Radiotherapy to the neck after neck dissection for head and neck squamous cell carcinoma from an unknown primary: A narrative review.

PURPOSE: To conduct a comprehensive narrative review of the evidence for radiotherapy target volumes to the neck, after neck dissection, for head and neck squamous cell carcinoma from an unknown primary (HNSCCUP). Inclusion or exclusion of mucosal irradiation is not the focus of interest for this review article. MATERIALS AND METHODS: Literature (PubMed-Medline, EMBASE database and Cochrane library) was searched using the relevant keywords. The search results were limited to the studies published in year 2000 or after. RESULTS: Eight studies met the inclusion criteria. All studies were retrospective in nature. The incidence of contralateral recurrence rates in the untreated neck when the involved neck only is treated remains very low (0%-10%). Survival has improved over the past two decades, most likely due to improved diagnostic techniques and the increase in incidence of HPV-related disease. CONCLUSION: Given the rarity of disease, level one evidence from randomised controlled trials is lacking. Available data are retrospective but support unilateral post-operative radiotherapy as a treatment option in selected cases.

Transcriptomic analysis reveals the beneficial effects of salt priming on enhancing defense responses in upland cotton under successive salt stress.

Priming-mediated stress tolerance in plants stimulates defense mechanisms and enables plants to cope with future stresses. Seed priming has been proven effective for tolerance against abiotic stresses; however, underlying genetic mechanisms are still unknown. We aimed to assess upland cotton genotypes and their transcriptional behaviors under salt priming and successive induced salt stress. We pre-selected 16 genotypes based on previous studies and performed morpho-physiological characterization, from which we selected three genotypes, representing different tolerance levels, for transcriptomic analysis. We subjected these genotypes to four different treatments: salt priming (P0), salt priming with salinity dose at 3-true-leaf stage (PD), salinity dose at 3-true-leaf stage without salt priming (0D), and control (CK). Although the three genotypes displayed distinct expression patterns, we identified common differentially expressed genes (DEGs) under PD enriched in pathways related to transferase activity, terpene synthase activity, lipid biosynthesis, and regulation of acquired resistance, indicating the beneficial role of salt priming in enhancing salt stress resistance. Moreover, the number of unique DEGs associated with G. hirsutum purpurascens was significantly higher compared to other genotypes. Coexpression network analysis identified 16 hub genes involved in cell wall biogenesis, glucan metabolic processes, and ribosomal RNA binding. Functional characterization of XTH6 (XYLOGLUCAN ENDOTRANSGLUCOSYLASE/HYDROLASE) using virus-induced gene silencing revealed that suppressing its expression improves plant growth under salt stress. Overall, findings provide insights into the regulation of candidate genes in response to salt stress and the beneficial effects of salt priming on enhancing defense responses in upland cotton.

Response of the Pardosa astrigera bacterial community to Cry1B protein.

While genetically modified (GM) crops bring economic benefits to human beings, their impact on non-target organisms has become an important part of environmental safety assessments. Symbiotic bacteria play an important role in eukaryotic biological functions and can adjust host communities to adapt to new environments. Therefore, this study examined the effects of Cry1B protein on the growth and development of non-target natural enemies of Pardosa astrigera (L. Koch) from the perspective of symbiotic bacteria. Cry1B protein had no significant effect on the health indicators of P. astrigera (adults and 2nd instar spiderlings). 16S rRNA sequencing results revealed that Cry1B protein did not change the symbiotic bacteria species composition of P. astrigera, but did reduce the number of OTU and species diversity. In 2nd instar spiderlings, neither the dominant phylum (Proteobacteria) nor the dominant genus (Acinetobacter) changed, but the relative abundance of Corynebacterium-1 decreased significantly; in adult spiders, the dominant bacteria genera of females and males were different. The dominant bacterial genera were Brevibacterium in females and Corynebacterium-1 in males, but Corynebacterium-1 was the dominant bacteria in both females and males feeding on Cry1B. The relative abundance of Wolbachia also increased significantly. In addition, bacteria in other genera varied significantly by sex. KEGG results showed that Cry1B protein only altered the significant enrichment of metabolic pathways in female spiders. In conclusion, the effects of Cry1B protein on symbiotic bacteria vary by growth and development stage and sex.

