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1.
Chemosphere ; 345: 140426, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37844698

ABSTRACT

The occurrence, seasonal variations and spatial distribution of emerging contaminants (ECs) in wastewater effluents from wastewater treatment plant (WWTP) and UAE's receiving coastal aquatic environment (seawater and sediments) were evaluated in the present study. A total of 21, 23, and 22 contaminants in the effluents, seawater, and sediments, respectively, at concentrations ranging from low ng L-1 up to 1782 ng L-1 in effluents, from low ng/l up to 236.10 ng L-1 in seawater, and from low ng g-1 up to 60.15 ng g-1 in sediments were recorded. The study revealed that imidacloprid, thiabendazole, and acetaminophen were the most ubiquitous compounds in effluents, seawater, and sediments, respectively, since they were found in all samples collected with a detection frequency of 100%. The study also revealed that the higher concentrations of most contaminants were recorded in autumn. However, thiabendazole in effluents and seawater, acetamiprid in effluents, and sulphapyridine in seawater and sediments showed a higher load in winter. This study highlights the need for proper monitoring and management of ECs in wastewater effluents, seawater, and sediments, especially during the autumn and winter seasons, to minimize their impact on the marine ecosystem and public health.


Subject(s)
Wastewater , Water Pollutants, Chemical , Seasons , Ecosystem , Water Pollutants, Chemical/analysis , United Arab Emirates , Thiabendazole , Environmental Monitoring
2.
ACS Omega ; 8(34): 30824-30837, 2023 Aug 29.
Article in English | MEDLINE | ID: mdl-37663505

ABSTRACT

Most engineering technologies, gadgets, and systems have been developed around the use of sophisticated materials. Composite laminates have found widespread application in various significant and innovative industries, such as aviation, maritime transportation, automobiles, and civil engineering. Recent studies have revealed that composite materials are extensively utilized in automotive, undersea, and structural applications. Extensive efforts have been dedicated to exploring the structural components constructed from composite materials due to their importance in engineering. While composite materials offer certain advantages over their metallic counterparts, they also present analysts and designers with intricate and challenging issues. Hence, this Review aims to highlight noteworthy studies on composite materials and their engineering applications, specifically focusing on structural components. Furthermore, this Review includes a comprehensive summary of the application of composite laminates, accompanied by a critical analysis of the existing literature in this field. By presenting this information, the Review intends to provide a valuable resource and guideline for researchers interested in leveraging composite materials for engineering structures.

3.
Materials (Basel) ; 16(4)2023 Feb 14.
Article in English | MEDLINE | ID: mdl-36837212

ABSTRACT

Over the last four decades, numerous studies have been conducted on the use of bonded composite repairs for aircraft structures. These studies have explored the repair of damaged plates through experimental, numerical, and analytical methods and have found that bonded composite repairs are effective in controlling crack damage propagation in thin plates. The use of double-sided composite repairs has been found to improve repair performance within certain limits. This study focuses on these limits and optimizes double-sided composite repairs by varying adhesive bond and composite patch parameters. The optimization process begins with a finite element analysis to determine the stress intensity factor (SIF) for various variables and levels, followed by the application of the Taguchi method to find the optimal combination of parameters for maximizing the normalized SIF. In conclusion, we successfully determined the stress intensity factor (SIF) for various variations and normalized it for optimization. An optimization study was then performed using the Taguchi design and the results were analyzed. Our findings demonstrate the repair performance of bonded composite patches using a cost-effective and energy-efficient approach.

4.
Materials (Basel) ; 15(9)2022 Apr 24.
Article in English | MEDLINE | ID: mdl-35591420

ABSTRACT

In aerospace engineering applications, lightweight material structures are considered to perform difficult service conditions and afford energy efficiency. Therefore, composite materials have gained popularity due to their light weights and high performances in structural design. Mechanical loads and environmental conditions primarily create damage to structural materials, thus numerous studies have considered the repair of the damaged structure. Bonded composite repairs are generally chosen, as they provide enhanced stress-transfer mechanisms and joint efficiencies with the increased use of advanced composite materials in primary and secondary aircraft structural components. Thus, it is essential to have reliable and repeatable bonded repair procedures to restore damaged structural components. However, composite bonded repairs, especially with primary structures, present several scientific challenges in the current existing repair technologies. In this review, a study has been done on the bonded composite repair of damaged structures with the stress-intensity factor (SIF) as the parameter for defining the extent of failure by composite repair and unrepaired material structures. In this work, various types of repair methods and the techniques used by researchers are critically reviewed, and future opportunities are explored. The present study was limited to the composite and aluminium materials that are common in aerospace applications.

