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1.
ACS Chem Neurosci ; 15(15): 2779-2794, 2024 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-39056181

RESUMEN

Colchicine, one of the oldest anti-inflammatory natural products still used clinically, inhibits NF-κB signaling and NLRP3 inflammasome activation. Despite its cytotoxicity and narrow therapeutic range, colchicine continues to intrigue medicinal chemists exploring its anti-inflammatory potential. This study aimed to investigate the colchicine scaffold for its role in Alzheimer's disease by targeting neuroinflammation and cholinesterases. Molecular docking revealed that colchicine's hydrophobic trimethoxyphenyl framework can potentially bind to the peripheral anionic site of cholinesterases. Hybrid structures combining colchicine with aryl/alkyl amines were designed to bind both peripheral and catalytic sites of cholinesterases. We describe here the design, synthesis, and in vitro cytotoxicity evaluation of these colchicine-aryl/alkyl amine hybrids, along with their in silico interactions with the cholinesterase active site gorge. Nontoxic analogs demonstrating strong cholinesterase binding affinity were further evaluated for their anticholinesterase and antineuroinflammatory activities. The colchicine-donepezil hybrid, SBN-284 (3x), inhibited both acetylcholinesterase and butyrylcholinesterase as well as the NLRP3 inflammasome complex at low micromolar concentrations. It achieved this through noncompetitive inhibition, occupying the active site gorge and interacting with both peripheral and catalytic anionic sites of cholinesterases. Analog 3x was shown to cross the blood-brain barrier and exhibited no toxicity to neuronal cells, primary macrophages, or epithelial fR2 cells. These findings highlight the potential of this lead compound for further preclinical investigation as a promising anti-Alzheimer agent.


Asunto(s)
Inhibidores de la Colinesterasa , Colchicina , Inflamasomas , Simulación del Acoplamiento Molecular , Proteína con Dominio Pirina 3 de la Familia NLR , Colchicina/farmacología , Inhibidores de la Colinesterasa/farmacología , Inhibidores de la Colinesterasa/síntesis química , Inhibidores de la Colinesterasa/química , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismo , Proteína con Dominio Pirina 3 de la Familia NLR/antagonistas & inhibidores , Animales , Inflamasomas/metabolismo , Humanos , Ratones , Aminas/farmacología , Aminas/química , Donepezilo/farmacología , Piperidinas/farmacología , Piperidinas/química
2.
J Integr Med ; 21(1): 62-76, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36253285

