The effect of oral anticoagulants on the incidence of dementia in patients with atrial fibrillation: A systematic review and meta-analysis

Background

Dementia is a recognized complication of atrial fibrillation (AF). Oral anticoagulant (OAC) therapy can potentially be protective against this complication.

Methods

A comprehensive search of MEDLINE and Embase for comparative observational studies reporting the efficacy of OAC therapy for the incidence of dementia in patients with AF was conducted from its inception until March 2023. Studies that had patients with prior use of OAC or with a previous history of dementia were excluded.

Results

A total of 22 studies were included in this review involving 617,204 participants. The pooled analysis revealed that OAC therapy, including direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs), was associated with a reduced incidence of dementia in AF patients. Specifically, compared to non-OAC treatment, OACs demonstrated a significant reduction in dementia incidence (HR 0.68, 95 % CI [0.58, 0.80], p < 0.00001), with similar findings observed for DOACs (HR 0.69, 95 % CI [0.51, 0.94], p = 0.02) and VKAs (HR 0.73, 95 % CI [0.56, 0.95], p = 0.02). The comparison of DOAC vs VKA revealed that DOACs are associated with reduced risk of dementia (HR 0.87, 95 % CI [0.79, 0.96], p = 0.004).

Conclusion

Our SR and meta-analysis showed that the use of OAC therapy is associated with a reduced risk of dementia in individuals with AF. However, our results are limited by the potential influence of confounding bias and significant heterogeneity in the analyses.

Plasma GDNF levels in spinal dysraphism and its relation with neurological impairment in children: A point of care study

AIMS

GDNF plays a crucial role in the stimulation of recovery, neuroplasticity and synaptic reorganization after spinal cord injury providing neuroprotection and neuroregeneration. Plasma GDNF levels are upregulated in cases of spina bifida owing to the intrauterine damage of the exposed spinal cord. Our aim was to compare the plasma GDNF levels in patients of spina bifida with non-spina bifida cases and assess the correlation with neurological impairment at one year of follow up.

METHODS

Single centre prospective analysis of cases of spina bifida from 2020 to 2022 at presentation and after one year of follow up post-surgery. Cases with hernia and hydrocele without any other disorders were recruited into the control group. Plasma GDNF levels were assessed with immunoassay kits and compared with neurological involvement.

RESULTS

85 cases were included in the study. GDNF levels were elevated in cases compared to controls (mean 6.62 vs 1.76) with significant p value (<0.01). Same was observed for open and closed defects (mean 7.63 vs 4.86: p < 0.01). At follow up of 52 cases post-surgery cases with neurogenic bladder with abnormal urodynamic studies, sphincter involvement and motor impairment had significantly elevated baseline levels of GDNF compared with those who did not have this neurological impairment (p < 0.01).

DISCUSSION

The neurotrophic factor up-regulation can reflect an endogenous attempt at neuroprotection against the biochemical and molecular cascades triggered by the spinal cord damage. This upregulation can be represented as important biochemical markers of severe spinal cord damage and can be associated with severity of spine injury in MMC patients. Our results are in keeping with these findings, that, there were increased levels of plasma GDNF levels in cases of spinal dysraphism compared to control population. Also, the type of lesion reflecting the severity whether a closed or an open dysraphism, showed significant difference in levels between them suggesting, yet again, more damage in open defect as expected. The levels were higher with involvement of bladder, sphincter and lower limb power.

CONCLUSION

There is significant elevation of plasma GDNF levels in cases of spina bifida and this elevation is proportional to the degree of spinal damage and hence the neurological impairment. GDNF levels are a good predictor for assessing the severity of the lesion and thus the outcome in these cases. Additional prospective and long-term studies with a larger cohort are needed for a better understanding of neurotrophin pattern modulation in MMC.

Role of non-contrast CT component of prostate-specific membrane antigen PET/CT scan in the detection of peripheral zone prostate cancer

OBJECTIVE

The aim of this study was to look for feasibility of non-contrast CT (NCCT) in detecting peripheral zone prostate cancer (PCa).

METHODS

A retrospective analysis included 50 biopsy-proven PCa patients between April 2019 and March 2022 who underwent staging whole body prostate-specific membrane antigen (PSMA)/CT prior to treatment. The control subjects were 50 randomly selected adult male patients who underwent PET/CT for non-prostate malignancy during the same time period. Two readers independently calculated the Hounsfield unit (HU) of normal peripheral zone, central zone, and corresponding PSMA avid focus in cases.

RESULTS

No significant difference was seen in the mean HU value of normal peripheral zone between cases and controls. Significant difference in the mean HU was seen between the PSMA avid focus in cases (40.1 ± 6.2) and normal peripheral zone of cases (28.2 ± 7.0) and controls (27.7 ± 5.8). No significant difference was found between the mean HU values of high-grade PCa and non-high-grade PCa. Receiver operating characteristic (ROC) curve analysis revealed a mean HU cut-off of ≥35 for detecting PCa with a sensitivity and specificity of 86% and 90%, respectively, between cases and controls (AUC 0.88).

CONCLUSION

Detection of clinically significant PCa is possible on routinely performed NCCT scans. Radiologists should routinely look for and convey these findings to facilitate further work-up and early detection of PCa.

ADVANCES IN KNOWLEDGE

Our study adds to the knowledge that NCCT scans performed for unrelated indications can serve as a screening tool for clinically significant PCa.

Ammonia gas treatment in low cost biological reactor

Ammonia gas contributes to a number of environmental and human health concerns. The use of chalk, a cheap alkalinity source may reduce costs for biological systems. This research studies a closed liquid flow reactor to treat ammonia gas using chalk as biomass media and alkalinity source with high value calcium nitrate fertilizer production. The proposed reactor showed complete ammonia gas removal at high rate (500 mg N/L/day) and with low cost; where chalk dissolution and ammonia gas absorption contributed to alkalinity in the water for nitrification. High calcium ion concentration (up to 10,000 mg Ca2+ as CaCO3/L) showed only minor effects on ammonia absorption and nitrification rate.

Evaluation of Dual Dye Technique for Sentinel Lymph Node Biopsy in Breast Cancer: Two-Arm Open-Label Parallel Design Non-Inferiority Randomized Controlled Trial

INTRODUCTION

Radioisotope and blue dye are standard agents for performing sentinel lymph node (SLN) biopsy in breast cancer. The paucity of nuclear medicine facility poses logistic challenge. This study evaluated performance of radioisotope & methylene blue (MB) with indocyanine green (ICG) and MB for SLNB.

PATIENTS AND METHODS

This randomized controlled trial was conducted from December 2019 to July 2022 comparing SLN identification proportions of radioisotope-blue dye [Group A] with dual dye (MB + ICG; Group B]. Secondary objective included time required and cost effectiveness of performing SLNB. Sample size of 70 (35 in each arm) was calculated. Upfront operable node negative early breast cancer was included in the study. Clinico-demographic data, number & type of SLN, time taken were noted. Cost analysis was done including the equipment, manpower & consumables. Chi-square/Fisher exact test was used to compare proportion between two groups. p value of less than 0.05 was considered to represent statistical significance.

