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Unhealthy diets and lifestyles cause a resistance to and/or relative deficiency of insulin production. Therefore, it is thought worthwhile to develop a natural remedy that may effectively manage the disease symptoms to a certain extent without causing adverse consequences. The objective was to develop the active biological constituent(s) for the use of Coccinia indica and its relationship to treating type II diabetic rats. The soxhlet extraction method was used to get the cocktail of phytochemicals of C. indica by using methanol. The composition of a high-sugar diet, followed by fructose (66%), was used to induce T2DM in rats. The preliminary predictive markers were body weight (pre- and post-treatment), blood glucose level (pre- and post-treatment), serum insulin, and pancreatic insulin. And the secondary outcomes were the pro-inflammatory mediators interleukin 6 (IL-6), transforming growth factor-? (TGF-?), and tumour necrosis factor alpha (TNF alpha). Additionally, pancreatic tissue was used to estimate beta cell mass, size, and necrosis, and the cell supernatant was used to observe superoxide dismutase (SOD), lipid peroxidation (LPO), and catalase (CAT). High sugar diet showed significant increase in body weight (p < 0.01), fasting blood glucose level (p < 0.001), and decrease in serum and pancreatic insulin levels (p < 0.001), whereas rats treated with methanolic extract of C. indica showed significant reduction in post-treatment body weight (p < 0.01), blood glucose levels (p < 0.01), and increase in serum and pancreatic insulin (p < 0.001), especially in higher doses, i.e., 400 mg/kg. Pro-inflammatory cytokines (IL-6, TGF-beta, and TNF-?) can increase insulin resistance, which results in poor glucose homeostasis, which has been reduced by treatment with C. indica (p<0.001). Superoxide radicals and a deficiency in catalase, both of which are linked to diabetes, but the extract of the plant has been shown to enhance the secretion of enzymes SOD and CAT (p<0.001). It has been proven to have a crucial role in the regulation of apoptosis because it lowers oxidative stress and similarly reduces the level of LPO (p<0.01). Additionally, the treated rat pancreas shows islets of Langerhans that are normal in number and size. No necrosis or reduction in size was seen. The current study conclusively shows that the phytoconstituents of C. indica have the potential to tackle long-term health complications and manage symptoms.
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The investigation of novel phytochemicals for the prevention and treatment of infections caused by multidrug-resistant pathogens is gaining attention. The current study evaluated the in-vitro antimicrobial activity of kaempferol against methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. Its in-vivo efficacy in inhibiting these pathogens was determined using an excision wound model in nicotinamide-streptozocin- -induced diabetic rats. Kaempferol displayed an inhibitory effect against the tested bacteria both in vitro and in vivo. It also healed excision wounds at a 1% (w/w) concentration. An increase in antioxidant enzymes in wounded tissue was observed on kaempferol treatment. A reduction in the MRSA and P. aeruginosa counts in wounded tissue together with a reduced epithelization period was observed when compared to the infected control. A thicker epithelium, new capillaries, and a decrease in inflammatory cells were detected by hematoxylin and eosin staining. Furthermore, an increase in collagen fibers and their deposition was observed by Masson's trichrome staining. Kaempferol at 40 µM did not display any toxicity for human keratinocytes grown in media containing high glucose and it did not affect the expression of the pro-healing cytokines genes vascular endothelial growth factor (VEGF) and transforming growth factor-b-1 (TGFß1). Kaempferol displayed antibacterial and antioxidant actions but did not increase the expression of proliferative genes.