RESUMEN

OBJECTIVE: The current study evaluated various new colchicine analogs for their anticancer activity and to study the primary mechanism of apoptosis and in vivo antitumor activity of the analogs with selective anticancer properties and minimal toxicity to normal cells. METHODS: Sulforhodamine B (SRB) assay was used to screen various colchicine analogs for their in vitro cytotoxicity. The effect of N-[(7S)-1,2,3-trimethoxy-9-oxo-10-(pyrrolidine-1-yl)5,6,7,9-tetrahydrobenzo[a] heptalene-7-yl] acetamide (IIIM-067) on clonogenicity, apoptotic induction, and invasiveness of A549 cells was determined using a clonogenic assay, scratch assay, and staining with 4',6-diamidino-2-phenylindole (DAPI) and annexin V/propidium iodide. Mitochondrial membrane potential (MMP) and reactive oxygen species (ROS) levels were observed using fluorescence microscopy. Western blot analysis was used to quantify expression of proteins involved in apoptosis, cell cycle, and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signaling. Pharmacokinetic and in vivo efficacy studies against Ehrlich ascites carcinoma (EAC) and Ehrlich solid tumor models were conducted using Swiss albino mice. RESULTS: IIIM-067 showed potent cytotoxicity and better selectivity than all other colchicine analogs screened in this study. The selective activity of IIIM-067 toward A549 cells was higher among other cancer cell lines, with a selectivity index (SI) value of 2.28. IIIM-067 demonstrated concentration- and time-dependent cytotoxicity against A549 cells with half-maximal inhibitory concentration values of 0.207, 0.150 and 0.106 µmol/L at 24, 48 and 72 h, respectively. It also had reduced toxicity to normal cells (SI > 1) than the parent compound colchicine (SI = 1). IIIM-067 reduced the clonogenic ability of A549 cells in a dose-dependent manner. IIIM-067 enhanced ROS production from 24.6% at 0.05 µmol/L to 82.1% at 0.4 µmol/L and substantially decreased the MMP (100% in control to 5.6% at 0.4 µmol/L). The annexin V-FITC assay demonstrated 78% apoptosis at 0.4 µmol/L. IIIM-067 significantly (P < 0.5) induced the expression of various intrinsic apoptotic pathway proteins, and it differentially regulated the PI3K/AKT/mTOR signaling pathway. Furthermore, IIIM-067 exhibited remarkable in vivo anticancer activity against the murine EAC model, with tumor growth inhibition (TGI) of 67.0% at a dose of 6 mg/kg (i.p.) and a reduced mortality compared to colchicine. IIIM-067 also effectively inhibited the tumor growth in the murine solid tumor model with TGI rates of 48.10%, 55.68% and 44.00% at doses of 5 mg/kg (i.p.), 6 mg/kg (i.p.) and 7 mg/kg (p.o.), respectively. CONCLUSION: IIIM-067 exhibited significant anticancer activity with reduced toxicity both in vitro and in vivo and is a promising anticancer candidate. However, further studies are required in clinical settings to fully understand its potential.


Asunto(s)
Antineoplásicos Fitogénicos , Proteínas Proto-Oncogénicas c-akt , Animales , Ratones , Proteínas Proto-Oncogénicas c-akt/metabolismo , Antineoplásicos Fitogénicos/farmacología , Fosfatidilinositol 3-Quinasas/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Serina-Treonina Quinasas TOR/metabolismo , Colchicina/farmacología , Apoptosis , Línea Celular Tumoral , Proliferación Celular , Mamíferos/metabolismo
3.
J Environ Manage ; 328: 116969, 2023 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-36495825

RESUMEN

Antibiotic-resistant bacteria and antibiotic resistance genes (ARGs) are pollutants of worldwide concern that seriously threaten public health and ecosystems. Machine learning (ML) prediction models have been applied to predict ARGs in beach waters. However, the existing studies were conducted at a single location and had low prediction performance. Moreover, ML models are "black boxes" that do not reveal their predictions' internal nuances and mechanisms. This lack of transparency and trust can result in serious consequences when using these models in high-stakes decisions. In this study, we developed a gradient boosted regression tree based (GBRT) ML model and then described its behavior using six explainable artificial intelligence (XAI) model-agnostic explanation methods. We used hydro-meteorological and qPCR data from the beaches in South Korea and Pakistan and developed ML prediction models for aac (6'-lb-cr), sul1, and tetX with 10-fold time-blocked cross-validation performances of 4.9, 2.06 and 4.4 root mean squared logarithmic error, respectively. We then analyzed the local and global behavior of the developed ML model using four interpretation methods. The developed ML models showed that water temperature, precipitation and tide are the most important predictors for prediction of ARGs at recreational beaches. We show that the model-agnostic interpretation methods not only explain the behavior of the ML model but also provide insights into the behavior of the ML model under new unseen conditions. Moreover, these post-processing techniques can be a debugging tool for ML-based modeling.


