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Antibiotic resistance poses a formidable challenge to global public health, necessitating comprehensive understanding and strategic interventions. This review explores the evolution and transmission dynamics of antibiotic resistance genes, with a focus on Bangladesh. The indiscriminate use of antibiotics, compounded by substandard formulations and clinical misdiagnosis, fuels the emergence and spread of resistance in the country. Studies reveal high resistance rates among common pathogens, emphasizing the urgent need for targeted interventions and rational antibiotic use. Molecular assessments uncover a diverse array of antibiotic resistance genes in environmental reservoirs, highlighting the complex interplay between human activities and resistance dissemination. Horizontal gene transfer mechanisms, particularly plasmid-mediated conjugation, facilitate the exchange of resistance determinants among bacterial populations, driving the evolution of multidrug-resistant strains. The review discusses clinical implications, emphasizing the interconnectedness of environmental and clinical settings in resistance dynamics. Furthermore, bioinformatic and experimental evidence elucidates novel mechanisms of resistance gene transfer, underscoring the dynamic nature of resistance evolution. In conclusion, combating antibiotic resistance requires a multifaceted approach, integrating surveillance, stewardship, and innovative research to preserve the efficacy of antimicrobial agents and safeguard public health.
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Introduction: Many people expressed concern over coronavirus vaccinations' reliability and side effects. This research aimed to assess university students' perceptions and experiences regarding the side effects of the COVID-19 vaccines in Bangladesh. Method: We conducted an online cross-sectional survey to collect responses from university students vaccinated with any vaccines administered in Bangladesh between November 2021 to April 2022. Bangladeshi university students over the age of 18 and having an internet connection was included in the study. A binary logistic regression analysis along with Pearson's Chi-square test were used to identify COVID-19 vaccine-related side effects predictors after receiving the first dose. Results: A total of 1,176 participants responded voluntarily to the online study, and most were vaccinated. More than half of the participants received the Sinopharm vaccine (56.5%), while others received Covishield (8.9%), Moderna (7.3%), and Pfizer (5.8%) vaccine. Around 32% of the participants reported side effects after receiving the first dose of the vaccine, including pain and edema (78.4%), body temperature (20.3%), and headache (14.5%), while a few experienced allergy, anxiety, and uneasy feelings. About 17% of the participants reported experiencing side effects after the second dose of the vaccine, including pain and edema (7.5%), body temperature (8.8%), and headache (7.3%). Most side effects were significantly associated with the Moderna vaccine (p < 0.001). Female students and those previously infected with COVID-19 were significantly associated with the side effects after taking the first dose of the vaccine. Conclusion: We found that side effects are mild and did not pose a significant challenge to Bangladesh's effort in managing and reducing the risk associated with the COVID-19 pandemic.
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Vacinas contra COVID-19 , COVID-19 , Estudantes , Humanos , Estudos Transversais , Masculino , Feminino , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Vacinas contra COVID-19/efeitos adversos , Vacinas contra COVID-19/administração & dosagem , Universidades , Bangladesh , COVID-19/prevenção & controle , Adulto Jovem , Inquéritos e Questionários , Adulto , Adolescente , SARS-CoV-2 , Vacinação/estatística & dados numéricos , Vacinação/psicologiaRESUMO
The Z-scan technique is a nonlinear optical method that has found applications in characterizing various materials, particularly those exhibiting nonlinear optical response (NLOR). This study applies the continuous wave (CW) Z-scan technique to examine the NLOR in terms of the nonlinear optical phase shifts(ΔΦ0) exhibited by the ccfDNA extracted from blood plasma samples collected from a group constituting 30 cancer-diagnosed patients and another group constituting 30 non-diagnosed individuals. The cancer group exhibited significantly higherΔΦ0versus incident power slopes compared to the non-cancer group (0.34 versus 0.12) providing a clear distinction between the two groups. The receiver operating characteristic (ROC) curve analysis of the results indicates a clear separation between cancer and non-cancer groups, along with a 94% accuracy rate of the data. The Z-scan results are corroborated by spectrophotometric analysis, revealing a consistent trend in the concentration values of ccfDNA samples extracted from both cancerous and non-cancerous samples, measuring 3.24 and 1.41 respectively. Additionally, more sensitive fluorometric analyses of the respective samples demonstrate significantly higher concentrations of ccfDNA in the cancer group, further affirming the correlation with the Z-scan results. The study suggests that the Z-scan technique holds promise as an effective method for cancer detection, potentially contributing to improved oncology diagnosis and prognosis in the future.
