Olanzapine-induced cardiomyopathy: A mimicker of obesity cardiomyopathy?

Olanzapine, an atypical antipsychotic medication, has gained prominence in the treatment of schizophrenia and related psychotic disorders due to its effectiveness and perceived safety profile. However, emerging evidence suggests a potential link between olanzapine use and adverse cardiovascular effects, including cardiomyopathy. This narrative review explores the mechanisms, clinical implications, and management strategies associated with olanzapine-induced cardiomyopathy. A comprehensive review of the literature was conducted to investigate the relationship between olanzapine and cardiomyopathy. The search included epidemiological studies, clinical case reports, and mechanistic research focusing on the pathophysiology of olanzapine-induced cardiomyopathy. The review also examined treatment strategies for managing this potential complication. Olanzapine-induced cardiomyopathy is hypothesized to be associated with metabolic disturbances and receptor antagonism. The metabolic effects of olanzapine, such as weight gain, insulin resistance, and dyslipidemia, share similarities with obesity-related cardiomyopathy. Additionally, olanzapine's antagonism of certain receptors may contribute to cardiovascular stress. The review highlighted that patients with new-onset heart failure and significant weight gain while on olanzapine should be closely monitored for signs of cardiomyopathy. Early detection and prompt withdrawal of olanzapine, along with initiation of goal-directed medical therapy, are crucial for mitigating this potentially life-threatening condition. The relationship between olanzapine and cardiomyopathy is complex and not yet fully understood. However, the potential for significant cardiovascular risk necessitates vigilance among healthcare providers. Early identification and management of olanzapine-induced cardiomyopathy can improve patient outcomes. Further research is needed to elucidate the precise mechanisms behind this adverse effect and to develop optimized treatment strategies for patients requiring antipsychotic therapy.

Understanding factors influencing healthcare workers' intention towards the COVID-19 vaccine.

Globally, healthcare workers (HCWs) are at high risk of acquiring Coronavirus infection. In addition, they are role models for the general public concerning attitudes towards the COVID-19 vaccine. In addition, they play a critical role in successfully promoting practices aiming to reduce the transmission of COVID-19 infection. Therefore, this study broadly based on the theory of planned behavior (TPB) explores the factors influencing HCWs' intention to be vaccinated. An online survey was administered using Google Form to collect data from HCWs working in the public health sector of Pakistan. The sample included 813 participants, two-thirds were female, and one-third were male. In addition, 41.5% of them were aged between 26-35 years, 32.6% had master's level education, 25% were nurses, and 57.7% of them were living in urban areas. Data analysis was run using Partial Least Squares Structural Equation Modeling (PLS-SEM). The research findings reveal the positive and significant effect of the TPB factors (attitude, subjective norms, and perceived behavioral control) and the extended factor of vaccine confidence on HCWs' intention to be vaccinated. This study's model explains 66.4% of variations in HCWs' intention to be vaccinated.

In-field deployable and facile nanosensor for the detection of pesticides residues.

Local air and water should be first priority to understand the environment of any area. Different categories of contaminants behave like bottleneck situation in collection and analysis of data about abiotic factors for the understanding and resolving the environmental issues. In digital age the emerging nano technology enroll its role to meet the needs of hour. Due to increase in pesticides residues, the global health threats are on bloom because it inhibits the functionality of acetylcholinesterase (AChE) enzyme. Smart nanotechnology based system can tackle this issue and sense the pesticides residues in environment and vegetables as well. Here Au@ZnWO4 composite is reported, for accurate detection of pesticides residues in biological food and environmental samples. The fabricated unique nanocomposite was characterized by SEM, FTIR, XRD and EDX. The characterized material used for the electrochemical detection of organophosphate pesticide (chlorpyrifos), with 1 pM LoD at a signal to noise ratio of 3. The main concern of study is to help out in disease prevention, food safety and ecosystem protection.

Predictors of entrepreneurial intentions: The role of prior business experience, opportunity recognition, and entrepreneurial education.

Entrepreneurship and its influence on the development of the economy are significant in competitive global advancement. Entrepreneurs need entrepreneurial intentions to improve the commercial environment of the country. Therefore, studying entrepreneurial intentions' influencing predictors is vital for business development. We collected data from small and medium-sized enterprises (SMEs) employees of the developing country and used partial least square structured equation modeling to analyze the proposed relationships. The results assist the literature extension and practically contribute to developing entrepreneurs' intentions through education and opportunity recognition. The findings aid the institutions in improving course planning and establishing practical business setups. This study facilitates the government's ideas of commencing entrepreneurial businesses through proper resource provisions for the entrepreneurs.