5.
Hematology ; 26(1): 529-542, 2021 Dec.
Article in English | MEDLINE | ID: mdl-34334100

ABSTRACT

Objectives: This study was conducted to investigate alteration in blood parameters and their association with the presence, severity, and mortality of COVID-19 patients as the data on hematological abnormalities associated with the Pakistani COVID-19 patients is limited.Methodology: A double-centered, hospital-based comparative retrospective case study was conducted, to include all the admitted patients (n = 317) having COVID-19 Polymerase chain reaction (PCR) positive. The control group (n = 157) tested negative for COVID-19.Results: Of 317 admitted cases, the majority were males n = 198 (62.5%). Associated comorbidities, lower lymphocytes, platelets, and higher White blood cells, neutrophil, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were found in COVID-19 cases as compared to healthy controls (p < 0.001 for all). The biochemical parameters of cases including Ferritin, D-Dimer, CRP, IL-6, LDH, ALT, AST, and APTT also showed a statistically significant difference compared with standard values (p < 0.001 for all). However, their comparison with a severity level of the severe and non-severe groups showed significance for WBCs, neutrophils, NLR (p < 0.001 for all), and PLR (p = 0.06) only. Receiver operating characteristic curve analysis showed that NLR had the highest area under curve (0.84) followed by 1/lymphocyte (0.82), neutrophils (0.74), PLR (0.67),1/platelets (0.68) and WBC's (0.65). Comparison of cases and controls with recommended cut-off values derived from sensitivity and 1-specificity was also done (p < 0.001).Conclusion: Monitoring all the hematological and biochemical parameters including novel hemograms NLR, PLR can aid clinicians to identify potentially severe cases at early stages and initiate effective management in time which may reduce the overall mortality of COVID-19 patients.


Subject(s)
COVID-19/diagnosis , SARS-CoV-2/isolation & purification , Adolescent , Adult , Blood Cell Count , COVID-19/blood , COVID-19/epidemiology , COVID-19 Nucleic Acid Testing , Female , Humans , Male , Middle Aged , Pakistan/epidemiology , Prognosis , Retrospective Studies , Young Adult
6.
J Assist Reprod Genet ; 38(7): 1691-1708, 2021 Jul.
Article in English | MEDLINE | ID: mdl-33977466

ABSTRACT

PURPOSE: The present study aims to summarize the current understanding of probable mechanisms and claims of adverse effects of SARS-CoV-2 on male fertility potential. METHODS: Our search was including original articles, reviews, guidelines, letters to the editor, comments on guidelines, and editorials, regarding the male reproductive system. We used the words SARS-CoV-2, coronavirus, severe acute respiratory syndrome coronavirus 2, "2019 ncov," testis, sperm, male factor infertility, fertility treatment, semen, assisted reproductive technology (ART), sexual transmission, and ACE2. RESULTS: Data showed coronavirus affects men more than women because of more expression of 2019 nCoV receptors (ACE2 and TMPRSS2) in testicular cells. Also, "Bioinformatics Analysis" suggests that sperm production may be damaged, since "Pseudo Time Analysis" has shown disruption in spermatogenesis. "Gene Ontology" (GO) showed an increase in viral reproduction and a decrease in sperm production-related terms. Recently, SARS-COV-2 mRNA and protein were detected in the semen of patients that had recovered from SARS-CoV-2 infection. Therefore, the probable disruption of blood-testis barrier (BTB) in febrile diseases is suspected in the acute phase of the disease enabling viral entry into the testes. Not only is spermatogenesis disturbed, but also disturbs gonadotropin, androgens, and testosterone secretion during SARS-CoV-2 infection. No sexual transmission has been reported yet; however, detection of the virus in semen still makes the sexual transmission an open question. CONCLUSION: There is a concern that male fertility may be disturbed after the SARS-CoV-2 infection. Therefore, follow-up of the reproductive functions and male fertility may be necessary in recovered cases, especially in aged men.