RESULTS

Seventy patients randomized to either group were similar in clinico-demographic and tumor characteristics. SLN identification rate (IR) was 91.43% in group A and 100% in group B. Overall IR of MB, radioisotope and ICG were 91.43%, 91.43% and 100%, respectively. Mean number of SLNs identified were 3 in group A and 4 in group B. Median time required for SLNB was 12 min and 14 min in either group, respectively. Cost of performing SLNB was higher in Group B.

CONCLUSION

SLNB using dual dye is non-inferior to radioisotope-blue dye in upfront operable early breast cancer. Trial registration number Clinical Trial registry India CTRI/2020/02/023503.

Investigation of structural, electronic, mechanical, & optical characteristics of Ra based-cubic hydrides RbRaX3 (X= F and cl) perovskite materials for solar cell applications: First principle study

Perovskite materials are considered the gateway of various physical applications to meet the production and consumption of energy and medical fields. Density Functional Theory (DFT) becomes the most important field in the modern era to investigate perovskite materials for various physical properties. DFT nowadays is used to explore the perovskite materials for a lot of applications like photocatalytic, optoelectronic, and photovoltaics. We discussed radium based cubic hydrides RbRaX3 (while X = F & Cl) perovskite material's electrical, optical, elastic, & physical characteristics with the help of DFT-based CASTEP code with PBE exchange-correlation efficient of GGA. The RbRaF3 & RbRaCl3 have three-dimensional nature by means of space group 221 (Pm3 m). According to electronic characteristics, the direct bandgap of RbRaF3 RbRaCl3 are 3.18eV and 2.209eV, respectively. Both compounds are brittle in nature via Poisson's ratio & Pugh's criteria. Thus, our novel RbRaX3 (X = F and Cl) compounds have excellent applications for solar cell and medical areas.

A comprehensive review of protein-based carriers with simple structures for the co-encapsulation of bioactive agents

The rational design and fabrication of edible codelivery carriers are important to develop functional foods fortified with a plurality of bioactive agents, which may produce synergistic effects in increasing bioactivity and functionality to target specific health benefits. Food proteins possess considerable functional attributes that make them suitable for the delivery of a single bioactive agent in a wide range of platforms. Among the different types of protein-based carriers, protein-ligand nanocomplexes, micro/nanoparticles, and oil-in-water (O/W) emulsions have increasingly attracted attention in the codelivery of multiple bioactive agents, due to the simple and convenient preparation procedure, high stability, matrix compatibility, and dosage flexibility. However, the successful codelivery of bioactive agents with diverse physicochemical properties by using these simple-structure carriers is a daunting task. In this review, some effective strategies such as combined functional properties of proteins, self-assembly, composite, layer-by-layer, and interfacial engineering are introduced to redesign the carrier structure and explore the encapsulation of multiple bioactive agents. It then highlights success stories and challenges in the co-encapsulation of multiple bioactive agents within protein-based carriers with a simple structure. The partition, protection, and release of bioactive agents in these protein-based codelivery carriers are considered and discussed. Finally, safety and application as well as challenges of co-encapsulated bioactive agents in the food industry are also discussed. This work provides a state-of-the-art overview of protein-based particles and O/W emulsions in co-encapsulating bioactive agents, which is essential for the design and development of novel functional foods containing multiple bioactive agents.

Urinary tract infection caused by Lactococcus garvieae in a premature neonate: A case report

Lactococcus garvieae is a gram-positive cocci that has primarily been described as a pathogen in various fish species, but has increasingly been reported to cause endocarditis and other infections in humans [1]. Neonatal infection caused by Lactococcus garvieae has not been previously reported. Here we describe a premature neonate who developed a urinary tract infection with this organism and was successfully treated with vancomycin therapy.

Microplastics assessment in Arabian Sea fishes: accumulation, characterization, and method development

Around the globe, plastic has been entering the aquatic system and is ingested by organisms. Identification, optimal digestion method, and characterization of the polymers to trace sources are of growing importance. Hence, the present work investigated microplastics accumulation, digestion protocol efficiency, and characterization of polymers with FTIR analysis in the guts of five fishes (Lethrinus nebulosus, Rastrelliger kanagurta, Acanthopagrus arabicus, Otolithes ruber, and Euryglossa orientalis) from the Karachi coastal area, Arabian Sea. A total of 1154 microplastics (MPs) were ingested by 29 out of 33 fish species (87%). The highest average MP/fish was recorded in Otolithes ruber (54) and the lowest in Rastrelliger kanagurta (19.42). Microfibers were the most abundant shape with the highest numbers (35.52%) as compared to the rest of the MPs identified. Transparent microfibers were recorded as the highest in numbers followed by red, black, blue, and green. In this study, KOH with different concentrations and exposure times along with oxidizing agent hydrogen peroxide was tested (Protocols 3 and 4). Results showed these bases were highly efficient in obtaining optimal digestion of the samples. FTIR analysis confirmed that the majority of the polymers found in the fish guts were polyethylene and polypropylene. This study validated for the first time the presence of these polymers of plastic in marine fish from Pakistan.

A commercial monovalent canine parvovirus vaccine performs better than a commercial combination vaccine in puppies

Thirty puppies were randomly divided in to 3 groups for comparative evaluation of two commercial CPV vaccines. Each group was further subdivided in to < 6 months and < 3 months -old puppies and either vaccinated with a monovalent vaccine: Primodog, a combination vaccine: Duramune or maintained as a non-vaccinated control. Humoral immune response was determined by Hemagglutination Inhibition (HAI) on 21 and 35 -days after vaccination. The geometric mean titer (GMT) induced by Duramune, 21 and 35 -days post-vaccination was GMT 73.3 and 137.2, respectively. Comparatively, Primodog demonstrated higher GMT on 21 and 35 -days after vaccination: 97.0 and 168.9, respectively. The older puppies (< 6 months old) demonstrated higher seroconversion to both vaccines.

HLA B27 in Ankylosing Spondylitis: Differences in Frequency and Relative Risk in American Blacks and Caucasians

Twenty-eight HLA alleles of the A and B loci were determined in 23 American Blacks and 50 Caucasians with primary ankylosing spondylitis (AS). The prevalence of HLA B27 was significantly increased in American Black patients (48 per cent) vs Black controls (two per cent), but was much less than the 94 per cent found in Caucasian patients (controls eight per cent). The lower prevalence of B27 in American Black patients vs Caucasian patients was significant (p < 0.001), and indicated that susceptibility to AS is not as closely associated with B27 in Blacks as in Caucasians. No other HLA antigen was significantly associated with AS in either racial group. Among B27 positive individuals, the relative risk of developing AS was significantly lower in American Blacks than in Caucasians. These data indicate that for diagnostic purposes, the absence of B27 is less important in ruling out AS in Blacks than in Caucasians.

[Medical rehabilitation of children with obstructive uropathy]

Obstructive uropathy in children is predominantly urinary system malformation and one of the leading causes of chronic renal failure. Antenatal ultrasound can detect obstructive uropathy in infants. It is important to conduct diagnostics not only to identify the obstruction level in urinary system, but to assess renal function, renal blood flow and urination. Children are given conservative and surgical treatment methods to restore urodynamics, prevent infectious complications, improve renal blood flow. Currently, there are no principles, approaches and technologies for medical rehabilitation of patients with obstructive uropathy, therefore, the use of selective chromotherapy, which has an activating effect on regional circulation, and sound stimulation improving muscles tone of pelvis and ureters, is pathogenetically reasonable and promising.