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Biomarcadores Tumorais , Ácidos Nucleicos Livres , Neoplasias , Curva ROC , Humanos , Biomarcadores Tumorais/sangue , Neoplasias/sangue , Ácidos Nucleicos Livres/sangue , Feminino , Masculino , Espectrofotometria/métodosRESUMO
Patient-derived xenograft (PDX) models are widely used in cancer research. To investigate the genomic fidelity of non-small cell lung cancer PDX models, we established 48 PDX models from 22 patients enrolled in the TRACERx study. Multi-region tumor sampling increased successful PDX engraftment and most models were histologically similar to their parent tumor. Whole-exome sequencing enabled comparison of tumors and PDX models and we provide an adapted mouse reference genome for improved removal of NOD scid gamma (NSG) mouse-derived reads from sequencing data. PDX model establishment caused a genomic bottleneck, with models often representing a single tumor subclone. While distinct tumor subclones were represented in independent models from the same tumor, individual PDX models did not fully recapitulate intratumor heterogeneity. On-going genomic evolution in mice contributed modestly to the genomic distance between tumors and PDX models. Our study highlights the importance of considering primary tumor heterogeneity when using PDX models and emphasizes the benefit of comprehensive tumor sampling.
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Carcinoma Pulmonar de Células não Pequenas , Heterogeneidade Genética , Neoplasias Pulmonares , Camundongos Endogâmicos NOD , Camundongos SCID , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Humanos , Animais , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Camundongos , Feminino , Sequenciamento do Exoma , Genômica/métodos , Masculino , Ensaios Antitumorais Modelo de Xenoenxerto , Xenoenxertos , Modelos Animais de Doenças , Idoso , Pessoa de Meia-IdadeRESUMO
Cancers of Unknown Primary (CUP) remains a diagnostic and therapeutic challenge due to biological heterogeneity and poor responses to standard chemotherapy. Predicting tissue-of-origin (TOO) molecularly could help refine this diagnosis, with tissue acquisition barriers mitigated via liquid biopsies. However, TOO liquid biopsies are unexplored in CUP cohorts. Here we describe CUPiD, a machine learning classifier for accurate TOO predictions across 29 tumour classes using circulating cell-free DNA (cfDNA) methylation patterns. We tested CUPiD on 143 cfDNA samples from patients with 13 cancer types alongside 27 non-cancer controls, with overall sensitivity of 84.6% and TOO accuracy of 96.8%. In an additional cohort of 41 patients with CUP CUPiD predictions were made in 32/41 (78.0%) cases, with 88.5% of the predictions clinically consistent with a subsequent or suspected primary tumour diagnosis, when available (23/26 patients). Combining CUPiD with cfDNA mutation data demonstrated potential diagnosis re-classification and/or treatment change in this hard-to-treat cancer group.