Subject(s)
COVID-19/complications , Genitalia, Male/pathology , Infertility, Male/pathology , SARS-CoV-2/isolation & purification , COVID-19/virology , Genitalia, Male/virology , Humans , Infertility, Male/epidemiology , Infertility, Male/virology , Male
7.
Trop Anim Health Prod ; 51(6): 1707-1715, 2019 Jul.
Article in English | MEDLINE | ID: mdl-30919321

ABSTRACT

The present study was conducted to explore the farmer's perception regarding constraints faced in adoption of dairy farming practices in Sindh province of Pakistan. The data were collected from 133 project dairy farmers of Pakistan Dairy Development Company (PDDC) and 133 non-PDDC dairy farmers. The constraints were measured with three-point continuum scale. The survey results revealed that on overall basis, technical, financial, and physical constraints, viz., poor conception rate of artificial insemination (AI) in buffaloes, high price of concentrates, high cost of treatment, etc. received higher scores for both groups (PDDC and non-PDDC farmers). In contrast, overall mean scores were relatively low for knowledge (lack of knowledge about proper time of AI/natural service, heat detection, disease control, scientific housing, clean milk production), skills (lack of technical skills regarding fodder conservation and preparation of balanced ration), and lack of financial support by government, etc.; recorded as severe constraints with higher scores for non-PDDC farmers as compared to PDDC farmers. These results indicate that augmenting extension services through PDDC on training and technical know-how is essential to overcome constraints of adoption by farmers who never adopted the practices, while technical, financial, and physical support to farmers are critical for a wider scale, sustained adoption of livestock practices.


Subject(s)
Dairying/economics , Dairying/methods , Farmers , Livestock , Animal Husbandry , Animals , Data Curation , Humans , Pakistan
8.
Genet Med ; 20(10): 1114-1121, 2018 10.
Article in English | MEDLINE | ID: mdl-30093710

ABSTRACT

Advances in genetic and genomic technology changed health-care services rapidly in low and middle income countries (LMICs) in the Asia-Pacific region. While genetic services were initially focused on population-based disease prevention strategies, they have evolved into clinic-based and therapeutics-oriented service. Many LMICs struggled with these noncommunicable diseases and were unprepared for the needs of a clinical genetic service. The emergence of a middle class population, the lack of regulatory oversight, and weak capacity-building in medical genetics expertise and genetic counseling services led to a range of genetic services of variable quality with minimal ethical oversight. Some of the current shortcomings faced include the lack of awareness of cultural values in genetic health care, the variable stages of socioeconomic development and educational background that led to increased demand and abuse of genetics, the role of women in society and the crisis of gender selection, the lack of preventive and care services for genetic and birth defects, the issues of gene ethics in medicine, and the lack of understanding of some religious controversies. These challenges provide opportunities for both developing and developed nations to work together to reduce the inequalities and to ensure a caring, inclusive, ethical, and cost-effective genetic service in the region.


Subject(s)
Genetic Counseling/trends , Genetic Services/trends , Genetics, Medical/trends , Asia , Delivery of Health Care , Developing Countries , Health Services Needs and Demand , Humans
9.
Reprod Biol ; 18(1): 40-45, 2018 Mar.
Article in English | MEDLINE | ID: mdl-29279181

ABSTRACT

A parallel group superiority prospective randomised controlled trial was devised to compare the culture characteristics of human pre-implantation stage embryos during uninterrupted culture in a time lapse incubator (TLI) versus the conventional model of interrupted culture in a standard incubator (SI) under low oxygen tension using a single step medium. 221 patients aged 35-and-under, 124 patients aged between 36 and 39 and 86 patients aged 40-and-over years were randomised and cultured either in a SI or in a TLI. Patients in the three age groups were distributed between the TLI and SI in a 1:1 ratio. The development of embryos on days 2, 3 and 5, and the clinical pregnancy and implantation rates were recorded. The fertilisation rate, development of day 2 and clinical pregnancy rates were similar in both treatments but the 8-cell development rate in all age groups combined (p = 0.016), blastocyst development rate (p = 0.0022) and the implantation rate (p = 0.0022) was significantly higher for the uninterrupted culture. These findings demonstrated significant differences between the two incubation groups. It also indicated less efficacious embryonic development with age in both treatments which appeared more pronounced in the conventional incubator. In conclusion uninterrupted culture is superior compared to the interrupted incubation culture system.