Asunto(s)
Inteligencia Artificial , Ecosistema , Bacterias/genética , Aprendizaje Automático , Farmacorresistencia Microbiana/genética
4.
Antibiotics (Basel) ; 11(11)2022 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-36421237

RESUMEN

Timely and efficacious antibiotic treatment depends on precise and quick in silico antimicrobial-resistance predictions. Limited treatment choices due to antimicrobial resistance (AMR) highlight the necessity to optimize the available diagnostics. AMR can be explicitly anticipated on the basis of genome sequence. In this study, we used transcriptomes of 410 multidrug-resistant isolates of Pseudomonas aeruginosa. We trained 10 machine learning (ML) classifiers on the basis of data on gene expression (GEXP) information and generated predictive models for meropenem, ciprofloxacin, and ceftazidime drugs. Among all the used ML models, four models showed high F1-score, accuracy, precision, and specificity compared with the other models. However, RandomForestClassifier showed a moderate F1-score (0.6), precision (0.61), and specificity (0.625) for ciprofloxacin. In the case of ceftazidime, RidgeClassifier performed well and showed F1-score (0.652), precision (0.654), and specificity (0.652) values. For meropenem, KNeighborsClassifier exhibited moderate F1-score (0.629), precision (0.629), and specificity (0.629). Among these three antibiotics, GEXP data on meropenem and ceftazidime improved diagnostic performance. The findings will pave the way for the establishment of a resistance profiling tool that can predict AMR on the basis of transcriptomic markers.

5.
Saudi J Biol Sci ; 29(5): 3687-3693, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35844400

RESUMEN

The lowest concentration of an antimicrobial agent that can inhibit the visible growth of a microorganism after overnight incubation is called as minimum inhibitory concentration (MIC) and the drug prescriptions are made on the basis of MIC data to ensure successful treatment outcomes. Therefore, reliable antimicrobial susceptibility data is crucial, and it will help clinicians about which drug to prescribe. Although few prediction studies based on strategies have been conducted, however, no single machine learning (ML) modelling has been carried out to predict MICs in N. gonorrhoeae. In this study, we propose a ML based approach that can predict MICs of a specific antibiotic using unitigs sequences data. We retrieved N. gonorrhoeae genomes from European Nucleotide Archive and NCBI and analysed them combined with their respective MIC data for cefixime, ciprofloxacin, and azithromycin and then we constructed unitigs by using de Brujin graphs. We built and compared 35 different ML regression models to predict MICs. Our results demonstrate that RandomForest and CATBoost models showed best performance in predicting MICs of the three antibiotics. The coefficient of determination, R2, (a statistical measure of how well the regression predictions approximate the real data points) for cefixime, ciprofloxacin, and azithromycin was 0.75787, 0.77241, and 0.79009 respectively using RandomForest. For CATBoost model, the R2 value was 0.74570, 0.77393, and 0.79317 for cefixime, ciprofloxacin, and azithromycin respectively. Lastly, using feature importance, we explore the important genomic regions identified by the models for predicting MICs. The major mutations which are responsible for resistance against these three antibiotics were chosen by ML models as a top feature in case of each antibiotics. CATBoost, DecisionTree, GradientBoosting, and RandomForest regression models chose the same unitigs which are responsible for resistance. This unitigs-based strategy for developing models for MIC prediction, clinical diagnostics, and surveillance can be applicable for other critical bacterial pathogens.

6.
Eur J Pharm Sci ; 176: 106238, 2022 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-35714943

RESUMEN

The limitations associated with cancer monotherapy including dose dependent toxicity and drug resistance can be addressed by combination chemotherapy. The combination of antineoplastic agents improves the cytotoxic activity in comparison to the single-agent based therapy in a synergistic or an additive mode by reducing tumor growth as well as metastatic ability. In the present investigation, we explored the potential of methylselenocysteine (MSC) in combination chemotherapy with gemcitabine (GEM). The cytotoxic activity of GEM and MSC was determined in various cell lines and based on the activity, A549 cells were explored for the mechanistic studies including DAPI staining, measurement of oxidative stress, mitochondrial membrane potential loss, nitric oxide level, western blotting, cell migration and colony formation assays. A549 cells in combination treatment with MSC and GEM demonstrated enhanced cytotoxicity with more irregular cellular morphology as well as chromatin condensation and nuclear blebbing. The selected combination also significantly triggered ROS generation and mitochondrial destabilization, and alleviated cell migration potential and clonogenic propensity of A549 cells. Also, caspase-3 and PARP mediated apoptosis was observed in the combination treated cells. MSC based drug combination could offer the attributes of improved drug delivery and there was a 6-folds dose reduction of GEM in combination. Further, antitumor study in Ehrlich solid tumor model showed the efficacy of MSC combination with GEM for the enhanced antitumor activity. The proposed combination demonstrated the potential for further translational studies.


