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Leaf rust, caused by Puccinia triticina, is the most common rust disease of wheat. The fungus is an obligate parasite capable of producing infectious urediniospores. To study the genetic structure of the leaf rust population 20 RAPD primers were evaluated on 15 isolates samples collected in Pakistan. A total of 105 RAPD fragments were amplified with an average of 7 fragments per primer. The number of amplified fragments varied from 1 to 12. GL Decamer L-07 and GL Decamer L-01 amplified the highest number of bands (twelve) and primer GL Decamer A-03 amplified the lowest number of bands i.e one. Results showed that almost all investigated isolates were genetically different that confirms high genetic diversity within the leaf rust population. Rust spores can follow the migration pattern in short and long distances to neighbor areas. Results indicated that the greatest variability was revealed by 74.9% of genetic differentiation within leaf rust populations. These results suggested that each population was not completely identical and high gene flow has occurred among the leaf rust population of different areas. The highest differentiation and genetic distance among the Pakistani leaf rust populations were detected between the leaf rust population in NARC isolate (NARC-4) and AARI-11and the highest similarity was observed between NARC isolates (NARC-4) and (NARC-5). The present study showed the leaf rust population in Pakistan is highly dynamic and variable.
A ferrugem da folha, causada por Puccinia triticina, é a ferrugem mais comum do trigo. O fungo é um parasita obrigatório, capaz de produzir urediniósporos infecciosos. Para estudar a estrutura genética da população de ferrugem da folha, 20 primers RAPD foram avaliados em 15 amostras de isolados coletadas no Paquistão. Um total de 105 fragmentos RAPD foram amplificados com uma média de 7 fragmentos por primer. O número de fragmentos amplificados variou de 1 a 12. GL Decamer L-07 e GL Decamer L-01 amplificaram o maior número de bandas (doze), e o primer GL Decamer A-03 amplificou o menor número de bandas, ou seja, um. Os resultados mostraram que quase todos os isolados investigados eram geneticamente diferentes, o que confirma a alta diversidade genética na população de ferrugem da folha. Os esporos de ferrugem podem seguir o padrão de migração em distâncias curtas e longas para áreas vizinhas. Os resultados indicaram que a maior variabilidade foi revelada por 74,9% da diferenciação genética nas populações de ferrugem. Esses resultados sugeriram que cada população não era completamente idêntica e um alto fluxo gênico ocorreu entre a população de ferrugem da folha de diferentes áreas. A maior diferenciação e distância genética entre as populações de ferrugem da folha do Paquistão foram detectadas entre a população de ferrugem da folha no isolado NARC (NARC-4) e AARI-11 e a maior similaridade foi observada entre os isolados NARC (NARC-4) e (NARC-5). O presente estudo mostrou que a população de ferrugem da folha no Paquistão é altamente dinâmica e variável.
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Triticum/parasitologia , Biomarcadores , Pragas da Agricultura , Fungos/genética , Puccinia/genéticaRESUMO
Objective To ascertain the efect of human immunodefciency virus (HIV) infection, as well as, antiretroviral therapy (ART) on neutrophil oxidative burst in children. Methods Fifty-fve children living with HIV infection (30 receiving ART for?2 y, 25 treatment-naïve) and 30 healthy controls, aged 18 mo–18 y, were assessed for hemogram and neutrophil oxidative burst. The treatment-naïve children were followed up and the above tests were repeated after 6 mo of ART. Results Mean (SD) serum MPO activity at 6 mo after ART [32.1 (±19.9) U/L] was comparable to that at disease onset [17.2 (±23.0) U/L], although it was signifcantly higher compared to that in children on ART?2 y [13.3 (±15.8) U/L] and controls [12.1 (±11.9) U/L]. Median fuorescence intensity (MFI) of unstimulated DHR was highest at 6 mo after ART and in the treatment-naïve group, which was signifcantly higher than in the controls, as well as, children receiving ART?2 y. Stimulation index was highest in the control group [442.4 (341.9–562.9)], which was comparable to that in children on ART?2 y [304.2 (153.2–664.8)], but was signifcantly higher than the treatment-naïve cohort [266.1 (148.2–339.4)] and children on ART for 6 mo [318.8 (154.9–395.6)]. Conclusion A hyperinfammatory state caused by an increased serum myeloperoxidase enzyme activity and increased basal neutrophil oxidative burst was seen in untreated HIV infection and during initial 6 mo of ART. ART given for?2 y normalized the impaired neutrophilic phagocytic functions.
