Frequency and Types of Anemia in Primary Hypothyroidism Patients: A Prospective Observational Study.

Background Primary hypothyroidism is a common endocrine disorder resulting from inadequate production of thyroid hormones. Anemia is a common condition that can occur in hypothyroidism. Anemia may occur due to nutrient deficiency, such as iron or vitamin B12 deficiency due to chronic disease in hypothyroidism. Therefore, it is important to evaluate the cause of anemia in hypothyroidism.  Objective The aim of this study was to determine the frequency of anemia and its types in patients with primary hypothyroidism. Methods This was a prospective cross-sectional observational study conducted at the Department of Medicine, Jinnah Postgraduate Medical Center, Karachi, Pakistan, using non-probability consecutive sampling. A total of 176 adults aged 18-65 years of either gender, newly diagnosed with primary hypothyroidism, or with any of its symptoms were included in the study. Patients already on anti-thyroid medication and with post-thyroidectomy hypothyroidism were excluded from the study. The duration of the study was 1.5 years, from January 2020 to July 2021. After ethical approval, written informed consent was obtained from each patient. Demographical data along with results of complete blood picture, including Hb and MCV for diagnosing anemia and its types were recorded on a pre-designed proforma. The chi-square test was applied keeping p < 0.05 as statistically significant. Results The mean age of the patients was 42.19 ± 8.43 years, with 59.66% (n = 105) females and 40.34% (n = 71) males. A total of 67% (n =118) patients were found to be anemic. Of these, 38.64% (n = 68) patients had normocytic anemia, 19.32% (n = 34) microcytic anemia, and 9.25% (n = 16) patients had macrocytic anemia; 56.34% (n = 40) males and 74.29% (n = 78) females were reported to be anemic (p = 0.01). Conclusion In our study, the frequency of anemia in patients with hypothyroidism was high, with normocytic anemia being the most common type. It is important to know the type of anemia in hypothyroidism, as normocytic anemia is due to the chronic disease process (anemia of chronic disease) and may not respond to nutrient supplementation. Conversely, microcytic anemia is commonly due to iron deficiency and macrocytic anemia is due to vitamin B12 deficiency and therefore, they require replacement therapy. In any case, it is important to identify and treat the underlying cause of anemia.

Kinetic and equilibrium study of graphene and copper oxides modified nanocomposites for metal ions adsorption from binary metal aqueous solution.

Presently, the main cause of pollution of natural water resources is heavy metal ions. The removal of metal ions such as nickel (Ni2+) and cadmium (Cd2+) has been given considerable attention due to their health and environmental risks. In this regard, for wastewater treatment containing heavy metal ions, graphene oxide (GO) nanocomposites with metal oxide nanoparticles (NPs) attained significant importance. In this study, graphene oxide stacked with copper oxide nanocomposites (GO/CuO-NCs) were synthesized and characterized by Fourier transform infrared (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-ray (EDX), and atomic force microscopy (AFM) analytical procedures. The prepared GO/CuO-NCs were applied for the removal of Ni2+ and Cd2+ ions from a binary metal ion system in batch and continuous experiments. The obtained results revealed that GO/CuO-NCs exhibited the highest removal efficiencies of Ni2+ (89.60% ± 2.12%) and Cd2+ (97.10% ± 1.91%) at the optimum values of pH: 8, dose: 0.25 g, contact time: 60 min, and at 50 ppm initial metal ion concentration in a batch study. However, 4 mL/min flow rate, 50 ppm initial concentration, and 2 cm bed height were proved to be the suitable conditions for metal ion adsorption in the column study. The kinetic adsorption data exhibited the best fitting with the pseudo-second-order model. The adsorption isotherm provided the best-fitting data in the Langmuir isotherm model. This study suggested that the GO/CuO nanocomposites have proved to be efficient adsorbents for Ni2+ and Cd2+ ions from a binary metal system.

Cardiac Involvement in Monkeypox Outbreak.