Differential seedling growth and tolerance indices reflect drought tolerance in cotton.

BACKGROUND: Cotton production is adversely effected by drought stress. It is exposed to drought stress at various critical growth stages grown under a water scarcity environment. Roots are the sensors of plants; they detect osmotic stress under drought stress and play an important role in plant drought tolerance mechanisms. The seedling stage is very sensitive to drought stress, and it needed to explore the methods and plant characteristics that contribute to drought tolerance in cotton. RESULTS: Initially, seedlings of 18 genotypes from three Gossypium species: G. hirsutum, G. barbadense, and G. arboreum, were evaluated for various seedling traits under control (NS) and drought stress (DS). Afterward, six genotypes, including two of each species, one tolerant and one susceptible, were identified based on the cumulative drought sensitivity response index (CDSRI). Finally, growth rates (GR) were examined for shoot and root growth parameters under control and DS in experimental hydroponic conditions. A significant variation of drought stress responses was observed across tested genotypes and species. CDSRI allowed here to identify the drought-sensitive and drought-resistant cultivar of each investigated species. Association among root and shoots growth traits disclosed influential effects of enduring the growth under DS. The traits including root length, volume, and root number were the best indicators with significantly higher differential responses in the tolerant genotypes. These root growth traits, coupled with the accumulation of photosynthates and proline, were also the key indicators of the resistance to drought stress. CONCLUSION: Tolerant genotypes have advanced growth rates and the capacity to cop with drought stress by encouraging characteristics, including root differential growth traits coupled with physiological traits such as chlorophyll and proline contents. Tolerant and elite genotypes of G. hirsutum were more tolerant of drought stress than obsolete genotypes of G. barbadense and G. arboreum. Identified genotypes have a strong genetic basis of drought tolerance, which can be used in cotton breeding programs.

Effect of chloramphenicol on the life table demography of Brachionus calyciflorus (Rotifera): A multigenerational study.

During the last two decades, there has been increasing concerns about the presence of antibiotics in aquatic environments. Phenicol antibiotics, such as chloramphenicol (CMP), commonly used in the veterinary and aquaculture fields to treat infections, have been often detected in aquatic environments, but scarce ecotoxicity information regarding the effects of CMP on non-target aquatic organisms is available, and multigenerational studies are seldom studied. Here we quantified the demographic responses of Brachionus calyciflorus exposed to sublethal concentrations (0, 5, 10, 30, 50, 70 and 90 mg L-1) of CMP for three successive generations (P0, F1, and F2). Our results showed that compared to the control, higher concentrations of CMP significantly decreased the life expectancy at hatching, generation time, net reproductive rate and intrinsic rate of population increase in all three generations, and the proportion of mictic offspring in the F1 generation of B. calyciflorus. With increasing generations, higher concentrations of CMP showed increased toxic effects on life expectancy at hatching and net reproductive rate, but irregular negative effects on generation time, intrinsic rate of population increase, and proportion of mictic offspring of the rotifers. These results indicate that multigenerational studies are necessary to prevent insufficient assessments of the impact of antibiotics in aquatic ecosystems.

Biotechnological Innovations from Ocean: Transpiring Role of Marine Drugs in Management of Chronic Disorders.

