ABSTRACT
SUMMARY: One of the reasons for acute kidney damage is renal ischemia. Nevertheless, there are limited protective and therapeutic approaches for this problem. Diacerein is an anti-inflammatory drug characterized by numerous biological activities. We aimed to determine the ameliorative impact of diacerein on renal ischemia/reperfusion injury (I/R) condition, exploring the underlying mechanisms. Twenty-four male rats were allotted into four groups (n= 6): sham group; Diacerein (DIA) group; I/R group, in which a non-crushing clamp occluded the left renal pedicle for 45 min, and the right kidney was nephrectomized for 5 min before the reperfusion process; I/R + diacerein group, injected intraperitoneally with 50 mg diacerein/kg i.m 30 minutes prior to I/R operation. Ischemia/ reperfusion was found to affect renal function and induce histopathological alterations. The flow cytometry analysis demonstrated an elevated expression of innate and mature dendritic cells in I/R renal tissues. Moreover, upregulation in the expression of the inflammatory genes (TLR4, Myd88, and NLRP3), and overexpression of the pro-inflammatory cytokines (IL-1β), apoptotic (caspase-3) and pyroptotic (caspase-1) markers were observed in I/R-experienced animals. The aforementioned deteriorations were mitigated by pre-I/R diacerein treatment. Diacerein alleviated I/R-induced inflammation and apoptosis. Thus, it could be a promising protective agent against I/R.
La isquemia renal es una de los motivos del daño renal agudo. Sin embargo, los enfoques protectores y terapéuticos para este problema son limitados. La diacereína es un fármaco antiinflamatorio caracterizado por numerosas actividades biológicas. Nuestro objetivo fue determinar el impacto de mejora de la diacereína en la condición de lesión por isquemia/ reperfusión renal (I/R), explorando los mecanismos subyacentes. Veinticuatro ratas macho se distribuyeron en cuatro grupos (n= 6): grupo simulado; grupo de diacereína (DIA); grupo I/R, en el que una pinza no aplastante ocluyó el pedículo renal izquierdo durante 45 min, y el riñón derecho fue nefrectomizado durante 5 min antes del proceso de reperfusión; Grupo I/R + diacereína, inyectado por vía intraperitoneal con 50 mg de diacereína/kg i.m. 30 min antes de la operación I/R. Se encontró que la isquemia/ reperfusión afecta la función renal e induce alteraciones histopatológicas. El análisis de citometría de flujo demostró una expresión elevada de células dendríticas innatas y maduras en tejidos renales I/R. Además, se observó una regulación positiva en la expresión de los genes inflamatorios (TLR4, Myd88 y NLRP3) y una sobreexpresión de las citoquinas proinflamatorias (IL-1β), marcadores apoptóticos (caspasa-3) y piroptóticos (caspasa-1) en animales con experiencia en I/R. Los deterioros antes mencionados fueron mitigados por el tratamiento previo a la diacereína I/R. La diacereína alivió la inflamación y la apoptosis inducidas por I/R. Por lo tanto, podría ser un agente protector prometedor contra I/R.
Subject(s)
Animals , Rats , Reperfusion Injury/drug therapy , Anthraquinones/administration & dosage , Kidney Diseases/drug therapy , Anti-Inflammatory Agents/administration & dosage , Dendritic Cells/drug effects , Reperfusion Injury/immunology , Signal Transduction , NF-kappa B/metabolism , Anthraquinones/immunology , Apoptosis/drug effects , Oxidative Stress , Toll-Like Receptor 4/metabolism , Interleukin-1beta/metabolism , Flow Cytometry , NLR Family, Pyrin Domain-Containing 3 Protein/metabolism , Inflammation , Injections, Intraperitoneal , Kidney Diseases/immunologyABSTRACT
Objective@#Endovascular treatment of cerebrovascular diseases is often challenging due to small caliber, tortuous distal vessels. Several devices and techniques have evolved to overcome these challenges. Recently, a low profile dual lumen microballoon catheter, specifically designed for distal navigation is employed for neurovascular procedures. Due to its recent advent, scarce data is available on clinical utility and safety of Scepter Mini. The aim of this case series is to report our initial experience with Scepter Mini in the management of various cerebrovascular diseases. @*Methods@#All interventional neurovascular cases performed using Scepter Mini between January 2020 till April 2021 were included. Data regarding patient demographics, procedural details and complications was retrospectively collected from patient’s electronic medical record and procedure reports. @*Results@#Total twelve embolization procedures were performed in eleven patients, including six brain arteriovenous malformation, two dural arteriovenous fistula, one vein of Galen malformation and three hyper-vascular glomus tumor embolizations. All procedures were successfully performed with adequate penetration of the embolic agent. Complete embolization was performed in six procedures, while intended partial embolization was performed in the rest of procedures. Scepter Mini was solely used in ten procedures, however in the other two embolization procedures it was used as an additional conjunct tool to complete the intended embolization. No balloon related complication was observed in any procedure. @*Conclusions@#Scepter Mini dual lumen microballoon catheter is safe and feasible for delivery of liquid embolic agents for cerebrovascular embolization procedures.
