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1.
Br J Neurosurg ; : 1-5, 2021 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-34969343

RESUMO

PURPOSE: To analyse baseline characteristics of patients with intraoperative rupture (IOR) or non-IOR who underwent microsurgical clipping for ruptured intracranial aneurysms. Additionally, to asses functional outcome in terms of Glasgow Outcome Scale (GOS) at 6 and 12 months. METHODS: A retrospective analysis of 471 patients who underwent microsurgical clipping for ruptured intracranial aneurysms from 2007 to 2018 in Nepal Mediciti Hospital, Nepal. Patients who underwent surgery for unruptured aneurysm were excluded from the study. The association of the base line characteristic in IOR and non-IOR were analysed. Variables analysed were the Hunt and Hess Scale (HHS) dichotomized as (1-3) and (4-5), Modified Fisher Scale dichotomized as (0-2) and (3-4), type of rupture, use of brain retractor, timing of IOR during surgery, aneurysmal factors (size of the neck, location, lobulation) and time of surgery. Outcome, GOS dichotomized into favourable (4-5) and unfavourable (1-3), assessed at 6 months and 12 months. RESULTS: Out of 471 patients treated for ruptured intracranial aneurysm, IOR occurred in 57 (12.10%) with mean age 49.47 (SD ±12.9), occurred more in smoker than non-smoker (45.6% vs. 18.6%; p=.000) and regular alcohol consumers (36.8% vs. 17.9%; p=.004). Favourable outcome with GOS (4-5) at 6 months was observed among patients with lower HHS (1-3), p=.025 and lower MFS (0-2), p=.04. However, outcome at 12 months was better associated with MFS (p=.013) and aneurysm size (p=.038), with more favourable outcome associated with aneurysm less than 10 mm. CONCLUSIONS: Alcohol consumption and smoking are associated risk factors that may contribute to IOR. HHS and MFS are strong predictors of outcome for IOR patients at 6 months. However, at 12 months, MFS is more predictive of outcome. Aneurysms greater than 10 mm had a strong association with outcome at 12 months than 6 months.

2.
Comput Intell Neurosci ; 2021: 2158184, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34737773

RESUMO

COVID-19 has claimed several human lives to this date. People are dying not only because of physical infection of the virus but also because of mental illness, which is linked to people's sentiments and psychologies. People's written texts/posts scattered on the web could help understand their psychology and the state they are in during this pandemic. In this paper, we analyze people's sentiment based on the classification of tweets collected from the social media platform, Twitter, in Nepal. For this, we, first, propose to use three different feature extraction methods-fastText-based (ft), domain-specific (ds), and domain-agnostic (da)-for the representation of tweets. Among these three methods, two methods ("ds" and "da") are the novel methods used in this study. Second, we propose three different convolution neural networks (CNNs) to implement the proposed features. Last, we ensemble such three CNNs models using ensemble CNN, which works in an end-to-end manner, to achieve the end results. For the evaluation of the proposed feature extraction methods and CNN models, we prepare a Nepali Twitter sentiment dataset, called NepCOV19Tweets, with 3 classes (positive, neutral, and negative). The experimental results on such dataset show that our proposed feature extraction methods possess the discriminating characteristics for the sentiment classification. Moreover, the proposed CNN models impart robust and stable performance on the proposed features. Also, our dataset can be used as a benchmark to study the COVID-19-related sentiment analysis in the Nepali language.


Assuntos
COVID-19 , Aprendizado Profundo , Humanos , Idioma , Pandemias , SARS-CoV-2
3.
Health Promot Int ; 32(3): 464-474, 2017 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-26519006

RESUMO

There is strong evidence that participatory approaches to health and participatory women's groups hold great potential to improve the health of women and children in resource poor settings. It is important to consider if interventions are reaching the most marginalized, and therefore we examined disabled women's participation in women's groups and other community groups in rural Nepal. People with disabilities constitute 15% of the world's population and face high levels of poverty, stigma, social marginalization and unequal access to health resources, and therefore their access to women's groups is particularly important. We used a mixed methods approach to describe attendance in groups among disabled and non-disabled women, considering different types and severities of disability. We found no significant differences in the percentage of women that had ever attended at least one of our women's groups, between non-disabled and disabled women. This was true for women with all severities and types of disability, except physically disabled women who were slightly less likely to have attended. Barriers such as poverty, lack of family support, lack of self-confidence and attendance in many groups prevented women from attending groups. Our findings are particularly significant because disabled people's participation in broader community groups, not focused on disability, has been little studied. We conclude that women's groups are an important way to reach disabled women in resource poor communities. We recommend that disabled persons organizations help to increase awareness of disability issues among organizations running community groups to further increase their effectiveness in reaching disabled women.


