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BACKGROUND: Truncus arteriosus is a rare CHD. Neonatal and early infancy repair is recommended though some cases may present late. The aim of our study is to investigate the current results of truncus arteriosus repair and to analyse the differences in outcome and reintervention need between early versus late truncus arteriosus surgical repair. MATERIAL AND METHODS: In this cohort study, we reviewed all children who underwent truncus arteriosus repair from 2001 till 2021. We divided patients into two groups; early repair group including patients repaired at age less than 3 months and late repair group including patients who had repair at 3 months of age and later. We compared both groups for outcome variables. RESULTS: Sixty-four children had truncus arteriosus repair including 48(75%) patients in early repair and 16(25%) patients in late repair groups. Peri-operative course was comparable between both groups. Post-surgery, we observed pulmonary hypertension in 6(12%) patients in early repair group comparing with 11(69%) patients in late repair group (p = 0.0001). In the last follow-up visit, pulmonary hypertension resolved in all early repair group patients while 6(37.5%) patients in late repair group continued to have pulmonary hypertension (p = 0.0001). Twenty-three(36%) patients required reintervention including 22(48%) in early repair group versus 1(6%) in late repair group (p = 0.007). CONCLUSION: In general, the outcome of early truncus arteriosus repair is excellent with resolution of pulmonary hypertension following early repair. Late repair caries higher risk of persistent pulmonary hypertension (37.5%). About one-third of the patients who had truncus arteriosus repair will require re-intervention within 38±38.4 months after initial surgery.
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Hipertensión Pulmonar , Tronco Arterial Persistente , Niño , Estudios de Cohortes , Estudios de Seguimiento , Cardiopatías Congénitas , Humanos , Hipertensión Pulmonar/cirugía , Lactante , Recién Nacido , Reoperación , Resultado del Tratamiento , Tronco Arterial/cirugía , Tronco Arterial Persistente/cirugíaRESUMEN
BACKGROUND: Epidemiological studies of insomnia in the Middle East remain scarce. The present study aimed to estimate the prevalence of insomnia and explore its associations in the general population of Qatar. With almost 100 nationalities, Qatar is one of the most culturally diverse, richest, and fastest developing countries in the Arabian Peninsula. METHODS: A probability sample of community-dwelling adults were surveyed in February of 2019. A total of 1611 respondents completed face-to-face interviews in Arabic or English. Logistic regression modeled associations with insomnia, our dependent variable, as defined by a score of ≤16 on the eight-item Sleep Condition Indicator or according to criteria for insomnia in the Diagnostic & Statistical Manual of Mental Disorders, fifth edition or DSM-5. RESULTS: Approximately, 5.5% of the sample screened positive for insomnia and the 30-day prevalence of those who met all the DSM-5 criteria for insomnia disorder was 3.0%. In addition, 2.0% of the sample screened positive for depression and 3.4% for anxiety in the past 2 weeks. Multivariable analysis showed the following were significantly associated with insomnia: Arab ethnicity, young age, unemployment, being married, having less than high school education, fair or poor health, anxiety, and depression. CONCLUSIONS: Insomnia prevalence was in the lower range of previously reported DSM-defined estimates from developed Western countries. Our findings highlight the need for raising awareness and improving sleep hygiene in potential risk groups such as younger adults and those of Arab ethnicity, in addition to incorporating insomnia screening in the provision of mental health services.
