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1.
3 Biotech ; 11(10): 445, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34631346

RESUMO

Green synthesis of nanoparticles (NPs) has gained great concern among researchers due to their unique properties, excellent applications and efficient route of synthesis. From the last decades, the number biologicals such as plants, fungus, bacteria, yeast, algae, and cyanobacteria and their products are using by various researchers for the synthesis of different NPs. However, the pillar of green chemistry keeps touching new heights to improve the performance. This review paper unveils almost recent cyanobacteria-assisted greener NP synthesis technique, characterization and application. The enormous potency of cyanobacteria in NP synthesis (silver, gold, copper, zinc, palladium, titanium, cadmium sulfide, and selenium) and significance of reducing enzymes were summarized. The extracellular and intracellular entity such as metabolites, enzyme, protein, pigments in cyanobacteria play a significant role in the conversion of metal ions to metal NPs with unique properties discussed briefly. The green synthesis of nanomaterials is valuable because of their cost-effective, nontoxic and eco-friendly prospects as well as the potential application metal NPs such as antibacterial, antifungal, anticancerous, catalytic, drug delivery, bioimaging, nanopesticide, nanofertilizer, sensing properties, etc. Therefore, in the present review, we have systematically discussed the mechanisms of synthesis and applications of cyanobacteria-assisted green synthesis of NPs.

3.
J Cutan Med Surg ; : 12034754211045378, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34494896
4.
BMJ Case Rep ; 14(7)2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34321272

RESUMO

The clinical manifestation of novel COVID-19 is variable. Pre-existing carcinoma and other comorbidities have been associated with increased COVID-19-related morbidity and mortality. Surgical intervention for advanced laryngeal carcinoma in old age during the COVID-19 pandemic may pose multiple challenges to the patient and the treatment team. We report a case of a 67-year-old elderly man who developed SARS-CoV-2 infection on the 21st day following total laryngectomy and neck dissection. The postoperative period was complicated by sequential development of pulmonary embolism, neck infection, pharyngeal leak and COVID-19 which were managed successfully. No close contacts were positive on the reverse transcription-PCR test for SARS-CoV-2. The patient is in follow-up for the past 7 months without any recurrence or COVID-19-related morbidity. The successful recovery and no cross-infection may be attributed to early diagnosis, immediate intervention and properly implemented institutional infection control policy.


Assuntos
COVID-19 , Pandemias , Idoso , Humanos , Laringectomia , Masculino , Recidiva Local de Neoplasia , SARS-CoV-2
6.
Crit Care Explor ; 3(5): e0425, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34036276

RESUMO

IMPORTANCE: In-hospital cardiac arrest survival among coronavirus disease 2019 patients has been reported to range from 0% to 12%. These numbers are significantly lower than reported prepandemic in-hospital cardiac arrest survival rates of approximately 20-25% in the United States for non-coronavirus disease 2019 patients. OBJECTIVE: To assess the incidence of in-hospital cardiac arrest survival of coronavirus disease 2019 patients. DESIGN: A retrospective cohort study of adult patients with coronavirus disease 2019 subsequently found to have in-hospital cardiac arrest and underwent cardiopulmonary resuscitation (cardiopulmonary resuscitation). SETTING: Multiple hospitals of the Cleveland Clinic Health System. PATIENTS: All adult patients (age ≥ 18 yr) admitted to Cleveland Clinic Health System with a diagnosis of coronavirus disease 2019 who experienced in-hospital cardiac arrest requiring cardiopulmonary resuscitation. MEASUREMENTS AND MAIN RESULTS: From March 01, 2020 to October 15, 2020, 3,555 patients with coronavirus disease 2019 were hospitalized; 1,372 were admitted to the ICU; 58 patients had in-hospital cardiac arrest. Median age of this cohort was 66.5 years (interquartile range, 55.0-76.0 yr). Patients were predominantly male (62.5%), White (53.4%), with a median body mass index of 29.7 (interquartile range, 25.8-34.6). Most in-hospital cardiac arrests were in critical care environments (ICU), 51 of 58 (87.9%); seven of 58 (12.1%) were on ward locations. Thirty-four of 58 patients (58.6%) were on mechanical ventilation prior to in-hospital cardiac arrest with a median duration of mechanical ventilation of 9 days (interquartile range, 2-18 d). Twenty-four of 58 patients (44%) were on vasopressors prior to arrest. Initial arrest rhythm was pulseless electrical activity at (63.8%), asystole (29.3%), and pulseless ventricular tachycardia/fibrillation (6.9%). Of the 58 patients, 35 (60.3%) attained return of spontaneous circulation, and 13 of 58 (22.4%) were discharged alive. CONCLUSIONS: We report a 22% survival to discharge after in-hospital cardiac arrest in coronavirus disease 2019 patients, a survival rate similar to before the coronavirus disease 2019 pandemic.