An extension of the theory of planned behavior to understand factors influencing Pakistani households' energy-saving intentions and behavior: a mediated-moderated model.

This study aims to explore the factors influencing households' intentions and actual behavior in relation to saving energy. This study is based on the theory of planned behavior (TPB), extending it by adding descriptive norms and moral responsibility. An online survey was administered to collect data from randomly selected households and data analysis was run using partial least squares structural equation modeling (PLS-SEM). The research findings reveal the positive and significant effect of TPB factors (attitude, subjective norms, and perceived behavior control) and the extended factors (descriptive norms and moral responsibility) on households' intention to save energy, as well as the significant effect of perceived behavior control, moral responsibility, and intention on household's energy-saving behavior. This study also evidences the significant mediating and moderating role of households' intention to save energy and moral responsibility. This study's model explains 70.5% of variations in households' intention to save energy and 63.1% of variations in households' energy-saving behavior. In particular, the extended model explains 11.6% more of the variation in households' intention to save energy compared to the TPB model. This research has several theoretical and practical implications for scholars, environmental protection agencies, and policy-makers.

Performance Monitoring, Subordinate's Felt Trust and Ambidextrous Behavior; Toward a Conceptual Research Framework.

The present research proposes an electronic performance monitoring framework based on ambidextrous leadership and social exchange theories in a dynamic environment. It reviews and integrates essential literature on electronic performance management (EPM), trust, and ambidextrous behavior. For this, authors have reviewed relevant literature on various themes and underpinned them for managing EPM. The study emphasizes individuals' psychological foundations that demonstrate trust behavior and relationship with their leaders. Eventually, through an ambidextrous approach, managers gain steady performance and relationships with their subordinates through EPM. The study shows that ambidexterity benefits organizations; it enhances employees' resources, resulting in enhanced performance that leads to the performance of an organization. The authors discuss the theoretical as well as practical implications of this study.

The Effects of eGovernment Efficiency on Subjective Wellbeing.

Undoubtedly, the internet has become the most convenient and efficient communication and service delivery channel adopted by most government agencies, referred to as eGovernment. This study explores how eGovernment efficiency influences users' subjective wellbeing (SWB), using trust as a covert stimulus with the capacity to alter individuals' overt behavior (utilization). Covert and overt stimuli act as significant factors influencing the relationship between citizens and the online environment, moderated by socio-demographic characteristics. Using situation-organism-behavior-consequence theory, we propose a research model consisting of online environment eGovernment efficiency (the situation) influencing trust development (the organism), which in turn influences utilization (the behavior), generating an impact on an individuals' SWB (the consequence). We followed the structural equation modeling (SEM) approach to analyze the data survey N = 300, using Amos statistical techniques. Results reveal that the correlation between eGovernment efficiency and trust is positive and strong, trust and utilization is positive and moderate, and the correlation between utilization and SWB is positive and very strong. Stepwise regression analysis reveals that the control variables affect the relationship between eGovernment efficiency and trust. In the regression model: the highest education level explained 36% of the variance (model 1); adding age increased the variance explained to 39% (in model 2), and adding internet use frequency increased the variance explained to 41% (model 3). This study develops theoretical concepts of eGovernment use and how it affects citizens by indicating the psychological and behavioral situations as antecedents and mediators influencing SWB. It also provides practical suggestions for improving systems to correlate users' feelings and behavior patterns to motivate trusting behavior, positively impacting users' SWB to benefit citizens effectively.

Trends in Stroke Presentations before and during the COVID-19 Pandemic: A Meta-Analysis / 대한뇌졸중학회지

Background@#and Purpose There are reports of decline in the rates of acute emergency presentations during coronavirus disease 2019 (COVID-19) pandemic including stroke. We performed a meta-analysis of the impact of COVID-19 pandemic on rates of stroke presentations and on rates of reperfusion therapy. @*Methods@#Following the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines, we systematically searched the literature for studies reporting changes in stroke presentations and treatment rates before and during the COVID-19 pandemic. Aggregated data were pooled using meta-analysis with random-effect models. @*Results@#We identified 37 observational studies (n=375,657). Pooled analysis showed decline in rates of all strokes (26.0%; 95% confidence interval [CI], 22.4 to 29.7) and its subtypes; ischemic (25.3%; 95% CI, 21.0 to 30.0), hemorrhagic (27.6%; 95% CI, 20.4 to 35.5), transient ischemic attacks (41.9%; 95% CI, 34.8 to 49.3), and stroke mimics (45.6%; 95% CI, 33.5 to 58.0) during months of pandemic compared with the pre-pandemic period. The decline was most evident for mild symptoms (40% mild vs. 25%–29% moderate/severe). Although rates of intravenous thrombolytic (IVT) and endovascular thrombectomy (EVT) decreased during pandemic, the likelihood of being treated with IVT and EVT did not differ between the two periods, both in primary and in comprehensive stroke centers (odds ratio [OR], 1.08; 95% CI, 0.94 to 1.24 and OR, 0.95; 95% CI, 0.83 to 1.09, respectively). @*Conclusions@#Rates of all strokes types decreased significantly during pandemic. It is of paramount importance that general population should be educated to seek medical care immediately for stroke-like symptoms during COVID-19 pandemic. Whether delay in initiation of secondary prevention would affect eventual stroke outcomes in the long run needs further study.