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Ácidos Nucleicos Livres , Neoplasias Primárias Desconhecidas , Humanos , Ácidos Nucleicos Livres/genética , Neoplasias Primárias Desconhecidas/genética , Biomarcadores Tumorais/genética , Metilação de DNA , Biópsia LíquidaRESUMO
Breast cancer stands as the prevailing invasive cancer globally, bearing high mortality rates among women. Existing evidence indicates diminished survival rates in younger patients. Consequently, this study endeavors to assess and contrast the pathological features of breast cancer in women under 40 years of age with their older counterparts. Conducted as a cross-sectional analysis, this study encompasses 560 patients diagnosed with breast cancer, seeking treatment at Mymensingh Medical College Hospital (MMCH), Community Based Medical College Bangladesh (CBMCB) and several private hospitals in Mymensingh. The gathered data incorporates information such as age, residential area, occupation, tumor histopathology, TNM classification, staging and status of hormone receptor. The patients' mean age (standard deviation) was 49.7±11.9 years, with 20.5% below 40, most were from rural areas and were housewives. Ductal carcinoma prevailed as the most common histopathologic type (87.67%). However, younger patients exhibited a higher prevalence of lobular and other rare carcinomas compared to their older counterparts (p=0.04). Additionally, the younger group demonstrated larger tumor sizes (p=0.01), lymphatic node involvement (p=0.04) and advanced staging (p=0.004). Notably, younger age showed more negativity for estrogen and/or progesterone receptors. The results suggested that women under 40 years old exhibit more aggressive tumor characteristics and a more severe form of breast cancer compared to their older counterparts.
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Neoplasias da Mama , Carcinoma Ductal de Mama , Humanos , Feminino , Idoso , Adulto , Pessoa de Meia-Idade , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Estudos Transversais , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/terapia , Estadiamento de Neoplasias , EstrogêniosRESUMO
Mn-substituted Cu and Zn co-doped spinel-typed nano-crystalline ferrites having nominal composition Ni0.50-xMnxCu0.15Zn0·35Fe2O4 (x = 0.00-0.25 in 0.05 increments) have been prepared through the citric acid assisted sol-gel auto-combustion technique. From the XRD measurements, it was found that several intense peaks ensured the cubic spinel-based ferrite structure beyond the formation of any impurity peaks. The crystallite sizes varied from 20 to 28 nm for ash-burnt powders following the coalescence process that decreased the lattice defects and strain. With an increase in Mn concentration, the hopping length (LA) of the tetrahedral A-site increases, while the hopping length (LB) of the octahedral B-site decreases with enhanced lattice constant. The sintered samples' average grain sizes, as measured using the Field Emission Scanning Micrographs (FESEM), differed from around 1.40 to 5.30 µm. Incorporating Mn-ion accelerates grain growth and crystallite size with increased bulk density and reduced porosity due to heat treatment. For increasing sintering temperature along with Mn concentration, porosity drops from 42% to 3%, resulting in enhancing the magnetic induction of the prepared ferrites. The 25% Mn substituted composition displays the maximum initial permeability (µi' = 315), which is â¼7 times larger than the pristine composition. Due to the reduction of Ni content, the relative quality factor rises but the magnetic loss tangent reduces. An increased trends of µi' are accompanied by decreased resonant frequency, obeying Snoek's law. According to the experimental findings, the high spin Mn substitution in the composition causes the saturation magnetization to increase while the coercivity and Néel temperature drop with increasing grain size. Hence, the locally prepared low-cost Nano-crystalline Ni-Mn-Cu-Zn ferrites bearing excellent properties can be a good candidate for promising future applications in nanotechnology.
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Endoscopic transnasal repair of CSF rhinorrhoea is gaining popularity around the world because of its tremendous success rate but it depends on defect site, size, technique of repair, experiences of surgeon and also patient's profile. Aim of this study was to analysis of surgical outcome of endoscopic transnasal repair of CSF rhinorrhoea. A retrospective study carried out in the department of ENT and Head neck surgery at Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2018 to December 2019. Of the total of 24 patients 16(66.0%) were female and 8(33.0%) males. The commonest site of the leak was in the cribriform plate in 18(75.3%) followed by 5(20.8%) in the fovea ethmoidalis, and 1(4.0%) in the sphenoid sinus, the overall success rate of this series with first surgical procedure was 95.83% and 100.0% with a second procedure. Meticulous pre-operative evaluation, proper identification of leakage site, choice of graft materials and surgical technique are keys to attaining excellent results.
