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BACKGROUND: The ever-evolving healthcare system of today demands physicians who steer their roles as treatment providers, managers and collaborators. Professionals are highly interdependent due to increased complexity of health problems and risk of errors increases with transitions in care. In hospitals, the main workforce is postgraduate residents; therefore, intraprofessional collaboration amongst residents is essential. Several instruments are available to evaluate interprofessional collaboration amongst physicians, nurses and hospital teams but none specifically assessed intra-professional collaborative practices amongst residents working in tertiary care hospitals in multi-disciplinary teams. This study intends to develop and validate an instrument to self-assess intraprofessional collaborative practices in postgraduate residents undergoing residency in multiple specialties at tertiary care hospitals. APPROACH: This study on Instrument Development employed mixed method study design executed in two phases. In phase 1, six domains of intraprofessional collaborative practices were identified from literature and 35 items were developed. Fifteen experts participated in qualitative content validation and provided comments. To establish content validity in phase 2, content validity index (CVI) and content clarity average (CCA) were assessed by seventeen experts. Response process validity was established by cognitive interviewing of 5 postgraduate residents. Pilot testing was done on a sample of 407 residents. Cronbach's alpha was determined, and confirmatory factor analysis established construct validity. RESULTS: During phase 1, items were modified based on qualitative feedback from 15 experts. In round 2, CVI and CCA were determined based on responses of 17 experts. The items having an I-CVI greater than 0.90 were accepted and six items underwent modifications as their I-CVI fell between 0.78 and 0.90. Similarly, four items with a CCA of less than 2.4 were modified to increase clarity. Cognitive interviews of participants on 30 items resulted in the deletion of 1 item and changes in 5 items. The final instrument had 29 items categorized under six constructs. All items had good factor loadings during CFA, so none was deleted. Cronbach's Alpha α was 0.937. CONCLUSION: Intraprofessional collaborative practices in residents is a valid and reliable self-assessment tool comprising 29 items measuring six constructs. It may be used by residents to assess their collaborative practices and incorporated in curricula to help develop collaborative practices and their assessment during training of postgraduate residents.
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Comportamento Cooperativo , Internato e Residência , Autoavaliação (Psicologia) , Centros de Atenção Terciária , Humanos , Relações Interprofissionais , Reprodutibilidade dos Testes , Educação de Pós-Graduação em Medicina , Feminino , Masculino , Inquéritos e Questionários , Equipe de Assistência ao PacienteRESUMO
OBJECTIVE: To use Raman Spectroscopy for qualitative and quantitative evaluation of pharmaceutical formulations of active pharmaceutical ingredient (API) of Cephalexin. SIGNIFICANCE: Raman Spectroscopy is a noninvasive, nondestructive, reliable and rapid detection technique used for various pharmaceutical drugs quantification. The present study explores the potential of Raman Spectroscopy for quantitative analysis of pharmaceutical drugs. METHOD: For qualitative and quantitative analysis of Cephalexin API, various standard samples containing less and more concentration of API than commercial tablet was prepared. To study spectral differences, the mean plot of all the samples was prepared. For qualitative analysis, Principal Component Analysis (PCA) and for quantitative analysis Partial Least Square Regression analysis (PLSR) was used. Both of these are Multivariate data analysis techniques and give reliable results as published in previous literature. RESULTS: PCA model distinguished all the Raman Spectral data related to the various Cephalexin solid dosage formulations whereas the PLSR model was used to calculate the concentration of different unknown formulations. For the PLSR model, RMSEC and RMSEP were determined to be 3.3953 and 3.8972, respectively. The prediction efficiency of this built PLSR model was found to be very good with a goodness of the model value (R2) of 0.98. The PLSR model also predicted the concentrations of Cephalexin formulations in the blind or unknown sample. CONCLUSION: These findings demonstrate that the Raman spectroscopy coupled to PLSR analysis could be regarded as a fast and effectively reliable tool for quantitative analysis of pharmaceutical drugs.