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Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory disease that affects the airways, alveoli, and pulmonary vasculature, leading to irreversible airflow limitation and loss of elastic recoil. This disease is highly prevalent in clinical practice, affecting approximately 10% of adults over 40 years of age, and it is expected to become the third leading cause of death by 2030. The study was conducted on 54 COPD patients diagnosed based on GOLD guidelines. The study observed a statistically significant association between Spirometric staging and the duration of symptoms. The mean value of FEV1/FVC, FEV1 in %, and 6MWD in meters decreased significantly as the grade of GOLD stage increased from stage II to stage III and stage IV. The study showed that COPD is associated with various co- morbidities, including hypertension, diabetes mellitus, hypothyroidism, and coronary artery disease. The study concludes that FEV1, BMI, MMRC grading, and the 6-minute walk test are significant predictors of morbidity among COPD patients. The study recommends early detection and management of COPD to prevent its progression and associated morbidity
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ABSTRACT This case report aims to show the anatomical and functional results of a patient diagnosed as having cancer-associated retinopathy treated with a controlled-release dexamethasone implant (Ozurdex). Anatomical outcomes were assessed using spectral domain optical coherence tomography; and functional outcomes, by measuring visual acuity, microperimetry, and mutifocal electroretinography. The follow-up period was 1 year.
RESUMO Este relato de caso tem como objetivo mostrar os resultados anatômicos e funcionais de um paciente com diagnóstico de retinopatia associada ao câncer tratado com implante de liberação controlada de dexametasona (Ozurdex®). Os resultados anatômicos foram avaliados por SD-OCT e os resultados funcionais por medida de acuidade visual, microperimetria e eletrorretinograma multifocal. O período de acompanhamento foi de um ano.
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Extraskeletal mesenchymal chondrosarcoma (EMCS) is a rare malignant soft tissue tumor of chondroprogenitor cell origin. Originally, it was restricted to the bone only but that is no longer the case. Recent literature reports that 20–33% of these tumors occur at the extraskeletal sites. We report one such case, in which the tumor involved the anterior abdominal wall muscles and also had a large intra-abdominal mass that covered a large part of the peritoneal cavity. The clinical features and computed tomography findings suggested the diagnosis of a malignant desmoid tumor with intra-abdominal extension; however, the histopathological examination and the immunohistochemistry proved the tumor to be EMCS. The case is reported due to the dilemma in diagnosis, its rarity, large size, parietal, and intra-abdominal extension with multiple site involvement.
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Background: Laparoscopic cholecystectomy is a type of surgery that uses smaller incision than open cholecystectomy. LC has been performed as outpatient procedure for many years. Few studies have been conducted with primary focus on patient acceptance and preferences in terms of safety and satisfaction. We tried to explore its feasibility in otherwise healthy individuals undergoing laparoscopic cholecystectomy. The aim of the study of laparoscopic cholecystectomy is significantly affected by acute cholecystitis. Mechanical, biochemical, and bacteriological factors which are believed to participate in this inflammatory process are responsible for the different pathological processes observed in acute cholecystitis and in symptomatic cholelithiasis. Material & Methods: Data from 57 patients between the age group 20 to 70 years with cholelithiasis who underwent laparoscopic cholecystectomy in a private Hospital, Madaripur, Bangladesh from April 2018 to June 2020 as ambulatory surgery (hospital stay 23 Hours) with or without overnight stay were analyzed. Complications, admissions and readmissions, patient satisfaction and treatment expenditure were assessed. Results: There were 48 (84.2%) female and 9 (15.8%) male with a median age of 42 years. Only 2.4% patients required readmission while 9.2% patients had unplanned admission. 76.4% percent patients were highly satisfied with the procedure. Treatment cost was about 15% lower than routine inpatient operation. Conclusion: Laparoscopic cholecystectomy is safe and feasible. LC can be performed as an outpatient procedure with a low rate of complications and admissions/readmissions. Patient acceptance in terms of satisfaction is high.