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Rinorreia de Líquido Cefalorraquidiano , Masculino , Humanos , Feminino , Rinorreia de Líquido Cefalorraquidiano/cirurgia , Rinorreia de Líquido Cefalorraquidiano/etiologia , Estudos Retrospectivos , Universidades , Endoscopia/efeitos adversos , Endoscopia/métodos , Seio EsfenoidalRESUMO
Electroencephalogram (EEG)-based cognitive load assessment is now an important assignment in psychological research. This type of research work is conducted by providing some mental task to the participants and their responses are counted through their EEG signal. In general assumption, it is considered that during different tasks, the cognitive workload is increased. This paper has investigated this specific idea and showed that the conventional hypothesis is not correct always. This paper showed that cognitive load can be varied according to the performance of the participants. In this paper, EEG data of 36 participants are taken against their resting and task (mental arithmetic) conditions. The features of the signal were extracted using the empirical mode decomposition (EMD) method and classified using the support vector machine (SVM) model. Based on the classification accuracy, some hypotheses are built upon the impact of subjects' performance on cognitive load. Based on some statistical consideration and graphical justification, it has been shown how the hypotheses are valid. This result will help to construct the machine learning-based model in predicting the cognitive load assessment more appropriately in a subject-independent approach.
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Análise e Desempenho de Tarefas , Carga de Trabalho , Humanos , Carga de Trabalho/psicologia , Eletroencefalografia/métodos , Máquina de Vetores de Suporte , CogniçãoRESUMO
The expansion and intensification of livestock production is predicted to promote the emergence of pathogens. As pathogens sometimes jump between species, this can affect the health of humans as well as livestock. Here, we investigate how livestock microbiota can act as a source of these emerging pathogens through analysis of Streptococcus suis, a ubiquitous component of the respiratory microbiota of pigs that is also a major cause of disease on pig farms and an important zoonotic pathogen. Combining molecular dating, phylogeography, and comparative genomic analyses of a large collection of isolates, we find that several pathogenic lineages of S. suis emerged in the 19th and 20th centuries, during an early period of growth in pig farming. These lineages have since spread between countries and continents, mirroring trade in live pigs. They are distinguished by the presence of three genomic islands with putative roles in metabolism and cell adhesion, and an ongoing reduction in genome size, which may reflect their recent shift to a more pathogenic ecology. Reconstructions of the evolutionary histories of these islands reveal constraints on pathogen emergence that could inform control strategies, with pathogenic lineages consistently emerging from one subpopulation of S. suis and acquiring genes through horizontal transfer from other pathogenic lineages. These results shed light on the capacity of the microbiota to rapidly evolve to exploit changes in their host population and suggest that the impact of changes in farming on the pathogenicity and zoonotic potential of S. suis is yet to be fully realized.
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Infecções Estreptocócicas , Streptococcus suis , Doenças dos Suínos , Animais , Humanos , Suínos , Infecções Estreptocócicas/veterinária , Fazendas , Doenças dos Suínos/epidemiologia , Virulência/genética , Streptococcus suis/genética , GadoRESUMO
Background: There are few guidelines on how to best manage craniovertebral junction (CVJ) tuberculosis (TB). Certainly, timely tissue diagnosis, immobilization of the neck, and decompression of CVJ with appropriate stabilization are the mainstays of treatment for TB at the CVJ. Case Description: Three patients, ages 16-68, presented with CVJ TB with atlanto-axial dislocation responsible for progressive quadriparesis/plegia. Based on X-rays, magnetic resonance, and computed tomography studies, patients underwent timely decompressions and fusions followed by antitubercular drug treatment. Conclusion: Early diagnosis, proper decompression with fusion, treated with anti-TB drug for proper period were keys to managing TB involving the craniocervical junction in these three patients.