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Cefalexina , Análise Espectral Raman , Análise Espectral Raman/métodos , Quimiometria , Composição de Medicamentos , Comprimidos/química , Análise dos Mínimos QuadradosRESUMO
OBJECTIVE: To determine whether individuals in the United States who speak languages other than English (LOE) are excluded from federally funded pediatric clinical trials and whether such trials adhere to the National Institutes of Health policy regarding inclusion of members of minority groups. STUDY DESIGN: Using ClinicalTrials.gov, we identified all completed, federally funded, US-based trials inclusive of children ≤17 and focused on one of 4 common chronic childhood conditions (asthma, mental health, obesity, and dental caries) as of June 18, 2019. We reviewed ClinicalTrials.gov online content, as well as published manuscripts linked to ClinicalTrials.gov entries, to abstract information about language-related exclusion criteria. Trials were deemed to exclude LOE participants/caregivers if explicit statements regarding exclusion were identified in the study protocol or published manuscript. RESULTS: Of total, 189 trials met inclusion criteria. Two-thirds (67%) did not address multilingual enrollment. Of the 62 trials that did, 82% excluded LOE individuals. No trials addressed the enrollment of non-English, non-Spanish-speaking individuals. In 93 trials with nonmissing data on ethnicity, Latino individuals comprised 31% of participants in trials that included LOE individuals and 14% of participants in trials that excluded LOE individuals. CONCLUSIONS: Federally funded pediatric trials in the United States do not adequately address multilingual enrollment, a seeming violation of federal and contractual requirements for accommodation of language barriers by entities receiving federal funding.
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Ensaios Clínicos como Assunto , Idioma , Participação do Paciente , Criança , Humanos , Etnicidade , Hispânico ou Latino , Grupos Minoritários , Estados Unidos , Seleção de PacientesRESUMO
This work reports on the synthesis of aspartic acid-functionalized graphene oxide-zinc oxide, as a functional porous material, and its potential to mitigate levofloxacin (LFXN). The adsorbent was characterized by various techniques, including ultraviolet-visible (UV-Vis), Fourier transform infrared (FT-IR) spectroscopy, powder X-ray diffraction (PXRD), and scanning electron microscopy (SEM). The average crystallite size of the prepared composite was about 17.30 nm. Batch adsorption studies were carried out to elucidate the adsorption process for LFXN. Different parameters, including contact time, LFXN initial concentration, adsorbent concentration, pH, temperature, and ionic strength were studied. The mechanism and kinetics were studied by fitting the data to Freundlich and Langmuir isotherms, pseudo-first-order and pseudo-second-order kinetic models, respectively. The isotherm data was better fitted to Langmuir isotherm (R2 = 0.999) as compared to the Freundlich model. The maximum adsorption capacity obtained at equilibrium was 73.15 mg/g. For kinetic studies, Pseudo first order was better fitted with R2 = 0.87797, confirming the physisorption process. Thermodynamics parameters revealed that the process was exothermic and spontaneous at low temperatures. The adsorption mechanism was studied and the impregnation of LFXN in the adsorbent was confirmed by FTIR studies. This research proved that the designed GO/Asp-ZnO was a novel and promising adsorbent for the removal of LFXN with an efficiency of 95.12% at 30 mg/L LFXN by 0.6 g/L adsorbent in 24 h at pH = 7 and T = 25 °C.
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Poluentes Químicos da Água , Óxido de Zinco , Óxido de Zinco/química , Levofloxacino , Adsorção , Cinética , Espectroscopia de Infravermelho com Transformada de Fourier , Água , Termodinâmica , Poluentes Químicos da Água/análise , Concentração de Íons de HidrogênioRESUMO
Forecasts are valuable to countries to make informed business decisions and develop data-driven strategies. The production of pulses is an integral part of agricultural diversification initiatives because it offers promising economic opportunities to reduce rural poverty and unemployment in developing countries. Pulses are the cheapest source of protein needed for human health. India's pulses production guidelines must be based on accurate and best forecast models. Comparing classical statistical and machine learning models based on different scientific data series is the subject of high-level research today. This study focused on the forecasting behaviour of pulses production for India, Karnataka, Madhya Pradesh, Maharashtra, Rajasthan and Uttar Pradesh. The data series was split into a training dataset (1950-2014) and a testing dataset (2015-2019) for model building and validation purposes, respectively. ARIMA, NNAR and hybrid models were used and compared on training and validation datasets based on goodness of fit (RMSE, MAE and MASE). This research demonstrates that due to the diverse agricultural conditions across different provinces in India, there is no single model that can accurately predict pulse production in all regions. This study's highest accuracy model is ARIMA. ARIMA outperforms NNAR, a machine learning model. Pulse production in India, Rajasthan, and Madhya Pradesh will expand by 26.11%, 12.62%, and 0.51% from 2020 to 2030, whereas it would decline by - 6.5%, - 6.21%, and - 6.76 per cent in Karnataka, Maharashtra, and Uttar Pradesh, respectively. The current forecast results could allow policymakers to develop more aggressive food security and sustainability plans and better Indian pulses production policies in the future.