Marine drugs are abundant in number, comprise of a diverse range of structures with corresponding mechanisms of action, and hold promise for the discovery of new and better treatment approaches for the management of several chronic diseases. There are huge reserves of natural marine biological compounds, as 70 percent of the Earth is covered with oceans, indicating a diversity of chemical entities on the planet. The marine ecosystems are a rich source of bioactive products and have been explored for lead drug molecules that have proven to be novel therapeutic targets. Over the last 70 years, many structurally diverse drug products and their secondary metabolites have been isolated from marine sources. The drugs obtained from marine sources have displayed an exceptional potential in the management of a wide array of diseases, ranging from acute to chronic conditions. A beneficial role of marine drugs in human health has been recently proposed. The current review highlights various marine drugs and their compounds and role in the management of chronic diseases such as cancer, diabetes, neurodegenerative diseases, and cardiovascular disorders, which has led to the development of new drug treatment approaches.

Understanding the role of atmospheric circulations and dispersion of air pollution associated with extreme smog events over South Asian megacity.

The winter fog/haze events in northeastern Pakistan and surrounding regions of India are often mixed with pollutants to form smog, and consequently damage human health and hampers daily life in the form of fatalities through road accidents, road blockages, and flight delays. The persistent anti-cyclonic conditions can further trigger the temperature inversion and prolong the smog event from days to weeks. The present study provides characteristics and lasting mechanisms of two persistent winter fog events (2016-2017) in Lahore, Pakistan, by using the fifth generation of European Center for Medium-Range Weather Forecast (ECMWF) ERA5 reanalysis data and National Oceanic and Atmospheric Administration (NOAA) Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model simulated with Global Data Assimilation System (GDAS) meteorological data. The results showed the presence of strong low-level anti-cyclonic circulations with wind speed less than 1.5 m/s from November to January over Eastern Punjab for two foggy winter seasons. The deep inversion during the fog events was observed that prevented the natural ventilation of air in the upper atmosphere and ultimately the smoke and heavy pollutant accumulated in the lower atmosphere. Furthermore, high relative humidity greater than 83% near the ground indicates a high condensation rate for water vapors to form fog near the ground. The analysis of the NOAA HYSPLIT trajectory model at different vertical heights revealed that smoke from stubble crop burning in the first week of November 2017 in Punjab and Haryana mixed with fog under favorable stable conditions that lead to intense smog over Lahore. This study will help to understand and to develop a forecasting mechanism of fog events by characterizing the meteorological conditions of the study area and to minimize the adverse impacts of smog on public health.

Shrinkage of the non-malignant prostate gland volume after receiving incidental radiotherapy for rectal cancer.

Background: The purpose of this study was to assess the impact of coincidental radiotherapy on the volume of the non-malignant prostate gland in rectal cancer patients treated with neo-adjuvant radiotherapy. Materials and methods: In this retrospective analysis, thirty male patients with rectal cancer who had neoadjuvant radiotherapy met the inclusion criteria. These patients had pre-treatment magnetic resonance imaging (MRI) and at least one post-treatment MRI of the pelvis and the whole of their prostate volume received the full prescribed radiotherapy dose; 45 Gy in 25 fractions (n = 22), 45 Gy in 20 fractions (n = 4) and 25 Gy in 5 fractions (n = 4). Results: The median age of this patient cohort was 66 years (range: 30-87). With a median interval between pre-treatment MRI and first MRI post-treatment of 2 months (range: 1-11), the mean prostate volume reduced from 36.1 cm3 [standard deviation (SD) 14.2] pre-radiotherapy to 31.3 cm3 (SD 13.0) post radiotherapy and this difference was significant (p = 0.0004). Conclusion: Radiotherapy may cause shrinkage in volume of normal (non-malignant) prostate. Further research is required in this field, since these results may be of some comfort to men contemplating the consequences of radiotherapy on their quality of life. The authors suggest recording flow-rate and international prostate symptom score (IPSS) during rectal radiotherapy as a next step.

Survival outcomes for patients with nasopharyngeal carcinoma in non-endemic region in the UK treated with intensity modulated based radiotherapy 65 Gy in 30 fractions ± weekly cisplatin chemotherapy.