Subject(s)
Ectogenesis , Embryo Culture Techniques , Infertility, Female/therapy , Adult , Blastocyst/cytology , Double-Blind Method , Embryo Transfer , Female , Humans , Kinetics , Malaysia/epidemiology , Maternal Age , Oocyte Retrieval , Ovulation Induction , Pregnancy , Pregnancy Rate , Sperm Injections, Intracytoplasmic
10.
Hum Fertil (Camb) ; 21(3): 174-182, 2018 Sep.
Article in English | MEDLINE | ID: mdl-28589740

ABSTRACT

Scientists working in assisted reproduction [members of Scientists in Reproductive Technology (SIRT) Australia, and subscribers of the online forums EmbryoMail and Quartec] were invited to complete an online questionnaire on the use of human blood products in assisted reproductive technologies (ART). A total of 260 started the questionnaire, with 208 (80%) completing it. A total of 62% of respondents had worked in human ART ≥8 years and 68% had post-graduate qualifications. The majority (82%) reported using products of animal or human origin, with 75% knowing why protein was added to culture media and 41% not worried by this. Almost half (49%) of respondents were unaware of regulations surrounding the use of human blood products in health care and 70% were unaware of adverse events involving human blood products in human ART. Most respondents (70%) indicated that they were not concerned about infections such as hepatitis, but agents such as prions were a cause for concern (57%). A total of 57% of respondents were unaware of alternatives, but 77% would use a suitable alternative. Using blood products in human ART is surrounded by a lack of awareness, often independent of respondents' qualifications or experience. A better understanding of these products and possible alternatives is required if informed decisions about their suitability are to be made.


Subject(s)
Attitude of Health Personnel , Blood , Bloodless Medical and Surgical Procedures , Cross Infection/prevention & control , Culture Media/adverse effects , Health Knowledge, Attitudes, Practice , Reproductive Techniques, Assisted/adverse effects , Animals , Australia/epidemiology , Biomedical Research , Blood/virology , Bloodless Medical and Surgical Procedures/education , Cross Infection/etiology , Cross Infection/virology , Culture Media/standards , Culture Media, Serum-Free/adverse effects , Culture Media, Serum-Free/standards , Female , Health Care Surveys , Hepatitis/epidemiology , Hepatitis/etiology , Hepatitis/prevention & control , Humans , Internet , Male , Medical Laboratory Personnel/education , Needs Assessment , Prion Diseases/epidemiology , Prion Diseases/etiology , Prion Diseases/prevention & control , Prion Diseases/transmission , Reproductive Techniques, Assisted/standards , Risk , Serum Albumin, Human/adverse effects , Workforce
11.
Reprod Biol ; 17(2): 172-179, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28511996

ABSTRACT

The objectives of this study is to evaluate the efficacy of protein-free media in the preparation, holding and crypreservation of spermatazoa for use in ART. Normozoospermic semen samples (N=71) were used to compare the effects of media on the survival and quality of spermatozoa when washed and cultured with different media with and without added proteins at 4°C, 15°C, 22°C and 37°C for 0, 4-7 and 24h. Survival and quality of spermatozoa were assessed after freeze-thaw with synthetic cryoprotectant with and without proteins. Ethics/IRB approval was obtained (Ref. 1073.52). Spermatozoa parameters were similar in all media after washing and culture for 24h. Post-thaw survival and quality of spermatozoa was not significantly different 24h after thawing of samples frozen in all cryoprotectant medium. In conclusion synthetic protein-free culture and cryoprotectant media are equal in efficacy to protein-containing media in culture and cryopreservation of spermatozoa . Use of these synthetic media are anticipated to significantly reduce the risk, potentially associated with conventional protein-containing media, of transmission of disease and possibly harmful undeclared proteins to the patient, baby and the healtcare worker. Synthetic media also ensure consistency of quality between batches of media.