12.
Scand J Trauma Resusc Emerg Med ; 29(1): 23, 2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-33509242

RESUMO

BACKGROUND: One factor leading to the high mortality rate seen in sepsis is the subtle, dynamic nature of the disease, which can lead to delayed detection and under-resuscitation. This study investigated whether serial hemodynamic parameters obtained from a non-invasive cardiac output monitor (NICOM) predicts disease severity in patients at risk for sepsis. METHODS: Prospective clinical trial of the NICOM device in a convenience sample of adult ED patients at risk for sepsis who did not have obvious organ dysfunction at the time of triage. Hemodynamic data were collected immediately following triage and 2 hours after initial measurement and compared in two outcome groupings: (1) admitted vs. dehydrated, febrile, hypovolemicdischarged patients; (2) infectious vs. non-infectious sources. Receiver operator characteristic (ROC) curves were calculated to determine whether the NICOM values predict hospital admission better than a serum lactate. RESULTS: 50 patients were enrolled, 32 (64 %) were admitted to the hospital. Mean age was 49.5 (± 16.5) years and 62 % were female. There were no significant associations between changes in hemodynamic variables and patient disposition from the ED or diagnosis of infection. Lactate was significantly higher in admitted patients and those with infection (p = 0.01, p = 0.01 respectively). The area under the ROC [95 % Confidence Intervals] for lactate was 0.83 [0.64-0.92] compared to 0.59 [0.41-0.73] for cardiac output (CO), 0.68 [0.49-0.80] for cardiac index (CI), and 0.63 [0.36-0.80] for heart rate (HR) for predicting hospital admission. CONCLUSIONS: CO and CI, obtained at two separate time points, do not help with early disease severity differentiation of patients at risk for severe sepsis. Although mean HR was higher in those patients who were admitted, a serum lactate still served as a better predictor of patient admission from the ED.


Assuntos
Débito Cardíaco , Monitorização Fisiológica , Medição de Risco , Sepse/diagnóstico , Adulto , Idoso , Serviço Hospitalar de Emergência , Feminino , Frequência Cardíaca , Humanos , Ácido Láctico/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Amostragem , Triagem
14.
Dermatol Ther ; 34(1): e14555, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33210434

RESUMO

Although intralesional triamcinolone acetonide (TA) is the most commonly prescribed treatment for localized alopecia areata (AA), the literature regarding the optimal concentration for attaining better efficacy with the most acceptable side effects is scarce. To compare hair regrowth and local side effects of various concentrations of intralesional TA in scalp AA using clinical and dermoscopic parameters. A double-blind randomized control trial with four treatment groups (10, 5, 2.5 mg/ml TA and normal saline [NS]) was conducted between March 2018 and August 2019. After recruitment, each AA patch was divided into quadrants and randomized before first injection. Injections were given and outcome parameters were analyzed every 4-weekly till 12-weeks. Statistical analysis was done by the R software employing generalized estimation equation. P-value <.05 was considered significant. Out of 105-patients (168-AA patches), 75-patients (121-patches) completed the study. Hair regrowth scale of all TA concentrations was better than NS group (P < .001). Other parameters such as quadrants with poor clinical response and dermoscopic disease activity signs were also favorable in TA groups in comparison to NS. However the evidence of atrophy and telangiectasia was maximum in 10 mg/mL group. 10 mg/mL TA showed a comparatively better response at the cost of increased adverse effects. Based on the clinical benefit and adverse risk assessment from our study, it may be better to start with 2.5 mg/mL intralesional TA in limited scalp AA patients. It can be implied that the concentration of TA can be increased as a step-up regimen based on the serial clinical and dermoscopic response.