Background: Nasopharyngeal carcinoma (NPC) is rare in the UK. The aim of the current study was to investigate survival outcomes for patients with NPC treated with (chemo)radiotherapy using 65 Gy in 30 fractions in a non-endemic region. Materials and methods: All consecutive 62 patients with histology proven non-metastatic nasopharyngeal carcinoma diagnosed between January 2009 to June 2019 were included in this retrospective analysis. Results: Median age was 59 years (range:19-81). The majority of patients had stage III disease (66.1%). Induction chemotherapy was given in 21% of patients and 82.3% of patients received concomitant systemic therapy. All patients were treated with 65 Gy in 30 fractions. There was disease recurrence in 17.4% patients. The 5-year disease-free, disease-specific and overall survival were 81.9%, 79.2% and 76.4%, respectively. On univariate analysis, disease recurrence was associated with N-stage (p = 0.047) and overall stage group (p = 0.023). Conclusion: To the best of authors' knowledge, this is the first report of the use of 65 Gy in 30 fractions of radiotherapy ± weekly cisplatin chemotherapy in NPC in a real-world setting. Our results are comparable to that from other non-endemic regions of the world using different dose fractionation of (chemo)radiotherapy. Future randomised control trials are warranted to compare various dose fractionations in these settings.

Minimum Length Scheduling for Multi-Cell Full Duplex Wireless Powered Communication Networks.

Wireless powered communication networks (WPCNs) will be a major enabler of massive machine type communications (MTCs), which is a major service domain for 5G and beyond systems. These MTC networks will be deployed by using low-power transceivers and a very limited set of transmission configurations. We investigate a novel minimum length scheduling problem for multi-cell full-duplex wireless powered communication networks to determine the optimal power control and scheduling for constant rate transmission model. The formulated optimization problem is combinatorial in nature and, thus, difficult to solve for the global optimum. As a solution strategy, first, we decompose the problem into the power control problem (PCP) and scheduling problem. For the PCP, we propose the optimal polynomial time algorithm based on the evaluation of Perron-Frobenius conditions. For the scheduling problem, we propose a heuristic algorithm that aims to maximize the number of concurrently transmitting users by maximizing the allowable interference on each user without violating the signal-to-noise-ratio (SNR) requirements. Through extensive simulations, we demonstrate a 50% reduction in the schedule length by using the proposed algorithm in comparison to unscheduled concurrent transmissions.

Assessment of quality of work life (QWL) among healthcare staff of intensive care unit (ICU) and emergency unit during COVID-19 outbreak using WHOQoL-BREF.

OBJECTIVE: The study aimed to document the quality of work life (QWL) among healthcare staff of intensive care units (ICUs) and emergency units during COVID-19 outbreak using the WHOQoL-BREF. METHODS: A multicenter cross-sectional study was conducted for two months (May - June 2020) among healthcare staff working in intensive care units (ICUs) and emergency units of the hospitals under the National Guard Health Authority (NGHA) across five cities of Saudi Arabia. The study used the WHOQoL-BREF instrument to document the QWL through an electronic institutional survey. The data was analyzed through IBM SPSS version 23. The study was approved by an ethics committee. RESULTS: A total of 290 healthcare professionals responded to the survey. The mean overall quality of life score was 3.37 ± 0.97, general health = 3.66 ± 0.88, domains, i.e., physical = 11.67 ± 2.16, psychological = 13.08 ± 2.14, social = 13.22 ± 3.31 and environment = 12.38 ± 2.59. Respondents aged > 40 years, male gender, married status, being a physician and, having a work experience > 15 years and no extra working hours, had higher mean scores for several domains of Quality of life (QoL), overall QoL and general health (p < 0.05). CONCLUSION: The QWL among healthcare staff during COVID-19 pandemic was low. Demographic factors were mainly the determinants for a higher QWL while the variable of extra working hours was a determinant of lower QWL. Despite the pandemic, no COVID-19 related variables affected the work life of healthcare staff.

Concurrent validity of the Arabic version of General Medication Adherence Scale using two validated indirect adherences measures in Saudi patients with non-communicable diseases.