Subject(s)
Blood Proteins/pharmacology , Cryopreservation/methods , Cryoprotective Agents/pharmacology , Semen Preservation , Sperm Motility , Spermatozoa/physiology , Adult , Humans , Male , Semen , Spermatozoa/drug effects
12.
Reprod Biol ; 17(3): 199-209, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28532595

ABSTRACT

There is a paucity of studies on effect of iron in embryo culture procedures. This study aims to ascertain the optimal, tolerance and toxic levels of iron in a protein-free embryo culture medium (PFM) to determine the effect of iron on embryonic development. The application of PFM in assisted reproductive technologies (ART) is intended to eliminate disease transmission and improve ART treatment outcome. The optimal, tolerance and toxic levels of iron on human spermatozoa and mouse embryos were determined by challenging them with different levels of iron (ferric iron; Fe+3). Human normozoospermic semen samples (n=24) and days 1-4 Quakenbush Special (Qs) mouse embryos (n=1160) were incubated in PFM supplemented with different concentrations of Fe+3 over different periods of time. 2.0µg/mL (35.8µM) of Fe+3 was the optimal level of Fe+3 for human spermatozoa with a tolerance range of 0.5-2µg/mL; whereas a level of 0.11µg/mL (2µM) of Fe+3 was the optimum for day 2 embryos. Levels of ferric iron at 0.11 to 2.8µg/mL appear to enhance spermatozoa motility, preserve its DNA integrity and possibly increase percentage of blastocysts developed but levels of ferric iron >16µg/mL is hazardous for both spermatozoa and embryos. In spite of beneficial effects of iron it is premature to recommend its supplementation in embryo culture media because of the known deleterious nature of iron and the paucity of toxicological data. Toxicological studies must be performed following which it can be decided whether it is safe to consider iron as a supplement in human embryo and spermatozoa culture media.


Subject(s)
Embryonic Development/drug effects , Iron/pharmacology , Spermatozoa/drug effects , Animals , Culture Media/chemistry , DNA Damage , Embryo Culture Techniques , Embryonic Development/physiology , Humans , Male , Mice , Sperm Motility/drug effects
13.
Methods Mol Biol ; 1568: 3-20, 2017.
Article in English | MEDLINE | ID: mdl-28421485

ABSTRACT

This chapter describes the development of the science of cryopreservation of gametes and embryos of various species including human. It attempts to record in brief the main contributions of workers in their attempts to cryopreserve gametes and embryos. The initial difficulties faced and subsequent developments and triumphs leading to present-day state of the art are given in a concise manner. The main players and their contributions are mentioned and the authors' aim is to do justice to them. This work also attempts to ensure that credit is correctly attributed for significant advances in gamete and embryo cryopreservation. In general this chapter has tried to describe the historical development of the science of cryopreservation of gametes and embryos as accurately as possible without bias or partiality.


Subject(s)
Cryopreservation , Embryo, Mammalian , Germ Cells , Animals , Cryopreservation/history , Cryopreservation/methods , History, 20th Century , History, 21st Century , Humans , Male , Oocytes , Spermatozoa
14.
Reprod Biol ; 14(4): 249-56, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25454490

ABSTRACT

A total of 341 fertilized and 37 unfertilized oocytes from 63 intracytoplasmic sperm injection (ICSI) treatment cycles were included for retrospective assessment using the Embryoscope time-lapse video system. The second polar body (pb2) extrusion occurred at 2.9±0.1 h (range 0.70-10.15 h) relative to sperm injection. All oocytes reduced in size following sperm injection (p<0.05) with shrinkage ceasing after 2h in the unfertilized and at pb2 extrusion in the fertilized oocytes. Pb2 extrusion was significantly delayed for women aged >38 years compared to those <35 years (3.4±0.2 vs. 2.8±0.1, p<0.01) or 35-38 years (3.4±0.2 vs. 2.8±0.1, p<0.01), but timing was not related to the Day 3 morphological grades (1-4) of subsequent embryos (2.9±0.1, 2.9±0.1, 2.8±0.2 and 3.0±0.1; p>0.05 respectively). A shorter time of first cleavage division relative to either sperm injection or pb2 extrusion is associated with both top grade (AUC=0.596 or 0.601, p=0.006 or 0.004) and usable embryos (AUC=0.638 or 0.632, p=0.000 respectively) on Day 3. In summary, (i) pb2 of human oocytes extrudes at various times following sperm injection, (ii) the timing of pb2 extrusion is significantly delayed when female age >38 years, but not related to subsequent embryo development, (iii) all human oocytes reduce in size following sperm injection, (iv) completion of pb2 extrusion in the fertilized oocytes is a pivotal event in terminating shrinkage of the vitellus, and (v) time to first cleavage division either from sperm injection or pb2 extrusion is a significant predictive marker for embryo quality on Day 3.