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Objective@#The aim of this in vitro study was to evaluate the changes in friction between orthodontic brackets and archwires coated with aluminum oxide (Al2O3), titanium nitride (TiN), or chromium nitride (CrN). In addition, the resistance of the coatings to intraoral conditions was evaluated. @*Methods@#Stainless steel canine brackets, 0.016-inch round nickel–titanium archwires, and 0.019 × 0.025-inch stainless steel archwires were coated with Al2O3 , TiN, and CrN using radio frequency magnetron sputtering. The coated materials were examined using scanning electron microscopy, an X-ray diffractometer, atomic force microscopy, and surface profilometry. In addition, the samples were subjected to thermal cycling and in vitro brushing tests, and the effects of the simulated intraoral conditions on the coating structure were evaluated. @*Results@#Coating of the metal bracket as well as nickel–titanium archwire with Al2O3 reduced the coefficients of friction (CoFs) for the bracket–archwire combination (p < 0.01). When the bracket and stainless steel archwire were coated with Al2O3 and TiN, the CoFs were significantly lower (0.207 and 0.372, respectively) than that recorded when this bracket–archwire combination was left uncoated (0.552; p < 0.01). The friction, thermal, and brushing tests did not deteriorate the overall quality of the Al2O3 coatings; however, some small areas of peeling were evident for the TiN coatings, whereas comparatively larger areas of peeling were observed for the CrN coatings. @*Conclusions@#Our findings suggest that the CoFs for metal bracket–archwire combinations used in orthodontic treatment can be decreased by coating with Al2O3 and TiN thin films.
ABSTRACT
Giant internal carotid artery (ICA) aneurysms are complex vascular lesions which are difficult to treat with open as well as endovascular surgery. Parent vessel occlusion is a well-established treatment option for such aneurysms. However, there have been a few reported cases of ruptured aneurysms related to the persistent retrograde filling after parent vessel occlusion. We report a case which highlights the usage of the flow diverter stent as a potential treatment strategy for the management of retrograde filling of aneurysms. A 54-year-old female was found to have a giant left ICA aneurysm on a brain magnetic resonance imaging during workup for headaches. She underwent occlusion of the left ICA proximal to the aneurysm using multiple coils. However, follow up angiograms after 6 months and 2 years demonstrated persistent retrograde filling of the left ICA aneurysm through the posterior communicating (PCOM) artery. Eventually, she was successfully treated with a flow diverter stent across the PCOM artery into the distal ICA. Follow up angiogram after 6 months showed patent flow in the PCOM artery and the distal ICA. with complete occlusion of the aneurysm. Using a flow diverter stent after insufficient parent vessel occlusion for giant intracranial aneurysms may be a feasible treatment option and an addition to the neurovascular treatment armamentarium.
