptic Nucleus Exhibit Signs Of Physiological Dysfunction In Aging. Sleep 2018. [DOI: 10.1093/sleep/zsy061.283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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0285 Chronic Suppression Of Cell Proliferation And Neurogenesis Causes Premature Aging Of The Sleep-wake Organization In Young Animals. Sleep 2018. [DOI: 10.1093/sleep/zsy061.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bladder exstrophy closure in the newborn period with external pelvic fixation performed without osteotomy: A preliminary report. J Pediatr Urol 2018; 14:32.e1-32.e7. [PMID: 29195831 DOI: 10.1016/j.jpurol.2017.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 08/12/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Successful primary bladder closure is the most crucial element for urinary continence in patients with classic bladder exstrophy (CBE). In the newborn period, bladder closure can be performed in the first 48 h without pelvic osteotomy or external fixation, but requires postoperative lower extremity immobilization (i.e., spica cast, Bryant's or Buck's traction). OBJECTIVE To present a novel surgical approach for primary bladder closure for CBE using two-pin external fixation without pelvic osteotomy, and without postoperative lower extremity immobilization. STUDY DESIGN A retrospective chart review of patients with CBE was performed at the current institution from 2000 to 2016, including all primary bladder closures with external fixation and without osteotomy or lower extremity immobilization. Patients were discharged with the external fixator in place, which was later removed in clinic. Baseline clinical and demographic variables, and follow-up data were recorded. RESULTS Thirteen patients were analyzed; eight (61.5%) were male. Pre-operative intersymphysial distance was 3.68 ± 1.0 cm (2.0-5.0). Mean follow-up was 56.8 ± 40.3 months (10-131). One patient had a partial bladder neck dehiscence, due to pin displacement on postoperative day 1: he had the lowest gestational age of 34 weeks (Summary table). DISCUSSION This approach used external fixation to bring the pubic bones together intra-operatively, and to decrease the tension in closing the pelvic ring and abdominal wall without osteotomy. External fixation with osteotomy and long-term immobilization, or using a spica cast without osteotomy offered the added advantage of improved wound care, due to lack of lower limb immobilization, less patient discomfort, and facilitation of mother/caregiver and newborn bonding. CONCLUSION The two-pin external fixator without osteotomy as an adjunct to primary bladder closure in CBE patients was technically feasible. At the current institution this approach had an equivalent success rate to previous reports in the literature for primary bladder closure, decreased the length of hospital stay, and precluded the need for lower extremity immobilization. Early data for bladder capacity were encouraging.
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NITROXYNIL UNCOUPLES OXIDATIVE PHOSPHORYLATION IN THE CELL MITOCHONDRIA AND A DRUG WHEREVER INJECTABLES ARE PREFERRED OVER DRENCHES. ACTA ACUST UNITED AC 2017. [DOI: 10.3329/bjvm.v15i1.34054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In the absence of effective vaccines and because of practical limitations in management options to control the snail intermediate hosts, the control of liver fluke infection and disease in livestock relies heavily on the use of flukicidal anthelmintics. Nitroxynil is a nitrate derivative from benzene compounds and presents a flukicide effect and is commonly used as the one with best spectrum from all the nitrate derivative trematocides. The drug is in fact, a low spectrum anthelmintic effective against fascioliasis, an important parasitic disease caused by flukes like Fasciola hepatica, Fasciola gigantica, affecting significantly the ruminant production by means of reducing the growth, conversion rate, milk production, quality and quantity of meat and reproduction. Nitroxynil also does hold efficacy against few roundworms mainly blood-sucking species as well as certain myiasis. It is not effective against most of the tape worms or external parasites. It is chemically constitute of yellow benzene crystals, slightly soluble in water and soluble in organic solvents, almost odorless and is characterized for being a stable solution, but it precipitates in presence of calcium and other salts. It is marketed as bright orange-red injectable solution due that by this route is six times more efficient than by oral route. Nitroxynil is a safe drug and it can be used at any stage of pregnancy. It does not affect fertility, gestation or fetus formation and in no way impede the reproductive performance of stallions. Its presented as two salts, nitroxynil megaglumine and nitroxynil eglumine. The nitroxynil in salt is hydrosoluble having neutral pH and is exclusively administered to animals by subcutaneous route. The flukicide resistance phenomenon is already present in many countries in the same way that resistance against other anthelmintic drugs is spreading around worldwide. Because of the absence of new drugs against fluke infections, it is necessary to prove and compare the efficacy of the anthelmintics to prevent resistance development. In view of that we endeavored elucidating the latest progress of one such widely used flukicide nitroxynil.
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The role of microglia in the pathobiology of neuropathic pain development: what do we know? Br J Anaesth 2017; 118:504-516. [DOI: 10.1093/bja/aex006] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Baseline study and risk analysis of landfill leachate - Current state-of-the-science of computer aided approaches. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 580:130-135. [PMID: 27986314 DOI: 10.1016/j.scitotenv.2016.10.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 10/03/2016] [Accepted: 10/05/2016] [Indexed: 06/06/2023]
Abstract
For the successful completion of a risk analysis process, its foundation (i.e. a baseline study) has to be well established. For this purpose, a baseline study needs to be more integrated than ever, particularly when environmental legislation is increasingly becoming stringent and integrated. This research investigates and concludes that no clear evidence of computer models for baseline study has been found in a whole-system and integrated format, which risk assessors could readily and effectively use to underpin risk analyses holistically and yet specifically for landfill leachate. This is established on the basis of investigation of software packages that are particularly closely related to landfills. Holistic baseline study is also defined along with its implications and in the context of risk assessment of landfill leachate. The study also indicates a number of factors and features that need to be added to baseline study in order to render it more integrated thereby enhancing risk analyses for landfill leachate.