OBJECTIVE

To develop technologies of physiotherapy application (sound stimulation, selective chromotherapy) for inclusion in comprehensive medical rehabilitation of children with megaloureter.

MATERIAL AND METHODS

Clinical observations and special examinations have been performed in 90 children with megaloureter aged from 1 to 10 years. The patients were divided into 2 groups: 30 children (study group) received sound stimulation combined with selective chromotherapy; 30 children (the 1st comparison group) - sound stimulation; 30 children (the 2nd comparison group) - selective chromotherapy (blue spectrum). General clinical methods, ultrasound of kidneys and bladder with Doppler monitoring of intrarenal blood flow, functional methods of bladder examination were used.

RESULTS

The positive effects of separate and combined application of sound stimulation and selective chromotherapy on clinical and laboratory indicators, urodynamics of urinary tract and renal blood flow in children with megaloureter after surgery have been revealed. The efficacy of selective chromotherapy use in children with megaloureter and comorbid neurologic bladder dysfunction has been proven.

CONCLUSION

Modern technologies for the application of physiotherapy, namely selective chromotherapy and sound stimulation, to include them in the comprehensive medical rehabilitation of children with megaloureter, have been developed for the first time and their high efficacy has been proven.

[The high-intensity pulsed magnetic therapy in the medical rehabilitation of children. (Literature review)]

In recent decades, a promising area of physiotherapy has been intensively developed In Russia and abroad - magnetic therapy, based on the use of various types of magnetic fields for preventive, curative and rehabilitative purposes. The use of high-intensity pulsed magnetotherapy is promising. The effectiveness of the method in a number of diseases of childhood, which has an active stimulating effect on the state of the neuromuscular apparatus, has been proven.

Successful Pregnancy with SLE-associated Antiphospholipid Syndrome: A Case Report

Pregnancy in women with systemic lupus erythematosus (SLE) is associated with an increased risk of adverse maternal and fetal outcomes. Risk is significantly increased when SLE pregnancy is complicated by anti-phospholipid syndrome (APS). Here, we present a case of a 21 year-old multi-gravid lady with SLE- associated APS who was diagnosed as such when she presented with multisystem flare at her 16 weeks of gestation. At presentation she had fever, multiple joint pain in both upper and lower limbs, loss of hair, history of recurrent oral ulcer, skin rash over hand and feet. Physical examination and laboratory evaluation were consistent with an active SLE flare. A diagnosis of antiphospholipid syndrome (APS) was made based on her clinical presentation and laboratory findings. The reported patient had APS secondary to SLE. She had all the risk factors that would confer a remarkably high risk of pregnancy morbidity: positive anti-SSA(RO) antibody and lupus anticoagulant, history of one neonatal death due to congenital heart block and two consecutive first trimester pregnancy loss. Multidisciplinary management approach with appropriate intervention and close monitoring can bring a successful outcome.

Evaluation of HE4 as a prognostic biomarker in uterine cervical cancer. Cancer Treat Res Commun 2023;34:100672. [PMID: 36525756 DOI: 10.1016/j.ctarc.2022.100672]

INTRODUCTION

Uterine cervical cancer (UCC) is the fourth most common health problem worldwide among women. Currently available biomarkers CA125, CA199, and CEA for diagnosis or prognostic evaluation of UCC have not got widespread acceptance.

METHOD

Whole blood samples of 64 patients with UCC were collected along with 63 healthy females and tested for serum levels of HE4 (sHE4). A cut-off value for positive result 64.0 pmol/L was set. Statistical analysis of different clinical variables was done.

RESULT

Serum level of HE4 has a significant role in the diagnosis of uterine cervical cancer. Its level increases with age, higher parity (P < 0.05), stage (P < 0.16), tumor size, and parametrial invasion. Negative result was seen with vaginal invasion, lymph node involvement & cases which had recurrence. Various histological types showed variable results. So the serum level of HE4 (sHE) level may play a role in the diagnosis & therapeutic monitoring of UCC. But the prognostic evaluation needs further studies.

CONCLUSION

sHE4 is useful in the diagnosis of cervical cancer, but its prognostic significance is under the question marks. It may be associated with higher values in higher stages. Higher parity of the patient is associated with higher level of HE4 in UCC.

Molecular epidemiology and phylogenetic analysis of Tams I gene of Theileria annulata in Khyber Pakhtunkhwa, Pakistan

Theileriosis is a hemoparasitic disease that affects a wide range of different animal species and is caused by various species of Theileria. This study aimed to determine the molecular epidemiology of Theileria annulata through microscopy and PCR, in crossbred cattle in some districts of Khyber Pakhtunkhwa, Pakistan. For this study, a total of 384 blood samples were collected from cattle in the Peshawar (n=120), Charsadda (n=94), Nowshera (n=84), and Swabi (n=86) districts. Microscopy and PCR were used to determine the overall prevalence of theileriosis, which was found to be 15.8 and 22.6%, respectively. Theileria annulata was detected in blood samples through PCR in the study area, and the target gene i.e., Tams 1, of positive samples was sequenced. The sequences in the current study revealed high sequence homology (ranging from 96 to 100%) with Tams 1 sequences of neighboring countries present in the NCBI database. Season, breed, age, and sex were found to be important risk factors among the several risk factors examined, whereas, among different clinical manifestations, lymphadenopathy showed a strong association with theileriosis. According to Cohen's kappa and ROC analysis, microscopy was proven to be a fair diagnostic test for detecting theileriosis in cattle, and may be used in combination with molecular techniques for screening a large number of animals.

A secure healthcare 5.0 system based on blockchain technology entangled with federated learning technique

In recent years, the global Internet of Medical Things (IoMT) industry has evolved at a tremendous speed. Security and privacy are key concerns on the IoMT, owing to the huge scale and deployment of IoMT networks. Machine learning (ML) and blockchain (BC) technologies have significantly enhanced the capabilities and facilities of healthcare 5.0, spawning a new area known as "Smart Healthcare." By identifying concerns early, a smart healthcare system can help avoid long-term damage. This will enhance the quality of life for patients while reducing their stress and healthcare costs. The IoMT enables a range of functionalities in the field of information technology, one of which is smart and interactive health care. However, combining medical data into a single storage location to train a powerful machine learning model raises concerns about privacy, ownership, and compliance with greater concentration. Federated learning (FL) overcomes the preceding difficulties by utilizing a centralized aggregate server to disseminate a global learning model. Simultaneously, the local participant keeps control of patient information, assuring data confidentiality and security. This article conducts a comprehensive analysis of the findings on blockchain technology entangled with federated learning in healthcare. 5.0. The purpose of this study is to construct a secure health monitoring system in healthcare 5.0 by utilizing a blockchain technology and Intrusion Detection System (IDS) to detect any malicious activity in a healthcare network and enables physicians to monitor patients through medical sensors and take necessary measures periodically by predicting diseases. The proposed system demonstrates that the approach is optimized effectively for healthcare monitoring. In contrast, the proposed healthcare 5.0 system entangled with FL Approach achieves 93.22% accuracy for disease prediction, and the proposed RTS-DELM-based secure healthcare 5.0 system achieves 96.18% accuracy for the estimation of intrusion detection.