Assuntos
Alopecia em Áreas , Triancinolona Acetonida , Alopecia em Áreas/tratamento farmacológico , Humanos , Injeções Intralesionais , Couro Cabeludo , Resultado do Tratamento , Triancinolona Acetonida/efeitos adversos
15.
Otol Neurotol ; 42(1): e60-e65, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33009286

RESUMO

OBJECTIVE: Evaluate a new autologous mushroom-shaped cortical bone partial ossicular replacement prosthesis (MPORP) for cost-effective and sustainable hearing results. STUDY DESIGN: Prospective study. SETTING: Tertiary care center. PATIENTS: Forty-two patients suffering from chronic otitis media with intact superstructure of the stapes and partially or completely eroded incus. INTERVENTIONS: Group-1 (n = 24) underwent only tympanoplasty with MPORP; group-2 (n = 18) underwent intact canal wall mastoidectomy (ICW) with MPORP. MAIN OUTCOME MEASURES: Hearing results were evaluated using a four frequency average (measured at 0.5, 1, 2, 3 kHz) pure tone air conduction (PTA), air-bone gap (ABG), and word recognition scores (WRS) after 3, 6, and 12 months and compared with preoperative results. RESULTS: Overall, successful rehabilitation of ABG to 20 dB or less was achieved in 92% of patients. Mean postoperative ABG was 15.35 ±â€Š4.18 dB showing mean improvement of 23.89 ±â€Š5.95 dB. In group-1, mean postoperative ABG was 18.47 ±â€Š3.65 dB, showing an improvement of 25.92 ±â€Š5.3 dB. In group-2, mean postoperative ABG was 18.47 ±â€Š3.65 dB showing an improvement of 20.14 ±â€Š4.96 dB. Hearing improvement in all the cases together and both the groups checked separately was statistically significant (paired t test, p < 0.001). Group 1 had, on average, 5 dB better hearing than group 2 (unpaired t test, p > 0.05). CONCLUSION: The MPORP is obtainable from the local site, easily constructed, bio-compatible, cost-effective, less bulky, adequately rigid for sound transmission, magnetic resonance imaging (MRI) compatible, and provides sustainable hearing gain because it has better chances of integration with the head of stapes.


Assuntos
Prótese Ossicular , Substituição Ossicular , Audiometria de Tons Puros , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Resultado do Tratamento , Timpanoplastia
16.
Autops Case Rep ; 10(4): e2020189, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33344316

RESUMO

Soft tissue tumors are not uncommon in childhood and comprise entities that range from common to very rare malignancies. Infantile fibrosarcoma (IFS) is a rare pediatric malignancy mainly seen in the first two years of life. The data about the incidence of infantile fibrosarcoma occurring in the neck in the Indian subcontinent is scarce. To the best of our knowledge, only one case of infant cervical IFS has been reported previously in the Indian subcontinent. We present another case of an eight-year-old male patient with a rapidly growing mass on the left side of the neck. He was successfully treated with a combined modality of surgery and chemotherapy with a good outcome. Among the soft tissue tumors of childhood, IFS is a rare entity. It has a good prognosis and lesser chance of distant metastasis as compared to adult fibrosarcoma. Though surgical excision is the mainstay of treatment, chemotherapy also has a significant role in the treatment of primary tumor and metastasis. We discuss the stated case to bring to the notice this uncommon cause, which can be considered as a differential diagnosis of upper cervical swellings. A better understanding of this entity would help in early diagnosis and aggressive treatment, reducing the overall morbidity and mortality.

17.
Sci Rep ; 10(1): 20395, 2020 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-33230117

RESUMO

The quick sequential organ failure assessment (qSOFA) score has been proposed as a means to rapidly identify adult patients with suspected infection, in pre-hospital, Emergency Department (ED), or general hospital ward locations, who are in a high-risk category with increased likelihood of "poor outcomes:" a greater than 10% chance of dying or an increased likelihood of spending 3 or more days in the ICU. This score is intended to replace the use of systemic inflammatory response syndrome (SIRS) criteria as a screening tool; however, its role in ED screening and identification has yet to be fully elucidated. In this retrospective observational study, we explored the performance of triage qSOFA (tqSOFA), maximum qSOFA, and first initial serum lactate (> 3 mmol/L) at predicting in-hospital mortality and compared these results to those for the initial SIRS criteria obtained in triage. A total of 2859 sepsis cases were included and the in-hospital mortality rate was 14.4%. The sensitivity of tqSOFA ≥ 2 and maximum qSOFA ≥ 2 to predict in-hospital mortality were 33% and 69%, respectively. For comparison, the triage SIRS criteria and the initial lactate > 3 mmol/L had sensitivities of 82% and 65%, respectively. These results demonstrate that in a large ED sepsis database the earliest measurement of end organ impairment, tqSOFA, performed poorly at identifying patients at increased risk of mortality and maximum qSOFA did not significantly outperform initial serum lactate levels.