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34 PRODUCTION OF TRANSGENIC CLONED BUFFALO EMBRYOS CONTAINING OVEREXPRESSED STEAROYL Co-A DESATURASE GENE FOLLOWING EFFICIENT TRANSFECTION. Reprod Fertil Dev 2017. [DOI: 10.1071/rdv29n1ab34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Stearoyl-CoA desaturase (SCD) is a rate-limiting enzyme that catalyses the synthesis of monounsaturated fatty acids and polyunsaturated fatty acids from saturated fatty acids, which are components of triglycerides, wax esters, cholesteryl esters, and membrane phospholipids. Alterations in phospholipid composition have been implicated in a variety of diseases including obesity and the associated metabolic syndrome. SCD also magnifies the conjugated linoleic acid (CLA) content in milk; CLA is a natural fat element, having reputed therapeutic health values including anti-carcinogenic properties. In light of this fact, this study was designed to amplify the levels of SCD at the gene level. In order to achieve the enhanced expression of SCD gene, combination of techniques were used. The somatic cells (fetal fibroblast) culture were established from ear pinnae obtained from bovine fetus procured from the abattoir and were cultured in basal medium, comprising DMEM with 10% fetal bovine serum, 1X NEAA and 1X PS antibiotics. These isolated cultured cells were transfected with a gene construct carrying buSCD gene (pAcGFPN1-buSCD) as BLGP-buSCD-BLG3′UTR-CMVP-EGFP-SV40. The buffalo fetal fibroblast cells were transfected using 3 methods: Nucleofection, Fugene and Lipofection. The successful transfection, as confirmed by PCR and Southern hybridisation, proved Nucleofection to be more efficient in transfecting cells among the techniques used, which were further maintained and selected by Geneticin (G418). These selected transfected cells were then used for nuclear transfer. Somatic cell nuclear transfer (SCNT) has provided an efficient pathway for the production of transgenic animals. Buffalo cumulus–oocyte complexes (COCs) were collected from ovaries collected from abattoir and matured in TCM-199 supplemented with 10% FBS, 5 µg mL−1 FSH, and 1 µg mL−1 β-oestradiol for 21 h in CO2 incubator at 5% CO2 in air and 38.5°C temperature with >95% relative humidity. After 21 h, these COCs were denuded and subjected to zona removal. These zona-free oocytes were manually enucleated using microsurgical blades and 2 enucleated oocytes were fused with a transgenic cell using electro cell manipulator. Further, these reconstructed embryos were activated using calcium ionophore and cultured in IVC media thereafter for 8 days. The developmental competence rate as recorded on Day 8 was 53.26 ± 1.73%, 69.87 ± 6.24%, 62.99 ± 7.15%, 42.71 ± 5.05% and 28.00 ± 3.33% for 2-cell, 4-cell, 8–16 cell, morula, and blastocyst, respectively. When observed under fluorescence microscope, the embryos showed successful expression of GFP, which can be further used for animal production or further research analysis. In conclusion, amplified SCD at gene level will result in a boost to the dairy sector as well ameliorating human health due to its crucial role in anti-cancer, anti-diabetic, reduced cardio-vascular disease, and improved immune responses.
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New Therapeutic Approach to Treat Allergic Rhinitis & Bronchial Asthma, Considering These Two as One United Airway Disease. Mymensingh Med J 2017; 26:216-221. [PMID: 28260781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The relationship between allergic rhinitis and asthma is now established, and most of the clinical, epidemiological and biological data recommend integrated management. This review discusses rhinosinusitis as a co-morbid condition, a precipitating or triggering condition, and an epiphenomenon as an integrated part of the disease. A better understanding and a more pragmatic method of diagnosis and management is needed using cost-effective long-term strategies. Allergic Rhinitis, though a non-life threatening disease, its pathogenesis reveals that Bronchial Asthma also develops by the same aetiopathogenesis. The United airway disease hypothesis proposes that the upper & lower airway diseases are both manifestations of a single inflammatory process and studies have already proved it. Allergic Rhinitis when once develops if not treated vigorously, can later turn up to Asthma. As chronic inflammation is the central process which is actually continuously changing pathologically the lower respiratory tract & helping to develop Bronchial Asthma. The conventional therapies for Allergic Rhinitis such as antihistamines & decongestants are only symptom relievers, to stop the ongoing pathogenesis of Bronchial Asthma to develop it, the chronic inflammatory process should have to be stopped. This can be done by corticosteroid nasal sprays. Also Asthma with Rhinitis is better controlled by them. Even Bronchial Asthma treatment should be started with inhaler corticosteroid therapy rather than getting it after intermittent use of only bronchodilators (salbutamol) only.
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Analysis of Circulating Tumor Exosomes: Their Role in the Tissue Microenvironment and Ability to Serve as a Biomarker for Recurrence in Lung Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Obstetrical transfusion medicine knowledge among faculty and trainee obstetricians: a prospective knowledge assessment study. Transfus Med 2016; 26:440-447. [DOI: 10.1111/tme.12360] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/31/2016] [Accepted: 09/01/2016] [Indexed: 11/28/2022]
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