295 SPEP IT UP! DEVELOPING AN ALGORITHM FOR ABNORMAL SERUM PLASMA ELECTROPHORESIS RESULTS IN HIP FRACTURE PATIENTS

Background

Hip fracture is a common manifestation of osteoporosis. All patients who sustain a hip fracture should receive a specialist bone health assessment, including Serum Protein Electrophoresis (SPEP) because plasma cell disorders such as multiple myeloma are an important differential diagnosis. SPEP results can be challenging to interpret without training and expertise. We aimed to review the proportion of abnormal SPEP results in hip fracture patients and used a newly developed algorithm to assess urgency of referral to haematology.

Methods

The Orthogeriatrics and Haematology teams collaborated to develop an algorithm to help facilitate decision making in hip fracture patients with abnormal SPEP results. A retrospective study was then conducted using data from the local Hip Fracture Database from Quarters 1 and 3 in 2020, and the hospital electronic laboratory system. The algorithm was used to retrospectively determine which patients warranted haematology review. The electronic appointment system was then accessed to review whether those who warranted haematology referral had appointments on the system.

Results

Of 270 hip fracture presentations, 19 duplicate records were excluded. Five patients had no data and three patients had passed away. Of the remaining 243 patients, 193 (79.42%) had SPEP’s sent. Abnormalities were detected in 116 patients (47.74%). According to the SPEP referral pathway, two patients warranted routine referral and one patient required an urgent referral, none of whom appeared to have been referred to haematology. Two patients who did not warrant haematology referral were already under haematology for different conditions.

Conclusion

Not all patients who sustain acute osteoporotic fractures with an abnormal SPEP result require haematology referral. The need for an urgent or routine haematology can be guided by the SPEP result along with other clinical features. With the introduction of this pathway, it is proposed that all hip fracture patients will be triaged in a timely, appropriate, and consistent manner.

Community- vs. hospital-based management of multidrug-resistant TB in Pakistan

BACKGROUND Multidrug-resistant TB (MDR-TB) treatment takes 18-24 months and is complex, costly and isolating. We provide trial evidence on the WHO Pakistan recommendation for community-based care rather than hospital-based care.METHODS Two-arm, parallel-group, superiority trial was conducted in three programmatic management of drug-resistant TB hospitals in Punjab and Sindh Provinces, Pakistan. We enrolled 425 patients with MDR-TB aged >15 years through block randomisation in community-based care (1-week hospitalisation) or hospital-based care (2 months hospitalisation). Primary outcome was treatment success.RESULTS Among 425 patients with MDR-TB, 217 were allocated to community-based care and 208 to hospital-based care. Baseline characteristics were similar between the community and hospitalised arms, as well as in selected sites. Treatment success was 74.2% (161/217) under community-based care and 67.8% (141/208) under hospital-based care, giving a covariate-adjusted risk difference (community vs. hospital model) of 0.06 (95% CI -0.02 to 0.15; P = 0.144).CONCLUSIONS We found no clear evidence that community-based care was more or less effective than hospital-based care model. Given the other substantial advantages of community-based care over hospital based (e.g., more patient-friendly and accessible, with lower treatment costs), this supports the adoption of the community-based care model, as recommended by the WHO.

Corona Virus Disease 2019 (COVID-19) Diagnostic Tests: A Glimpse

Mass testing for COVID-19 infection is one of the core measures in tackling the global spread of the disease. Testing is vital to diagnose and estimate cases, attack rates and case fatality rates- critical data for policy-making. As COVID-19 continues to spread globally, the demand for more extensive laboratory testing and innovative technology increases. However, countries around the world have been struggling to keep up pace with the worldwide demand to expand testing strategy. The pandemic evolves, so does our knowledge and understanding of diagnostic tests of COVID-19. Here we aim to review major challenges related to COVID-19 diagnostic tests and future development. So, the ongoing urgency and demand for tests would certainly steer the rapid uptake of novel techniques, which in turn would boost our understanding of diagnostic tests for COVID-19.

Identification of SCAR markers for genetic authentication of Dendrobium nobile Lindl

Dendrobium nobile Lindl. is an orcid plant with important medicinal values. This is a colourful houseplant, and also a popular herb in traditional Chinese medicine (TCM). The variants of this plant from different geographic regions might be high, and in this study, we aimed to develop specific sequence characterized amplified region (SCAR) markers for the identification of specific variant of this plant. Different cultivars of D. nobile were collected from nine different places of China, and one cultivar from Myanmar. DNA materials were extracted from the plant samples, random amplified polymorphic DNA (RAPD) were developed, cloned and sequenced for the development of SCAR markers. We have developed four SCAR markers, which are specific to the cultivar from Luzhou China, and clearly distinguishable (genetically) from other cultivars. These SCAR markers are deposited in GenBank (accession number MZ417502, MZ484089, MZ417504 and MZ417505). Four SCAR markers for D. nobile are effective molecular technique to genetically identify the different cultivars or species, and this method is applicable for genetic characterization and identification of other plant species too.

Impact of COVID-19 pandemic on quality of partner relationship and sexual activity among COVID positive males: a cross sectional study

OBJECTIVE

Our aim was to assess sexual activity, partner relationships among males who had been infected with COVID-19, to study the impact of COVID-19 infection on partner relationship and to find out the association between partner and sexual relationship during lockdown.

MATERIALS AND METHODS

A cross sectional study was conducted in Saudi Arabia through social media platforms via online questionnaire between December 1, 2020 and January 31, 2021 among 871 participants after a pilot study among 20 participants of which 497 were included in the study. Statistical analysis was conducted using SPSS version 20.0 (IBM Inc., Armonk, NY, USA). Responses were presented as frequencies and percentages and the association was studied using Chi squared test/Fisher's exact test. The value of p ≤ .05 was considered significant.

RESULTS

Out of the total study participants, nearly 85% of them belonged to the age range of 18 to 39 years, more than half of the participants were married. In the six months prior to the study being conducted, 268 respondents (53.9%) did not have sexual relationships. Respondents with positive COVID-19 infection reported that their partner lived with them in the same house during home isolation and was also found to be significantly associated with having intact sexual relationships in the last six months of the lockdown period (p-value < .001). Moreover, respondents who reported having good relationships with their partners during the pandemic were found to be significantly associated with having intact sexual relationships during the pandemic lockdown (p-value < .001).

CONCLUSIONS

Among the COVID-19-positive respondents, sexual activity and partner relationships were largely found to be intact during the pandemic lockdown period.

Highly biocompatible formulations based on Arabic gum Nano composite hydrogels: Fabrication, characterization, and biological investigation

In the study, fabrication of Arabic gum (AG) hydrogels via reverse micellization method is reported. AG hydrogels were utilized as capping agents to encapsulate zinc sulphide (ZnS), and cadmium sulphide (CdS) nanoparticles via in-situ reduction. Pristine and nanocomposite hydrogels (AG-ZnS and AG-CdS) were characterized through SEM, EDX, TEM, XRD, FTIR, TGA, UV/Visible, and photoluminescence spectroscopy. The hydrogels were subjected to multiple biological assays including antimicrobial, antioxidant, and anti-diabetic formulation, in addition to biocompatibility test. The hydrogels were found to be more effective against bacterial and fungal strains. For instance, AG-ZnS exhibited excellent growth inhibition activity against Escherichia coli (ZoI: 12 ± 1.04 mm) and Candida albicans (35 ± 0.94 mm). Likewise, the nanocomposites hydrogel also displayed excellent DPPH and ABTS free radical scavenging capacity, total antioxidant capacity (TAC), and total reducing power (TRP) ability. Among the hydrogels, AG-ZnS demonstrated considerable α-amylase, and α-glucosidase inhibition potential. Above all, the hydrogels were found highly compatible with human red blood cells (hRBCs). Owing to remarkable antioxidant, antibacterial, antifungal, and bio-compatible nature, the fabricated nanocomposites hydrogels have the potential to be explored in tissue engineering, wound healing, drug delivery, and in environmentally friendly hygiene products.