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Mycobacterium tuberculosis is one of the major invasive intracellular pathogens causing most deaths by a single infectious agent. The interaction between host immune cells and this pathogen is the focal point of the disease, Tuberculosis. Host immune cells not only mount the protective action against this pathogen but also serve as the primary niche for growth. Thus, recognition of this pathogen by host immune cells and following signaling cascades are key dictators of the disease state. Immune cells, mainly belonging to myeloid cell lineage, recognize a wide variety of Mycobacterium tuberculosis ligands ranging from carbohydrate and lipids to proteins to nucleic acids by different membrane-bound and soluble pattern recognition receptors. Simultaneous interaction between different host receptors and pathogen ligands leads to immune-inflammatory response as well as contributes to virulence. This review summarizes the contribution of pattern recognition receptors of host immune cells in recognizing Mycobacterium tuberculosis and subsequent initiation of signaling pathways to provide the molecular insight of the specific Mtb ligands interacting with specific PRR, key adaptor molecules of the downstream signaling pathways and the resultant effector functions which will aid in identifying novel drug targets, and developing novel drugs and adjuvants.
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To reduce the direct side effects of chemotherapy, researchers are trying to establish a new approach of a drug-delivery system using nanomaterials. In this study, we investigated graphene and its derivative nanomaterials for their favorable adsorption behavior with the anti-cancer drug hydroxyurea (HU) using DFT calculations. Initially, different pristine and doped graphene and its derivatives were taken into consideration as HU drug carriers. Among them, AlN, GaN, GaN-doped AlN, and AlN-doped GaN nanosheets exhibited favorable adsorption behavior with HU. The HU adsorbed on these four nanosheets with adsorption energies of -0.92, -0.75, -0.83, and -0.69 eV, transferring 0.16, 0.032, 0.108, and 0.230 e charges to the nanosheets, respectively, in air medium. In water solvent media, these four nanosheets interacted with HU by -0.56, -0.45, -0.58, and -0.56 eV by accepting a significant amount of charge of about 0.125, 0.128, 0.192, and 0.126 e from HU. The dipole moment and COSMO analysis also indicated that these nanosheets, except for GaN-doped AlN, show high asymmetricity and solubility in water solvent media due to the increased values of the dipole moment by two or three times after the adsorption of the HU drug. Quantum molecular descriptors also suggest that the sensitivity and reactivity of the nanosheets are enhanced during the interaction with HU. Therefore, these nanosheets can be used as anti-cancer drug carriers.
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MYZUS PERSICAE-INDUCED LIPASE1 (MPL1) encodes a lipase in Arabidopsis thaliana that is required for limiting infestation by the green peach aphid (GPA; Myzus persicae), an important phloem sap-consuming insect pest. Previously, we demonstrated that MPL1 expression was up-regulated in response to GPA infestation, and GPA fecundity was higher on the mpl1 mutant, compared with the wild-type (WT), and lower on 35S:MPL1 plants that constitutively expressed MPL1 from the 35S promoter. Here, we show that the MPL1 promoter is active in the phloem and expression of the MPL1 coding sequence from the phloem-specific SUC2 promoter in mpl1 is sufficient to restore resistance to GPA. The GPA infestation-associated up-regulation of MPL1 requires CYCLOPHILIN 20-3 (CYP20-3), which encodes a 12-oxo-phytodienoic acid (OPDA)-binding protein that is involved in OPDA signaling, and is required for limiting GPA infestation. OPDA promotes MPL1 expression to limit GPA fecundity, a process that requires CYP20-3 function. These results along with our observation that constitutive expression of MPL1 from the 35S promoter restores resistance to GPA in the cyp20-3 mutant, and MPL1 acts in a feedback loop to limit OPDA levels in GPA-infested plants, suggest that an interplay between MPL1, OPDA, and CYP20-3 contributes to resistance to GPA.