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ABSTRACT Background: Safety and efficacy concerns regarding coronavirus disease 2019 (COVID-19) vaccines are common among the public and have a negative impact on their uptake. We aimed to report the adverse effects currently associated with the vaccine in Pakistan to build confidence among the population for its adoption. Methods: A cross-sectional study was conducted in five districts of the Punjab province of Pakistan between January and March 2022. The participants were recruited using convenience sampling. All data were analyzed using SPSS 22. Results: We recruited 1622 people with the majority aged between 25-45 years. Of these, 51% were female, including 27 pregnant women and 42 lactating mothers. Most participants had received the Sinopharm (62.6%) or Sinovac (17.8%) vaccines. The incidences of at least one side effect after the first (N = 1622), second (N = 1484), and booster doses (N = 219) of the COVID-19 vaccine were 16.5%, 20.1%, and 32%, respectively. Inflammation/erythema at the injection site, pain at the injection site, fever, and bone/muscle pain were common side effects of vaccination. No significant differences were observed in the adverse effect scores between all demographic variables except for pregnancy (P = 0.012) after the initial dose. No significant association was observed between any variable and the side effect scores of the second and booster doses of the vaccine. Conclusions: Our study showed a 16-32% prevalence of self-reported side effects after the first, second, and booster COVID-19 vaccinations. Most adverse effects were mild and transient, indicating the safety of different COVID-19 vaccines.
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Background: The coronavirus disease 2019 (COVID-19) lockdown was a strange and new occurrence, which left many individuals ill-equipped to cope with the new way of living. Sportspersons had to adapt to a new training style within a new environment, both physically and mentally. Aim: The purpose of this study was to understand the physical, mental and emotional parameters among sportspersons during the COVID-19 lockdown regulations. Setting: The study consisted of 105 regular sportspersons (from South Africa). Methods: This was a quantitative research study design using an online questionnaire. An online questionnaire was adapted and distributed via online social platforms (WhatsApp, Twitter and Instagram) to collect data in which sportspersons (n = 105) answered questions about the effects that they experienced during lockdown on their physical, mental and emotional well-being. Results: Sportspersons participated in cardiovascular training, flexibility training, strength training and bodybuilding exercises during pre-lockdown. During lockdown, more than 74% of sportspersons had adequate training space, equipment and the time to perform physical activity. However, more than 43% of these sportspersons experienced a decrease in flexibility, muscle mass and muscle strength. Exercise was used as a form of stress relief by 77.1% of sportspersons throughout lockdown. In addition, sportspersons who used exercise as a form of stress relief continued to experience an increase in stress throughout lockdown. Conclusion: The outcomes from this study demonstrated how the COVID-19 lockdown had adverse effects on the overall health and well-being of most sportspersons. Other outcomes included the effects that physical inactivity had among sportspersons, including changes in diet and sleep. Contribution: This study highlights the urgency for the sports fraternity to adopt measures to provide various methods of stress relief (as well as opportunities for physical activity) during similar periods of lockdown (or exercise restrictions) for those who rely on exercise as their daily physical, mental and emotional outlet.
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Controle Social Formal , Exercício Físico , Treinamento Resistido , Comportamento Sedentário , COVID-19 , Aptidão Física , AtletasRESUMO
Placental site trophoblastic tumour (PSTT) is a rare variant of gestational trophoblastic disease developing from intermediate trophoblasts. PSTTs are incredibly rare tumours with 1 in 100000 pregnancies and only about 200 cases reported till date with mortality reaching up to 25% in undiagnosed c ases. We present the case of a 37year old female, gravida 4 para 3, presenting with uncontrollable post caesarean haemorrhage for which she underwent subtotal hysterectomy. Histopathological examination revealed Placental site trophoblastic tumour. Placent al site trophoblastic tumour, being a rare entity, pose difficulties in its early diagnosis. Delayed diagnosis can lead to distant metastases, thus worsening the prognosis.