Subject(s)
Cleavage Stage, Ovum/physiology , Fertilization/physiology , Oocytes/physiology , Sperm Injections, Intracytoplasmic/methods , Time-Lapse Imaging/methods , Adult , Analysis of Variance , Area Under Curve , Body Weights and Measures , Female , Humans , Maternal Age , Pregnancy , Retrospective Studies , Time Factors , Video Recording
15.
Asian Pac J Trop Biomed ; 4(5): 410-5, 2014 May.
Article in English | MEDLINE | ID: mdl-25182728

ABSTRACT

OBJECTIVE: To establish quality control parameters of a locally occurring medicinal plant, Malva parviflora which is utilized as folk medicine in Sialkot area in Pakistan. METHODS: In pharmacognostic studies different types of evaluations were carried out that focus on microscopic, macroscopic, fluorescence analysis and organoleptic evaluations. RESULTS: The distinguishing characters of stem were the presence of parenchyma, cork cells, irregular shape calcium oxalate crystals, simple and compound starch granules and fusiform fibers with pits. Root microscopic characters were presence of simple and spherical starch granules with rounded or slit hilum, groups of lignified xylem fibers, reticulate vessels, and sieve tissues. Leaves microscopy indicated the presence of paracytic stomata, lignified fibers having pits, spiral and annular vessels, numerous sclereids while in fruit microscopy epicarp, thin walled cells endocarp, thin walled parenchyma and collenchyma of mesocarp and abundant thick walled endospermic cells containing aleurone grains and micro rosette crystals. Macroscopic study of leaves showed, 5-7 lobed reniform-shape, glabrous-surface, reticulate-venation in the leaves. Macroscopic features of roots showed type of root-taproot, surface-glabrous and stem was 1-10 dm tall simple to branched and may be prostrate or ascending. Similarly fruit was of schizocarp type. CONCLUSIONS: This study provides the scientific data for the proper identification and establishment of standards for the use of Malva parviflora.

16.
BMC Med Ethics ; 15: 10, 2014 Feb 05.
Article in English | MEDLINE | ID: mdl-24499356

ABSTRACT

BACKGROUND: Approximately one-fourth of all the inhabitants on earth are Muslims. Due to unprecedented migration, physicians are often confronted with cultures other than their own that adhere to different paradigms. DISCUSSION: In Islam, and most religions, abortion is forbidden. Islam is considerably liberal concerning abortion, which is dependent on (i) the threat of harm to mothers, (ii) the status of the pregnancy before or after ensoulment (on the 120th day of gestation), and (iii) the presence of foetal anomalies that are incompatible with life. Considerable variation in religious edicts exists, but most Islamic scholars agree that the termination of a pregnancy for foetal anomalies is allowed before ensoulment, after which abortion becomes totally forbidden, even in the presence of foetal abnormalities; the exception being a risk to the mother's life or confirmed intrauterine death. SUMMARY: The authors urge Muslim law makers to also consider abortion post ensoulment if it is certain that the malformed foetus will decease soon after birth or will be severely malformed and physically and mentally incapacitated after birth to avoid substantial hardship that may continue for years for mothers and family members. The authors recommend that an institutional committee governed and monitored by a national committee make decisions pertaining to abortion to ensure that ethics are preserved and mistakes are prevented. Anomalous foetuses must be detected at the earliest possible time to enable an appropriate medical intervention prior to the 120th day.


Subject(s)
Abortion, Therapeutic/ethics , Beginning of Human Life , Congenital Abnormalities , Islam , Mothers/psychology , Policy Making , Religion and Medicine , Abortion, Therapeutic/psychology , Attitude to Health , Beginning of Human Life/ethics , Delayed Diagnosis , Female , Fetal Development , Gestational Age , Guidelines as Topic , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Complications
17.
Neurosciences (Riyadh) ; 18(2): 143-6, 2013 Apr.
Article in English | MEDLINE | ID: mdl-23545612