Unusual presentations and uncommon clinical manifestations of Monkeypox (Mpox) in the current outbreak highlight the need to focus on cardiac symptoms of the virus. Owing to limited discussion regarding cardiac involvement in recent cases of Mpox, we conducted a scoping review to determine the range of existing research and provide a descriptive overview of the current literature on these manifestations. This review was conducted using a previously developed six-stage methodological approach and keeping in view the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR). Records retrieved from PubMed, ScienceDirect and Google Scholar, using a two-step search strategy, were subjected to title and abstract screening, followed by full text screening of remaining articles against specified eligibility criteria. Relevant information was extracted and summarized. Our search yielded 707 records. Following title and abstract screening, 23 articles were retrieved for full text screening. Finally, a total of nine articles were included in this review (three case series and six case reports discussing a total of 13 patients). Myocarditis was identified as the most frequently reported cardiac manifestation of Mpox. Novel clinical presentations included pharyngitis, sore throat, proctalgia, and perianal irritation. Most patients reported chest pain as the primary symptom of cardiac system involvement. Elevated troponin was the most commonly reported investigation finding followed by an elevated C- Reactive Protein. There exists a lack of high-quality studies investigating cardiac system involvement in the current outbreak of Mpox. More information is needed regarding risk factors for cardiac complications, disease progression, and cardio tropism and immunological response to improve preventive/therapeutic strategies. We highlight the paucity of relevant data and call for further discussion to improve the understanding of cardiac manifestations of Mpox. This scoping review sheds light on the underexplored cardiac manifestations of Mpox and highlights the need for heightened awareness of cardiac symptoms in the current outbreak.

Diversity, Equity, and Inclusion on Editorial Boards of Global Health Journals.

Journals have been described as "duty bearers" of upholding fundamental ethical principles that are essential for maintaining the ethical integrity of newly generated and disseminated knowledge. To play our part, we evaluated diversity and inclusion in the leadership and management of global and international health journals. We developed Journal Diversity Index (JDI) to measure three parameters of diversity and representation (gender, geographic, socioeconomic status). Relevant information regarding editorial board members of systematically screened journals was sequentially extracted and job titles were categorized into five editorial roles. Chi-squared test was utilized to study associations between gender and geographic distribution of editors along with the Medline indexing of the journal and its impact factor. Out of 43 journals included, 62.7% were published from two high-income countries. Women comprised 44% of the total editors. Among all the editorial board members, we did not find any information suggesting the representation of non-binary and transgender individuals. Furthermore, 68.2% of editors were based in high-income countries with 67.3% of the editors belonging to the Global North. This disparity in geographic region and socioeconomic level was observed across all five editorial roles. Among all women editors, more than 70% worked in non-Medline and non-impact factor journals. Only two journals scored "excellent" on JDI. Despite the continuous evolution of the definition of global health ethics, marginalized individuals, and their perspectives remain underrepresented in this field. Thus, we call for swift action regarding the decentralization and redistribution of global and international health journal editorial boards. Supplementary Information: The online version contains supplementary material available at 10.1007/s41649-023-00243-8.

Ecosystem based approach to delineate coastal degradation of Hawks bay, Karachi, Pakistan.

Hawks Bay (HB) a renowned recreational beach, an important small scale fishery and nesting ground of an endangered turtle species encountering massive environmental degradation. Its eastern bay cover scattered mangrove patches and the western bay embraces sandy and rocky beach that terminus the area into great ecological and economic concerns. Here, we have figured out tendency of contamination entering in the ecosystem and elaborate food âˆ¼ web dynamics around HB. An integrated approach was applied to evaluate level of contamination in water, sediments, planktons, seaweeds, mangrove leaves, crabs and fishes. In the sampled population phytoplankton were comprises of (39 Taxa), zooplankton (21), crab (1) and fishes (9) from pelagic demersal domains. The concentration of copper (Cu), iron (Fe), zinc (Zn), lead (Pb) and chromium (Cr) were detected using double-beam Atomic Absorption Spectrophotometer (AAS). The trophic transfer (TTF), contamination factor (CF), pollution load index (PLI), bioaccumulation factor (BAF) and accumulation factor (AF) were calculated round the year. The CF reveals that the area is moderately contaminated whereas PLI (>1) indicate that area is massively polluted by the industrial wastes. Multivariate approach of Principle Component Analysis was applied using pooled data of TTF that defines PC-I (41.56%) and PC- II (31.44%) variability among axes. Evaluation of metal contamination from micro to macro and from surface to bottom exhibits considerable load being received by HB ecosystem echoes stringent actions to curb further degradation of an important area.