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Trastornos del Inicio y del Mantenimiento del Sueño , Adulto , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Humanos , Medio Oriente , Prevalencia , Qatar/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/diagnóstico , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiologíaRESUMEN
OBJECTIVE: To determine the value of MRI for the detection and assessment of the anatomic extent of residual sarcoma after a Whoops procedure (unplanned sarcoma resection) and its utility for the prediction of an incomplete second resection. MATERIALS AND METHODS: This study included consecutive patients who underwent a Whoops procedure, successively followed by gadolinium chelate-enhanced MRI and second surgery at a tertiary care sarcoma center. RESULTS: Twenty-six patients were included, of whom 19 with residual tumor at the second surgery and 8 with an incomplete second resection (R1: n = 6 and R2: n = 2). Interobserver agreement for residual tumor at MRI after a Whoops procedure was perfect (κ value: 1.000). MRI achieved a sensitivity of 47.4% (9/19), a specificity of 100% (7/7), a positive predictive value of 100% (9/9), and a negative predictive value of 70.0% (7/17) for the detection of residual tumor. MRI correctly classified 2 of 19 residual sarcomas as deep-seated (i.e., extending beyond the superficial muscle fascia) but failed to correctly classify 3 of 19 residual sarcomas as deep-seated. There were no significant associations between MRI findings (presence of residual tumor, maximum tumor diameter, anatomic tumor extent, tumor margins, tumor spiculae, and tumor tail on the superficial fascia) with an incomplete (R1 or R2) second resection. CONCLUSION: Gadolinium chelate-enhanced MRI is a reproducible method to rule in residual sarcoma, but it is insufficiently accurate to rule out and assess the anatomic extent or residual sarcoma after a Whoops procedure. Furthermore, MRI has no utility in predicting an incomplete second resection.
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Sarcoma , Neoplasias de los Tejidos Blandos , Medios de Contraste , Humanos , Imagen por Resonancia Magnética , Neoplasia Residual/diagnóstico por imagen , Sarcoma/diagnóstico por imagen , Sarcoma/cirugía , Neoplasias de los Tejidos Blandos/diagnóstico por imagen , Neoplasias de los Tejidos Blandos/cirugíaRESUMEN
Toxoplasmosis is a zoonotic protozoal disease caused by Toxoplasma gondii, an intracellular opportunistic protozoan parasite that can infect any warm-blooded vertebrate cell. In this study, zirconium, and iron-based metal-organic framework was prepared according to the solvothermal method. New nanocomposite (Curcumin@MOFs) was prepared by reacting curcumin with amino-functionalized metal-organic frameworks (Fe-MOF and UiO-66-NH2). Besides characterizations of the composite by powder X-ray diffraction and scanning electron microscope, nano-Curcumin@MOFs was used as a new novel structure as atrial for treatment of chronic toxoplasmosis. Results showed a reduced number of brain cysts, high levels of serum Toxo IgG, and normal histo-morphology with preserved parenchymal, and stromal tissues in rats groups treated with curcumin and Curcumin@MOFs nanocomposite.
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Curcumina/química , Estructuras Metalorgánicas/química , Nanocompuestos/química , Toxoplasmosis/tratamiento farmacológico , Animales , Productos Biológicos/química , Encéfalo/efectos de los fármacos , Encéfalo/parasitología , Enfermedad Crónica/terapia , Femenino , Inmunoglobulina G/química , Hígado/metabolismo , Microscopía Electrónica de Rastreo , Nanomedicina/métodos , Porosidad , Polvos , Ratas , Espiramicina/química , Bazo/metabolismo , Toxoplasma , Difracción de Rayos X , Circonio/químicaRESUMEN
Platinum nanoparticles (PtNPs) attract much attention due to their excellent biocompatibility and catalytic properties, but their toxic effects on normal (CHANG) and cancerous (HuH-7) human liver cells are meagre. The cytotoxic and apoptotic effects of PtNPs (average size, 3 nm) were determined in CHANG and HuH-7 cells. After treating these cells were with PtNPs (10, 50, 100, 200, and 300 µg/mL) for 24 and 48 hours, we observed dose- and time-dependent cytotoxicity, as evaluated by using (3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide, a tetrazole) (MTT) and neutral red uptake (NRU) assays. The production of reactive oxygen species (ROS) was increased in both cells after treatment with the above dose of PtNPs for 24 and 48 hours. Determination of morphological changes of cells, chromosome condensation, mitochondrial membrane potential, and caspase-3 assays showed that PtNPs induce cytotoxicity and apoptosis in CHANG and HuH-7 cells by altering the cell morphology and density, increasing cell population in apoptosis, and causing chromosome condensation. Furthermore, we have studied fragmentation of DNA using alkaline single cell gel electrophoresis and expression of apoptotic genes by real-time PCR (RT-PCR). The percentage of DNA fragmentation was more at 300 µg/mL for 48 hours in both cells, but slightly more fragmentation was found in HuH-7 relative to CHANG cells. Considering all of the above parameters, PtNPs elicited cytotoxicity on CHANG and HuH-7 cells by blocking cell proliferation and inducing apoptosis. Thus this study may be useful in in vitro laboratory studies using cell lines for screening the genotoxic and apoptotic potential of nanoparticles.