Activity of Fosfomycin Against The Spectrum of Uropathogens Causing Cystitis

Background:

Urinary tract infections (UTIs) are the most frequent bacterial infections, commonly seen in females. High degree of antimicrobial resistance in uropathogens has challenged the use of therapeutic agents. Fosfomycin which is an old antibiotic with distinctive characteristics, seems to be a promising novel therapeutic agent with a good bactericidal activity towards multi-drug resistant (MDR) uropathogens.

Objective:

The main objective of the study is to evaluate the antibacterial activity of fosfomycin among uropathogens causing cystitis.

Methods:

The study was carried out between 2017-2018. A total of 2060 UTI suspects from outpatient department (OPDs) and inpatient department (IPDs) were screened. Out of 2060 screened patients 1658 were IPD patients and 402 were OPD patients. Patient’s midstream urine samples were collected aseptically and processed according to standard protocols. The frequency of extended-spectrum-beta lactamases (ESBLs) producer and carbapenem resistance were estimated respectively. Cultures with significant growth of uropathogens were identified and minimum inhibitory concentration (MIC) to fosfomycin was determined by agar dilution (AD) and by E-test methods.

Results:

184 out of 2060 (8.9%) urine samples showed significant growth of uropathogens. Uropathogenic Escherichia coli (UPEC) (64%,118/184) was found to be the mostly isolated uropathogen. Among these Gram-negative uropathogens, 80% were ESBLs producers, 43.2% were carbapenem-resistant and 78% isolates were found to be MDR. The fosfomycin susceptibility for UPEC was 95% by AD method.

Conclusions:

This study suggests that Fosfomycin is reasonably effective and can be used in the treatment of MDR uropathogens along with uncomplicated UTIs.

Zirconium-based cubic-perovskite materials for photocatalytic solar cell applications: a DFT study

The structural, electronic, optical, and mechanical characteristics of cubic inorganic perovskites XZrO3 (X = Rb and K) were studied using the Cambridge serial total energy package-based DFT.

Influence of VO2 based structures and smart coatings on weather resistance for boosting the thermochromic properties of smart window applications

Vanadium dioxide (VO₂)-based energy-saving smart films or coatings aroused great interest in scientific research and industry due to the reversible crystalline structural transition of VO₂ from the monoclinic to tetragonal phase around room temperature, which can induce significant changes in transmittance and reflectance in the infrared (IR) range. However, there are still some obstacles for commercial application of VO₂-based films or coatings in our daily life, such as the high phase transition temperature (68 °C), low luminous transmittance, solar modulation ability, and poor environmental stability. Particularly, due to its active nature chemically, VO₂ is prone to gradual oxidation, causing deterioration of optical properties during very long life span of windows. In this review, the recent progress in enhancing the thermochromic properties of VO₂-hybrid materials especially based on environmental stability has been summarized for the first time in terms of structural modifications such as core–shell structures for nanoparticles and nanorods and thin-films with single layer, layer-by-layer, and sandwich-like structures due to their excellent results for improving environmental stability. Moreover, future development trends have also been presented to promote the goal of commercial production of VO₂ smart coatings.

VO₂ based energy saving smart coatings are of great interest in research and industry due to the reversible crystalline structural transition of VO₂ which can induce significant transmittance and reflectance changes in the infrared range.

[Medical rehabilitation for children with scoliosis]

The article presents a literature review on the prevalence, relevance, social significance, and principles of medical rehabilitation of children with different types of scoliosis in scoliotic disease. The current classification, diagnostics features, and clinical course of the disease are addressed. Current approaches to the choice of medical rehabilitation methods for scoliotic disease in children are described: therapeutic exercise, hydrokinesiotherapy, massage, physiotherapeutic treatment, kinesiotaping, and corseting. Special consideration is given to postoperative management and stages of medical rehabilitation of children with scoliosis, including resort treatment.

Anti-hyperglycemic and anti-hyperlipidemic effects of a methanolic extract of Debregeasia salicifolia in Alloxan-induced diabetic albino mice

Diabetes mellitus (DM), an endocrine syndrome characterized by high blood glucose levels due to abrogated insulin activity. The existing treatments for DM have side effects and varying degrees of efficacy. Therefore, it is paramount that novel approaches be developed to enhance the management of DM. Therapeutic plants have been accredited as having comparatively high efficacy with fewer adverse effects. The current study aims to elucidate the phytochemical profile, anti-hyperlipidemic, and anti-diabetic effects of methanolic extract D. salicifolia (leaves) in Alloxan-induced diabetic mice. Alloxan was injected intraperitoneally (150 mg kg-1, b.w), to induced diabetes in mice. The mice were divided into three groups (n=10). Group 1 (normal control) received normal food and purified water, Group II (diabetic control) received regular feed and clean water and group III (diabetic treated) received a methanolic extract of the plant (300 mg kg-1) for 28 days with a typical diet and clean water throughout the experiment. Blood samples were collected to checked serum glucose and concentration of LDL, TC, TG. The extract demonstrated significant antihyperglycemic activity (P<0.05), whereas improvements in mice's body weight and lipid profiles were observed after treatment with the extract. This study establishes that the extract has high efficacy with comparatively less toxicity that can be used for DM management.

Fabrication and characterization of quercetin loaded casein phosphopeptides-chitosan composite nanoparticles by ultrasound treatment: Factor optimization, formation mechanism, physicochemical stability and antioxidant activity

Ultrasound treatment was used to successfully prepare Quercetin (Qu)-loaded Casein phosphopeptides (CPP)/chitosan (CS) nanoparticles. Compared with the control, the above ternary nanoparticles with the smallest size (241.27 nm, decreased by 34.32%), improved encapsulation efficiency of Qu (78.55%, increased by 22.12%) when prepared under following conditions: ultrasonic frequency, 20/35/50 kHz; the power density, 80 W/L; the time, 20 min, and the intermittent ratio, 20 s/5s. Electrostatic interactions, hydrogen bonding, and hydrophobic interactions were the main driving forces for nanoparticles formulation, which were strengthened by ultrasound treatment. The compact, homogeneous and spherical composite nanoparticles obtained by sonication were clearly observed by scanning electron microscope and atomic force microscope. The environmental stability (NaCl, pH, exposure time, storage time, and simulated gastrointestinal digestion) and antioxidant activity of the ternary nanoparticles were remarkably enhanced after ultrasonic treatment. Furthermore, the ternary nanoparticles prepared by ultrasound exhibited excellent stability in simulated gastrointestinal digestion. The above results indicate that ultrasound not only increases the loading of the nanoparticles on bioactive substances but also improves the environmental stability and antioxidant activity of the formed nanoparticles. Ultrasound-assisted preparation of nanoparticles loaded with bioactive substances could be well used in the functional food and beverage industry.