PURPOSE: This study aimed to evaluate the concurrent validity of the Arabic version of the General Medication Adherence Scale (GMAS) using two validated scales namely Adherence to Refills and Medications Scale (ARMS) and Medication Adherence Rating Scale (MARS) in Saudi patients with non-communicable diseases. METHODS: A cross sectional study was conducted for 2 months in out-patient departments at a tertiary care hospital in Khobar, Saudi Arabia. The study collected data from patients with chronic illnesses through convenience sampling. Pearson correlation (ρ) was conducted to report concurrent validity of GMAS. A correlation coefficient value ≥ 0.5 with p-value < 0.01 was considered threshold for establishing concurrent validity. The study was approved by an ethics committee (IRB-2019-05-002). RESULTS: A total of 406 patients responded to the study. The average age was 42.4 ± 5.94 years, and most patients were females (53.7%), married (70%), graduates (65.3%), employed (39.9%) and, had a monthly family income > SAR 10,000, i.e., USD 2666.2 (56.4%). The mean adherence scores obtained from MARS, ARMS and GMAS were 7.09, 19.9, and 27.4. The correlation (ρ) between GMAS and MARS scores was 0.65, and between GMAS and ARMS scores was -0.79, p < 0.01 for both comparisons. CONCLUSION: The concurrent validity of GMAS-AR was established in this study that would further substantiate psychometric properties of the scale in this population.

REVIEW: Nanobiotechnology: Cradle for revolution in drug carrier systems.

The role of nanobiotechnology in the treatment of diseases is limitless. In this review we tried to focus main aspects of nanotechnology in drug carrier systems for treatment and diagnosis of various diseases such as cancer, pulmonary diseases, infectious diseases, vaccine development, diabetes mellitus and the role of nanotechnology on our economy and its positive social impacts on our community. We discussed here about the different "Biotechnano Strategies" to develop new avenues and ultimately improve the treatment of multiple diseases.

Formulation development and in vitro characterization of triple layer tablet containing amlodipine besylate, rosuvastatin calcium and hydrochlorothiazide.

Triple layered tablet having various excipients and a new combination of APIs i.e. amlodipine besylate, rosuvastatin calcium and hydrochlorothiazide was prepared through wet granulation. The concentration of disintegrant and diluent was kept different in formulations of all APIs. At compression stage, nine different formulations from H1 to H9 having different combinations were prepared. Layers T1, T2 and T3 of all the three APIs had disintegrant concentration of 3%, 5% and 7 % respectively. In vitro analysis of granules was made by determining angle of repose, loss on drying, bulk density, tapped density, hausner ratio. Results of all these parameters were quite similar in all layers, which showed that change in disintegrant concentration does not affect the flow ability of granules to much extent. After compression, tablets were further subjected to weight variation, hardness, thickness, friability, disintegration, dissolution studies and FTIR. In vitro drug release data of all formulations were studied which showed that all the formulations exhibited zero order release. Results indicated that H8 had the best results in terms of physicochemical properties, assay and dissolution studies. The external morphology of formulations were further analyzed using scanning electron microscopy and differential scanning calorimetry. Triple layered tablet was successfully developed and characterized.

Determining the release kinetics of risperidone controlled release matrices to treat schizophrenia.

Risperidone is an atypical antipsychotic agent clinically used to treat schizophrenia, bipolar diseases, and autism. Usually, the frequency of doses is twice daily. In the present study, risperidone controlled release matrices formulated using hydrophilic and hydrophobic polymers. The tablets were prepared by direct compression. The pre-compression and post-compression properties were assessed, along with swelling studies. The morphology of particles observed using scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FT-IR). The stability study on the drug was performed using thermal gravimetric analysis (TGA) and differential thermal analysis (DTA). The optimized formulation was prepared with the help of hydrophilic polymer K100M (40% ratio). Furthermore, release kinetics had investigated. The release pattern of optimized formulation FT5 fitted best to zero-order kinetics and showed excellent release characteristics. The model-independent approach had been used, formulations FT6 and FT8 showed resemblance with FT5 in all three media, respectively. The once daily formulation of risperidone could be beneficial for schizophrenia patients and their caregivers and will improve patient compliance.