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Apoptosis/efectos de los fármacos , Daño del ADN , Expresión Génica/efectos de los fármacos , Hígado/efectos de los fármacos , Nanopartículas del Metal/química , Estrés Oxidativo/efectos de los fármacos , Platino (Metal)/farmacología , Apoptosis/genética , Caspasa 3/genética , Caspasa 3/metabolismo , Muerte Celular , Línea Celular Tumoral , Fragmentación del ADN/efectos de los fármacos , Humanos , Hígado/metabolismo , Hígado/patología , Potencial de la Membrana Mitocondrial/efectos de los fármacos , Estrés Oxidativo/genética , Platino (Metal)/química , Proteínas Proto-Oncogénicas c-bcl-2/genética , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Proteína X Asociada a bcl-2/genética , Proteína X Asociada a bcl-2/metabolismoRESUMEN
OBJECTIVE: There is a need to treat cancer cells with safe and natural nanoparticles to avoid the side effects of chemotherapeutic agents. Chamomile is considered a safe, natural plant with anticancer activity. We synthesize simple, inexpensive, and eco-friendly silver nanoparticles (SNs) using Chamomile (CHM) to tune their anticancer properties. MATERIALS AND METHODS: SN-CHM was synthesized by reducing 1 mM silver nitrate aqueous solution in 100 mL with the aqueous ethanolic flower extract of CHM (18 mg/mL, w/v). The reaction proceeded overnight at 600 rpm and 28°C. SN-CHM was characterized for their % yield, average diameter, charge, morphology, and silver release. Moreover, SN-CHM was investigated for its antioxidant and anticancer activities at 200 µg/mL and 5 mg/ mL, respectively. RESULTS: A 59.12% yield and a uniform SN-CHM size of 115 ± 3.1 nm with a ζ-potential of -27.67 ± (-3.92) mv were observed. The UV-visible absorption showed shifts from 379.5 to 383.5 nm for CHM and SN-CHM, respectively. Moreover, Ag+ was ultimately released from SN-CHM after 5 h. Fourier Transform Infrared Spectroscopy (FT-IR) showed characteristic absorption peaks of CHM and produced SN-CHM. Furthermore, SN-CHM showed moderate antioxidant activity. SN-CHM inhibited the % viability of SW620 and HT-29 cell lines at 20 µM. SN-CHM may also greatly upregulate the apoptotic gene BAX while considerably downregulating the anti-apoptotic genes BCL2 and BCL-Xl. CONCLUSIONS: CHM can be a safe soft drink, especially when conjugated with Ag ions as anticancer NPs. SN-CHM is considered potent anticancer activity against SW620, and HT-29 cell lines.
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Neoplasias Colorrectales , Matricaria , Nanopartículas del Metal , Humanos , Sustancias Reductoras/farmacología , Nanopartículas del Metal/química , Espectroscopía Infrarroja por Transformada de Fourier , Plata/farmacología , Muerte Celular , Antioxidantes/farmacología , Extractos Vegetales/farmacología , Extractos Vegetales/química , Neoplasias Colorrectales/tratamiento farmacológico , Antibacterianos/farmacologíaRESUMEN
Background: Repair of aortic coarctation through left thoracotomy is the standard treatment when anatomically feasible. Long-term outcomes are well studied, including the need for reintervention. However, the timely variation in residual gradients across the repaired segment is ill-defined. The aim of this work was to study the progressive changes of estimated peak gradient (ePG) acquired by transthoracic continuous-wave Doppler echocardiography across the aortic arch after repair and to assess the role of timing of assessment and values of ePG in prediction of reintervention. Materials and Methods: All eligible patients for this study who underwent aortic coarctation repair through left thoracotomy from 2001 to 2017 were reviewed. Details of the aortic arch dimensions and associated lesions were obtained by transthoracic echocardiography (TTE). The primary outcome was the ePG across the aortic arch after repair. Longitudinal data analyses with mixed effect modeling were used to determine independent predictors for ePGs. Results: A total of 312 patients were included. Median age and weight were 30 days and 4 kg, respectively. Associated lesions included ventricular septal defect (VSD) (53%), bicuspid aortic valve (53%) and mitral stenosis (25%). Over 15-years follow-up the freedom from reintervention was 92.3%, while 24 out of the 312 patients underwent reintervention (7.7%). Longitudinal data analyses of serial 2566 TTE studies were done. The graphical display showed that the ePG across coarctation area in the first postoperative TTE was the most notable difference between those who underwent reintervention and those who did not. Further testing with proportional hazard and logistic regression modeling confirmed this finding. The area under receiver operating curve statistics showed that an ePG of 25 mmHg is an optimal cutoff value for the prediction of the reintervention. Conclusions: The ePG acquired in the first postoperative TTE is the most important predictor for reinterventions. The presence of VSD is associated with decreased ePGs. We propose that an ePG in the first postoperative TTE of 25 mmHg or more is a strong predictor for the need of reintervention.