ABSTRACT
Background@#Supraventricular tachycardia (SVT) is a major cause of emergency room visits where vagal maneuver is used as first-line therapy. The valsalva maneuver (VM) is proven to be safe and, to some extent, effective in termi‑ nating SVT episodes. We aimed to compare the standard VM (SVM) to the modified valsalva maneuver (MVM). We hypothesized that MVM is more effective in terminating SVT episodes and reducing the time spent in the emergency department. @*Methods@#In this systematic review and meta-analysis, we searched Medline/PubMed, Ovid, Web of Science, and Cochrane Central Register of Controlled trials. We included only randomized controlled trials (RCTs) that compared the modified valsalva to the standard valsalva maneuver in treating SVT. Our main outcome was the termination of SVT within 1 min. @*Results@#Four articles met the eligibility criteria of our review. Sinus rhythm was achieved 2.5 times more in the MVM group compared to the SVM group (risk ratio (RR) = 2.54, CI 1.98–3.24, P < 0.001) and thus lowered the need of intrave‑ nous SVT termination medication without any significant increase in adverse events or time spent in the emergency department. @*Conclusion@#Our review found MVM to be more effective than the SVM in terminating SVT. This should encourage broader adoption of the MVM as a first-line vagal maneuver in subjects presenting with SVT in the emergency room.
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@# Through the regional control programme, Malaysia has been successfully reducing the incidence of Plasmodium falciparum and Plasmodium vivax infections. However, the incidence of zoonotic malaria Plasmodium knowlesi infection is increasing and now has been the major cause of malaria in Malaysia especially Malaysian Borneo. The emergence of knowlesi infection has threatened the malaria elimination programme which the government aims to reduce the overall malaria infections by 2020. Unlike other benign human Plasmodium spp., P. knowlesi can cause fatal infections. The aim of this study was to determine the incidence and distribution of five human malaria parasites including P. knowlesi in Peninsular Malaysia and Malaysian Borneo. A total of 112 blood samples were collected from seven states and district hospitals in Peninsular Malaysia and Malaysian Borneo from year 2015 to 2016. The samples were examined by microscopy and further confirmed by nested PCR assay targeting 18S rRNA gene of Plasmodium spp. Following the nested PCR assays, a total of 54 (48.2%) samples were positive for P. knowlesi infections, 12 (10.7%) cases were positive for P. vivax infections, followed by 7 (6.3%) cases of P. falciparum and 4 (3.5%) cases of P. malariae. There were 3 cases (2.7%) of mixed infections (P. knowlesi/P. vivax). However, no cases were identified as P. ovale. A total of 32 (28.6%) cases were found as negative infections. LoopMediated Isothermal Amplification Assay (LAMP) was performed to confirm inconclusive results produced by microscopy and nested PCR. P. knowlesi showed the highest prevalence in Sarawak (n= 30), Sabah (n=13), Pulau Pinang (n=5) and Pahang (n=6). PCR and LAMP was not able to detect a large number of microscopy positive samples due to DNA degradation during storage and shipping. Among all the states involved in this study, the highest prevalence of P. knowlesi infection was found in Sabah and Sarawak.
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BACKGROUND@#At present osteoporosis has come into view as a major health concern. Skeletal diseases typified by weak and fragile bones have imposed threats of fissure. Hydroxyapatite (HAP) is known to induce osteoblast like differentiation and provide mechanical strength, hence, used in bone tissue engineering; whereas, Nigella Sativa has also demonstrated potential to treat bone and muscle diseases. This study was aimed to develop potential orthopedic scaffold exploiting natural resources of Saudi Arabia which can be used as prospective tissue engineering implant. @*METHODS@#The bone scaffold was developed by grafting biogenic HAP with Nigella Sativa essential oil. Nigella Sativa was applied for boosting osteogenesis and to stimulate antimicrobial potential. Antimicrobial potential was investigated utilizing S. aureus bacteria. Spectroscopic and surface characters of Nigella Sativa grafted HAP scaffolds were analyzed using Fourier-transform infrared spectroscopy, X-ray crystallography and Scanning electron microscopy. To ensure biocompatibility of scaffolds; we selected C2C12 cell-lines; best model to study mechanistic pathways related to osteoblasts and myoblasts differentiation. @*RESULTS@#Grafting of HAP with Nigella Sativa did not affect typical spherical silhouette of nanoparticles. Characteristically; protein loaded polynucleated myotubes are result of in vitro myogenesis of C2C12 myoblasts in squat serum environment. @*CONCLUSION@#It is first study of unique combination of Nigella Sativa and HAP scaffold as a possible candidate of implantation for skeletal muscles regeneration. Outcome of this finding revealed Nigella Sativa grafted HAP enhance differentiation significantly over that of HAP. The proposed scaffold will be an economical natural material for hard and soft tissue engineering and will aid in curing skeletal muscle diseases. Our findings have implications for treatment of muscular/ bone diseases.