Asunto(s)
Antineoplásicos , Desoxicitidina , Antineoplásicos/farmacología , Antineoplásicos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/farmacología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Apoptosis , Línea Celular Tumoral , Desoxicitidina/análogos & derivados , Desoxicitidina/farmacología , Desoxicitidina/uso terapéutico , Selenocisteína/análogos & derivados , Gemcitabina
8.
Mol Carcinog ; 60(10): 671-683, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34324743

RESUMEN

Rohitukine, a chromone alkaloid extracted from Dysoxylum binectariferum, has a propitious anticancer activity. Our previous study shows that a new Rohitukine derivative IIIM-290 restricts the growth of pancreatic cancer in vivo and in vitro. In the present findings, we report the mechanism of cell death induced by IIIM-290 in MOLT-4 cells (acute lymphoblastic leukemia) and its anticancer potential against various murine leukemic tumor models in vivo. We found that IIIM-290 induced apoptosis through upregulation of different apoptotic proteins like PUMA, BAX, cytochrome c, cleaved (active) caspase-3, and cleaved PARP in MOLT-4 cells. Moreover, IIIM-290 abated mitochondrial membrane potential, elevated calcium levels, reactive oxygen species, and arrested growth of MOLT-4 cells in the synthesis (S) phase of the cell cycle. Interestingly, the elevation in proapoptotic markers was p53 dependent-the silencing of p53 abrogated apoptosis (programmed cell death) triggered by IIIM-290 in MOLT-4 cells. Furthermore, IIIM-290 significantly enhanced the survival of animals with P388 and L1210 leukemia. Thus, our results put IIIM-290 as a potential candidate for the anticancer lead.


Asunto(s)
Antineoplásicos Fitogénicos/farmacología , Apoptosis/efectos de los fármacos , Cromonas/farmacología , Mitocondrias/efectos de los fármacos , Mitocondrias/metabolismo , Piperidinas/farmacología , Leucemia-Linfoma Linfoblástico de Células Precursoras/metabolismo , Animales , Proteínas Reguladoras de la Apoptosis/genética , Proteínas Reguladoras de la Apoptosis/metabolismo , Línea Celular Tumoral , Cromonas/química , Modelos Animales de Enfermedad , Regulación Neoplásica de la Expresión Génica , Humanos , Ratones , Piperidinas/química , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Proteína p53 Supresora de Tumor/metabolismo , Ensayos Antitumor por Modelo de Xenoinjerto
9.
Chem Biol Drug Des ; 98(1): 127-143, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33969634

RESUMEN

Indanocine, a potent anticancer investigational drug of National Cancer Institute-USA, has been much discussed in recent years. Present communication aimed at total synthesis of indanocine and its close analogues. Total synthesis was improved by double yields than previously reported yields. Some of the benzylidene and 2-benzyl derivatives with free rotation at C2 position exhibited potential cytotoxicities against various human cancer cell lines. Five such analogues exhibited potential antiproliferative effect against HCT-116 and MIA PACA-2 cell lines. Benzylindanocine 12i induced microtubule destabilization by occupying colchicine binding pocket of ß-tubulin. It also exhibited anti-inflammatory activity by down-regulating IL-6 and TNF-α. In Ehrlich ascites carcinoma model, 12i reduced 78.4% of EAC tumour in Swiss albino mice at 90 mg/kg (i.p.) dose. Further, in in vivo safety studies, 12i was found to be safe to rodents up to 1,000 mg/kg dose. Concomitant anticancer and anti-inflammatory activity of benzylindanocine is distinctive, which suggests its further optimization for better efficacy and druggability.