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La neuroinmunología es una disciplina que cada vez amplía más sus horizontes en la comprensión de las enfermedades neurológicas. Contemporáneamente, y a la luz de los nexos fisiopatológicos de las enfermedades neurológicas y la inmunología, se han planteado enfoques diagnósticos y terapéuticos específicos. A pesar de los importantes avances de esta disciplina, existen múltiples dilemas que le conciernen y se filtran en la práctica clínica. En esta revisión, se presentan y discuten 15 controversias, las cuales se construyen con la información clínica disponible más actualizada. Los temas incluidos son: disminución de esteroides en recaídas de esclerosis múltiple; recomendaciones terapéuticas en esclerosis múltiple a la luz de la pandemia por el SARS-CoV-2; evidencia de vacunación en esclerosis múltiple y en otras enfermedades desmielinizantes; panorama actual del síndrome clínico y radiológico aislado; y fallas terapéuticas en esclerosis múltiple; además, criterios para suspender las terapias modificadoras de la enfermedad; evidencia del manejo en recaídas leves; recomendaciones para la profilaxis contra Strongyloides stercolaris; utilidad de un segundo ciclo de inmunoglobulina en el síndrome de Guillain-Barré; criterios para diferenciar una polineuropatía crónica desmielinizante inflamatoria de inicio agudo de un síndrome de Guillain-Barré y, utilidad de la enzima convertidora de angiotensina en neurosarcoidosis. En cada una de las controversias, se presenta la problemática general y se ofrecen recomendaciones específicas que pueden adoptarse en la práctica clínica diaria.
Neuroimmunology is a discipline that increasingly broadens its horizons in the understanding of neurological diseases. At the same time, and in front of the pathophysiological links of neurological diseases and immunology, specific diagnostic and therapeutic approaches have been proposed. Despite the important advances in this discipline, there are multiple dilemmas that concern and filter into clinical practice. This article presents 15 controversies and a discussion about them, which are built with the most up-to-date evidence available. The topics included in this review are: steroid decline in relapses of multiple sclerosis; therapeutic recommendations in MS in light of the SARS-CoV-2 pandemic; evidence of vaccination in multiple sclerosis and other demyelinating diseases; overview current situation of isolated clinical and radiological syndrome; therapeutic failure in multiple sclerosis, as well as criteria for suspension of disease-modifying therapies; evidence of the management of mild relapses in multiple sclerosis; recommendations for prophylaxis against Strongyloides stercolaris; usefulness of a second course of immunoglobulin in the Guillain-Barré syndrome; criteria to differentiate an acute-onset inflammatory demyelinating chronic polyneuropathy versus Guillain-Barré syndrome; and, the utility of angiotensin-converting enzyme in neurosarcoidosis. In each of the controversies, the general problem is presented, and specific recommendations are offered that can be adopted in daily clinical practice.
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Vacinas , Coronavirus , Esclerose Múltipla , Sarcoidose , Síndrome de Guillain-Barré , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica , NatalizumabRESUMO
Abstract Introduction Disease phobia may impose distressing manifestations along with compromised quality of life, particularly in young age. COVID-19 caused substantial psychological concerns in general population which required the attention of health authorities to address the issue as soon as possible. Objective This study was aimed to determine COVID-19 phobia in Pakistani youth during the current pandemic. Method A cross-sectional study was conducted to ascertain the extent of fear of COVID-19 among university students in Lahore, Pakistan using the COVID-19 Phobia Scale (C19P-S). Psychological, somatic, social, and economic factors were ascertained among students. The relationship of demographics with the phobia score was determined through appropriate statistical tests. Result This study included 374 students with a male preponderance (64.7%). The mean C19P-S score was 59.08 ± 14.44 (IQR: 50 - 70), with no significant difference among demographics except gender (male 57.65 ± 14.77 vs female 61.70 ± 13.47; p = .009). The mean psychological, psycho-somatic, economic, and social subscale scores were 19.59 ± 5.00 (25th percentile = 16 and 75th percentile = 24), 12.29 ± 4.56 (25th percentile = 10 and 75th percentile = 15), 11.22 ± 3.67 (25th percentile = 8 and 75th percentile = 14) and 15.97 ± 4.04 (25th percentile = 13.75 and 75th percentile = 19), respectively. Male students had a significantly lower score on social and psychological subscales than females (p< .05). Discussion and conclusion One fourth of the students achieved a fear score > 70 on C19P-S. These results indicate the need of dire maneuvers for reducing corona-phobia among university students.