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Objectives: To explore quality management policy and procedures of the pharmacy occupational safety and health system in pharmacy practice as a new initiative in Saudi Arabia. Methods: It was a narrative review of the pharmacy occupational safety and health system and quality management policy and procedures in pharmacy practice. Literature searched various databases, including PubMed, Medline, and Google Scholar. The search period is from the 1960s until 06 December 2023. The term is in full-text English and includes Case Reports, Classical Articles, Clinical Conferences, Clinical Studies, Clinical Trials, Evaluation Studies, Government Publications, Guidelines, meta-analyses, Observational Studies, Practice Guidelines, Randomized Controlled Trials, Reviews, Systematic Reviews, with Humans subject. All hospital or community pharmacy services are included in a search term. Besides, the National and international guidelines of occupational safety and health in hospital practice. The committee of pharmacy occupational safety and health policy and procedures formulated and consisted of various expert members. That includes clinical pharmacists, occupational safety specialists, Crisis and Disaster Management, and fire safety experts. The guidelines of the policy draft by one member by the second member were reviewed and corrected. The third revision was by the occupational safety specialists. The topic emphasizes the occupational safety and health system and quality management policy and procedures. Results: The review for quality management of occupational safety and health system policy and procedures in pharmacy practice has consisted of pharmacy occupational safety and health auditing and quality management performance indicators. Besides, it discusses the techniques of conducting quality management systems for occupational safety and health programs in pharmacy practice. Conclusion: The quality management of occupational safety and health system policy and procedures in pharmacy practice demands keeping adherence to occupational safety health standards at an appropriate level, with unnecessary cost control. Besides, monitor key performance indicators of pharmacy occupational safety and health auditing system. Thus, quality management of occupational safety and health system policy and procedures is highly recommended for pharmacy career professionals worldwide.
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Objectives: To explore the KSA-Self Assessments of Pharmacy Safety and Occupational Health as a new initiative project in Saudi Arabia. Methods: It was a narrative review of KSA-Self Assessments of Pharmacy Safety and Occupational Health. Literature searched various databases, including PubMed, Medline, and Google Scholar. The search period is from the 1960s until 06 December 2023. The term is in full-text English and includes Case Reports, Classical Articles, Clinical Conferences, Clinical Studies, Clinical Trials, Evaluation Studies, Government Publications, Guidelines, meta-analyses, Observational Studies, Practice Guidelines, Randomized Controlled Trials, Reviews, Systematic Reviews, with Humans subject. All hospital or community pharmacy services are included in a search term. Besides, the National and international guidelines of general occupational safety and health in hospital practice. The committee of pharmacy accounting policy and procedures formulated and consisted of various expert members. That includes clinical pharmacists, occupational safety specialists, Crisis and Disaster Management, and fire safety experts. The self-assessment is based on guidelines based on occupational safety and health societies’ regulations. In addition to Institution Safe Medication Practice (ISMP) criteria and KSA-Self assessment of pain management drug safety. The policy draft by one member by the second member was reviewed and corrected. The third revision was by the occupational safety specialists. The topic emphasizes self-assessments of Pharmacy Safety and Occupational Health. Results: The KSA Self Assessments of Pharmacy Safety and Occupational Health consisted of nine items. That has included Characteristics of Pharmacy Services, Pharmacy and warehouse building, Fire Safety, Crises and Disaster Management. Besides the Medication Information, Pharmacy Safety Practice, Patient/Family Education, Pharmacy staff competency and training, and Total Quality and Risk Management. Each element had various closedended questions scored using the 5-point Likert response scale system. Conclusion: The KSA-Self Assessments of Pharmacy Safety and Occupational Health policy is a new initiative project in Saudi Arabia. The KSA-Self Assessments of Pharmacy Safety and Occupational Health policy improves the Pharmacy Safety and Occupational Health system foundations. In addition, it encourages pharmacists to adhere to Pharmacy Safety and Occupational Health regulations in different places in the public and healthcare organizations. Therefore, the KSA-Self Assessments of Pharmacy Safety and Occupational Health policy is highly recommended for pharmacy career professionals in Saudi Arabia.
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Background: Monkeypox is a self-limiting disease first reported in 1970 in Zaire. It is characterised with small pox like eruptions and presently there is no approved anti–viral drug yet, clinical management of human monkey pox cases is mainly by supportive treatment and symptomatic treatment. This study assessed the knowledge, perception and safety practices of monkey pox disease among healthcare workers in a tertiary facility in Southwest state, Nigeria. Methods: The study was a descriptive cross-sectional study, web-based conducted among 402 healthcare workers in a tertiary health centre in Southwestern Nigeria. The 38-item survey instrument for the quantitative study was adapted from a similar study on COVID-19 among healthcare workers. Data was analysed using SPSS software version 20.0. Level of significance was pre-determined at p value <0.05 at a confidence level of 95%. Results: Female respondents constituted 241 (60%) while 161 (40%) were males. Mean age was 35.4±6.5 years with age group 26-35 years (49.0%) being the majority. Majority, 311 (77.4%) had poor knowledge of monkeypox while 69.9% had good perception. There was statistically significant association between age (?- 0.001), work experience (?- 0.001), tribe (?- 0.001), and average monthly income (?- 0.001) with perception about monkey pox infection among the respondents. Conclusions: Monkeypox is endemic in Nigeria and the knowledge and perceptions of healthcare workers towards the disease is a critical epidemiological determinant of its transmission rate, it is therefore imperative that intensive training be targeted among all cadres of healthcare professional including non-medical workers in healthcare setting.