Bilaterally Asymmetrical Becker's Nevus.

Becker's nevus is a main epidermal hypermelanotic condition that usually presents in adolescence, though childhood cases are seen less commonly. Congenital cases have been rarely reported. Nevus is usually unilateral having increased pigmentation and is characterized by hypertrichosis. It usually presents as a patch on back, proximal upper extremities, arms and upper trunk. Becker's Nevus presenting as bilateral asymmetrical patch is rare. A case of 23 year's old male with bilateral hyperpigmentad patch over the back has been reported. The histological exams established the clinical hypothesis of Becker's Nevus.

Effectiveness Of Oral Omega 3 In Reducing Mucocutaneous Side Effects Of Oral Isotretinoin In Patients With Acne Vulgaris.

BACKGROUND: Acne vulgaris has been a common clinical condition. Due to. high prevalence and unclear etio-pathogenesis of acne vulgaris, large number of treatment options have been available across the globe. Limited work has been done to explore the options which may manage or prevent these adverse effects and improve the adherence to the prescribed medications. We therefore conducted this trial to look for effectiveness of oral omega 3 in reducing mucocutaneous side effects of oral isotretinoin in patients with acne vulgaris. OBJECTIVE: To look for effectiveness of oral omega 3 in reducing mucocutaneous side effects of oral isotretinoin in patients with acne vulgaris. It was a randomized control trial conducted at Department of Dermatology Pak Emirates Military Hospital Rawalpindi. Ten months, June 2019 to May 2020. METHODS: A total of 60 patients of acne vulgaris put on oral isotretinoin by consultant dermatologist were included in the study. Patients were randomized into groups by lottery method. Group A received the placebo along with oral isotretinoin while Group B received oral omega 3 in standard dose in addition to oral isotretinoin. Comparison was made in both the groups regarding common mucocutaneous side effects. RESULTS: Out of 60patients with acne vulgaris and put on isotretinoin included in the study, 26 (43.3%) received placebo in addition to isotretinoin while 34 (56.7%) received omega 3 in addition to isotretinoin. Forty (66.7%) patients were female while 20 (33.3%) were male. Cheilitis 35 (58.3%) was the commonest side effect followed by lip dryness 33 (55%). Application of chi-square test revealed that cheilitis, lip dryness and xerosis were significantly found in more patients who received placebo as compared to those who received omega 3 along with isotretinoin. CONCLUSION: Mucocutaneous side effects were a very common finding among patients of acne vulgaris managed with isotretinoin. Cheilitis was the most reported mucocutaneous side effects among the target population. This RCT demonstrated that omega 3 was superior to placebo in order to prevent or manage cheilitis, xerosis or dry lips.

Bismuth vanadate/MXene (BiVO4/Ti3C2) heterojunction composite: enhanced interfacial control charge transfer for highly efficient visible light photocatalytic activity.

We have synthesized BiVO4/Ti3C2 nanocomposite via a low-cost hydrothermal method and investigate its photocatalytic degradation activity against monoazo (methyl orange) and diazo dye (Congo red) in an aqueous solution under visible light. The physiochemical characterization exhibited that the addition of MXene in pristine BiVO4 nanocomposite led to an increase in specific surface area and reduction in optical band gap energy. MXene also helps in enhancing visible light response via a higher electron-hole pair generation rate and long lifetime. The synthesized BiVO4/Ti3C2 heterojunction composite exhibited 99.5 % degradation efficiency within 60 min for Congo red and 99.1 % for methyl orange solution in 130 min owed to a large specific surface area (1.79 m2/g), reduced band gap (1.99 eV), and low recombination rate of charge carriers. The chemical mechanism for BiVO4/Ti3C2 nanocomposite proposes that Ti3C2 role-plays as electron capture because of the higher potential of MXenes, tuning band gap energy which paves the way to excellent photocatalytic action. This work opens a new basis for developing Ti3C2 based promising and inexpensive co-catalyst for efficient solar utilization in photocatalytic-related applications in the future.