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Purpose: Osteoporosis is especially prevalent in the older population and in women. Fractures lead to many health complications, placing an enormous burden on the health system. Improved knowledge will encourage healthy practices that prevent osteoporosis and help community members avoid unhealthy lifestyles and habits. The goal of this study was to evaluate the knowledge, attitudes, and practices relating to osteoporosis among male and female students of the Jazan community. Methods: The Jazan region has 13 governorates and a population of more than 1.5 million. For this study, 440 participants were selected from seven different governorates, and the osteoporosis knowledge assessment tool (OKAT) was used together with five background variables and some questions on attitude and practice. A Chi-squared test was implemented to identify any significant relationships between the background variables and the knowledge and practice scores. A P value of less than 0.05 was considered significant. Results: Of the 440 participants, 53% were men and 47% women. Thirty-three percent of them held government jobs, 73% had completed university, and 50% had a monthly income of less than 5,000 riyals. Regarding the risk factors for osteoporosis, 62 (14%) smoked, 37 (8.4%) used steroids, 184 (41.8%) had a family history of osteoporosis, and 393 (89.3%) had not attended an education campaign on osteoporosis. The highest number of correct answers in the OKAT was to the question "osteoporosis increases the risk of fractures" (423, 96.1%), and the lowest number of correct answers was to the question "osteoporosis is more common in men" (60, 13.6%). Regarding protective behaviors against osteoporosis, namely physical activity, daily intake of dairy products, attending an education campaign, and background characteristics, attending an education campaign was statistically significant, with a P value of 0.003, but marital status, education level, body mass index (BMI), and occupation were not statistically significant. For the risk factors, sex was statistically significant, along with the daily soft drink intake and smoking but not with the use of steroids. Other background characteristics, such as education level and BMI, were not statistically significant as osteoporosis risk factors. Conclusions: The participants' level of knowledge was high, and the risk factors for osteoporosis were still present together with a low level of achievement for protective measures. It is highly recommended that education campaigns be implemented to increase knowledge and encourage improved attitudes and practices.
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Adolescence and youth are stages of life that other great opportunities for reduction of future health needs. A cross-sectional study was carried out to assess the physical, mental, emotional and social health status of adolescents and youths attending 2 large universities in Benghazi city, Libya, and to determine variables associated with their health status. Stratified sampling was used to select 383 students aged 17-24 years and data were collected by face-to-face interview and self-administered questionnaires. Major health problems were depression/anxiety and pain/discomfort, and these were suffered by significantly more females than males. Mental health was at the transitional stage in Dabrowski's emotional development theory (spontaneous multilevel disintegration). Females had higher levels of emotional development. Regular physical activity was practised by 34.7% overall (25.8% of women) and 17.2% were smokers. The main social activity was visiting family members.