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Femtosecond laser has been introduced in refractive surgery to create a thin-hinged corneal flap without using any blade. The current review was planned to analyse and compare femtosecond-assisted laser in-situ keratomileusis (LASIK), the latest refractive procedure, with conventional techniques in refractive surgery. The analysis showed that femtosecond-assisted LASIK yielded more predictable corneal flaps, lesser ocular aberrations, better uncorrected visual acuity, lesser variations in intraocular pressure (IOP) and fewer chances of developing dry eyes. Transient light sensitivity, diffuse lamellar keratitis, opaque bubble layer, corneal haze and rainbow glare are some of the demerits of femtosecond-assisted LASIK, but these can be prevented with certain precautions. The early visual rehabilitation and preservation of corneal anatomy are added benefits in the long run. Though it is expensive currently, the competition in market is expected to cut down the cost soon.
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Ceratomileuse Assistida por Excimer Laser In Situ/instrumentação , Complicações Pós-Operatórias/epidemiologia , Ofuscação , Humanos , Ceratite/epidemiologia , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Fotofobia/epidemiologia , Procedimentos Cirúrgicos Refrativos/instrumentação , Procedimentos Cirúrgicos Refrativos/métodosRESUMO
Autism spectrum disorders (ASD) are characterized by social impairments and restricted/stereotyped behaviors and currently affect an estimated 1 in 68 children aged 8 years old. While there has been substantial recent focus on ASD in research, both the biological pathology and, perhaps consequently, a fully effective treatment have yet to be realized. What has remained throughout is the hypothesis that ASD has neurobiological underpinnings and the observation that both the phenotypic expression and likely the underlying etiology is highly heterogeneous. Given the neurodevelopmental basis of ASD, a biologically based marker (biomarker) could prove useful not only for diagnostic and prognostic purposes, but also for stratification and response indices for pharmaceutical development. In this review, we examine the current state of the field for MEG-related biomarkers in ASD. We describe several potential biomarkers (middle latency delays [M50/M100], mismatch negativity latency, gamma-band oscillatory activity), and investigate their relation to symptomology, core domains of dysfunction (e.g., language impairment), and putative biological underpinnings.
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Transtorno do Espectro Autista/fisiopatologia , Biomarcadores/metabolismo , Fenômenos Eletrofisiológicos , Magnetoencefalografia , Animais , Modelos Animais de Doenças , Humanos , IdiomaRESUMO
Enzyme immobilization on solid support offers advantages over free enzymes by overcoming characteristic limitations. To synthesize new stable and hyperactive nano-biocatalysts (co-precipitation method), ginger peroxidase (GP) was surface immobilized (adsorption) on ZnO/SnO2 and ZnO/SnO2/SA nanocomposite with immobilization efficacy of 94 % and 99 %, respectively. Thereafter, catalytic and biochemical characteristics of free and immobilized GP were investigated by deploying various techniques, i.e., FTIR, PXRD, SEM, and PL. Diffraction peaks emerged at 2θ values of 26°, 33°, 37°, 51°, 31°, 34°, 36°, 56°, indicating the formation of SnO2 and ZnO. The OH stretching of the H2O molecules was attributed to broad peaks between 3200 and 3500 cm-1, whereas ZnO/SnO2 spikes occurred in the 1626-1637 cm-1 range. SnO stretching mode and ZnO terminal vibrational patterns have been verified at corresponding wavelengths of 625 cm-1 and 560 cm-1. Enzyme entrapment onto substrate was verified via interactions between GP and ZnO/SnO2/SA as corroborated by signals beneath 1100 cm-1. GP-immobilized fractions were optimally active at pH 5, 50 °C, and retained maximum activity after storage of 4 weeks at -4 °C. Kinetic parameters were determined by using a Lineweaver-Burk plot and Vmax for free GP, ZnO/SnO2/GP and ZnO/SnO2/SA/GP with guaiacol as a substrate, were found to be 322.58, 49.01 and 11.45 (µM/min) respectively. A decrease in values of Vmax and KM indicates strong adsorption of peroxidase on support and maximum affinity between nano support and enzyme, respectively. For environmental remediation, free ginger peroxidase (GP), ZnO/SnO2/GP and ZnO/SnO2/SA/GP fractions effectively eradicated highly intricate dye. Multiple scavengers had a significant impact on the depletion of the dye. In conclusion, ZnO/SnO2 and ZnO/SnO2/SA nanostructures comprise an ecologically acceptable and intriguing carrier for enzyme immobilization.