Resumen Introducción La fobia a las enfermedades puede imponer malestar psicológico y comprometer la calidad de vida, particularmente en edades tempranas. El COVID-19 causó serias preocupaciones psicológicas en la población en general y éstas requieren la atención de las autoridades de salud para abordar el problema cuanto antes. Objetivo Este estudio buscó determinar la fobia al COVID-19 en jóvenes paquistaníes durante la pandemia actual. Método Se realizó un estudio transversal basado en la web para evaluar el miedo al COVID-19 entre los estudiantes universitarios en Lahore; para esto se utilizó la Escala de Fobia COVID-19 (C19P-S). Se evaluaron factores psicológicos, somáticos, sociales y económicos entre los estudiantes. La relación de la demografía con la puntuación de fobia se determinó mediante pruebas estadísticas apropiadas. Resultados Este estudio incluyó a 374 estudiantes con preponderancia masculina (64.7%). La puntuación media de C19P-S fue 59.08 ± 14.44 (IQR: 50 - 70), sin diferencias significativas entre los datos demográficos, excepto el género (hombres 57.65 ± 14.77 versus mujeres 61.70 ± 13.47; p = .009). Las puntuaciones medias de las subescalas psicológicas, psicosomáticas, económicas y sociales fueron 19.59 ± 5.00 (percentil 25 = 16 y percentil 75 = 24), 12.29 ± 4.56 (percentil 25 = 10 y percentil 75 = 15), 11.22 ± 3.67 (percentil 25) = percentil 8 y 75 = 14) y 15.97 ± 4.04 (percentil 25 = 13.75 y percentil 75 = 19), respectivamente. Los estudiantes varones obtuvieron una puntuación significativamente menor en las subescalas sociales y psicológicas que las mujeres (p< .05). Discusión y conclusión Una cuarta parte de los estudiantes obtuvo una puntuación de miedo > 70 en la C19P-S. Estos resultados indican la necesidad de aplicar medidas extremas para reducir la fobia al Coronavirus entre los estudiantes universitarios.
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A granular cell tumour is a tumour of neural origin and is mostly benign and rarely malignant and commonly found in the skin, oral cavity or digestive tract. This report describes a case of a 23 - year - old female with a palpable painless mass on the back near the left axilla with progressive growth. While her laboratory tests and radiological were within normal limits histopathological examination revealed round to polygonal PAS positive atypical cells with large vesicular nuclei and coarsely granular cytoplasm along with foci of spindling an d necrosis which on IHC were S - 100 and CD68 positive and negative for cytokeratin, desmin, EMA. Thus, rendering a diagnosis of a malignant granular tumour of primary origin. This case highlights the importance of accurate histopathological examination to r ecognise and further categorization of Granular cell tumours along with clinical and radiological correlation .
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Placental site trophoblastic tumour (PSTT) is a rare variant of gestational trophoblastic disease developing from intermediate trophoblasts. PSTTs are incredibly rare tumours with 1 in 100000 pregnancies and only about 200 cases reported till date with mortality reaching up to 25% in undiagnosed c ases. We present the case of a 37year old female, gravida 4 para 3, presenting with uncontrollable post caesarean haemorrhage for which she underwent subtotal hysterectomy. Histopathological examination revealed Placental site trophoblastic tumour. Placent al site trophoblastic tumour, being a rare entity, pose difficulties in its early diagnosis. Delayed diagnosis can lead to distant metastases, thus worsening the prognosis.
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Abstract Objective: Evaluate the effectiveness of a children's soap with physiological pH in maintaining cutaneous pH and moisture of the newborn (NB)'s skin after the first bath. Methods: Randomized, controlled and double-blind clinical trial in a rooming-in of a tertiary maternity hospital in southern Brazil with 204 newborns > 34 gestational weeks. Gestational and obstetric history was evaluated, and newborns were randomized into two groups according to the product applied in the bath: the control group (CG), which used common liquid soap with pH 7.0 and experimental group (EG), which used children's liquid soap with pH 5.8. Evaluation was made immediately before and after bath with skin pH measurement, corneometry and clinical parameters (erythema, scaling and moisture), on the forehead, abdomen and thigh. Results: There was no difference between groups regarding gestational, obstetric and family history (p > 0.05). In CG, skin pH increased in the abdomen and thigh (p < 0.05). In EG there was an improvement in clinical parameters after bathing with: increased moisture, less erythema and less scaling (p < 0.05). On the forehead, there was a significant increase in pH after bathing (p < 0.001) similar in both groups, although no use of soap. There was no difference in corneometry between groups after bathing. Conclusions: Children's liquid soap with physiological pH maintained the acidic skin pH and moisture of the newborn's skin after the first bath, which reinforces the importance of using products with physiological pH in the hygiene of newborns. Registration number RBR-9ky84vd.