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Estado de Salud , Salud Mental , Adolescente , Distribución de Chi-Cuadrado , Estudios Transversales , Femenino , Humanos , Entrevistas como Asunto , Libia , Masculino , Medio Social , Estudiantes , Encuestas y Cuestionarios , Universidades , Adulto JovenRESUMEN
The objective of this study was to review the outcome of patients who underwent transcatheter closure of ventricular septal defect (VSD) using Nit-Occlud® LeË VSD-Coil.A retrospective study was carried out at King Abdulaziz Cardiac Center on all paediatric patients who underwent interventional VSD closure, during the period from 2011 and 2016. Data were collected, including demographic information, cardiac diagnosis, pre-operative diagnosis, intra-operative findings and postoperative events. Out of 46 patients, who were evaluated for VSD device closure, 17 of them were excluded; 24 patients out of 29 had successful closure of VSD using Nit-Occlud LeË VSD-Coil (success rate of 83%), and five cases were referred to surgery. The age group was from 2 years up to 18 years. Almost 90% of VSD was the perimembranous (PM) type (26 patients) and 3 patients (10%) with muscular VSD. Ten of the 26 PM VSDs had TV accessory tissue partially covering the VSD defects. The hemodynamic assessment showed pulmonary blood flow to systemic blood flow ratio (Qp:Qs) > 1.5 in almost all the patients who underwent defect closure. Immediate closure of the defect was achieved in 11/24 patients (45%). In ï¬ve additional patients, there was a tiny residual and eight with a small residual. With 6 months of follow-up, only six patients remained with tiny residual VSD defects.The Nit-Occlud® LeË VSD-Coil device has minimal effects on the aortic and tricuspid valves, and there was no permanent atrioventricular block, especially in patients with PM VSDs. Patients with a residual shunt should be followed, especially for haemolysis.
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Although the evidence base regarding the impact of the COVID-19 pandemic on children has been growing, descriptions of their experiences remain scarce. In this cross-sectional study, the authors used the Child-Reported Spence Children's Anxiety Scale to collect data from 91 children visiting a pediatric emergency center in Qatar during the pandemic. Around 25% of the children reported elevated levels of overall anxiety. Obsessive-compulsive symptoms were the most common, with 59.3% of children reporting elevated symptoms. The mean score of physical injury fears was significantly affected by gender, with females having higher scores. Overall rates for elevated anxiety symptoms were similar in natives and expatriate children. The findings suggest that the effects of the pandemic on children may depend on several vulnerability factors, including developmental age and gender. This study highlights the need to plan multidisciplinary strategies to enhance children's access to mental health services during and after the current health crisis.
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COVID-19 , Femenino , Niño , Humanos , Pandemias , Estudios Transversales , Qatar/epidemiología , Ansiedad/epidemiologíaRESUMEN
Free-floating right-heart thrombus (FFRHT) in the context of a pulmonary embolism (PE) is a rare but serious encounter with no guidelines addressing its management. We performed a systematic review and meta-analysis addressing prevalence, clinical behavior, and outcomes of FFRHT associated with PE. Among the included 397 patients with FFRHT and PE, dyspnea was the main presenting symptom (73.3%). Obstructive shock was documented in 48.9% of cases. Treatment with thrombolytic therapy, surgical thrombectomy, and percutaneous thrombectomy was documented in 43.8%, 32.7%, and 6.5% of patients, respectively. The overall mortality rate was 20.4%. Syncope (p: 0.027), chest pain (p: 0.006), and obstructive shock (p: 0.037) were significantly associated with mortality. Use of thrombolytic therapy was significantly associated with survival (p: 0.008). A multivariate logistic regression model to determine mortality predictors revealed that syncope (OR: 1.97, 95% CI: 1.06-3.65, p: 0.03), and obstructive shock (OR: 2.23, 95% CI: 1.20-4.14, p: 0.01) were associated with increased death odds. Treatment with thrombolytic therapy (OR: 0.22, 95% CI: 0.086-0.57, p: 0.002) or surgical thrombectomy (OR: 0.35, 95% CI: 0.137-0.9, p: 0.03) were associated with reduced death odds. Meta-analysis of observational studies revealed a pooled prevalence of FFRHT among all PE cases of 8.1%, and overall mortality of 23%. Although uncommon, the presence of FFRHT in the context of PE is associated with high obstructive shock and mortality rates. Favorable survival odds are observed with thrombolytic therapy and surgical thrombectomy. Data are derived from case reports and observational studies. Clinical trials elucidating these findings are needed.