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Nanocompostos , Óxido de Zinco , Peroxidase/química , Óxido de Zinco/química , Alginatos/química , Nanocompostos/química , Peroxidases , Enzimas Imobilizadas/química , ÁguaRESUMO
Evaluation of the controlled release of ciprofloxacin (CIP.HCl) and the antibacterial efficacy of alginate (ALG)-based nanocarriers constitute the primary objectives of the current work. Herein, ALG-based nano-structures were prepared by the co-precipitation method and thoroughly analyzed using different characterization techniques, i.e., fourier transform infrared (FT-IR), powder X-ray diffraction (PXRD), scanning electron microscopy (SEM) and zeta potential (ZP). The intense peaks emerged at 500, 545, and 750 cm-1 due to the CeO bond. Peaks that appeared at 550-600 cm-1 and 525 cm-1 are due to the stretching vibrations of FeO and ZnO bonds, respectively. Lowering of the peaks from 1640 to 1630 cm-1 and 1420 to 1384 cm-1 were observed in ALG-based nanocomposite (NC) due to the interaction of ALG with metal oxides (MO), which confirmed the formulation of CeO2/ZnFe2O4/ALG nanocomposite. The diffraction peaks at 28.6°, 56.6°, 76.5°, 37°, 47.9°, 62.3°, 74°, 13°, 21° confirmed the synthesis of MO (crystallite size 15.74 nm) and CeO2/ZnFe2O4/ALG (12 nm). In accordance with morphological studies, CeO2/ZnFe2O4 oxides had a uniform distribution throughout the relatively smooth and permeable surface of the ALG-based NC. Ciprofloxacin (CIP) was used as a model drug. Negative values of ZP revealed that CIP-loaded nanocomposite (CeO2/ZnFe2O4/ALG/CIP) had more stability than CeO2/ZnFe2O4/ALG. The maximum percentage of loading around 25 % on ALG NC was examined using the optical density (OD) method at pH 5.5. Correlation coefficients from the first order (0.971), Korsmeyer (0.9858), and Hixson (0.9021) models show the best-fitted models of the release profile in all circumstances. The release mechanism was investigated using various kinetics models. The controlled drug released was observed around 17 % at 40 °C after 3 h at pH 7.4, which is almost identical to the body temperature of a human, which is 37 °C. Similarly, after 24 h, sustained and controlled in-vitro release of the drug was studied, and it was 37, 72, and 74 % at pH 2.2, 7.4, and 9.4, respectively. Thus, prepared ALG-based NC is suitable for the controlled in-vitro release of (CIP.HCl). Metal oxides (CeO2/ZnFe2O4) and ALG-based nanocomposite (CeO2/ZnFe2O4/ALG) showed great antibacterial activity against Staphylococcus aureus (S. aureus) like 15 mm and 14 mm than Escherichia coli (E. coli).
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Alginatos , Antibacterianos , Ciprofloxacina , Portadores de Fármacos , Alginatos/química , Antibacterianos/farmacologia , Antibacterianos/química , Portadores de Fármacos/química , Ciprofloxacina/química , Ciprofloxacina/farmacologia , Liberação Controlada de Fármacos , Nanocompostos/química , Staphylococcus aureus/efeitos dos fármacos , Nanopartículas/química , Sistemas de Liberação de Medicamentos , Espectroscopia de Infravermelho com Transformada de Fourier , Testes de Sensibilidade Microbiana , Escherichia coli/efeitos dos fármacos , Difração de Raios XRESUMO
Methicillin-resistant Staphylococcus aureus (MRSA) is gram positive bacteria and leading cause of a wide variety of diseases. It is a common cause of hospitalized and community-acquired infections. Development of increasing antibiotic-resistance by methicillin-resistant S. aureus (MRSA) strains demand to develop alternate novel therapies. Bacteriophages are now widely used as antibacterial therapies against antibiotic-resistant gram-positive pathogens. So, there is an urgent need to find fast detection techniques to point out phage susceptible and resistant strains of methicillin-resistant S. aureus (MRSA) bacteria. Samples of two separate strains of bacteria, S. aureus, in form of pellets and supernatant, were used for this purpose. Strain-I was resistant to phage, while the other (strain-II) was sensitive. Surface Enhanced Raman Spectroscopy (SERS) has detected significant biochemical changes in these bacterial strains of pellets and supernatants in the form of SERS spectral features. The protein portion of these two types of strains of methicillin-resistant S. aureus (MRSA) in their relevant pellets and supernatants is major distinguishing biomolecule as shown by their representative SERS spectral features. In addition, multivariate data analysis techniques such as principal component analysis (PCA) and a partial least squares-discriminant analysis (PLS-DA) were found to be helpful in identifying and characterizing various strains of S. aureus which are sensitive and resistant to bacteriophage with 100% specificity, 100% accuracy, and 99.8% sensitivity in case of SERS spectral data sets of bacterial cell pellets. Moreover, in case of supernatant samples, the results of PLS-DA model including 95.5% specificity, 96% sensitivity, and 96.5% accuracy are obtained.