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Objective@#The aim of this in vitro study was to evaluate the changes in friction between orthodontic brackets and archwires coated with aluminum oxide (Al2O3), titanium nitride (TiN), or chromium nitride (CrN). In addition, the resistance of the coatings to intraoral conditions was evaluated. @*Methods@#Stainless steel canine brackets, 0.016-inch round nickel–titanium archwires, and 0.019 × 0.025-inch stainless steel archwires were coated with Al2O3 , TiN, and CrN using radio frequency magnetron sputtering. The coated materials were examined using scanning electron microscopy, an X-ray diffractometer, atomic force microscopy, and surface profilometry. In addition, the samples were subjected to thermal cycling and in vitro brushing tests, and the effects of the simulated intraoral conditions on the coating structure were evaluated. @*Results@#Coating of the metal bracket as well as nickel–titanium archwire with Al2O3 reduced the coefficients of friction (CoFs) for the bracket–archwire combination (p < 0.01). When the bracket and stainless steel archwire were coated with Al2O3 and TiN, the CoFs were significantly lower (0.207 and 0.372, respectively) than that recorded when this bracket–archwire combination was left uncoated (0.552; p < 0.01). The friction, thermal, and brushing tests did not deteriorate the overall quality of the Al2O3 coatings; however, some small areas of peeling were evident for the TiN coatings, whereas comparatively larger areas of peeling were observed for the CrN coatings. @*Conclusions@#Our findings suggest that the CoFs for metal bracket–archwire combinations used in orthodontic treatment can be decreased by coating with Al2O3 and TiN thin films.
ABSTRACT
Giant internal carotid artery (ICA) aneurysms are complex vascular lesions which are difficult to treat with open as well as endovascular surgery. Parent vessel occlusion is a well-established treatment option for such aneurysms. However, there have been a few reported cases of ruptured aneurysms related to the persistent retrograde filling after parent vessel occlusion. We report a case which highlights the usage of the flow diverter stent as a potential treatment strategy for the management of retrograde filling of aneurysms. A 54-year-old female was found to have a giant left ICA aneurysm on a brain magnetic resonance imaging during workup for headaches. She underwent occlusion of the left ICA proximal to the aneurysm using multiple coils. However, follow up angiograms after 6 months and 2 years demonstrated persistent retrograde filling of the left ICA aneurysm through the posterior communicating (PCOM) artery. Eventually, she was successfully treated with a flow diverter stent across the PCOM artery into the distal ICA. Follow up angiogram after 6 months showed patent flow in the PCOM artery and the distal ICA. with complete occlusion of the aneurysm. Using a flow diverter stent after insufficient parent vessel occlusion for giant intracranial aneurysms may be a feasible treatment option and an addition to the neurovascular treatment armamentarium.
ABSTRACT
Background@#Supraventricular tachycardia (SVT) is a major cause of emergency room visits where vagal maneuver is used as first-line therapy. The valsalva maneuver (VM) is proven to be safe and, to some extent, effective in termi‑ nating SVT episodes. We aimed to compare the standard VM (SVM) to the modified valsalva maneuver (MVM). We hypothesized that MVM is more effective in terminating SVT episodes and reducing the time spent in the emergency department. @*Methods@#In this systematic review and meta-analysis, we searched Medline/PubMed, Ovid, Web of Science, and Cochrane Central Register of Controlled trials. We included only randomized controlled trials (RCTs) that compared the modified valsalva to the standard valsalva maneuver in treating SVT. Our main outcome was the termination of SVT within 1 min. @*Results@#Four articles met the eligibility criteria of our review. Sinus rhythm was achieved 2.5 times more in the MVM group compared to the SVM group (risk ratio (RR) = 2.54, CI 1.98–3.24, P < 0.001) and thus lowered the need of intrave‑ nous SVT termination medication without any significant increase in adverse events or time spent in the emergency department. @*Conclusion@#Our review found MVM to be more effective than the SVM in terminating SVT. This should encourage broader adoption of the MVM as a first-line vagal maneuver in subjects presenting with SVT in the emergency room.