682 Pre-clinic mpMRI Prostate for Suspected Localised Significant Prostate Cancer – Incidental Findings and Outcomes

Aim

Two week wait pathways demand rapid investigation of patients with suspected prostate cancer. To facilitate this, mpMRI prostate imaging is now routinely organised for patients whom meet specific criteria, without prior physical review by an urologist. We sought to establish what incidental findings were amongst this patient group and whether management was affected.

Method

All patients referred between 1/4/2019 – 30/4/20 on a suspected prostate cancer pathway to the Leicester General Hospital were included with those coded to have had pre-clinic MRI selected.

Results

During this period 1487 patients were referred on the pathway of which 482 were coded as having has pre-clinic MRI. 8 patients were excluded due to incorrect coding leaving 474 to be analysed. 121 patients had incidental findings mentioned in the report, of these a higher proportion did not have prostate cancer (69%). There were just 11 (2%) significant findings that required further investigation or intervention. These included colorectal lesions, primary bone lesions, suspected bladder cancers and urinary tract calculi. Of this group 3 patients had prostate cancer. Of note 13% of these patients were noted to have diverticular disease and 6% had herniae noted although none required emergent treatment. In this series 32% of patients were confirmed to have prostate cancer with 67.1% of MRI scan reported as PIRADS 3-5.

Conclusions

Pre-clinic MRI prostate facilitates rapid investigation for suspected prostate cancer. There is a small chance of establishing a significant incidental finding which is slightly more common in the non-cancer group.

Review: Markers and proxies to monitor ruminal function and feed efficiency in young ruminants

Developing the rumen's capacity to utilise recalcitrant and low-value feed resources is important for ruminant production systems. Early-life nutrition and management practices have been shown to influence development of the rumen in young animals with long-term consequences on their performance. Therefore, there has been increasing interest to understand ruminal development and function in young ruminants to improve feed efficiency, health, welfare, and performance of both young and adult ruminants. However, due to the small size, rapid morphological changes and low initial microbial populations of the rumen, it is difficult to study ruminal function in young ruminants without major invasive approaches or slaughter studies. In this review, we discuss the usefulness of a range of proxies and markers to monitor ruminal function and nitrogen use efficiency (a major part of feed efficiency) in young ruminants. Breath sulphide and methane emissions showed the greatest potential as simple markers of a developing microbiota in young ruminants. However, there is only limited evidence for robust indicators of feed efficiency at this stage. The use of nitrogen isotopic discrimination based on plasma samples appeared to be the most promising proxy for feed efficiency in young ruminants. More research is needed to explore and refine potential proxies and markers to indicate ruminal function and feed efficiency in young ruminants, particularly for neonatal ruminants.

Hyperhomocysteinemia as an Independent Risk Factor for Coronary Heart Disease. Comparison with Conventional Risk Factors

The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.

Habitat selection by Asiatic black bear (Ursus thibetanus) in Siran and Kaghan Valleys, Pakistan

Asiatic black bear is present in variety of habitats like broad-leaves and coniferous forests, extending form sea level to 4300m elevation and change their habitat for food purpose seasonally. The present study was conducted at Kaghan and Siran Valleys, District Mansehra, Khyber Pakhtunkhwa, Pakistan to assess habitat of black bear. Line transect method was used for observation of bear signs. Twelve meter circular radius plots were selected for the concern vegetation's i.e. (trees, shrubs and herbs) and three to six plots were placed in each transect. At the result of sign survey, thirteen different categories of bear signs were recorded and encounter rate was calculated for each sign. A total of 1858 signs were observed during field surveys. Total (81%) coniferous species were recoded among trees, with the highest appearance of Pinus wallichiana (34.22%) and Spruce spp (27.76%), similarly broad leaves trees (18.56%) were also recoded from habitat plots. Most of the signs were encountered in bushy areas, whereas high number of Viburnum Spp (60.29%) was present. It is indicated that black bear prefers blend of Coniferous Trees, Viburnum and Ferns Species; probably because these plants provide enough food, protection, and meticulous shelter because more than 80% of habitat composed of these three species. Currently habitat destruction and increase in human population are the up-growing issues for wild animals (especially Asiatic black bear), which is highly sensitive to such problems. High levels of conservation efforts are recommended for the protection of black bear habitat and to avoid human interference in their territory.

Exploring the therapeutic potential of Hibiscus rosa sinensis synthesized cobalt oxide (Co3O4-NPs) and magnesium oxide nanoparticles (MgO-NPs)

Herein, we present a green, economic and ecofriendly protocol for synthesis of cobalt oxide (Co3O4-NPs) and magnesium oxide nanoparticles (MgO-NPs) for multifaceted biomedical applications. In the study, a simple aqueous leaf extract of Hibiscus rosa sinensis, was employed for the facile one pot synthesis of Co3O4-NPs and MgO-NPs. The well characterized NPs were explored for multiple biomedical applications including bactericidal activity against urinary tract infection (UTI) isolates, leishmaniasis, larvicidal, antidiabetic antioxidant and biocompatibility studies. Our results showed that both the NPs were highly active against multidrug resistant UTI isolates as compared to traditional antibiotics and induced significant zone of inhibition against Proteus Vulgaris, Pseudomonas Aurigenosa and E.coli. The NPs, in particular Co3O4-NPs also showed significant larvicidal activity against the Aedes Aegypti, the mosquitoes involve in the transmission of Dengue fever. Similarly, excellent leishmanicidal activity was also observed against both the promastigote and amastigote forms of the parasite. Furthermore, the particles also exhibited considerable antidiabetic activity by inhibiting α-amylase and α-glucosidase enzymes. The biosynthesized NPs were found to be excellent antioxidant and biocompatible nanomaterials. Owing to ecofriendly synthesis, non-toxic and biocompatible nature, the Hibiscus rosa sinensis synthesized Co3O4-NPs and MgO-NPs can be exploited as potential candidates for multiple biomedical applications.

Effect of postpartum collection time and colostrum quality on passive transfer of immunity, performance, and small intestinal development in preweaning calves