ABSTRACT

OBJECTIVE: To compare the effectiveness of 2 novel antiepileptic drugs, topiramate and levetiracetam, as a second line treatment for infantile spasm when oral steroids fail. METHODS: Forty infants under 2 years with clinically- and EEG-proven infantile spasms that did not respond to prednisone (2mg/kg/day in 2 divided doses) were recruited and randomized into 2 groups. They were randomly assigned to either topiramate (group 1; 1mg/kg/day for 3 days then increased by 1mg/kg/day every third day up to 6mg/kg/day) or levetiracetam (group 2; 10mg/kg/day for 5 days and then increased by 10mg/kg/day every 5 days up to 60mg/kg/day). The study was conducted in the Pediatric Neurology Department at the National Neuroscience Institute of King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia between January 2008 and December 2010. RESULTS: Of the 20 patients included in the final data analysis, 11 (55%) were administered topiramate and 9 (45%) levetiracetam. Eighteen patients did not respond to the first drug, and subsequently to the other drug when crossed-over. Two patients with infantile spasm responded to either one drug without crossover. Their EEGs improved with time. CONCLUSION: The present study demonstrated the ineffectiveness of topiramate and levetiracetam suggesting current treatment modalities are grossly inadequate underscoring the urgent need for more research efforts to overcome current deficiencies. Two patients with cryptogenic infantile spasm responded to treatment suggesting the potential for treatment of such patients with these 2 drugs, and merits further multicenter investigation.


Subject(s)
Anticonvulsants/therapeutic use , Fructose/analogs & derivatives , Piracetam/analogs & derivatives , Prednisone/therapeutic use , Spasms, Infantile/drug therapy , Cross-Over Studies , Drug Administration Schedule , Drug Therapy, Combination , Female , Fructose/therapeutic use , Humans , Infant , Infant, Newborn , Levetiracetam , Male , Piracetam/therapeutic use , Prospective Studies , Retreatment , Topiramate , Treatment Failure
18.
BMC Pediatr ; 13: 39, 2013 Mar 25.
Article in English | MEDLINE | ID: mdl-23530936

ABSTRACT

BACKGROUND: The authors review the role of selenium and highlight possible low selenium levels in soil that may result in deficient states in Saudi Arabia. CASE PRESENTATION: The authors report a case of selenium-responsive cardiomyopathy in a 15-month old Saudi Arabian boy. This case of selenium deficiency causing dilated cardiomyopathy is presented with failure to thrive, prolonged fever and respiratory distress. The investigations revealed selenium deficiency. Selenium supplementation along with anti-failure therapy [Furosimide, Captopril] was administered for 6 months. Following therapy the cardiac function, hair, skin and the general health of the patient improved significantly. CONCLUSION: The patient with dilated cardiomyopathy of unknown etiology, not responding to usual medication may be deficient in selenium. Serum selenium measurements should be included in the diagnostic work-up to ensure early detection and treatment of the disease. The selenium level in the Saudi population needs be determined. Vulnerable populations have to undergo regular selenium measurements and supplementation if indicated. Dependence on processed foods suggests that the Saudi population fortify themselves with nutrient and micronutrient supplements in accordance to the RDA.


Subject(s)
Cardiomyopathy, Dilated/etiology , Selenium/deficiency , Trace Elements/deficiency , Cardiomyopathy, Dilated/diagnosis , Humans , Infant , Male , Saudi Arabia
19.
Am J Case Rep ; 13: 143-5, 2012.
Article in English | MEDLINE | ID: mdl-23569512

ABSTRACT

BACKGROUND: Neonatal diabetes is a rare cause of hyperglycemia, affecting 1: 500,000 births, with persistent hyperglycemia occurring in the first months of life lasting more than 2 weeks and requiring insulin. This condition in infants less than 6 months of age is considered as permanent neonatal diabetes mellitus. CASE REPORT: A rare case of permanent neonatal diabetes mellitus presented with intrauterine growth retardation (IUGR; birth weight: 1460 grams; female), hyperglycemia, glycosuria, and mild dehydration, a normal Apgar score of 8 and 9 at 1 and 5 minutes, respectively. The parents, of consanguineous union, had no prior history of diabetes mellitus. Of their 4 children, the first child had a diagnosis similar to the patient (their last child). The patient was initially started on continuous infusion of insulin, and then switched to regular insulin subcutaneously, but response was sub-optimal. She was started on neutral protamine Hagedorn, following which her condition improved. She was discharged on neutral protamine Hagedorn with regular follow-up. CONCLUSIONS: In view of widespread consanguinity in Saudi Arabia it appears prudent and pertinent to suspect permanent neonatal diabetes mellitus following diagnosis of hyperglycemia in small-for-age infants, especially those with positive family history of diabetes. Close blood glucose monitoring is essential as long as hyperglycemia persists. Prolong follow-up is imperative.

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