Isatin thiazoles as antidiabetic: Synthesis, in vitro enzyme inhibitory activities, kinetics, and in silico studies.

Diabetes mellitus is one of the most prevalent diseases nowadays. Several marketed drugs are available for the cure and treatment of diabetes, but there is still a dire need of introducing compatible drug molecules with lesser side effects. The current study is based on the synthesis of isatin thiazole derivatives 4-30 via the Hantzsch reaction. The synthetic compounds were characterized using different spectroscopic techniques and evaluated for their α-amylase and α-glucosidase inhibition potential. Of 27 isatin thiazoles, five (4, 5, 10, 12, and 16) displayed good activities against the α-amylase enzyme with IC50 values in the range of 22.22 ± 0.02-27.01 ± 0.06 µM, and for α-glucosidase, the IC50 values of these compounds were in the range of 20.76 ± 0.17-27.76 ± 0.17 µM, respectively. The binding interactions of the active molecules within the active site of enzymes were studied with the help of molecular docking studies. In addition, kinetic studies were carried out to examine the mechanism of action of the synthetic molecules as well. Compounds 3a, 4, 5, 10, 12, and 16 were also examined for their cytotoxic effect and were found to be noncytotoxic. Thus, several molecules were identified as good antihyperglycemic agents, which can be further modified to enhance inhibition ability and to find the lead molecule that can act as a potential antidiabetic agent.

Coupling of electrocoagulation and powder activated carbon for the treatment of sustainable wastewater.

The present research work is based on an electrochemical technique in combination with powdered activated carbon (PAC) for the removal of micropollutants by adsorption as an advanced stage purification step from effluents of pilot plant wastewater treatment plants (WWTP). The effluents of sedimentation tank comprised of wastewater plus PAC (WWPAC). The pilot plant mainly consists of two parts: the first one consists of electrocoagulation (EC) reactor, and the second consists of electrophoretic deposition (EPD) discs and electroflotation (EF) setup. The electrocoagulation (EC) reactor consisted of the electrode material (Al and Fe). Both types of electrodes have been tested with the outflow of sedimentation tank. The outflow from the sedimentation tank has been entered into the EC reactor for the determination of EC reactor efficacy for the successful accomplishment of EC process at the designed pilot plant for WW treatment. The effect of different operational parameters, PAC dosage (20 mg), electrode nature (Fe and Al) and current density (0.34-2.02 A/m2), has been studied to find out the optimum conditions. Sludge volume index (SVI) of the sludge, thermogravimetric (TG), differential thermal analyses (DTA) and particle size distribution (PSD) of the flocs generated after the EC process has also been studied. The turbidity, pH and conductivity of effluents before and after EC treatment have also been carried out. The research work performed detailed analysis of the wastewater effluents at pilot plant scale and gave promising results for future work in advance wastewater treatment direction.

CRISPR/Cas9: A powerful genome editing technique for the treatment of cancer cells with present challenges and future directions.

Cancer is one of the most leading causes of death and a major public health problem, universally. According to accumulated data, annually, approximately 8.5 million people died because of the lethality of cancer. Recently, a novel RNA domain-containing endonuclease-based genome engineering technology, namely the clustered regularly interspaced short palindromic repeat (CRISPR)-associated protein-9 (Cas9) have been proved as a powerful technique in the treatment of cancer cells due to its multifunctional properties including high specificity, accuracy, time reducing and cost-effective strategies with minimum off-target effects. The present review investigates the overview of recent studies on the newly developed genome-editing strategy, CRISPR/Cas9, as an excellent pre-clinical therapeutic option in the reduction and identification of new tumor target genes in the solid tumors. Based on accumulated data, we revealed that CRISPR/Cas9 significantly inhibited the robust tumor cell growth (breast, lung, liver, colorectal, and prostate) by targeting the oncogenes, tumor-suppressive genes, genes associated to therapies by inhibitors, genes associated to chemotherapies drug resistance, and suggested that CRISPR/Cas9 could be a potential therapeutic target in inhibiting the tumor cell growth by suppressing the cell-proliferation, metastasis, invasion and inducing the apoptosis during the treatment of malignancies in the near future. The present review also discussed the current challenges and barriers, and proposed future recommendations for a better understanding.