This study evaluated the effects of postpartum collection time and quality of colostrum fed to calves on the failure of passive transfer, growth, and small intestine development in the first 5 wk of life. Newborn calves (Holstein-Friesian × Jersey) were identified at birth and collected either early (E; within 12 h postpartum; n = 20) or late (L; 18-24 h postpartum; n = 20) and fed either high-quality colostrum [HQC, first milking colostrum with Brix% = 23 ± standard deviation (SD) 2] or low-quality colostrum (LQC, mixed colostrum and transition milk with Brix% = 12 ± 1) to create 4 treatments: E-HQC, E-LQC, L-HQC, and L-LQC (n = 10/treatment). After collection, calves (body weight = 32.3 ± 4.6 kg/calf) were fed either HQC or LQC (7.5% of their arrival body weight per feed) for the first 3 (L calves) or 4 feedings (E calves). All calves were then managed and fed similarly using automatic feeders which recorded individual intake of milk replacer and calf starter. Blood samples were taken at d 1 (after collection from dams but before colostrum feeding), 4, 14, and 35 of age to analyze selected metabolites. All calves were killed at d 35 ± 2 of age and histomorphology of duodenum, jejunum, and ileum was evaluated. At collection, 75% of E calves and 58% of L calves had serum total protein ≤52 g/L. At d 4 of age, calves fed HQC had greater serum total protein than calves fed LQC; however, failure of passive transfer (serum total protein ≤52 g/L) incidence did not differ between HQC and LQC. Collection time did not affect the scouring duration, but the amount of electrolyte used to treat sick calves was lower in L versus E calves, whereas feeding HQC versus LQC lowered both the scouring duration and electrolyte use to treat sick calves. Calves fed HQC had a greater total surface area of the duodenum (+23%) and jejunum (+17%) compared with LQC calves. Duodenal crypts were deeper in E-LQC calves than E-HQC and L-HQC calves, whereas L-LQC calves were intermediate. Villus height to crypt depth ratio in duodenum, jejunum, and ileum was greater in HQC than LQC calves. A trend toward greater average daily gain was observed in HQC versus LQC calves (667 vs. 590 g/d) but the average daily gain was not influenced by collection time. Serum IGF-1 at d 4 was higher in HQC versus LQC calves and this might have contributed to greater average daily gain and small intestine development. Calves fed HQC had higher feed conversion ratios (FCR; total body weight gain/total dry matter intake) compared with LQC calves, and L calves had higher FCR compared with E calves. In conclusion, in comparison to feeding LQC, feeding HQC reduced the scouring duration, enhanced surface area of duodenum and jejunum, and improved FCR during the first 5 wk of calf age. Postpartum collection time of calves did not affect small intestine development, but L calves had higher FCR and required a lesser volume of electrolytes to treat scours compared with E calves during the first 35 d of life.

COVID-19-induced Guillain-Barre Syndrome: A Rare Complication of SARS-CoV-2 Infection

SARS-CoV-2 causing COVID-19 initially began in Wuhan, China and now has been declared a pandemic by the World Health Organization (WHO). In addition to respiratory symptoms, it can cause various complications ranging from neurological to myocardial injuries. Guillain-Barre Syndrome (GBS) is an acute polyradiculoneuropathy affecting more often lower limbs than upper limbs and is often related to previous infectious diseases. We, herein, describe a case of a young female who presented with typical symptoms of GBS after having COVID-19 and was later on confirmed with nerve conduction study and lumbar puncture. Key Words: COVID-19, SARS-CoV-2, Guillain-barre syndrome.

Phytochemicals induce apoptosis by modulation of nitric oxide signaling pathway in cervical cancer cells

OBJECTIVE

Nitric Oxide (NO) is produced by NO synthases (NOS) and is a key signaling molecule that regulates tumorigenesis, both aiding and alleviating it. Elevated NO levels are cytotoxic to cancer cells, making NOS an important target for cancer treatment. In the present study, the modulatory effects of the phytochemicals, quercetin, sulforaphane, genistein, and epigallocatechin-3-gallate on NO pathway and apoptosis were shown in HeLa cervical cancer cells.

MATERIALS AND METHODS

Fluorescent microscopy and flow cytometry were used to assess apoptosis. A Griess assay was used to quantitatively measure NO, quantitative PCR array was used to assess the expression levels of genes involved in the NO signaling pathway, and immunocytochemistry was used to determine NOS protein expression. The functional association among the modulated genes was evaluated using network biology analysis, gene set enrichment, and KEGG pathway analysis.

RESULTS

Treatment with the phytochemicals elevated NO levels in HeLa cells and modulated various genes involved in nitric oxide biosynthesis, superoxide metabolism, and oxidative stress, including NOS1, NOS2, NOS3, ALOX12, and SOD2, with a concomitant increase in NOS2 and NOS3 protein expression levels; also, the phytochemicals were found to induce apoptosis.

CONCLUSIONS

These results suggest that the phytochemical-induced cell death is partially attributed to the activation of the NO pathway and upregulation of pro-oxidant ROS generators. Further experimental studies are required to explore this mechanistic association of NO signaling pathway activation and induction of apoptosis in other types of cancer.

Partition and stability of folic acid and caffeic acid in hollow zein particles coated with chitosan

The carriers for hydrophobic bioactives have been extensively studied, while those for hydrophilic bioactives are still challenging. The partition of bioactives in the particles depends greatly on their solubility, interaction with carrier materials, as well as structure of carriers. In this study, chitosan-coated hollow zein particles using calcium phosphate as a sacrificing template (CS-HZ) were fabricated to co-encapsulate folic acid (FA) and caffeic acid (CA). Partition, photostability, and antioxidant capacity of bioactive compounds were also studied. The size, polydispersity index and ζ-potential of optimized CS-HZ were 176.3 nm, 0.14 and +39.3 mV, respectively, indicating their small and uniform dimension with excellent colloidal stability. FA interacted with chitosan to form complexes and then coated on the zein particles where CA was encapsulated. After co-encapsulation in CS-HZ, the photostability of both FA and CA was improved in comparison with encapsulation of single compound, with 85% of FA remaining after 240 min of UVA irradiation, and 90% of CA remaining after 80 min. Antioxidant activity of CA decreased upon encapsulation, but significantly increased after irradiation. Findings in this study shed some light on the design of carriers for co-delivery of hydrophilic compounds in acidic condition.

[Medical rehabilitation of children with bronchial asthma]

Medical rehabilitation of children suffering from bronchial asthma is based on the complex use of natural therapeutic factors, drug, non-drug therapy and other methods in order to achieve control over the disease and long-term remission. The use of non-drug technologies is necessary taking into account the pathogenesis of the bronchial asthma development and is aimed at relieving bronchospasm, reducing the activity of allergic inflammation in the bronchi, improving their drainage function, strengthening the respiratory muscles and increasing exercise tolerance. When carrying out rehabilitation measures it is important to observe the basic principles of medical rehabilitation. An individual medical rehabilitation program is drawn up taking into account the assessment of the child's clinical condition at each stage with the diagnosis of the initial rehabilitation status, the establishment of a rehabilitation diagnosis and an assessment of the rehabilitation potential. The article presents the data of the analysis of scientific publications and our own research allowing to draw up an algorithm for the formation of an individual program of medical rehabilitation for children with bronchial asthma.

Proportion of Low Back Pain among Physicians Working in a Tertiary Level Hospital of Bangladesh

Low back pain (LBP) is a common problem and is an important public health issue. A major proportion of LBP is concomitant with prolong and repetitive awkward postures, related with occupation like miners, health workers and professional drivers. Physicians are exposed to a wide range of occupational risk factors which results in LBP. A variety of occupational and personal factors are responsible for increased risk of low back pain among physicians. This cross sectional descriptive study was carried out at Mymensingh Medical College Hospital during the period of January 2018 to June 2018, to estimate the proportion of LBP among physicians. Data were collected from purposively selected 102 physicians of different levels by face to face interview using a case record form. Informed written consent of participants was taken prior to interview. Data were analyzed by using SPSS version 20.0. The study results revealed that majority (60.8%) of the physicians were in the age group of 31-50 years. Mean age of the physicians was 49.9 years with a standard deviation (SD) of 3.61 years. More than three fourth (79, 77.5%) of the physicians were male and 23(22.5%) were female. Out of 102 physicians more than two third (70, 68.6%) had LBP while 32(31.4%) did not have any LBP. Proportion of low back pain among physician was 68.6%. Low back pain was found in all age group. Among the physicians having low back pain, 55(78.6%) were male and 15(21.4%) were female. Among 102 physicians, 45(44.1%) had different types of comorbidities while 57(55.9%) did not have any comorbidities. Among the co-morbidities HTN, DM, Dyslipidemia, CHD and asthma were common. Results of the study concluded that 68.6% physicians had low back pain. Physicians of age group 31-60 years (88.5%) and male (78.6%) experienced LBP more. Further multi-centric large scale case control study is recommended to determine the risk factors of LBP among physicians of Bangladesh.