ABSTRACT
BACKGROUND@#At present osteoporosis has come into view as a major health concern. Skeletal diseases typified by weak and fragile bones have imposed threats of fissure. Hydroxyapatite (HAP) is known to induce osteoblast like differentiation and provide mechanical strength, hence, used in bone tissue engineering; whereas, Nigella Sativa has also demonstrated potential to treat bone and muscle diseases. This study was aimed to develop potential orthopedic scaffold exploiting natural resources of Saudi Arabia which can be used as prospective tissue engineering implant. @*METHODS@#The bone scaffold was developed by grafting biogenic HAP with Nigella Sativa essential oil. Nigella Sativa was applied for boosting osteogenesis and to stimulate antimicrobial potential. Antimicrobial potential was investigated utilizing S. aureus bacteria. Spectroscopic and surface characters of Nigella Sativa grafted HAP scaffolds were analyzed using Fourier-transform infrared spectroscopy, X-ray crystallography and Scanning electron microscopy. To ensure biocompatibility of scaffolds; we selected C2C12 cell-lines; best model to study mechanistic pathways related to osteoblasts and myoblasts differentiation. @*RESULTS@#Grafting of HAP with Nigella Sativa did not affect typical spherical silhouette of nanoparticles. Characteristically; protein loaded polynucleated myotubes are result of in vitro myogenesis of C2C12 myoblasts in squat serum environment. @*CONCLUSION@#It is first study of unique combination of Nigella Sativa and HAP scaffold as a possible candidate of implantation for skeletal muscles regeneration. Outcome of this finding revealed Nigella Sativa grafted HAP enhance differentiation significantly over that of HAP. The proposed scaffold will be an economical natural material for hard and soft tissue engineering and will aid in curing skeletal muscle diseases. Our findings have implications for treatment of muscular/ bone diseases.
ABSTRACT
Background: Thyroid gland may have a group of a medical condition that affects its main function. The thyroid gland is located at the front of the neck and produces thyroid hormones. The released hormones go through the blood to many body organs for regulating their function, meaning that it is an endocrine organ. These hormones normally act in the body to regulate energy use, infant development, and childhood development. The study aimed to assess the epidemiology of thyroid disorders among cases in the south-western region, Saudi Arabia, and to assess the reporting quality for these cases data.Methods: A retrospective record based descriptive approach was used through reviewing medical records of all cases that were admitted and diagnosed as thyroid related disorders for different indications in the main hospital (king Khalid Hospital) during the period from January 2018 to January 2020. Data extracted throng pre-structured questionnaire including patient's bio-clinical data, preoperative radiological and laboratory investigations. Also, laryngoscope pre and post operatively was reviewed to record findings.Results: The study included 405 cases with thyroid disorders whose ages ranged from 15 to 71 years old with a mean age of 30.5±10.6 years. Females were 82.7% of the included cases, and 83.8% were Saudi. Thyroid related symptoms were recorded for 1-2 years among 58.1% of the cases and for more than 5 years among 15.8%. Thyroid enlargement was recorded for 73.1% of the cases. The multinodular enlargement was recorded for 53.5% of the cases followed with diffuse thyroid enlargement (27.3%). Regarding the type of surgery undergone, total thyroidectomy was the most recorded followed with lobectomy.Conclusions: The study revealed that the majority of the cases were females at middle age presented with benign lesions with Euthyroid status. The most important conclusion was the significant remarkable underreporting of the different clinical data for the cases with many missing items.