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Embolia Pulmonar , Trombosis , Humanos , Prevalencia , Embolia Pulmonar/complicaciones , Embolia Pulmonar/terapia , Embolia Pulmonar/diagnóstico , Trombosis/tratamiento farmacológico , Terapia Trombolítica/efectos adversos , Síncope/complicaciones , Síncope/tratamiento farmacológicoRESUMEN
Oil exploration in Egypt is a major contributor to the national Gross Domestic Product (GDP). With 50-65% of the oil resources located in the Gulf of Suez (GoS) region, the impact of such activity upon the region's water environment and its quality cannot be overlooked because of the volume of effluent generated. The objective of this study (September 2000-September 2001) was to assess the impact of a 650,000 barrels/day (bl/d) (100,000 m3/d) effluent arising from a major oil exploration site located south of GoS upon the local water environment. Another objective was to identify the pollutant contents amenable for reduction relative to the new Egyptian regulations. This was achieved by the characterization of the main contributing streams and the identification of the final effluent parameter constraints relative to the type of injection waters used. Subsequent investigations for the reduction of these contents were conducted on site and the results obtained are reviewed herewith.
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Industria Procesadora y de Extracción , Contaminantes Químicos del Agua/análisis , Contaminación del Agua/prevención & control , Purificación del Agua/métodos , Egipto , Monitoreo del Ambiente , Industria Procesadora y de Extracción/normas , Arquitectura y Construcción de Instituciones de Salud , Estaciones del Año , Purificación del Agua/instrumentaciónRESUMEN
Pulmonary vascular resistance (PVR) plays a major role in congenital heart management and critical decision. The impact of pulmonary vascular disease in the early and late morbidity and mortality after cardiac surgery and interventional catheterization in congenital heart defect (CHD) highlights the importance of critical evaluation for PVR. Currently, PVR is evaluated with invasive cardiac catheterization for hemodynamic data collection, processing, and analysis. Despite the limitation of hemodynamic evaluation in the setting of CHD, accurate data analysis, and interpretation have significant impact on clinical outcome and procedure success. This article reviews the basic calculation of PVR in the setting of congenital heart disease with diagrammatic illustration for easy understanding of the hemodynamic.
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The present research displays the green synthesis of stable silver nanoparticles (AgNPs). The aqueous solution of Fucoidan from Fucus vesiculosus source (brown marine algae) is used as a reducing and capping agent. UV-Vis spectroscopy, XRD, FT-IR, SEM, EDX, and TEM with selected area electron diffraction are used to characterize the synthesized silver nanoparticles (AgNPs). The synthesized AgNPs exhibit a surface plasmon resonance at 430 nm after 24 h. The characterization results showed that AgNPs are crystalline in nature and exhibit mostly spherical shapes with an average diameter of 4-45 nm. Silver nanoparticles showed effective antibacterial activity against representative pathogens of bacteria. The activities of commercial antibiotics were enhanced by impregnation with the synthesized AgNPs. It also shows good fungicidal and anticancer activity against liver and lung cell lines and shows significant antioxidant efficacy (84%) at 10 µg/ml AgNP concentration against DPPH. The utilization of environmentally synthesized AgNPs offers numerous benefits of ecofriendliness and compatibility for biomedical applications.