Asunto(s)
Antiinflamatorios/síntesis química , Antineoplásicos/síntesis química , Indanos/síntesis química , Microtúbulos/efectos de los fármacos , Animales , Antiinflamatorios/farmacología , Antineoplásicos/farmacología , Apoptosis/efectos de los fármacos , Compuestos de Bencilideno/química , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Colchicina/química , Relación Dosis-Respuesta a Droga , Humanos , Indanos/farmacología , Interleucina-6/metabolismo , Ratones , Simulación del Acoplamiento Molecular , Relación Estructura-Actividad , Tubulina (Proteína)/química , Factor de Necrosis Tumoral alfa/metabolismo
10.
PLoS Negl Trop Dis ; 15(5): e0009371, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33939717

RESUMEN

BACKGROUND: Malaria, disproportionately affects poor people more than any other disease of public health concern in developing countries. In resource-constrained environments, monitoring the occurrence of malaria is essential for the success of national malaria control programs. Militancy and military conflicts have been a major challenge in monitoring the incidence and controlling malaria and other emerging infectious diseases. The conflicts and instability in Afghanistan have resulted in the migration of refugees into the war-torn tribal districts of Pakistan's Khyber Pakhtunkhwa (KPK) province and the possible introduction of many contagious epidemics. Although malaria is very common in all tribal districts, molecular, clinical and epidemiological data are scarce in these high-burden districts. Therefore, for the proper surveillance, detection, and control of malaria, obtaining and analyzing reliable data in these districts is essential. METHODOLOGY/PRINCIPAL FINDINGS: All 1,127 malaria-suspected patients were sampled within the transmission season in the tribal districts of KPK province between March 2016 to December 2018. After a detailed demographic and clinical investigation of malaria-suspected patients, the data were recorded. The data of the control group was collected simultaneously at the same site. They were considered as uncomplicated cases for statistical analyses. Blood samples were collected from malaria-suspected patients for the detection of Plasmodium species using microscopy and nested PCR (nPCR). Microscopy and nPCR examination detected 78% (n = 882) and 38% (n = 429) Plasmodium-positive patients, respectively. Among1,127 of 429nPCR detected cases with both species of malaria, the frequency of complications was as follows: anemia (n = 71; 16.5%), decompensated shock (n = 40; 9%), hyperpyrexia (n = 117; 27%), hyperparasitaemia (n = 49; 11%) hypoglycemia (n = 45; 10.5%), jaundice (n = 54; 13%), multiple convulsions (n = 37; 9%), and petechia (n = 16; 4%). We observed that 37% (n = 157 out of 429) of those patients infected by both Plasmodium species were children between the ages of 1 and 15 years old. The results revealed that Bajaur (24%), Kurram (20%), and Khyber (18%) districtshada higher proportion of P. vivax than P. falciparum cases. Most of the malaria cases were males (74%). Patients infected by both Plasmodium species tended to less commonly have received formal education and ownership of wealth indicators (e.g., fridge, TV set) was lower. CONCLUSIONS/SIGNIFICANCE: Malaria in tribal districts of the KPK province largely affects young males. P. vivax is a major contributor to the spread of malaria in the area, including severe malaria. We observed a high prevalence of P. vivax in the Bajaur district. Children were the susceptible population to malaria infections whereas they were the least expected to use satisfactory prevention strategies. A higher level of education, a possession of TV sets, the use of bed nets, the use of repellent fluids, and fridges were all associated with protection from malaria. An increased investment in socio-economic development, a strong health infrastructure, and malaria education are key interventions to reduce malaria in the tribal districts.