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Objectives: To explore the occupational safety and health emphasis on fire safety policy and procedures in pharmacy practice as a new initiative in Saudi Arabia. Methods: It was a narrative review of pharmacy practice fire safety policy and procedures. Literature searched various databases, including PubMed, Medline, and Google Scholar. The search period is from the 1960s until 06 December 2023. The term is in full-text English and includes Case Reports, Classical Articles, Clinical Conferences, Clinical Studies, Clinical Trials, Evaluation Studies, Government Publications, Guidelines, meta-analyses, Observational Studies, Practice Guidelines, Randomized Controlled Trials, Reviews, Systematic Reviews, with Humans subject. All hospital or community pharmacy services are included in a search term. Besides, the National and international guidelines of general occupational safety and health in hospital practice. The committee of pharmacy occupational safety and health policy and procedures formulated and consisted of various expert members. The policy included fire prevention, Emergency Plans, Fire Protection, Safety conditions, and requirements for the pharmacy buildings and medication stores. Results: The fire safety of pharmacy practice policy and procedures in pharmacy practice had various benefits, such as fire safety risk assessment, Usage of fire extinguishers type per each fire at each section of pharmacy services, illustrate the fire safety equipment requirement for pharmaceutical warehouse and pharmacy buildings, and instruction prevention of fire and during fire incident. Conclusion: Fire safety as part of occupational safety and health policy and procedures in pharmacy practice is a new initiative in Saudi Arabia. They will improve the pharmacy safety measurement and better occupational safety and health. In addition, it encourages pharmacy staff to adhere to local and international occupational safety and health regulations and standards. Therefore, The pharmacy occupational safety and health emphasis on fire safety highly recommended policies, procedures, and related risk assessment analysis in the pharmacy businesses in Saudi Arabia.
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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.
Assuntos
Animais , Ratos , Traumatismo por Reperfusão/tratamento farmacológico , Antraquinonas/administração & dosagem , Nefropatias/tratamento farmacológico , Anti-Inflamatórios/administração & dosagem , Células Dendríticas/efeitos dos fármacos , Traumatismo por Reperfusão/imunologia , Transdução de Sinais , NF-kappa B/metabolismo , Antraquinonas/imunologia , Apoptose/efeitos dos fármacos , Estresse Oxidativo , Receptor 4 Toll-Like/metabolismo , Interleucina-1beta/metabolismo , Citometria de Fluxo , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Inflamação , Injeções Intraperitoneais , Nefropatias/imunologiaRESUMO
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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84 years old gentle man with past medical history of hypertension and diabetes presented with sudden onset right sided weakness and aphasia for two hours. Initial neurological assessment revealed National Institute of Health Stroke Scale (NIHSS) 17. Computed tomography (CT) scan demonstrated minimal early ischemic changes along left insular cortex with occlusion of left middle cerebral artery (MCA). Based on clinical and imaging findings, decision was made to perform mechanical thrombectomy procedure. Initially, right common femoral artery approach was utilized. However, due to unfavorable type-III bovine arch, left internal carotid artery could not be engaged via this approach. Subsequently, access was switched to right radial artery. Angiogram revealed small caliber radial artery, with larger caliber ulnar artery. Attempt was made to advance the guide catheter through the radial artery, however significant vasospasm was encountered. Subsequently, ulnar artery was accessed and successful thrombolysis in cerebral infarction (TICI) III left MCA reperfusion was achieved with a single pass of mechanical thrombectomy via this approach. Post procedure neurological examination demonstrated significant clinical improvement. Doppler ultrasound 48 hours after the procedure demonstrated patent flow in radial and ulnar arteries with no evidence of dissection.
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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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@# 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@#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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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.
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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.
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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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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.
RESUMO
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.
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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.
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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.