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Afídeos , Proteínas de Arabidopsis , Arabidopsis , Animais , Arabidopsis/genética , Arabidopsis/metabolismo , Lipase/genética , Lipase/metabolismo , Afídeos/fisiologia , Proteínas de Arabidopsis/genética , Proteínas de Arabidopsis/metabolismo , Hidrolases de Éster Carboxílico/metabolismo , Mutação , Doenças das Plantas , Regulação da Expressão Gênica de PlantasRESUMO
An organic, lead-free, n-i-p planar perovskite solar cell (PSC) based on CH3NH3SnI3 was demonstrated in this work using a solar cell capacitance simulator (SCAPS). A material cell design of FTO/ZnO/CH3NH3SnI3/Cu2O/Au has been investigated for this study. A detailed analysis has been performed on the role of thickness, electron affinity, doping concentration of the perovskite layer, ETL, HTL, defect density of perovskite layer and temperature on PSC performance. For optimum conditions, the energy conversion efficiency is around 26.55%, accompanied by fill factor = 85.58%, open circuit voltage = 1.03 V, short circuit current density = 30.14 mA/cm2, and quantum efficiency of 80%-90%. This model shows the prospect of CH3NH3SnI3 as a perovskite material to produce toxic-free environment-friendly solar cells with high efficiency.
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Purpose: The article discusses the contemporary educational crisis of Rohingya children in Bangladesh. It aims to identify the challenges of formal and non-formal education faced by Rohingya children and their prospects. In this scholarship, the author attempts to answer the questions-what are the current formal and non-formal educational services in the Rohingya refugee camps and how and to what extent do the existing educational services intensify the other crisis in their lives, and what are the prospects for them going forwards. Method: ology: This study is primarily based on secondary sources of data. It focuses on the available educational services and key obstacles that affect Rohingya children's formal and non-formal educational opportunities in Bangladesh and their prospects in Myanmar. Findings: The study found the absence of formal and non-formal education for Rohingya children in refugee camps has a significant impact on their ability to become an active member of society. Although refugee children and their parents express a willingness to formal education under the Myanmar curriculum, limited educational services and various structural and legal barriers hinder their progress. Finally, the study explores the prospects of formal and non-formal education for Rohingya children in Bangladesh and concludes with recommendations to improve their educational opportunities. Limitation: The study results can differ in other contexts and countries hosting refugees. Practical implications: Findings of the study may be helpful for policymakers and practitioners.
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Shigellaa Gram-negative, non-motile bacillus, is the primary causative agent of the infectious disease shigellosis, which kills 1.1 million people worldwideevery year. The children under the age of five are primarily the victims of this disease. This study has been conducted to assess the prevalence of shigellosis through selective plating, biochemical test and conventional PCR assays, where the samples were collected from suspected diarrheoal patients. Invasive plasmid antigen H (ipaH) and O-antigenic rfc gene were used to identify Shigella spp. and S. flexneri respectively. For validation of these identification, PCR product of ipaH gene of a sample (Shigella flexneri MZS 191) has been sequenced and submitted to NCBI database (GenBank accession no- MW774908.1). Further this strain has been used as positive control. Out of 204, around 14.2% (n = 29)(P> 0.01) pediatric diarrheoal cases were screened as shigellosis. Another interesting finding was that most of shigellosis affected children were 7 months to 1 year (P> 0.01).The significance of this study lies in the analyses of the occurrenceand the molecular identification of Shigellaspp. and S. flexneri that can be utilized in improving the accurate identification and the treatment of the most severe and alarming shigellosis.
