Tailoring structural and optical properties of Cu(II)-induced MgAl2O4 nanoparticles and their response to toxic dyes under solar illumination.

Worldwide environmental challenges pose critical problems with the growth of the global economy. Addressing these issues requires the development of an eco-friendly and sustainable catalyst for degrading organic dye pollutants. In this study, copper-doped magnesium aluminates (CuxMg1-xAl2O4) with x = 0.0-0.8 were synthesized using a citrate-based combustion route. The inclusion of Cu(II) significantly impacted the structural, microstructural, optical, and photocatalytic activity of the catalyst. Rietveld analysis of X-ray diffraction powder profiles revealed single-phase spinels crystallized in the face-centered cubic unit cell with Fd 3 ¯ m space group. Chemical states of the ions, surface morphology, and elemental investigation were analyzed by X-ray photoelectron spectroscopy, field-emission scanning electron microscopy, and energy-dispersive X-ray spectroscopy, respectively. UV-visible and diffuse reflectance spectroscopies confirmed the reduction of the band gap due to Cu(II) doping, validated by first-principle investigations using the WIEN2k code. The catalyst with x = 0.8 showed higher photocatalytic efficacy (90% and 93%) for removing two azo organic dye pollutants, rhodamine B and methyl orange, respectively, within 120 min. Degradation kinetics followed a pseudo-first-order mechanism. The doped (0.8) sample was structurally and morphologically stable and reusable under visible irradiation, retaining performance after three runs. Scavenger studies confirmed hydroxyl and superoxide radicals' involvement in the degradation. This work presents an effective approach to enhancing CuxMg1-xAl2O4 catalysts' photodegradation performance, with potential applications in pharmaceuticals and wastewater remediation.

Prevalence of Aortic Root Pathologies in Platypnea-Orthodeoxia Syndrome Secondary to Intra-Cardiac Shunts.

Background: Atrial septal defects can allow right to left shunting of venous blood which presents clinically as platypnea-orthodeoxia syndrome. It is believed that concomitant presence of aortic root pathologies increases the likelihood of shunting. Methods: The study included a review of 510 articles listed in PubMed of patients with platypnea-orthodeoxia syndrome. Case reports of patients with extra-cardiac etiologies of platypnea-orthodeoxia were excluded. Results: We reviewed 191 case reports, and 98 cases (51.3%) had evidence of concomitant aortic root pathology. Furthermore, of the remaining 93 case reports, 69 ones excluded any mention of the nature of the aortic root altogether, further suggesting that this is an underreported number. Conclusions: There is a high prevalence of aortic root pathologies in patients with platypnea-orthodeoxia syndrome secondary to intra-cardiac shunts. In patients with unexplained hypoxemia and incidental finding of aortic root pathology, it may be worthwhile to obtain postural oxygen saturation measurements to exclude intra-cardiac shunts as the potential cause.

Magnetic macroporous chitin microsphere as a support for covalent enzyme immobilization.

In this study, a novel magnetic macroporous chitin microsphere (MMCM) was developed for enzyme immobilization. Chitin nanofibers were prepared and subsequently subjected to self-assembly with magnetic nanoparticles and PMMA (polymethyl methacrylate). Following this, microspheres were formed through spray drying, achieving a porous structure through etching. The MMCM serves as an effective support for immobilizing enzymes, allowing for their covalent immobilization both on the microsphere's surface and within its pores. The substantial surface area resulting from the porous structure leads to a 2.1-fold increase in enzyme loading capacity compared to non-porous microspheres. The MMCM enhances stability of the immobilized enzymes under various pH and temperature conditions. Furthermore, after 20 days of storage at 4 °C, the residual activity of the immobilized enzyme was 2.93 times that of the free enzyme. Even after being recycled 10 times, the immobilized enzyme retained 56.7 % of its initial activity. It's noteworthy that the active sites of the enzymes remained unchanged after immobilization using the MMCM, and kinetic analysis revealed that the affinity of the immobilized enzymes rivals that of the free enzymes.

The Spectrum of Heart Failure Management.

Heart failure, a complex cardiovascular condition, is a huge burden on patients, caregivers, and healthcare systems and it is prevalent worldwide. Heart failure is caused by a wide variety of underlying conditions that include both cardiac and non-cardiac pathologies. Identifying the underlying cause enables us to apply etiology-based interventions. The spectrum of heart failure management ranges from classification to transplantation. In addition to its classification and monitoring, this article reviews various management strategies, including both conventional methods and the latest innovations. These include lifestyle interventions, pharmacotherapy, device therapy, transplantation, and regenerative medicine.