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Background:There are some common diseases found among the students of different areas in Bangladesh which are either communicable or non-communicable. Different infectious diseases occur due to lack of hygiene practice and non-infectious diseases are developed because of many irregular daily habits all over the world. Our aim was to evaluate the habit of practicing hygiene and other daily activities to observe their impacts on the health status among the students from different regions of Chattogram in Bangladesh.Methods:With ethical approval, questionnaire forms of daily habits/activities were filled up by 750 students of different educational institutions. The data were analysed afterwards. Results:Among the population of the study 89% (n=667) students werefound to take regular bath; hand washing was regular among 32% (n=240) students, 54% (n=405) students were irregular in hand washing and the rests wash their hands rarely; on the other hand 41% (n=308) students consume street foods regularly; 38% (n=285) students wear eyeglasses due to weak sight; 23% (n=173) suffer from different skin diseases and 63% (n=473) students usually suffer from different gastro intestinal diseases.Conclusions:Our results are not so frustrating, but also not so much good as majority of the students are fond of unhealthy street foods, don’t wash hands regularly and more than half of the students suffer from GI tract diseases with other health problems. It could be recommended that some daily habits including avoiding street foods, intake of sufficient drinking water and hygiene practices should be improved more.
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Background: Hypertension is one of the most common diseases nowadays. It affects about 25% of the adult globalpopulation and can lead to highly morbid cardiovascular or cerebrovascular complications. However, whenrecognized early, appropriate lifestyle-related measures and occasionally pharmacologic interventions can helpgreatly reduce its risks. Objective: In this study, we aim to provide summarized, yet comprehensive review paperfocusing on diagnosis and management of hypertension. Methods: We searched PubMed using keywords such ashypertension, its screening, diagnosis, and treatment, and family medicine. Conclusion: Essential hypertensionis a systemic disease that can kill the affected people silently. Nevertheless, knowing a lot about its risk factorsand how they can be tackled to prevent it or even to greatly reduce its effects once it develops is of highimportance; and here the major role of a family physician is revealed.
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Background: Liver trauma is one of the most common affected organs in blunt abdominal trauma. It is associatedwith a high rate of morbidity and mortality. Therefore, choosing the best modality for diagnosis and managingsuch high-risk patients is crucial. Objectives: In this study, we aim to review the literature focused on mechanismof liver trauma, pathophysiology, risk factors, diagnosis, and management with a focus on surgical approach.Methodology: PubMed database was used for articles selection using the following keywords: liver injury, andits management, and evaluation. Conclusion: Management of liver trauma patients depends on their status duringthe general assessment of the case. In hemodynamically unstable patients and those with gun-shot wounds, thefirst line is surgery. However, non-operative management remains the mainstay of therapy in blunt liver injury.The main rule dictating this decision is hemodynamic stability. Certain factors increase the risk of failedconservative therapy, and these should alert the surgeon to the possibility of conversion to the surgicalintervention.
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@#Introduction: The Gallbladder stone (GBS) disease is most commonly asymptomatic that may lead to several complications such as ascending cholangitis and obstructive jaundice. In this study the frequency of gallbladder stones among patients referred for abdominal ultrasound at the University of Science and Technology hospital (USTH), Sana’a – Yemen, have been estimated during the period between January and June 2013. Methods: This study is a record-based and conducted at the radiology department in USTH, on cases underwent abdominal ultrasound during the period from January – June 2013. Information were collected from abdominal ultrasonography reports. Results: In this study 4935 patients’ records are included. Of them, 2541 were males and 2394 were females. The frequency of patients with GBS was 5.53%. Multiple stones were observed in 3.57% of patients and 4.34% patients had large stones with size ≥ 5 mm. Females had significantly higher frequency of GBS (8.0%: 191/2394) than males (3.2%: 82/2541) (P < 0.001). It was found that, no significant difference between males and females in harboring small stones (< 5mm) (P = 0.251). However, significantly higher frequency of large GBS (≥ 5 mm) was found among females compared to males (P < 0.001). The frequencies of GBS, small size of GBS and large size of GBS have significantly increased with increasing age (P < 0.001). Conclusion: In this study it was found that females had significantly higher frequency of GBS than males. No significant difference between males and females in harboring small stones. There was a significantly higher frequency of large GBS was found among females compared to males. The frequencies of GBS, small size of GBS and large size of GBS have significantly increased with increasing age.