Inhibition of Hepatitis B Virus with the Help of CRISPR/Cas9 Technology.

Hepatitis B infection caused by hepatitis B virus (HBV) is a serious health issue worldwide. Existing therapeutic strategies hardly eradicate HBV infections, and they fail to attain complete cure. Advanced treatment strategies are urgently needed to successfully terminate further spread of HBV infection and eliminate hidden reservoirs of virus. Recently, a novel RNA-guided gene editing tool, known as the clustered regularly interspaced short palindromic repeats/CRISPR-associated nuclease 9 (CRISPR/Cas9) system, has been established. It facilitates site-specific mutagenesis and reveals a new way to develop applicable techniques for disease treatment, such as extermination of infectious agents like HBV This study highlights the current developments in CRISPR/Cas9 technology and its importance for target-specific inhibition of HBV genome. Benefits, challenges, feasible solutions, and proposed guidelines for forthcoming study in CRISPR/Cas9 are described to highlight the possible cures of and treatments for chronic HBV infection.

Potent α-amylase inhibitors and radical (DPPH and ABTS) scavengers based on benzofuran-2-yl(phenyl)methanone derivatives: Syntheses, in vitro, kinetics, and in silico studies.

Thirty benzofuran-2-yl(phenyl)methanones 1-30 were synthesized and characterized their structures by spectroscopic techniques. Substituted phenacyl bromide and different derivatives of 2-hydroxy-benzaldehyde treated in the presence of anhydrous K2CO3 in acetonitrile at room temperature to afford the desired benzofurans 1-30. All compounds were screened for their in vitro α-amylase inhibitory and radical scavenging (DPPH and ABTS) activities. Results revealed that para substituted compounds were found to be more active than the others with IC50 values ranges for α-amylase inhibition (IC50 = 18.04-48.33 µM), DPPH (IC50 = 16.04-32.33 µM) and ABTS (IC50 = 16.99-33.01 µM) radical scavenging activities. Activities results were compared with the standards acarbose (IC50 = 16.08 ± 0.07 µM) for α-amylase, ascorbic acid (IC50 = 15.08 ± 0.03 and 15.09 ± 0.17 µM) for DPPH and ABTS radical scavenging activities, respectively. Kinetic studies predicted that all compounds followed non-competitive mechanism of inhibition. Molecular docking results showed good protein-ligand interactions profile against the corresponding target. To the best of our knowledge, out of thirty molecules, ten compounds 18-20, 22, and 25-30 were structurally new.

Pharmacists' viewpoint towards their professional role in healthcare system: a survey of hospital settings of Pakistan.

BACKGROUND: Pharmacy service is an essential part of a healthcare system. The profession of pharmacy is well recognized and is practiced to its full potential in developed countries however, it is underutilized in developing countries such as Pakistan. The recognition of pharmacist's role as healthcare professional is limited. This study aimed to document pharmacists' attitude towards their role in Pakistan's healthcare system, their experience with doctors and their perceptions towards involvement in medicines management. METHODS: A 4-month cross-sectional survey (Jan - Apr 18) was conducted targeting pharmacists practising in 26 tertiary care hospitals across Pakistan using a developed and validated questionnaire in both Urdu/English languages. Chi square (χ2) test was used to report any associations between independent variables, i.e., education, type of hospital and work experience and, dependent variables, i.e., pharmacists' attitudes, experience, and perception. A p-value of ≤0.01 with value of Cramer's V ≥ 0.3 was considered cut-off for establishing statistical significance. The study was approved by ethical committee and local hospital committees. RESULTS: Three hundred ninety-six questionnaires were returned out of 500, i.e., response rate = 87.9%. Most participants (92.2%) interacted with doctors at least once daily. Most interactions were related to drug availability inquiry (72.5%). Most pharmacists (91.4%) mentioned that pharmacy duties are mostly clinical in nature. 93.4% of the respondents indicated that pharmacists are reliable source of information regarding general medicines. Furthermore, 87.4% reasoned inadequate training for not being able to discuss issues of clinical nature with doctors. CONCLUSION: Pharmacists were willing to perform their duties and provide healthcare benefits to patients however, they seemed sceptical of advanced clinical pharmacy roles such as intervening in prescriptions and medication therapy, consultations and prescribing. There is a need to increase awareness regarding pharmacist's role. Therefore, it would be helpful if trainings and seminars are conducted on the importance of clinical pharmacy to improve the pharmacy services in Pakistan's healthcare system.