Sudden Cardiac Death in Athletes: Consensuses and Controversies.

Exercise is widely considered beneficial for cardiovascular health. However, on rare occasions, athletes experience sudden cardiac death without any preceding symptoms. The devastating nature of these events necessitates us to understand the underlying causes. In younger athletes (age <35), the underlying causes are usually hereditary/genetic, whereas in older athletes (age >35), coronary artery disease is prevalent. Sudden cardiac death in athletes can occur regardless of the presence of any structural abnormality in the heart. Despite divergence between guidelines, the majority of cardiology societies recommend at least taking a comprehensive history and performing physical examinations for initial screening for all athletes. This article reviews the consensuses and controversies regarding the incidence, causes, and prevention of sudden cardiac death in athletes.

Design, Preparation, and Evaluation of Enteric Coating Formulation of HPMC and Eudragit L100 on Carboxylated Agarose Hydrogel by Using Drug Tartrazine.

Enteric-coated application on drug is used to prevent the drug from inactivation which are degraded by gastric enzyme. The present study is aimed at achieving controlled drug delivery in acidic medium of gastrointestinal tract (GIT) by enteric coating of hydroxy propyl methylcellulose (HPMC) and Eudragit L100 on carboxylated agarose hydrogel, creating a pH-dependent delivery system. Fourier-transformed infrared spectroscopy (FTIR) was for the detection of carboxylic group on agarose hydrogel, and scanning electron microscope (SEM) was used for the determination surface of prepared formulation. To check the pH sensitivity of enteric-coated formulation, different pH solution was used. It was found that the formulation was not dissolved in 1.2 but dissolve in pH 6.8 similarly; hydrogels lacking coating showed that tartrazine was more dissolved in pH 1.2, and less dissolved at pH 6.8. The release of tartrazine from the hydrogels was measured by using spectrophotometer and using a scanning electron microscope to examine the morphology and surface appearance of hydrogel capsules. This study revealed cracks on coated samples, while noncoated samples showed clear appearance with no cracks. Our findings revealed that this method could be useful for the development of an enteric coating drug delivery system.

Congenital Mediastinal Neuroenteric Cyst as a cause of respiratory distress since birth.

Mediastinal Neuroenteric Cyst is a rare congenital presentation in infants and is associated with a high mortality rate. It is a very uncommon benign lesion and usually develops from abnormal embryological development of the foregut. Till now, only 106 cases have been reported worldwide. In Pakistan only three cases have been published, with varying presentations. The clinical presentation and age at presentation vary from asymptomatic and coincidental finding on chest x-ray, to limb numbness or early presentation with severe symptoms like those in our case. In fact, it poses an important challenge for paediatricians. We present a rare case with emphasis on clinical presentation and diagnostic criteria.

Facile synthesis of silver modified zinc oxide nanocomposite: An efficient visible light active nanomaterial for bacterial inhibition and dye degradation.

The present study reports the synthesis of silver (Ag) decorated zinc oxide (ZnO) nanocomposite via green synthesis method by using Acacia arabica plant leaves extract as both reducing and capping agent. The results clearly indicate a uniform distribution of Ag nanoparticles (NPs) over ZnO surface. Various analytical and spectroscopic techniques were used for investigating the formation and morphology of as-synthesized Ag/ZnO nanocomposites. Emergence of SPR at 424 and 378 nm confirmed the synthesis of AgNPs and ZnO respectively. The confirmation of elemental composition and crystal structure of prepared nanomaterials (NMs) was carried out via EDX and XRD analysis. Results obtained from HRTEM and SEM analysis indicated small sized spherically shaped NMs. The as-synthesized was checked for its photocatalytic activity towards degradation of MB in the presence as well as absence of light irradiation. Results of degradation study revealed that Ag/ZnO exhibits remarkable photocatalytic activity in the presence of light whereby removing 90% of MB within 80 min. Moreover, the antibacterial activity of synthesized nanocomposite was examined in both visible light and dark conditions. The experiment showed that nanomaterial depicts enhanced antibacterial activity in light in comparison to dark. The results showed that the inhibition diameter of Ag/ZnO nanocomposite in light was found to be 18 (±0.2), 22 (±0.3) against E. coli and S. aureus respectively. The inhibition zone of the said nanomaterial against E. coli and S. aureus in dark was 11 (±0.3), 14 (±0.5) respectively. These results conclude that activity is delivered both in the presence of visible light and dark but efficiency of antibacterial activity is found to be more in visible light in comparison.