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Bacteriófagos , Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Humanos , Staphylococcus aureus , Análise Espectral Raman , Antibacterianos/farmacologia , Infecções Estafilocócicas/microbiologia , Testes de Sensibilidade MicrobianaRESUMO
Raman spectroscopy is reliable tool for analyzing and exploring early disease diagnosis related to body fluids, such as blood serum, which contain low molecular weight fraction (LMWF) and high molecular weight fraction (HMWF) proteins. The disease biomarkers consist of LMWF which are dominated by HMWF hence their analysis is difficult. In this study, in order to overcome this issue, centrifugal filter devices of 30 kDa were used to obtain filtrate and residue portions obtained from whole blood serum samples of control and breast cancer diagnosed patients. The filtrate portions obtained in this way are expected to contain the marker proteins of breast cancer of the size below this filter size. These may include prolactin, Microphage migration inhabitation factor (MIF), γ-Synuclein, BCSG1, Leptin, MUC1, RS/DJ-1 present in the centrifuged blood serum (filtrate portions) which are then analyzed by the SERS technique to recognize the SERS spectral characteristics associated with the progression of breast cancer in the samples of different stages as compared to the healthy ones. The key intention of this study is to achieve early-stage breast cancer diagnosis through the utilization of Surface Enhanced Raman Spectroscopy (SERS) after the centrifugation of healthy and breast cancer serum samples with Amicon ultra-filter devices of 30 kDa. The silver nanoparticles with high plasmon resonance are used as a substrate for SERS analysis. Principal Component Analysis (PCA) and Partial Least Discriminant Analysis (PLS-DA) models are utilized as spectral classification tools to assess and predict rapid, reliable, and non-destructive SERS-based analysis. Notably, they were particularly effective in distinguishing between different SERS spectral groups of the cancerous and non-cancerous samples. By comparing all these spectral data sets to each other PLSDA shows the 79 % accuracy, 76 % specificity, and 81 % sensitivity in samples with AUC value of AUC = 0.774 SERS has proven to be a valuable technique for the rapid identification of the SERS spectral features of blood serum and its filtrate fractions from both healthy individuals and those with breast cancer, aiding in disease diagnosis.
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Neoplasias da Mama , Nanopartículas Metálicas , Humanos , Feminino , Neoplasias da Mama/diagnóstico , Análise Espectral Raman/métodos , Nanopartículas Metálicas/química , Soro , Prata/química , Análise de Componente PrincipalRESUMO
LSD is an important transboundary disease affecting the cattle industry worldwide. The objectives of this study were to determine trends and significant change points, and to forecast the number of LSD outbreak reports in Africa, Europe, and Asia. LSD outbreak report data (January 2005 to January 2022) from the World Organization for Animal Health were analyzed. We determined statistically significant change points in the data using binary segmentation, and forecast the number of LSD reports using auto-regressive moving average (ARIMA) and neural network auto-regressive (NNAR) models. Four significant change points were identified for each continent. The year between the third and fourth change points (2016-2019) in the African data was the period with the highest mean of number of LSD reports. All change points of LSD outbreaks in Europe corresponded with massive outbreaks during 2015-2017. Asia had the highest number of LSD reports in 2019 after the third detected change point in 2018. For the next three years (2022-2024), both ARIMA and NNAR forecast a rise in the number of LSD reports in Africa and a steady number in Europe. However, ARIMA predicts a stable number of outbreaks in Asia, whereas NNAR predicts an increase in 2023-2024. This study provides information that contributes to a better understanding of the epidemiology of LSD.