Biotransformation and toxicity evaluation of functionalized manganese doped iron oxide nanoparticles.

Safe inorganic nanomaterials are tremendously used for diagnosis and therapies. However, essential processing in the microbiological environment changed the physical properties and in situ degradability, which is evaluated meticulously. In this research article, bare, Polyethylene glycol, and citrate coated manganese doped iron oxide nanoparticles are synthesized through the coprecipitation route. Structural, magnetic, optical, and morphological analyses are performed through different characterization tools. X-ray diffraction confirmed the formation of single-phase FeMnO3 with a crystallite size of 48.91 nm. Vibrating sample magnetometer analysis confirmed the formation of soft ferromagnetic behavior of bare and coated nanoparticles (NPs). Scanning electron microscopy and transmission electron microscopy confirmed the formation of spherical shaped nanoparticles. Single-dose in vivo acute toxicity testing is performed through the intraperitoneal route of administration on groups of healthy albino rats. Elevated enzyme levels of kidney and liver are observed at day 1 but a transient decrease is observed at later stages. Through optical follow-up, degradation effects are studied by adding prepared NPs in lysosomal like medium. Finally, metabolization of degraded products based on manganese/iron ions is studied by adding apoferritin into a lysosome like solution. These studies showed partial storage of manganese ions from NPs, while no substantial transfer is observed in the case of manganese salt.

Role Of Intralesional Vitamin-D In Viral Wartse.

BACKGROUND: The study was to look for effectiveness of vitamin D-3 in cutaneous warts in comparison with cryotherapy at dermatology department of Pak Emirates Military Hospital Rawalpindi. It was a randomized control trial conducted at the Department of dermatology Pak Emirates Military Hospital Rawalpindi. Ten months, June 2019 to May 2020. METHODS: A total of 50 patients of cutaneous warts diagnosed by consultant dermatologist were included in the study. Patients were randomized into groups by lottery method. Group A received the Intralesional vitamin D 3 while Group B received cryotherapy. Comparison was made in both the groups regarding the response as complete or partial or no resolution of the wart. RESULTS: Out of 50 patients with cutaneous warts on any location of the body, 23 (46%) received intralesional vitamin D3 while 27 (54%) received cryotherapy as allocated treatment. Twenty-four (48%) patients were female while 26 (52%) were male. Planter warts 41 (82%) were the commonest type according to the site of warts followed by palmar 6 (12%). Application of chi-square test revealed that Vitamin D3 was statistically significantly related to complete resolution of warts as compared to cryotherapy (p-value<0.05). CONCLUSION: Cutaneous warts were most commonly seen on the feet of the affected patients. They had a good response to both of the therapies but intralesional vitamin D3 emerged as more effective option of the two in terms of management of these cutaneous warts.

Construction of 1T-MoS2 quantum dots-interspersed (Bi1-x Fe x )VO4 heterostructures for electron transport and photocatalytic properties.

The present study reports trigonal phase molybdenum disulfide quantum dots (MoS2/QDs)-decorated (Bi1-x Fe x )VO4 composite heterostructures. Initially, (Bi1-x Fe x )VO4 heterostructure nanophotocatalysts were synthesized through the hydrothermal method decorated with 1T-MoS2 via a sonication process. 1T-MoS2@(Bi1-x Fe x )VO4 heterostructures were characterized in detail for phase purity and crystallinity using XRD and Raman spectroscopy. The Raman mode evaluation indicated monoclinic, mixed monoclinic-tetragonal and tetragonal structure development with increasing Fe concentration. For physiochemical properties, SEM, EDX, XPS, PL, EPR, UV-visible and BET techniques were applied. The optical energy band gaps of 1T-MoS2@(Bi1-x Fe x )VO4 heterostructures were calculated using the Tauc plot method. It shows a blue shift initially within a monoclinic structure then a red shift with an increase of Fe concentration. 1T-MoS2@(Bi40Fe60)VO4 with 2 wt% of 1T-MoS2-QDs carrying a mixed phase exhibited higher photocatalytic activity. The enhanced photocatalytic activity is attributed to the higher electron transportation from (Bi1-x Fe x )VO4 surface onto 1T-MoS2 surface, consequently blocking the fast electron-hole recombination within (Bi1-x Fe x )VO4. 1T-MoS2 co-catalyst interaction with (Bi1-x Fe x )VO4 enhanced the light absorption in the visible region. The close contact of small 1T-MoS2-QDs with (Bi1-x Fe x )VO4 develops a high degree of crystallinity, with fewer defects showing mesoporous/nanoporous structures within the heterostructures which allows more active sites. Herein, the mechanism involved in the synthesis of heterostructures and optimum conditions for photocatalytic degradation of crystal violet dye are explored and discussed thoroughly.