Educational Environment In The Transition Phase Of Curriculum At Ayub Medical College Abbottabad, Pakistan.

BACKGROUND: Evaluation of the educational environment is key to the delivery of high-quality medical education. Especially, when an institute is in the transition phase of curriculum. In curriculum transformation phase of Ayub Medical College Abbottabad, no such evaluation has been done. This study aimed to find the direction of Educational environment in the transition phase curriculum of Ayub Medical College Abbottabad and compare different domains of educational environment with gender, residency, pre-medical education's medium of instruction, and doctors among sibling or parents. METHODS: This descriptive cross-sectional survey was conducted among students of integrated and traditional curriculum of Ayub Medical College, Abbottabad from 1st December 2019 to 29th February 2020. By Non-probability convenience sampling technique, pre-validated Dundee Ready Educational Environment Measure questionnaire was used. Descriptive and inferential statistics were calculated in SPSS v22. RESULTS: A total 149 (100%) participants, 66 (44.3%) males and 83 (55.7%) females with mean age of 20.5±1.07 years responded. Among total, 76 (51%) were from integrated curriculum and 73 (49%) were of traditional curriculum. Significant difference was found among different aspect of education environments and both classes. CONCLUSIONS: The current transitional phase of curriculum at Ayub Medical College Abbottabad is more positive than negative. Some areas like student social-self-perception still need improvement. Moreover, gender and place of birth affect student's perception about their learning environment.

Pulmonary Hypertension as a Predictor of Early Outcomes of Mitral Valve Replacement: A Study in Rheumatic Heart Disease Patients.

Aim Mitral valve pathology in rheumatic heart disease patients is a common cause of secondary pulmonary hypertension (PH). Our aim was to evaluate pulmonary hypertension severity as a predictor of in-hospital mortality and early complications following mitral valve replacement. Methods A retrospective review of rheumatic heart disease patients who underwent mitral valve replacement between January 2017 and August 2020 was performed. Systolic pulmonary artery pressure (sPAP) was used to classify patients as no PH (<35 mmHg), mild PH (35-44 mmHg), moderate PH (45-59 mmHg) or severe PH (>60 mmHg). Patients subjected to additional cardiac procedures (such as aortic valve replacement and coronary artery bypass grafting) were excluded from the study sample. Results The study group was composed of 159 patients (mean age: 40; 73 male, 86 female) categorized as no PH (n = 32; 20.1%), mild PH (n = 14; 8.8%), moderate PH (n = 65, 40.9%) and severe PH (n = 48, 30.2%) groups. Patient demographic data and preoperative comorbidities were comparable among the four groups. Use of intraoperative and postoperative blood products was similar in all the groups. Severe PH patients had similar in-hospital mortality (4.2%; p = 0.74) as in groups with lesser degrees of pulmonary hypertension. Likewise, increasing severity of pulmonary hypertension did not confer any significant increase in early postoperative complications, namely prolonged ICU stay (10.4%; p = 0.41), prolonged ventilation (2.1%; p = 0.70), reintubation (4.2%; p = 0.90), reopening for bleeding tamponade (6.3%; p = 0.39), new-onset renal failure (6.3%; p = 0.91), postoperative stroke (4.2%; p = 0.52) or prolonged length of stay (mean: 5.6 + 2.8 days; p = 0.49). Conclusions Increasing severity of pulmonary hypertension does not appear to have a significant impact on in-hospital mortality or early postoperative outcomes of patients undergoing mitral valve replacement.

Learning Based On Principles Of Cognitivism.

Sometimes, knowledge or information becomes difficult to understand and/or memorize. Cognitive load theory aids a learner to gain information effectively. It provides a scientific roadmap to the design of learning materials. Through a complex set of mental processes, information is acquiring, process, retain, and comprehend information. Applying mental effort for remembering is a very crucial phenomenon. The core of memory process is apprehending and saving of information into long term memory. Because of limited capacity of working memory, delivering or acquiring of information should not be overloaded with irrelevant materials. Based on cognitive load theory dozens of strategies can be intervened at different loci of cognitive process and every piece of information is easily remembered. Not only learners, but teachers can also get benefits from them. In this commentary, John Sweller ideology is further discussed and strategies are presented for better comprehension and memorization of difficult information.

Major Depressive Disorder: An Alarming Stigma Of Pregnant Women.