Assuntos
Participação da Comunidade/estatística & dados numéricos , Pessoas com Deficiência/estatística & dados numéricos , Adulto , Feminino , Humanos , Nepal , População Rural/estatística & dados numéricos , Apoio Social , Fatores Socioeconômicos , Inquéritos e Questionários , Saúde da Mulher
4.
Acta Anaesthesiol Scand ; 58(1): 61-73, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24261316

RESUMO

BACKGROUND: The first-line medication gabapentin and the acetylcholinesterase inhibitor donepezil represent a new promising combination to improve treatment outcomes for patients with severe neuropathic pain. The drugs have previously shown synergism following co-administration in nerve-injured rats. METHODS: The clinical relevance of adding donepezil to existing gabapentin treatment in patients with post-traumatic neuropathic pain was explored in this open-label study. The study comprised two consecutive periods of minimum 6 weeks: (1) titration of gabapentin to the highest tolerable dose or maximum 2400 mg daily, and (2) addition of donepezil 5 mg once daily to the fixed gabapentin dose. Efficacy and tolerability were assessed by ratings of pain intensity, questionnaires for pain and health-related quality of life, and reporting of adverse events. Pain scores were also analysed using mixed-effects analysis with the software NONMEM to account for intersubject variability. RESULTS: Eight patients commenced treatment with donepezil, of which two withdrew because of adverse events. Addition of donepezil resulted in clinically relevant reductions of pain (> 11 units on a 0-100 scale) and improved mental wellness in three of six patients. The remaining three patients had no obvious supplemental effect. Mixed-effects analysis revealed that pain scores were significantly lower during co-administration (P < 0.0001 combination vs. monotherapy). CONCLUSION: Donepezil may provide additional analgesia to neuropathic pain patients with insufficient pain relief from gabapentin as monotherapy. The promising results support controlled clinical trials of the drug combination. The usefulness of mixed-effects analysis in small-scale trials and/or for data with high intersubject variability was also demonstrated.


Assuntos
Aminas/uso terapêutico , Analgésicos/uso terapêutico , Ácidos Cicloexanocarboxílicos/uso terapêutico , Indanos/uso terapêutico , Neuralgia/tratamento farmacológico , Fármacos Neuroprotetores/uso terapêutico , Piperidinas/uso terapêutico , Ácido gama-Aminobutírico/uso terapêutico , Adulto , Idoso , Algoritmos , Aminas/efeitos adversos , Analgésicos/efeitos adversos , Ácidos Cicloexanocarboxílicos/efeitos adversos , Cicloexanóis/uso terapêutico , Donepezila , Quimioterapia Combinada , Feminino , Gabapentina , Humanos , Indanos/efeitos adversos , Masculino , Pessoa de Meia-Idade , Fármacos Neuroprotetores/efeitos adversos , Medição da Dor/efeitos dos fármacos , Piperidinas/efeitos adversos , Qualidade de Vida , Tamanho da Amostra , Cloridrato de Venlafaxina , Ácido gama-Aminobutírico/efeitos adversos
5.
Kathmandu Univ Med J (KUMJ) ; 10(38): 14-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23132468