Adverse Drug Reaction Monitoring and Reporting Among Physicians and Pharmacists in Pakistan: A Cross-sectional Study.

BACKGROUND: The success of a reporting system of adverse drug reaction (ADR) depends on the knowledge, attitudes, and practices of the health care professionals. However, due to a lack of knowledge and poor contribution by healthcare workers, ADR remains underreported. To improve safety, proper identification and ADR reporting is necessary. OBJECTIVE: This study was carried out to determine knowledge, attitude, and practices of ADR among physicians and pharmacists working in Pakistan and the factors which encourage and discourage effective reporting. METHODS: A cross-sectional study was conducted using a pretested questionnaire. Questionnaires were distributed among 333 physicians and 34 pharmacists with a 95.5% response rate. The Statistical Package for Social Science (SPSS) was used for data analysis. RESULTS: Pharmacists have more knowledge regarding ADR compared to physicians (47.1% vs. 13.8%, p < 0.001). Pharmacists also have a positive attitude compared to physicians (97.1% vs. 76.3%, p < 0.001). No significant difference was noticed in ADR practice by physicians and pharmacists (12.3% vs. 11.8, p = 0.92). The seriousness of ADR was the main factor that encouraged nearly all pharmacists to report, whereas among physician's, seriousness and the unusualness of reaction, the new drug involvement, and confidence in diagnosis were the factors which encouraged them to report ADR. CONCLUSION: Overall, pharmacists had more knowledge and a positive attitude regarding ADR reporting compared to physicians, but practices of ADR reporting remained the same among both. Therefore, it is suggested that educational interventions, along with training programs, should be developed.

An In Vitro Study of the Photodynamic Effectiveness of GO-Ag Nanocomposites against Human Breast Cancer Cells.

Graphene-based materials have garnered significant attention because of their versatile bioapplications and extraordinary properties. Graphene oxide (GO) is an extremely oxidized form of graphene accompanied by the functional groups of oxygen on its surface. GO is an outstanding platform on which to pacify silver nanoparticles (Ag NPs), which gives rise to the graphene oxide-silver nanoparticle (GO-Ag) nanocomposite. In this experimental study, the toxicity of graphene oxide-silver (GO-Ag) nanocomposites was assessed in an in vitro human breast cancer model to optimize the parameters of photodynamic therapy. GO-Ag was prepared using the hydrothermal method, and characterization was done by X-ray diffraction, field-emission scanning electron microscope (FE-SEM), transmission Electron Microscopy (TEM), energy dispersive X-rays Analysis (EDAX), atomic force microscopy and ultraviolet-visible spectroscopy. The experiments were done both with laser exposure, as well as in darkness, to examine the phototoxicity and cytotoxicity of the nanocomposites. The cytotoxicity of the GO-Ag was confirmed via a methyl-thiazole-tetrazolium (MTT) assay and intracellular reactive oxygen species production analysis. The phototoxic effect explored the dose-dependent decrease in the cell viability, as well as provoked cell death via apoptosis. An enormously significant escalation of ¹O2 in the samples when exposed to daylight was perceived. Statistical analysis was performed on the experimental results to confirm the worth and clarity of the results, with p-values < 0.05 selected as significant. These outcomes suggest that GO-Ag nanocomposites could serve as potential candidates for targeted breast cancer therapy.

Limpets of the genus Cellana (Patellogastropoda) from Pakistan, North Arabian Sea: species identification based on DNA sequencing.

The true limpets are found in the intertidal zone of the rocky shores of Pakistan, North Arabian Sea. Partial sequence of the mitochondrial cytochrome oxidase I was used to estimate the degree of genetic differentiation among the morphological forms of Cellana, which were considered as three separate species earlier in Pakistan. The study revealed that the three morphs of Cellana on COI sequence generated a single haplotype and matched with the COI sequence of Cellana karachiensis. This point out the phenotypic plasticity between the proposed species.