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Doença Nodular Cutânea , Vírus da Doença Nodular Cutânea , Animais , Bovinos , África/epidemiologia , Ásia/epidemiologia , Surtos de Doenças/veterinária , Europa (Continente)/epidemiologia , Doença Nodular Cutânea/epidemiologia , Fatores de TempoRESUMO
BACKGROUND: Melasma is a very common skin problem that is much more prevalent in women. In our society, it results in many psycho-social implications and eventually leads to an impaired quality of life. Many treatment modalities have been developed for it. However, in recent years resistant forms of melasma have emerged that are unresponsive to the usual first line treatment options. Thus, this study is being conducted to explore new treatment modalities for this disease by using micro-needling with vitamin C and tranexamic acid. METHODS: Thirty patients participated in this non-randomized clinical trial including 11 males and 19 females. All patients received Tranexamic acid via micro-needling on right side of the face and Vitamin C on the left side. A total of three biweekly sessions were performed. Patients' response was evaluated at week 2, 4 and 6 on the basis of Physician Global Assessment, Patient Global Assessment, modified Melasma Area Severity Index and clinical assessment. Paired sample t-tests were used to calculate the difference in the means of two groups at 2, 4 and 6 weeks and p-value of <0.05 was considered significant. RESULTS: After first session, there was more improvement observed with tranexamic acid. At the end of 6 weeks, modified Melasma Area Severity Index, Physician Global Assessment and Patient Global Assessment showed significant improvement with both tranexamic acid and vitamin C. However, the difference between them was not statistically significant (p>0.05). CONCLUSIONS: Both Tranexamic acid and Vitamin C are potent therapies for melasma as an adjuvant to micro-needling.
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Melanose , Ácido Tranexâmico , Ácido Ascórbico/uso terapêutico , Feminino , Humanos , Masculino , Melanose/tratamento farmacológico , Qualidade de Vida , Ácido Tranexâmico/uso terapêutico , Resultado do TratamentoRESUMO
Chitosan (CS)/metal oxide (MO) nano-carriers have recently attracted attention due to their great integration into several biomedical applications. Herein, CS and dysprosium oxide based bio-nanocomposites (Dy2O3/CuFe3O4/CS) were prepared using a citrate sol-gel route for biomedical settings at large and drug delivery, in particular. The chemical structure, average crystallite size, and surface morphology of Dy2O3/CuFe3O4/CS bio-nanocomposites were characterized using spectroscopic techniques, including FT-IR, PXRD, and SEM. The prepared nano composite's drug loading or release kinetics were investigated by FT-IR, zeta potential (ZP), and ultraviolet-visible spectroscopy (UV-Vis). In the FT-IR spectrum, the peaks in the range of 800-400 cm-1 confirmed the formation of meta-oxides, while amide bands at 1661 and 1638 cm-1 revealed the existence of CS in the bio-nanocomposite. The peaks at 2θ = 35.46 and 28.5, 39.4 indicated the presence and chemical interaction of Dy2O3 and CuFe3O4, respectively. The crystallite size was <20 nm. The model drug used in the loading and in vitro release assays was ciprofloxacin hydrochloride. Ciprofloxacin's CF stretch caused a modest peak to be seen at 1082 cm-1 and changed in zeta potential value from 7.90 mV to 8.88 mV endorsing that the drug had been loaded onto the nanomaterial. The loading efficiency (%) of CIP onto the composite was from 25 to 30 %, calculated from optical density measurements. Different kinetic models, such as zero-order, first-order, Higuchi, Hixon-Crowell, and Korsmeyer-Peppas, were determined to confirm the drug release mechanism. The percent (%) of drug release from the surface of Dy2O3/CuFe3O4/CS in PBS (pH 7.4), acidic (pH 2.2) and basic (pH 9.4) dissolution media were found to be 70, 28 and 20 %, respectively. Drug kinetics showed that mainly the release is fickian type followed "Fick's law of diffusion", slightly deviated from fickian release (dissolution-dependent system). Korsmeyer-Peppas (R2 0.9773, n < 0.4) and Higuchi's (R2 0.9846) models were the best for fitting controlled drug release data. The results revealed that the Dy2O3/CuFe3O4/CS bio-nanocomposite has good potential for a controlled drug delivery system.