RESUMO

BACKGROUND: Enteric opportunistic parasitic infections are the major source of diarrheal disease in developing countries mainly in Human Immunodeficiency virus (HIV) infected patients. OBJECTIVE: The study was to detect enteric parasites causing diarrhea and their association with immune status in HIV-seropositive patients. METHODS: The present study was conducted in Dirgh-Jeevan Health Care Research Center and Tribhuvan University Teaching Hospital, Public Health Research Laboratory, Kathmandu, Nepal between June 2010 and May 2011 involving 146 Human Immunodeficiency virus (HIV) positive patients. Serostatus from these patients were detected by Enzyme Linked Immunosorbent assay. CD4+ T cell counts were done by flow cytometry. Stool was examined for enteric parasites by microscopy with special staining methods. RESULTS: A total of 146 HIV sero-positive patients with and without diarrhea age between 20 to 45 years were included in the study. Of the 146 patients, the protozoan parasitic infection was found in 30.13% (44/146). Out of 146 patients, 78 had diarrhea in which parasitic infection was 39 (50%) and 7.35% (5/68) protozoal parasites positive cases did not have diarrhea. A significant difference (p less than 0.05) was observed in the level of infection of intestinal protozoan between the HIV seropositive with diarrhea and HIV-seropositive without diarrhea. Out of 43 patients whose CD4+ T cells were less than 200/µl, 29 (67.4%) had opportunistic parasitic infection whereas out of 103 patients whose CD4+ T cells were =200/mcl, only 15 (14.56%) had opportunistic parasitic infection (P less than 0.05). CONCLUSION: Enteric opportunistic parasitic infections were detected in 30.1% among HIV-seropositive patients and low CD4+ T count indicated high enteric opportunistic infection. Early detection of enteric parasitic infections will help in the management and to improve the quality of life for HIV-infected individuals.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Soropositividade para HIV , Enteropatias Parasitárias/epidemiologia , Adulto , Humanos , Pessoa de Meia-Idade , Nepal/epidemiologia
6.
Prostaglandins Other Lipid Mediat ; 88(1-2): 10-7, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18812233

RESUMO

N-Arachidonoyl dopamine (NADA) is an endogenous lipid that modulates signal transduction in neuronal and immune pathways. NADA activates the non-selective cation channel, transient receptor potential vanilloid type 1 (TRPV(1)) and cannabinoid receptor 1. That NADA is comprised of an arachidonic acid (AA) backbone suggests that it may be metabolized through many of the enzymes that act upon AA such as the other AA-derived signaling lipids, the endogenous cannabinoids. To investigate the metabolism of NADA through the cytochrome P450 (CYP450) metabolic pathway, we studied the in vitro rat liver microsomal production of hydroxylated metabolites and their activity at recombinant human TRPV(1) receptors. We showed that following microsomal activation in the presence of NADA, omega and (omega-1) hydroxylated metabolites (19- and 20-HETE-DA) were formed. These metabolites were active at recombinant human TRPV(1) receptors, inducing a dose-dependent calcium influx. Both metabolites exhibited lower potency compared to NADA. We conclude that CYP450 enzymes are capable of metabolizing this signaling lipid forming a larger family of potential neuromodulators.


Assuntos
Ácidos Araquidônicos/química , Ácidos Araquidônicos/metabolismo , Dopamina/análogos & derivados , Microssomos Hepáticos/metabolismo , Canais de Cátion TRPV/metabolismo , Animais , Sistema Enzimático do Citocromo P-450/metabolismo , Dopamina/química , Dopamina/metabolismo , Humanos , Ácidos Hidroxieicosatetraenoicos/química , Ácidos Hidroxieicosatetraenoicos/metabolismo , Cinética , Espectrometria de Massas , Ratos , Proteínas Recombinantes/metabolismo , Canais de Cátion TRPV/genética
7.
Artigo em Inglês | MEDLINE | ID: mdl-18187816

RESUMO

BACKGROUND AND AIMS: The prevalence of polymorphic light eruption (PLE) varies between 10-20% in different countries but no such data is available from India, where exposure to sunlight is high. METHODS: A clinico-epidemiological study of PLE was done in the skin outpatient department (OPD) of Institute of Medical Sciences Hospital from January to December. RESULTS: The ages of the patients varied from 5-70 years. Out of a total of 39,112 OPD cases, 220 cases of PLE (138 females and 82 males) were recorded, giving a prevalence of 0.56% in this study population. The skin type varied between IV and VI in 96% of the cases. Housewives were 81, students 67, office persons 39, farmers 22, businessmen 6 and unemployed 5. DISCUSSION: The manifestation of PLE was most common in housewives in areas exposed to the sun. Most of the PLE patients presented with mild symptoms and rash around the neck, forearms and arms which was aggravated on exposure to sunlight. PLE was more prevalent in the months of March and September and the disease was recurrent in 31.36% of the cases. CONCLUSIONS: The prevalence of PLE was 0.56%. It was mild in nature and only areas exposed to the sun were involved.


Assuntos
Transtornos de Fotossensibilidade/epidemiologia , Transtornos de Fotossensibilidade/etiologia , Luz Solar/efeitos adversos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Ocupações/estatística & dados numéricos , Prevalência , Pigmentação da Pele
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