An experimental and algorithm-based study of the spectral features of breast cancer patients by a photodiagnosis approach.

In the present study, the spectral diagnosis of blood plasma samples of breast cancer patients and an equal number of normal controls was investigated. A set of ratio parameters was acquired by employing SXS and FES. The samples were also analyzed statistically by employing Welch two-sample t-tests, and the effects of three ratio parameters, R1, R2, and R3, were also studied by plotting them against the subject numbers. A linear discriminant was also applied to verify the exact classification of normal control and breast cancer patients. It was observed that the levels of biofluorophores such as porphyrin, NADH, tryptophan and flavins were elevated 2- to 3-fold for breast cancer patients compared to normal controls, with an accuracy of approximately 100 %. We have also confirmed the validity of the obtained experimental results by using an advanced robust diagnostic algorithm. The experimental results of the current study may have a vital and substantial impact on the detection and screening protocols used for future breast cancer patients. The spectral analysis of body fluid could be of great value to add to and enhance the current procedures with an accuracy of approximately 100 % with limited number of samples. The results and objectives of this preliminary study were encouraging and useful for the discrimination of the features of breast cancer patients compared to those of normal controls.

An approach to enhanced stability: Formulation and characterization of Solanum lycopersicum derived lycopene based topical emulgel.

Focus of the study was to design a novel and cost effective extraction technique for the lycopene from Lycopersicum esculentum L. fruit and to develop and characterize a stable emulgel formulation containing lycopene as an active ingredient as well as to design an analytical method to determine lycopene concentration in emulgel. Emulgel formulation was prepared and evaluated for its stability at different storage conditions, 8 °C, 25 °C, 40 °C, 40 °C + 75% relative humidity (RH) and 50 °C, for 6 months. Results were statistically analyzed using two way ANOVA, Post-Hoc test and paired sample t-test at 5% significance level. Designed extraction technique presented comparable yield, 154.83 mg/Kg of tomato fruit, with all recoveries in the range of 145-156 mg/Kg of tomato. "P-values" calculated for different levels of stability parameters were <0.05, except at 50 °C and time points of 60th day and later. Analytical method designed was having linear range of lycopene 1-10 µg/mL with limit of detection 0.11 µg/mL and limit of quantification 0.34 µg/mL. All inter-day and intra-day recoveries were in the range of 94-105% while in all measurements RSD % was ≤5.36. It can be concluded that the extraction technique was cost effective with comparable results and analytical method was simple, robust, specific and sensitive enough to be used for lycopene concentration determination in emulgel formulation. Furthermore, designed formulation was stable even at high temperature of 40 °C and RH 75%.

Association of ABO blood groups with glaucoma in the Pakistani population.

OBJECTIVE: To study the association of blood groups with different types of glaucoma including primary open-angle glaucoma (POAG), primary closed-angle glaucoma (PCAG), and pseudoexfoliative glaucoma (PEXG) in the Pakistani population. STUDY DESIGN: The present study was a prospective case control study. PARTICIPANTS: ABO and Rh blood groups were analyzed in 2046 controls and 477 glaucoma patients (220 POAG, 146 PCAG, and 111 PEXG). METHODS: Hemagglutination patterns were used to determine the prevalence of the ABO and Rh blood groups in all the subjects. Logistic regression analysis was carried out to evaluate any association of the different blood groups with glaucoma. RESULTS: In the present study, the percentage of blood groups A, B, AB, and O in patients was found to be 19%, 41%, 10%, and 30%, and in the control group, the values were 26%, 31%, 12%, and 31%, respectively. A significant positive association was found between the B blood group and glaucoma (p value < 0.05, odds ratio [OR] 1.5, and c2 15.8). Logistic regression analysis revealed that the blood group B was associated with all types of glaucoma with OR of 1.35 (95% CI 1.01-1.80; p = 0.04) for POAG, 1.71 (95% CI 1.21-2.40; p = 0.002) for PCAG, and 1.61 (95% CI 1.09-2.36; p = 0.016) for PEXG. POAG was also found to be associated with the Rh- allele (p < 0.05) with an OR of 4.05 (95% CI 2.98-5.51), as compared with controls. CONCLUSIONS: In the Pakistani patient cohort, blood group B is associated with all types of glaucoma and the Rhallele is associated only with POAG.