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Disenteria Bacilar , Shigella , Criança , Humanos , Disenteria Bacilar/diagnóstico , Disenteria Bacilar/epidemiologia , Bangladesh/epidemiologia , Shigella/genética , Diarreia/epidemiologia , Diarreia/complicações , Shigella flexneri/genéticaRESUMO
The magnetic properties, magnetocaloric effect, and critical analysis of magnetic behavior of Co1+xCrxFe2-xO4 (x = 0.125, 0.250, 0.375, and 0.500) with a non-stoichiometric ratio are studied in detail. All the synthesized samples exhibit single-domain behavior. The Cr3+ associated with excess Co2+ led to tuning the magnetic moment, exchange interaction, magnetocrystalline anisotropy constant, and microwave frequency. The second-order magnetic phase transition has been confirmed from the Arrot and Arrot-Noakes plots for all the samples. The Cr3+ associated with excess Co2+ also tuned the magnetocaloric (MCE) properties showing the maximum relative cooling power of 156 J kg-1, which is a higher value than that of previously reported Cr3+ substituted stoichiometric cobalt ferrite. The reliability of MCE and the nature of the magnetic phase transition of the investigated samples are confirmed by analyzing the critical exponent analysis, universal curve scaling, and scaling analysis of MCE.
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In our country majority of the coronary artery bypass surgery (CABG) are done off-pump and was reported having excellent clinical outcome along with cost efficiency by various investigators. Heparin is commonly used as most effective anticoagulant, and protamine sulfate is now generally used to reverse the anticoagulant action of heparin. While under dosing of protamine may result in incomplete heparin reversal and prolonged anticoagulation, protamine overdosing is associated with impaired clot formation exerted by the intrinsic anti-coagulation properties of protamine itself, moreover protamine administration is associated with mild to severe cardiovascular and pulmonary complications. Apart from traditional full neutralization of heparin now-a-days, half dose protamine was also introduced showing good outcome regarding lower activated clotting time (ACT), overall, less surgical bleeding with less transfusion. This comparative study was designed to detect differences between traditional and decreased protamine dosing in Off-Pump Coronary Artery Bypass (OPCAB) surgery. Four hundred (400) patients who underwent Off-Pump Coronary Artery Bypass Surgery (OPCAB) surgery at our institution over a period of 12 months were analyzed and were divided into two groups. Group A- received 0.5mg of protamine per 100 unit of heparin; Group B-received 1.0mg of protamine per 100 unit of heparin. ACT, blood loss, hemoglobin and platelet count units of blood and blood product transfusion requirements, clinical outcome and hospital stay were assessed in each patient. This study showed that 0.5mg of protamine per 100 unit of heparin was always able to reverse the anticoagulant effect of heparin with no significant difference in hemodynamic parameters, amount of blood loss and requirements of blood transfusion in between the groups. A standard protamine dosing formula (protamine-heparin at ratio of 1:1) adequate for on-pump cardiac surgical procedures significantly overestimates protamine requirements for OPCAB. Patients treated with decreased protamine do not appear to have adverse outcomes in terms of post-operative bleeding.
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Ponte de Artéria Coronária sem Circulação Extracorpórea , Heparina , Humanos , Heparina/uso terapêutico , Heparina/efeitos adversos , Ponte de Artéria Coronária sem Circulação Extracorpórea/métodos , Protaminas/uso terapêutico , Anticoagulantes/uso terapêutico , Ponte de Artéria Coronária/efeitos adversosRESUMO
Porphyria cutanea tarda is a rare disorder of heme metabolism due to deficiency of the enzyme uroporphyrinogen decarboxylase which is manifested as some typical dermatological features and hepatic dysfunction. The Hepatitis-C virus co-infection is common and it can be aggravated by other environmental factors. We report a case of porphyria cutanea tarda in a 37-year-old woman, who presented with recurrent skin blisters and has concomitant Hepatitis-C virus infection. She was taking oestrogen containing oral contraceptive pill for a long duration. The diagnosis of porphyria cutanea tarda was considered on the basis of clinical features and high level of urine porphyrin level. She was put on hydroxychloroquine and combination drugs for Hepatitis-C virus with significant improvement after 3 months of therapy.