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Objectives: The outbreak of COVID-19 has caused an unprecedented health crisis and dramatically changed human lives. This study aims to identify risk factors related to health-related quality of life (HRQoL) among COVID-19 patients who were discharged from the hospital. Material and Methods: A total of 557 COVID-19 patients of Jhenaidah district of Bangladesh who had tested positive before February 1 of 2021 were selected for this cross-sectional study. The EuroQol 5-dimensional-5 level questionnaire was used to measure the HRQoL. Thai value set was used to assess the full health status. Chi-square test was used to find out the association of HRQoL with sociodemographic and clinical factors. Finally, logistic regression was used to find out the predictors of the dimensions of HRQoL. Results: Using the Thai value set, it is observed that 57.27% of participants had reported that they had experienced moderate or severe health problems. About 40.57% of the respondent reported anxiety or depression, whereas 39.14% of the participants had experienced moderate or severe pain or discomfort. The result of the logistic regression showed that age, gender, occupation, place of care, heart problems, and diabetes significantly affect various dimensions of the HRQoL. Conclusion: The COVID-19 significantly depletes the health condition of the patients in both mental and physical aspects. Therefore, the policy-makers and government should need to come with comprehensive strategies to reduce the psychological and physical health woe of COVID-19 patients.
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Resumen Introducción: La ventilación no invasiva reduce la necesidad de intubación y la estancia en la unidad de cuidados intensivos en los pacientes con edema pulmonar cardiogénico. Objetivo: Evaluar la posible asociación entre el inicio de la ventilación no invasiva desde el ingreso a urgencias con la mortalidad y el requerimiento de intubación en pacientes con edema pulmonar cardiogénico. Método: Estudio analítico de cohorte retrospectiva, en el que se revisaron las historias clínicas de pacientes mayores de 18 años hospitalizados en una institución de Medellín, Colombia. Resultados: 70 pacientes cumplieron los criterios de inclusión y se compararon según el estado vital al alta. Sobrevivientes (49): la edad promedio fue de 63 años, el 34.7% fueron mujeres, el 57.1% tuvieron historia de neumopatía crónica y el 89% eran hipertensos; el promedio para recibir la intervención fue de 10 horas y el 20% requirieron intubación orotraqueal. No sobrevivientes (21): la edad promedio fue de 74 años, el 57.1% fueron mujeres, el 57.1% tuvieron historia de neumopatía crónica y el 90% eran hipertensos; el promedio para recibir la intervención fue de 7 horas y el 62% requirieron intubación. Tiempo de inicio en relación con la mortalidad en el análisis multivariado: odds ratio (OR) 1,05, intervalo de confianza del 95% (IC95%) 0.89-1.24, p = 0.499; y por variable instrumental: 7% de diferencia de medias. En cuanto al tiempo de inicio y su asociación con la necesidad de intubación: OR 0.93, IC95% 0,86-1,01. Conclusiones: Este estudio sugiere que el inicio tardío de la ventilación no invasiva es un factor de riesgo; sin embargo, no se halló asociación estadísticamente significativa, por lo que se requieren estudios adicionales para confirmar este hallazgo.
Abstract Introduction: Non-invasive ventilation reduces the need for intubation and intensive care stay in cardiogenic pulmonary edema. Objective: To evaluate the possible relationship between the initiation of non-invasive ventilation on admission to the emergency room and mortality and the need for intubation in patients with cardiogenic pulmonary edema. Method: A retrospective analytical cohort study. A chart review of patients over the age of 18 hospitalized at an institution in Medellín, Colombia. Results: 70 patients met the inclusion criteria and were compared by vital status at discharge. Survivors (49): the average age was 63 years, 34.7% were women, 57.1% had a history of chronic pulmonary disease, 89% had hypertension, 10 hours was the average for receiving the intervention, and 20% required orotracheal intubation. Non-survivors (21): the average age was 74 years, 57.1% were women, 57.1% had a history of chronic pulmonary disease, 90% had hypertension; 7 hours was the average for receiving the intervention, and 62% required intubation. Timing of initiation related to mortality on the multivariate analysis: odds ratio (OR) 1.05, 95% confidence interval (95%CI) 0.89-1.24, p = 0.499; and by instrumental variable: 7% difference in means. With regard to timing of initiation and its association with the need for intubation: OR 0.93, 95%CI 0.86-1.01. Conclusions: This study suggests that late initiation of non-invasive ventilation is a risk factor; however, no statistically significant association was found. Therefore, further studies are needed to confirm this finding.