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Antibacterianos/farmacología , Antineoplásicos/farmacología , Depuradores de Radicales Libres/farmacología , Nanopartículas del Metal , Polisacáridos/farmacología , Nitrato de Plata/farmacología , Células A549 , Antibacterianos/química , Antineoplásicos/química , Bacterias/efectos de los fármacos , Bacterias/crecimiento & desarrollo , Compuestos de Bifenilo/química , Supervivencia Celular/efectos de los fármacos , Pruebas Antimicrobianas de Difusión por Disco , Composición de Medicamentos , Depuradores de Radicales Libres/química , Tecnología Química Verde , Células Hep G2 , Humanos , Nanotecnología , Neoplasias/tratamiento farmacológico , Neoplasias/patología , Picratos/química , Polisacáridos/química , Nitrato de Plata/químicaRESUMEN
BACKGROUND: Pulmonary arteriovenous malformations (PAVMs) are the major cause of progressive cyanosis in patients palliated with bidirectional cavopulmonary connection (BCPC). The aim of our study is to analyze the occurrence of PAVMs in patients after Kawashima procedure, to study the effect of total cavopulmonary connection (TCPC) on PAVMs, to evaluate the effect of axillary arteriovenous fistula (AAVF) creation on PAVMs, and to study the risk factors for PAVMs. METHODS: In this retrospective cohort study, all patients with left isomerism and azygous continuation of an interrupted inferior vena cava who underwent Kawashima procedure from July 2001 to December 2017 were included. RESULTS: Twenty.six patients after Kawashima procedure were included in our study. PAVMs were diagnosed in 12 patients (46%). Five of these 12 patients underwent TCPC with complete resolution of hypoxemia. Three patients underwent AAVF creation, 2 had complete resolution, while 1 had partial resolution of hypoxemia. Fourteen patients (54%) did not develop PAVMs. Nakata index below 267 mm2/m2and McGoon ratio below 1.9 predicted the development of PAVMs with high sensitivity and specificity. CONCLUSIONS: PAVMs represent a serious complication in patients who undergo Kawashima procedure. Small size of pulmonary arteries is an important risk factor for the development of PAVMs. Resolution of hypoxemia after TCPC completion supports the hepatic factor hypothesis. Early TCPC completion in these patients may help to avoid the development of PAVMs by restoring the hepatic factor. Resolution of hypoxemia after AAVF creation may support the lack of pulsatile flow hypothesis.
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Global COVID-19 pandemic containment necessitates understanding the risk of hesitance or resistance to vaccine uptake in different populations. The Middle East and North Africa currently lack vital representative vaccine hesitancy data. We conducted the first representative national phone survey among the adult population of Qatar, between December 2020 and January 2021, to estimate the prevalence and identify potential determinants of vaccine willingness: acceptance (strongly agree), resistance (strongly disagree), and hesitance (somewhat agree, neutral, somewhat disagree). Bivariate and multinomial logistic regression models estimated associations between willingness groups and fifteen variables. In the total sample, 42.7% (95% CI: 39.5-46.1) were accepting, 45.2% (95% CI: 41.9-48.4) hesitant, and 12.1% (95% CI: 10.1-14.4) resistant. Vaccine resistant compared with hesistant and accepting groups reported no endorsement source will increase vaccine confidence (58.9% vs. 5.6% vs. 0.2%, respectively). Female gender, Arab ethnicity, migrant status/type, and vaccine side-effects concerns were associated with hesitancy and resistance. COVID-19 related bereavement, infection, and quarantine status were not significantly associated with any willingness group. Absence of or lack of concern about contracting the virus was solely associated with resistance. COVID-19 vaccine resistance, hesitance, and side-effects concerns are high in Qatar's population compared with those globally. Urgent public health engagement should focus on women, Qataris (non-migrants), and those of Arab ethnicity.
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Sickle cell disease (SCD) is a medical condition caused by mutation in a single nucleotide in the ß-globin gene. It is a health problem for people in sub-Saharan Africa, the Middle East and India. Orthodox drugs developed so far for SCD focus largely on symptomatic respite of pain and crisis mitigation. We investigated the antisickling effects of chrysin via modulation of deoxy-haemoglobin, 2,3-bisphosphoglycerate mutase, redox homeostasis and alteration of functional chemistry in human sickle erythrocytes. In silico and in vitro methods were adopted for the studies. Chrysin was docked against deoxy-haemoglobin and 2,3-bisphosphoglycerate mutase, with binding energies (-24.064 and -18.171 kcal/mol) and inhibition constant (K i) of 0.990 µM and 0.993 µM at their active sites through strong hydrophobic and hydrogen bond interactions. Sickling was induced with 2% metabisulphite at 3 h. Chrysin was able to prevent sickling maximally at 2.5 µg/mL and reversed the same at 12.5 µg/mL, by 66.5% and 69.6%, respectively. Treatment with chrysin significantly (p < 0.05) re-established the integrity of erythrocytes membrane as evident from the observed percentage of haemolysis relative to induced erythrocytes. Chrysin also significantly (p < 0.05) prevented and reversed lipid peroxidation. Similarly, glutathione and catalase levels were observed to significantly (p < 0.05) increase with concomitant significant (p < 0.05) decrease in superoxide dismutase activity relative to untreated. From Fourier-transform infrared results, treatment with chrysin was able to favourably alter the functional chemistry, judging from the shifts and functional groups observed. Sickling-suppressive effects of chrysin may therefore be associated with sequestration of deoxy-haemoglobin, 2,3-bisphosphoglycerate mutase, alteration of redox homeostasis and functional chemistry of sickle erythrocytes.