Asunto(s)
Malaria Falciparum/epidemiología , Malaria Vivax/epidemiología , Plasmodium falciparum/aislamiento & purificación , Plasmodium vivax/aislamiento & purificación , Adolescente , Conflictos Armados/estadística & datos numéricos , Estudios de Casos y Controles , Niño , Preescolar , Indicadores de Enfermedades Crónicas , Femenino , Humanos , Lactante , Masculino , Pakistán/epidemiología , Plasmodium falciparum/genética , Plasmodium vivax/genética , Reacción en Cadena de la Polimerasa , Refugiados/estadística & datos numéricos , Estudios Retrospectivos , Factores Socioeconómicos , Adulto Joven
13.
Acta Crystallogr F Struct Biol Commun ; 74(Pt 10): 644-649, 2018 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-30279316

RESUMEN

Metallo-ß-lactamases (MBLs) are present in major Gram-negative pathogens and environmental species, and pose great health risks because of their ability to hydrolyze the ß-lactam rings of antibiotics such as carbapenems. PNGM-1 was the first reported case of a subclass B3 MBL protein that was identified from a metagenomic library from deep-sea sediments that predate the antibiotic era. In this study, PNGM-1 was overexpressed, purified and crystallized. Crystals of native and selenomethionine-substituted PNGM-1 diffracted to 2.10 and 2.30 Šresolution, respectively. Both the native and the selenomethionine-labelled PNGM-1 crystals belonged to the monoclinic space group P21, with unit-cell parameters a = 122, b = 83, c = 163 Å, ß = 110°. Matthews coefficient (VM) calculations suggested the presence of 6-10 molecules in the asymmetric unit, corresponding to a solvent content of ∼31-58%. Structure determination is currently in progress.


Asunto(s)
Organismos Acuáticos/química , Proteínas Bacterianas/química , Metagenoma , beta-Lactamasas/química , Secuencia de Aminoácidos , Organismos Acuáticos/enzimología , Proteínas Bacterianas/genética , Proteínas Bacterianas/metabolismo , Clonación Molecular , Cristalización , Cristalografía por Rayos X , Escherichia coli/genética , Escherichia coli/metabolismo , Expresión Génica , Vectores Genéticos/química , Vectores Genéticos/metabolismo , Sedimentos Geológicos/microbiología , Océanos y Mares , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Alineación de Secuencia , Homología de Secuencia de Aminoácido , beta-Lactamasas/genética , beta-Lactamasas/metabolismo
15.
J Glob Antimicrob Resist ; 14: 302-305, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29842976

RESUMEN

OBJECTIVES: In order to find antimicrobial resistance gene(s) pre-dating the use of antibiotics through metagenomics, functional screening of a metagenomic library from the deep-seep sediments of Edison Seamount (ca. 10000 years old) was performed. METHODS: Among 60 antimicrobial-resistant clones, a single clone with the highest minimum inhibitory concentration (MIC) for ampicillin was selected. Sequence analysis revealed a new metallo-ß-lactamase (MBL) gene, designated as blaPNGM-1. PNGM-1 retains a zinc ion-binding motif (H116XH118XD120H121, H196 and H263), conserved in subclass B3 MBLs. The catalytic parameters of purified PNGM-1 and the MICs of ß-lactams for Escherichia coli TOP10 transformants harbouring the blaPNGM-1 gene were assessed. RESULTS: Antimicrobial susceptibility testing indicated reduced susceptibility to penicillins, narrow- and extended-spectrum cephalosporins, and carbapenems in E. coli TOP10 transformants harbouring the blaPNGM-1 gene. In addition, kinetic analyses revealed that PNGM-1 hydrolysed almost all ß-lactams. CONCLUSIONS: The PNGM-1 enzyme is the first case of a subclass B3 MBL derived from a functional metagenomic library of a deep-sea sediment that pre-dates the antibiotic era.