BACKGROUND: Major depressive disorder is the most common psychiatric disease affecting women. Pregnancy significantly increases its prevalence, especially in developing countries. Antenatal major depression is an alarming condition for the mother and the growing foetus. This study aimed to find the frequency of antenatal depression and its relation with obstetric predictors. METHODS: This crosssectional study was conducted during Jan-March of 2014, in Benazir Bhutto women and children, Hospital, Abbottabad. By non- probability consecutive sampling techniques, total 96 pregnant women in third trimester were included during outpatient visiting hours. After inclusion and exclusion criteria, they were diagnosed for low back pain and major depressive disorder. All the data and questions were recorded in a pre-tested questionnaire. Verbal informed consents were obtained. SPSS software (version 21) was used for statistical analysis. RESULTS: The sample included 96 participants with a mean age of 24.56±4.24 years, and mean duration of pregnancy 35.06±3.80 weeks. Forty-one women (42.7%) had high school education level, women from urban areas were 50 (52.1), 54 (56.3%) were from age group, 21-25 years, and 54 (56.3%) had first pregnancy. Among the total, 68 (70.8%) were depressed and 42 (43.8%) were of mild severity. Two third, i.e., 66 (68.8%) had low back pain. None of the results were statistically significant. CONCLUSIONS: Major depressive disorder (of mild severity) is quite high in 3rd-trimester pregnant population of Abbottabad. Frequency was more in uneducated younger age group women, resident of remote areas with first conception were more depressed.

Two years analysis of acute poisoning in patients presented to Emergency Department of Ayub Teaching Hospital, Abbottabad.

BACKGROUND: Acute poisoning is one of the most common causes of poisoning worldwide and is the fourth leading cause of death. It is either accidental or suicidal and causes a high mortality and morbidity. It is more common in males due to prolonged occupational exposure. The objective of this study is to find the pattern of acute poisoning and its relation with demographic variables in the emergency department of Ayub Teaching Hospital, Abbottabad. METHODS: This cross-sectional study was carried out on patients of acute intoxication brought to the emergency department of Ayub Teaching Hospital in the year 2017-18. Data was analyzed by SPSS-16.0 and presented as tables and figures. Chi-square test was applied at 5% level of significance. RESULTS: A total of 76 patients, 48 (63.16%) females and 28 (36.84%) males were included during the period. Mean age was 24.12±9.058 years. Thirty-nine (51.32)% cases belonged to rural areas and 37 (48.68)% were from urban areas. Cases of medicinal poisoning were 25 (32.89%) followed by 19 (25%) cases of organophosphate poisoning. Most cases of poisoning 36 (47.4%) were presented in the night shift. Thirty-one (40.79%) cases were brought to the hospital within 1-2 hours of incident. Cases of intentional poisoning were 51 (67.11%) while 25(32.89%) were due to accidental poisoning. CONCLUSION: Females within the age group 21-35 belonging to rural areas were more prone to poisoning. The common type of poisoning is medicinal poisoning. Most patients were presented to the emergency in the night shift within 1-2 hours of intoxication.

Frequency and Antibiogram of Isolates from Surgical Units of a Tertiary Care Hospital in Quetta.

OBJECTIVE: To determine the frequency and antibiogram of the isolates from infected patients in surgical units of a tertiary care hospital. STUDY DESIGN: Cross-sectional, descriptive study. PLACE AND DURATION OF STUDY: Department of Microbiology, Combined Military Hospital, Quetta, from March to October 2015. METHODOLOGY: Clinical samples from the surgical units received in Department of Microbiology for culture and sensitivity were analyzed by Gram stain, culture and biochemical tests for identification of the isolates; and the antibiotic susceptibility was determined by modified Kirby Bauer disc diffusion method. Data was analyzed by Statistical Package for Social Sciences (SPSS) version 19. RESULTS: The commonest isolate was Acinetobacter baumannii (22%) followed by Escherichia coli (20%), Pseudomonas spp. (15%) and Methicillin-resistant Staphylococcus aureus (MRSA) (11%). Acinetobacter baumannii showed highest susceptibility to doxycycline (41%), Enterobacteriaceae to meropenem (96%), Pseudomonas spp. to polymyxin-B (100%) and Gram positive bacteria to linezolid (100%). Seventy-two percent of the isolates were found to be multi-drug resistant. CONCLUSION: There was a high infection rate in surgical patients with Acinetobacter baumannii, Eschericia coli, Pseudomonas spp. and MRSA being the commonest isolates. Acinetobacter baumannii showed highest susceptibility to doxycycline, Enetrobacteriaceae to meropenem, Pseudomonas spp. to polymyxin-B and Gram positive bacteria to linezolid.