Modeling of Cu(II) Adsorption from an Aqueous Solution Using an Artificial Neural Network (ANN).

This research optimized the adsorption performance of rice husk char (RHC4) for copper (Cu(II)) from an aqueous solution. Various physicochemical analyses such as Fourier transform infrared spectroscopy (FTIR), field-emission scanning electron microscopy (FESEM), carbon, hydrogen, nitrogen, and sulfur (CHNS) analysis, Brunauer-Emmett-Teller (BET) surface area analysis, bulk density (g/mL), ash content (%), pH, and pHZPC were performed to determine the characteristics of RHC4. The effects of operating variables such as the influences of aqueous pH, contact time, Cu(II) concentration, and doses of RHC4 on adsorption were studied. The maximum adsorption was achieved at 120 min of contact time, pH 6, and at 8 g/L of RHC4 dose. The prediction of percentage Cu(II) adsorption was investigated via an artificial neural network (ANN). The Fletcher-Reeves conjugate gradient backpropagation (BP) algorithm was the best fit among all of the tested algorithms (mean squared error (MSE) of 3.84 and R2 of 0.989). The pseudo-second-order kinetic model fitted well with the experimental data, thus indicating chemical adsorption. The intraparticle analysis showed that the adsorption process proceeded by boundary layer adsorption initially and by intraparticle diffusion at the later stage. The Langmuir and Freundlich isotherm models interpreted well the adsorption capacity and intensity. The thermodynamic parameters indicated that the adsorption of Cu(II) by RHC4 was spontaneous. The RHC4 adsorption capacity is comparable to other agricultural material-based adsorbents, making RHC4 competent for Cu(II) removal from wastewater.

Assessing quality of life using WHOQOL-BREF: A cross-sectional insight among patients on warfarin in Malaysia.

BACKGROUND AND AIM: The effect of anticoagulation control on overall Health-Related Quality of Life (HRQoL) in patients taking warfarin in Malaysia has not been explored yet. Therefore, this study aimed to evaluate HRQoL among patients on warfarin in Malaysia. METHODS: HRQoL among patients on warfarin was measured using WHOQOL-BREF (World Health Organization Quality of life Assessment: Brief Version). Descriptive and inferential statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 22. RESULTS: Out of 319 patients, more female patients were observed than the males (n = 221, 69.3%, and n = 98, 30.7% respectively). Mean scores for the physical (61.14 ± 15.96), psychological (68.58 ± 16.11), social (63.55 ± 27.06) and environmental domains (62.78 ± 17.58) were observed. Statistically, a significant association was found between the comorbidities other than CVDs with health satisfaction (p = 0.002), physical (p = 0.001), psychological (p < 0.001), social (p = 0.003) and environmental domains of the WHOQOL-BREF. A weak positive correlation between overall health satisfaction and the social domain (r = 0.153) and a moderate positive correlation between the physical and environmental domains (r = 0.628) of the WHOQOL-BREF were observed. CONCLUSION: Patients had overall better perceived HRQoL scores in the psychological domain as compared with the rest of the domains of the WHOQOL-BREF. Age, gender, employment status, education level, the indication of use and duration of warfarin therapy associated with overall perceived HRQoL.