Asunto(s)
Sedimentos Geológicos/microbiología , Metagenómica/métodos , beta-Lactamasas/genética , Bacterias/efectos de los fármacos , Bacterias/genética , Proteínas Bacterianas/genética , Farmacorresistencia Bacteriana Múltiple , Pruebas de Sensibilidad Microbiana
16.
J Pak Med Assoc ; 66(10): 1281-1285, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27686304

RESUMEN

OBJECTIVE: Purpose of the study is to determine the frequency of dysphagia after stroke and to see the factors associated with it. METHODS: Cross Sectional study design was used by including individuals pre-diagnosed as stroke on the basis of CT scan or MRI findings. Study was conducted in three hospitals of Lahore within six months. Sample size of 150 patients of any age and both gender was taken by using convenient sampling technique. To assess the conscious level, Glasgow coma scale was administered and those who scored mild or moderate on GCS were included in the study. Modified Massey Bedside Swallow Screener was used to screen out the patients for dysphagia. SPSS-19 was used for the statistical analysis. RESULTS: In the sample of 150 individuals with stroke 53% of patients had dysphagia. Females were 38% while males were 62%. Individuals who were older were more likely to have dysphagia. Among dysphagic individuals 65% had ischemic stroke while 35% were with haemorrhagic. There were 87% of dysphagic individuals who presented with history of smoking and 13% were without any. These factors demonstrate significant relationship by showing p-value <0.05. While no significant difference was seen between levels of alertness and risk of dyspagia by showing p-value 0.2. CONCLUSIONS: Dysphagia after stroke occurs frequently that should be actively assessed and factors like type of stroke and history of smoking are significantly related to this condition.


Asunto(s)
Trastornos de Deglución/etiología , Accidente Cerebrovascular/complicaciones , Estudios Transversales , Deglución , Trastornos de Deglución/epidemiología , Femenino , Humanos , Masculino , Pakistán/epidemiología , Factores de Riesgo , Fumar/efectos adversos
17.
PLoS Negl Trop Dis ; 10(1): e0004399, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26809063

RESUMEN

BACKGROUND: Military conflict has been a major challenge in the detection and control of emerging infectious diseases such as malaria. It poses issues associated with enhancing emergence and transmission of infectious diseases by destroying infrastructure and collapsing healthcare systems. The Orakzai agency in Pakistan has witnessed a series of intense violence and destruction. Military conflicts and instability in Afghanistan have resulted in the migration of refugees into the area and possible introduction of many infectious disease epidemics. Due to the ongoing violence and Talibanization, it has been a challenge to conduct an epidemiological study. METHODOLOGY/PRINCIPAL FINDINGS: All patients were sampled within the transmission season. After a detailed clinical investigation of patients, data were recorded. Baseline venous blood samples were taken for microscopy and nested polymerase chain reaction (nPCR) analysis. Plasmodium species were detected using nested PCR (nPCR) and amplification of the small subunit ribosomal ribonucleic acid (ssrRNA) genes using the primer pairs. We report a clinical assessment of the epidemic situation of malaria caused by Plasmodium vivax (86.5%) and Plasmodium falciparum (11.79%) infections with analysis of complications in patients such as decompensated shock (41%), anemia (8.98%), hypoglycaemia (7.3%), multiple convulsions (6.7%), hyperpyrexia (6.17%), jaundice (5%), and hyperparasitaemia (4.49%). CONCLUSIONS/SIGNIFICANCE: This overlooked distribution of P. vivax should be considered by malaria control strategy makers in the world and by the Government of Pakistan. In our study, children were the most susceptible population to malaria infection while they were the least expected to use satisfactory prevention strategies in such a war-torn deprived region. Local health authorities should initiate malaria awareness programs in schools and malaria-related education should be further promoted at the local level reaching out to both children and parents.


Asunto(s)
Malaria/epidemiología , Adolescente , Adulto , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , Malaria/diagnóstico , Malaria/parasitología , Malaria/transmisión , Masculino , Persona de Mediana Edad , Pakistán/epidemiología , Plasmodium/clasificación , Plasmodium/genética , Plasmodium/aislamiento & purificación , Estudios Retrospectivos , Guerra , Adulto Joven
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