Hyponatraemia in Adult Patients with Pneumonia in a Medical College Hospital of Bangladesh

Pneumonia is an acute on chronic infection involving the pulmonary parenchyma. Most cases are caused by microbial pathogens usually bacteria or viruses and less often fungi or parasites. Hyponatraemia on admission is associated with greater risk of death and increased length of hospital stays. Hyponatraemia is usually related to severe disease and specially occur in old aged people. This study is designed to identify proportion of hyponatraemia in patients with pneumonia and to determine the association of hyponatraemia with the severity of pneumonia. The cross sectional descriptive study was carried out at Mymensingh Medical College Hospital during the period of January 2018 to December 2018. Data were collected from purposively selected 73 admitted patients with pneumonia by interview, clinical examination and laboratory investigations using a pre-tested case record form. Data were analyzed by using SPSS version 20.0. Quantitative variables were summarized by mean and standard deviation. On the other hand qualitative variables were summarized by percentage. Necessary bivariate analysis was done. Majority (68.5%) of the patients were in the age group of 21 years to 50 years. Mean age of the patients was 41.9 years with a SD of 17.4 years. More than three fourth (57, 78.1%) were male and 16(21.9%) were female. More than two third (51, 69.9%) of the patients were smoker and 45(61.6%) was abuse of chewable tobacco or ghul. All the patients had fever (73, 100.0%); 70(95.9%) had cough, 50(68.5%) had chest pain, 10(13.5%) had respiratory distress and 8(11.0%) had haemoptysis. Vomiting was present in 9(12.3%) patients and 3(4.1%) had impaired level of consciousness. About one third of patients (32, 43.8%) had comorbidities. On chest X-ray consolidation was found in 59(80.8%) of patients with pneumonia. In 35(47.9%) patients serum Na⁺ level was normal and 38(52.1%) had different level of hyponatraemia; 26(35.6%) patients had mild hyponatraemia, 7(9.6%) had moderate hyponatraemia and 5(6.8%) had severe hyponatraemia. Majority (58, 79.5%) had lobar pneumonia and 71(97.3%) had community acquired pneumonia. Severity of pneumonia was assessed according to CURB 65. Less than half (35, 47.9%) of the patients had mild (score 0-1) pneumonia; 33(45.2%) had moderate (score 2) pneumonia and 5(6.8%) patients had severe (score ≥3) pneumonia. Average duration of hospital stay was 6.5±3.2 days. Maximum (69, 94.5%) patients were cured after treatment. In case of 3(4.1%) patients pneumonia was unresolved. One (1.4%) patients died due to pneumonia. In this study hyponatraemia was not associated with the severity of pneumonia (p>0.05) and outcome on discharge from the hospital (p>0.05). Difference in mean duration of hospital stay between patients of pneumonia with or without hyponatraemia was not significant (>0.05). The study results revealed that 52.1% patients with pneumonia developed different level of hyponatraemia. Hyponatraemia was not associated with the severity of pneumonia, duration of hospital stay and outcome of pneumonia.

Synthesis, characterization, and biological screening of metal nanoparticles loaded gum acacia microgels

We report novel gum acacia (GA) based microgels composites for multifunctional biomedical application. High yield of spherical GA microgels particles within 5-50 μm size range was obtained via crosslinking the polymer in the reverse micelles of surfactant-sodium bis (2-ethylhexyl) sulfosuccinate (NBSS) in gasoline medium. The prepared microgels were then utilized for in situ silver (Ag) and cobalt (Co) nanoparticles (NPs) synthesis to subsequently produce GNAg and GNCo nanocomposite microgels, respectively. Ag and Co NPs of particle of almost less than 40 nm sizes were homogenously distributed over the matrices of the prepared microgels, and therefore, negligible agglomeration effect was observed. Pristine GA microgels, and the nanocomposite microgels were thoroughly characterized through FTIR, DSC, TGA, XRD, SEM, EDS, and TEM. The well-characterized pristine GA microgels and the nanocomposite microgels were then subjected to multiple in vitro bioassays including antioxidant, antidiabetic, and antimicrobial activities as well as biocompatibility investigation. Our results demonstrate that the prepared nanocomposites in particular GNAg microgels exhibited excellent biomedical properties as compared to pristine GA microgels. Among the prepared samples, GNAg nanocomposites were highly active against Fusarium oxysporum and Aspergillus niger that show 47.73% ± 0.25 inhibition and 32.3% ± 2.0 with IC-50 of 220 μg ml^-1 and 343 μg ml^-1 , respectively. Moderate antidiabetic activity was also observed for GNAg nanocomposites with considerable inhibition of 15.34% ± 0.20 and 14.7% ± 0.44 for both α-glucosidase and α-amylase, respectively. Moreover, excellent antioxidant properties were found for both the GNAg and GNCo nanocomposites as compared to pristine GA microgels. A remarkable biocompatible nature of the nanocomposites in particular GNAg makes the novel GA composites, to be exploited for diverse biomedical applications.

Edible mushroom (Flammulina velutipes) as biosource for silver nanoparticles: from synthesis to diverse biomedical and environmental applications

The current study reports advanced, ecofriendly and biosynthesized silver NPs for diverse biomedical and environmental applications using Flammulina velutipes as biosource. In the study, a simple aqueous extract of F. velutipes was utilized to reduce the AgNO₃ into stable elemental silver (Ag⁰) at a nanometric scale. The NPs had average size of 21.4 nm, spherical morphology, and were highly stable and pure. The characterized nanoparticles were exploited for a broad range of biomedical applications including bacteriocidal, fungicidal, leishmanicidal, in vitro antialzheimer's, antioxidant, anti-diabetic and biocompatibility studies. Our findings showed that F. velutipes mediated AgNPs exhibited high activity against MDR bacterial strains and spore forming fungal strains. All the tested urinary tract infection bacterial isolates, were resistant to non-coated antibiotics but by applying 1% of the synthesized AgNPs, the bactericidal potential of the tested antibiotics enhanced manifolds. The NPs also exhibited dose-dependent cytotoxic potential against Leishmania tropica with significant LC₅₀ of 248 μg ml^-1 for promastigote and 251 μg ml^-1 for amastigote forms of the parasite. Furthermore, promising antialzheimer and antidiabetic activities were observed as significant inhibition of α-amylase, α-glucosidase, acetylcholinesterase (AChE) and butrylcholineterase (BChE) were noted. Moreover, remarkable biocompatible nature of the particles was found against human red blood cells. The biosynthesized AgNPs as photocatalyst, also resulted in 98.2% degradation of indigo carmine dye within 140 min. Owing to ecofriendly synthesis, biosafe nature and excellent physicochemical properties F. velutipes AgNPs can be exploited as novel candidates for multifaceted biomedical and environmental applications.