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Quitosana , Nanocompostos , Amidas , Quitosana/química , Ciprofloxacina/química , Citratos , Portadores de Fármacos/química , Liberação Controlada de Fármacos , Cinética , Nanocompostos/química , Óxidos , Espectroscopia de Infravermelho com Transformada de FourierRESUMO
BACKGROUND: Acne vulgaris (AV) is an inflammatory disorder of pilosebaceous unit and it affects over 85% of teenagers (peak age 17 years) during some point in their lives. Of these 30% have acne severe enough to require medical treatment. The overall incidence is comparable in both genders. Objective was to compare the efficacy of azithromycin plus levamisole with azithromycin alone in the treatment of moderate to severe acne. It was a single centre randomized controlled trial, conducted at the Department of Dermatology at Military Hospital Rawalpindi. METHODS: We selected 118 patients of acne who fulfilled the inclusion criteria from the dermatology outpatient department. Diagnosis was based on clinical features of acne and severity defined using Acne Global Severity Score. The patients were randomly assigned two treatment groups; Patients in group A received Azithromycin 500 mg per day given for 3 days a week plus oral levamisole 150 mg per day was given for 2 days a week for a total of 08 weeks. Group B patients (n= 59) received Azithromycin 500 mg per day given for 3 days a week for a total of 08 weeks. Patients were followed up fortnightly till they completed their treatment. Response to treatment was graded according to the Acne Global Severity Score. Scoring was done at first visit before therapy and after 08 weeks of therapy in both groups. Therapy was considered efficacious if the patients achieved post-therapy reduction of global score below 19 at the end of 8th week of initiation of therapy. RESULTS: Among our 118 study cases, we had 38 male patients while 80 were female patients. The study cases had mean age of 20.10±2.65 years. Mean global severity was 31.25±3.41 while 56 (47.5%) had moderate acne and 62 (52.5%) had severe acne. Efficacy was found to be higher in patients receiving Azithromycin plus levamisole combination. CONCLUSIONS: Azithromycin plus levamisole was observed as a more effective therapy for the treatment of acne as compared to Azithromycin alone. The study supports the administration of combination therapy for the treatment of Acne to achieve desired outcomes in patients.
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Acne Vulgar , Azitromicina , Acne Vulgar/tratamento farmacológico , Adolescente , Adulto , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Feminino , Humanos , Levamisol/uso terapêutico , Masculino , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto JovemRESUMO
Heterotaxy syndrome (HS) or situs ambiguous refers to the abnormal arrangement of viscera across the body axis, and abnormalities arise depending on the isomerism of the right or left atrial appendage. The cause remains unexplained and is attributed to a combination of genetic mutations and environmental factors. It is a rare condition and may remain undiagnosed for a long time. In this report, we aim to highlight an unusual presentation and aggravation of an infection due to the underlying isomerism of the left atrial appendage. We discuss the case of a female patient who presented with symptoms of fever and cough. The patient underwent prolonged antibiotic treatment, and her recovery was slow. The presence of bilobed lungs, vertical left-bronchus, and polysplenia on CT scan explained the left-sided aspiration pneumonia. The hypofunctioning spleen (polysplenia) caused her to have a weak immunological response, necessitating prolonged antibiotic use. She was followed up over time and had a recurrence of pneumonia within a few months. The condition is associated with high morbidity and mortality, and the role of early diagnosis and reporting to prevent complications is paramount. The recurrent pneumonia observed in the patient also raises questions related to long-term antibiotic use and immunization in the case of polysplenia in this patient population.
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In Dec 2019, a novel pathogen emerged, and within weeks, led to the emergence of the biggest global health crises seen to date. The virus called 'SARS-CoV-2', causes coronavirus disease which was named 'COVID-19' by the World Health Organization (WHO). The speedy spread of this infection globally became a source of public worry and several unknowns regarding this new pathogen created a state of panic. Mass media became the major source of information about the novel coronavirus. Much like the previous pandemics of SARS (2003), H1N1 (2009), and MERS (2012), the media significantly contributed to the COVID-19 infodemics. In this review, we analyze the role of mass media and public health communications from December 31, 2019 to July 15, 2020, and make scientific inferences. The COVID-19 pandemic highlights multiple social, cultural, and economic issues arising from the media's arguable role. The racial prejudices linked to the origin of the virus prevented collaborations among scientists to find a solution. Media coverage of coronavirus news during geographical lockdowns, extended quarantines, and financial and social hardships induced fear and caused psychological stress. Domestic and elderly abuse upsurged. The unscientific cures and unverified medicines endorsed by the politicians and fake doctors proved harmful. The media played a worldwide role in coronavirus disease tracking and updates through live updates dashboard. The media allowed for timely interventions by the Center For Disease Control And Prevention (CDC) and the World Health Organization (WHO), enabling a rapid and widespread reach of public health communications. We saw an upward trend for the promotion of health and hygiene practices worldwide by adaption of safe health practices such as increased hand washing, use of face coverings, and social distancing. Media reinforced illness-preventing guidelines daily, and people were encouraged to use telehealth to meet their healthcare needs. Mass media has an imperative role in today's world and it can provide a unified platform for all public health communications, comprehensive healthcare education guidelines, and robust social distancing strategies while still maintaining social connections. It can enable equal access to healthcare, end discrimination, and social stigmatization. The role of media and public health communications must be understood and explored further as they will be an essential tool for combating COVID-19 and future outbreaks.