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We demonstrate a modified internal limiting membrane (ILM) inverted flap technique for closure of macular holes (MHs) concurrent with rhegmatogenous retinal detachment in myopic eyes. Multiple ILM flaps were created in a flower?petal configuration around the MH over the detached retina after shallowing the retina as much as possible. Traction was always in a direction that allowed the optic disc to act as an anchor to limit iatrogenic breaks and to bridge the hole with multiple, more secure flaps should one of the flaps revert or break away. The technique proved safe and efficient in MH closure in our series of eight cases. The modification described provides an effective approach for challenging myopic cases in which ILM flap creation is needed over a detached retina.
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Background: Gastric cancer is the fourth commonest cancer worldwide. It is also recognized as the second commonest cause of cancer related death in the global perspective. Although the incidence of gastric cancer has gradually decreased over the last half of the century, it varies among the different part of the world and different ethnic group. Mortality from gastric cancer extremely high, and it is second only to lung cancer. Gastric cancer occurs more frequently in men than in women. Aim of the study: Aim of the study was to find the clinic-profile outcome HER2 Positive Gastric and Gastroesophageal Adenocarcinoma.Methods:This cross sectional study was conducted in the Department of Surgical Oncology of National Institute of Cancer, Research and Hospital, Mohakhali, Dhaka. The study period was from March, 2014 to April, 2015. A total of 80 patients were included for the study. After receiving the gastrectomy specimen, it was fixed in 10% formaldehyde. Data were compiled and necessary statistical analysis were carried out using computer based software package for social science (SPSS 16.1). Ethical clearance was taken from the ethical committee of NICRH.Results:The highest patients were from 61-70 years� age group and the lowest were from 71-80 years. The mean age of the patients was 59.71 (�.19) years. The female to male ratio in this study was 1: 2.48. 66 (82.5%) patients were presented with anemia which was followed by 39 (48.75%) cases with dehydration. Most of the tumors were located in the distal part of the stomach (11.67%). Regarding staging 79(12.65%) patients were in the advanced stage of the disease. The correlation between HER2 overexpression and TNM staging has been tabulated below where it is shown that only Nodal (N) staging has the significant correlation with the HER2 overexpression.Conclusion:It is already mentioned that, in early history of immunohistochemistry, HER2 overexpression in case of carcinoma stomach was highly varied in different studies (from 9-92%). But recently, it was found around 9-32%, in several studies all over the world. It is necessary to conduct further studies with larger samples and long term follow-up in order to draw definite conclusions regarding the role of HER2/neu overexpression
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Abstract Snakebite is one of the major health issues posing considerable morbidity and mortality. According to an estimate of World Health Organization (WHO) (World health organization, 2021) approximately 5 million people are bitten by several species of snakes resulting in up to 2.5 million envenomation cases annually. The mainstay of treatment for envenomation is intravenous administration of anti-snake venom. Although antivenom neutralizes the systemic effects but it does not relieve the symptoms such as venom-induced hemorrhage, necrosis and nephrotoxicity. Moreover, the use of antivenoms is associated with hypersensitivity reactions including urticaria, anaphylaxis, or serum sickness due to their heterologous property. Furthermore, stringent storage conditions and narrow specificity of antivenoms limit their use in both developed as well as developing countries. In this context, researchers have been searching for natural products and plant extracts to explore their antivenom activity along with anti-myotoxic, anti-hemorrhagic and anti-inflammatory properties. Plant remedies may prove to be an effective alternate for antivenom sera with less adverse events and better tolerability. To the best of our knowledge, this is the first comprehensive review of medicinal plants possessing anti-snake venom activities against certain species of snakes. The current review highlights the investigated plants with their phytochemical analysis to integrate the available information for future research and development of antivenom sera.