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Anemia de Células Falciformes/sangre , Antidrepanocíticos/farmacología , Bisfosfoglicerato Mutasa/metabolismo , Eritrocitos/efectos de los fármacos , Flavonoides/farmacología , Hemoglobina Falciforme/metabolismo , Adulto , Biomarcadores/sangre , Simulación por Computador , Eritrocitos/química , Eritrocitos/metabolismo , Homeostasis/efectos de los fármacos , Humanos , Simulación del Acoplamiento Molecular , Fragilidad Osmótica/efectos de los fármacos , Oxidación-Reducción , Unión Proteica , Adulto JovenRESUMEN
OBJECTIVE: To investigate if patients with confirmed traumatic abdominal injury and a false-negative focused abdominal sonography for trauma (FAST) examination have a more favorable prognosis than those with a true-positive FAST. METHODS: This study included 97 consecutive patients with confirmed traumatic abdominal injury (based on computed tomography [CT] and/or surgical findings) who underwent FAST. RESULTS: FAST was false-negative in 40 patients (41.2%) and true-positive in 57 patients (58.8%). Twenty-two patients (22.7%) had an unfavorable outcome (defined as the need for an interventional radiologic procedure, laparotomy, or death due to abdominal injury). Univariately, a false-negative FAST (odds ratio [OR] 0.24; p = 0.017) and a higher systolic blood pressure (OR, 0.97 per mmHg increase; p = 0.034) were significantly associated with a favorable outcome, whereas contrast extravasation on CT (OR, 7.17; p = 0.001) and shock index classification (OR, 1.89 for each higher class; p = 0.046) were significantly associated with an unfavorable outcome. Multivariately, only contrast extravasation on CT remained significantly associated with an unfavorable outcome (OR, 4.64; p = 0.016). When excluding contrast extravasation on CT from multivariate analysis, only a false-negative FAST result was predictive of a favorable outcome (OR, 0.28; p = 0.038). CONCLUSION: Trauma patients with confirmed abdominal injury and a false-negative FAST have a better outcome than those with a positive FAST. FAST may be valuable for risk stratification and prognostication in patients with a high suspicion of abdominal injury when CT has not been performed yet or when CT is not available.
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INTRODUCTION: The catalytic behavior of metal oxide nanomaterials for removal of organic pollutants under dark ambient conditions, without any additional stimulant, is of great interest among the scientific community. METHODS: In this account, a nanomaterial of ternary metal oxides (MoO3-NiO-PdO-Pd) was synthesized via greener approach and was explored for degradation of methyl orange in water environment in dark ambient conditions in comparison with light conditions. The biochemical species of Abies pindrow were treated with aqueous solution of precursor's salt following sol gel synthesis strategy. We further attuned morphology and chemistry of MoO3-NiO-PdO-Pd by incorporating bioactive compounds of A. pindrow. RESULT AND DISCUSSION: The bio-fabricated MoO3-NiO-PdO-Pd revealed outstanding catalytic behavior with 92% degradation of methyl orange within 15 min in the dark at ambient temperature and pressure. Whereas, in the presence of visible light irritation, the catalyst degraded 97% of methyl orange in 15 min. According to the reaction kinetics of degradation, the catalysts illustrated good stability in light (R2=0.93) as well as in dark conditions (R2=0.98). Furthermore, the outstanding reusability and recyclability of the synthesized nanomaterial was observed for four runs of the experiment under dark and light conditions. CONCLUSION: Therefore, A. pindrow-synthesized MoO3-NiO-PdO-Pd nanocatalyst demonstrated significant potential for detoxification of organic pollutants for water remediation.