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Coinheritance of germline mutation in cyclin-dependent kinase inhibitor 2A (CDKN2A) and loss-of-function (LOF) melanocortin 1 receptor (MC1R) variants is clinically associated with exaggerated risk for melanoma. To understand the combined impact of these mutations, we established and tested primary human melanocyte cultures from different CDKN2A mutation carriers, expressing either wild-type MC1R or MC1RLOF variant(s). These cultures expressed the CDKN2A product p16 (INK4A) and functional MC1R. Except for 32ins24 mutant melanocytes, the remaining cultures showed no detectable aberrations in proliferation or capacity for replicative senescence. Additionally, the latter cultures responded normally to ultraviolet radiation (UV) by cell cycle arrest, JNK, p38, and p53 activation, hydrogen peroxide generation, and repair of DNA photoproducts. We propose that malignant transformation of melanocytes expressing CDKN2A mutation and MC1RLOF allele(s) requires acquisition of somatic mutations facilitated by MC1R genotype or aberrant microenvironment due to CDKN2A mutation in keratinocytes and fibroblasts.
Assuntos
Predisposição Genética para Doença , Melanócitos/metabolismo , Melanócitos/efeitos da radiação , Mutação/genética , Receptor Tipo 1 de Melanocortina/genética , Raios Ultravioleta , Adolescente , Adulto , Animais , Células Cultivadas , Senescência Celular/genética , Inibidor de Quinase Dependente de Ciclina p15/genética , Inibidor de Quinase Dependente de Ciclina p15/metabolismo , Dano ao DNA , Feminino , Heterozigoto , Humanos , Masculino , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/metabolismo , Fosforilação/efeitos da radiação , Receptor Tipo 1 de Melanocortina/metabolismo , Proteína do Retinoblastoma/genética , Proteína do Retinoblastoma/metabolismo , Adulto Jovem , beta-Galactosidase/metabolismoRESUMO
Several electrophysiological parameters, including the auditory evoked response component M50/M100 latencies and the phase synchrony of transient and steady-state gamma-band oscillations have been implicated as atypical (to various extents) in autism spectrum disorder (ASD). Furthermore, some hypotheses suggest that an underlying neurobiological mechanism for these observations might be atypical local circuit function indexed by atypical levels of inhibitory neurotransmitter, GABA. This study was a randomized, placebo-controlled, double-blind, escalating-dose, acute investigation conducted in 25 14-18 year-old adolescents with ASD. The study assessed the sensitivity of magnetoencephalography (MEG) and MEGAPRESS "GABA" magnetic resonance spectroscopy (MRS) to monitor dose-dependent acute effects, as well as seeking to define properties of the pre-drug "baseline" electrophysiological and GABA signatures that might predict responsiveness to the GABA-B agonist, arbaclofen (STX-209). Overall, GABA levels and gamma-band oscillatory activity showed no acute changes at either low (15 mg) or high (30 mg) dose. Evoked M50 response latency measures tended to shorten (normalize), but there was heterogeneity across the group in M50 latency response, with only a subset of participants (n = 6) showing significant M50 latency shortening, and only at the 15 mg dose. Findings thus suggest that MEG M50 latency measures show acute effects of arbaclofen administration in select individuals, perhaps reflecting effective target engagement. Whether these subjects have a greater trend towards clinical benefit remains to be established. Finally, findings also provide preliminary support for the use of objective electrophysiological measures upon which to base inclusion for optimal enrichment of populations to be included in full-scale clinical trials of arbaclofen.
RESUMO
OBJECTIVE: To compare the mean change of tooth movement in canine retraction between elastic module and Ni Ti coil spring. STUDY DESIGN: Comparative study. PLACE AND DURATION OF STUDY: Orthodontics Department, Armed Forces Institute of Dentistry, Rawalpindi, from May 2015 to January 2016. METHODOLOGY: Thirty-two patients were inducted. After alignment and extraction of maxillary first premolars, canine retraction was started with closed Ni Ti coil spring on one side of the maxillary arch and with active tie back on the other side. The distance between the lateral incisor and the canine was measured on both sides before starting canine retraction. The same measurements were recorded after four weeks of retraction. The difference between pre and post retraction measurements was recorded. The difference in the rate of canine retraction between both modalities was compared using independent sample t-test. RESULTS: The study included 56% females and 43% males. The mean rate of tooth movement in Ni Ti coil group and in the elastomeric module group was 1.1 mm and 0.7 mm in one month, respectively (p=0.05). CONCLUSION: The rate of tooth movement is more rapid with Ni Ti coil spring than with the elastomeric module.