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@#Introduction: Estimation of gestational age (GA) is clinically crucial for managing pregnancy and assessing the foetal anatomy, growth and development. Transverse cerebellar diameter (TCD) has been reported as an accurate tool for dating the pregnancy. This study aimed to determine the accuracy of foetal TCD for dating the pregnancy and to construct a reference chart for GA of Yemeni foetuses. Methods: We conducted this prospective cross-sectional study among 400 Yemeni pregnant women between 18 and 40 weeks of gestation provided that they were with known last menstrual period and singleton normal pregnancies. Sonographic TCDs were measured for each foetus. The mean TCD was measured for gestational weeks separately, and a polynomial regression model was then used to predict the GA by TCD. Results: There was a robust correlation between GA and TCD (r = 0.995, p <0.001). The coefficient of determination was 0.989, which indicates that the TCD explains 98.9% of GA change. Conclusion: TCD is an accurate tool to estimate the GA in second and third trimesters, including final weeks, among Yemeni pregnant women as in developed countries. The narrow range between the 5% and 95% percentiles is a significant indication of the accuracy of the TCD in estimating the GA. Therefore, clinicians are recommended to use TCD for estimating the GA and should be trained on measuring it accurately.
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Objective: To optimize the ultrasonication method for efficient extraction of P-sitosterol and lupeol from the roots of Astragalus atropilosus using Box-Behnken design of response surface methodology (RSM), and its validation by high performance thin layer chromatography (HPTLC) method. Methods: Ultrasonication method was used to extract β-sitosterol and lupeol from Astragalus atropilosus (roots). RSM was used to optimize the different extraction parameters viz. liquid to solid ratio (10-14 mL/g), temperature (60-80 °C) and time (40-60 min) to maximize the yield of β-sitosterol and lupeol. The quantitative estimation of β-sitosterol and lupeol was done in chloroform extract of Astragalus atropilosus by validated HPTLC method on 10 cm × 20 cm glass-backed silica gel 60F
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Objective: Postoperative atrial fibrillation (POAF) is an arrhythmia most commonly seen after cardiac surgery. Its association with increased mortality, cost and adverse events has made it crucial to identify those at risk and to prevent POAF through preoperative therapy. In order to do that, we have studied the utilization and predictive power of the CHA2DS2-VASc score, and the relationship between other factors such as preoperative medications and patient clinical characteristics. Methods: A retrospective observational study was conducted by reviewing medical charts for patients who underwent coronary arteries bypass grafting (CABG) with or without aortic valve replacement or mitral valve/tricuspid valve repair and aged >18 years. Patients with a preoperative history of atrial fibrillation (AF) or flutter, patients with a pacemaker, patients with prior antiarrhythmic drugs use within the last 6 months, patients who underwent MAZE procedures, or patients with mechanical mitral valve were excluded. Results: At a cut-off score of ≥ 2 the CHA2DS2-VASc showed a 96.8% sensitivity and 23.1% specificity for predicting POAF. It also showed an increased risk at higher scores, a score of at least 3 significantly predicted the occurrence of events (p<0.000). Age, male gender, high BMI were significant predictors of POAF (p<0.001, p<0.05, p<0.001). Patients who received statins preoperatively were at significant lower risk (p<0.001). Conclusion: The CHA2DS2-VASc score is a strong predictor of adverse events postoperatively.
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Human-landing catch (HLC) technique was undertaken in nine selected study sites within Peninsular Malaysia to determine the biting cycle of Aedes, Armigeres, Culex, and Mansonia mosquitoes. HLC was conducted 24 hours on three different nights in a duration of one week at each study site. Aedes albopictus were found in all study sites with bimodal biting cycle, whereas the biting peak of Aedes butleri was recorded between 1600 and 1900 hr. For Armigeres, five study sites demonstrated similar biting peak hour (1900 – 2000 hr) for Ar. kesseli four study sites showed biting peak at 1800 – 1900 hr for Ar. subalbatus. Culex quinquefasciatus was collected from all study sites except in Sungai Penchala with its biting activity beginning from 1900 hr. Both Mansonia annulifera and Mansonia uniformis captured in two different study sites showed similar biting peaks (1500 – 1600 hr). It is recommended that vector control activities be carried out at dusk as almost all mosquito species captured started their biting activities at that time.