Assuntos
Ácido Láctico/sangue , Escores de Disfunção Orgânica , Sepse/diagnóstico , Sepse/mortalidade , Triagem/métodos , Adulto , Idoso , Biomarcadores/sangue , Bases de Dados Factuais , Serviço Hospitalar de Emergência , Feminino , Mortalidade Hospitalar/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Curva ROC , Estudos Retrospectivos , Medição de Risco , Sepse/sangue , Sepse/patologia
18.
Indian J Otolaryngol Head Neck Surg ; 72(4): 428-436, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33088770

RESUMO

Bilateral hearing loss is attributed to almost 50% of times with genetic etiology, while most unilateral sensorineural hearing loss (USNHL) are not attributable to it. Limited literature is available on epidemiology of USNHL. Etiology of USNHL is very diverse and vast, it ranges from as common as Meniere's disease to as rare as an electric shock injury. A prospective study was carried out to find rare causes of USNHL in adults. In this manuscript, we present a case series of 7 rare etiologies of USNHL in adults like auditory neuropathy, chemoradiotherapy, dialysis-induced SNHL, common cavity inner ear malformation, multiple sclerosis, acute otitis media-induced SNHL and vertebrobasilar dolichoectasia. This study discusses the rare possible etiologies of USNHL that can be easily missed if these are not ruled out properly. We present these cases to consider these heterogeneous and distinct causes of USNHL because of rarity of these etiologies. If such an etiology is diagnosed in time, they may be managed effectively.

19.
J Family Med Prim Care ; 9(8): 4311-4316, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33110851

RESUMO

Background and Aims: Human papilloma virus (HPV) infection is the most common sexually transmitted infection responsible for cervical cancer in women. There is no cure for HPV but safe and effective vaccinations before sexual debut can definitely decrease the incidence of cervical cancer. This research aims to explore the basic understanding of medical students about cervical cancer, HPV and HPV vaccination. Methods and Material: This was a descriptive, questionnaire based cross-sectional study conducted among the undergraduate medical students of All India Institute of Medical Sciences, Jodhpur from April 2018 to May 2018. A total of 238 respondents participated in the study. For statistical analysis, 'Z' score was used for categorical data and student t test was used for normally distributed continuous data. Results: Overall, 41% students had good knowledge about HPV infection and HPV vaccination while 44% students had average knowledge and 15% had poor knowledge. The majority of them (>80%) knew that HPV is responsible for cervical cancer and ano-genital warts but their awareness was not of the same order when it came to associating HPV with penile and oropharyngeal cancer (60%). Females had better knowledge as compared to males and this difference was statistically significant (P < 0.05). 88% of the students were willing to accept the vaccination while only 10% of females were previously vaccinated. Conclusion: Medical students, who are potential recipients of the HPV vaccine themselves, can play a unique role in promoting awareness about HPV vaccination in the future.

20.
Int J Dermatol ; 59(11): 1358-1370, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32936462

RESUMO

BACKGROUND: Besides predominant respiratory and gastrointestinal manifestations, reports on cutaneous manifestations in COVID-19 patients are being noted increasingly. OBJECTIVES: To estimate the prevalence of cutaneous manifestations in COVID-19 patients. METHODS: This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A detailed literature search was done in PubMed and Embase from December 1, 2019, till May 1, 2020. Studies reporting cutaneous manifestations in COVID-19 patients were included. Irrespective of the heterogeneity of data, a random effects model with inverse-variance approach was used for pooling the prevalence using meta package in R version 3.6.2. RESULTS: Out of 15,143 articles, 2086 articles were selected for full-text read. Forty-three articles were selected for qualitative analysis, of which 10 articles (N = 1682) were included for meta-analysis. The pooled prevalence of overall cutaneous lesions was 5.69 (95% confidence interval [CI]: 1.87-15.98; I2 88%). The pooled prevalence of other outcome parameters were as follows: viral exanthem-like presentation 4.15 (95% CI: 1.33-12.23; I2 88%), maculopapular rash 3.81 (95% CI: 1.02-13.18; I2 87%), vesiculobullous lesions 1.67 (95% CI: 0.70-3.96; I2 0%). CONCLUSION: The estimated prevalence of cutaneous manifestations in COVID-19 was 5.69%. Other manifestations were urticaria, chilblain-like lesions, livedo reticularis, and finger/toe gangrene. Although it is premature to conclude the prevalence of the cutaneous manifestations during this ongoing pandemic, our report may be a stimulating factor for the physicians to perform further vigilant streamlined reporting of cutaneous manifestations in COVID-19 patients to estimate the final prevalence.


Assuntos
COVID-19/complicações , Dermatopatias/epidemiologia , Dermatopatias/virologia , Humanos , Prevalência , SARS-CoV-2
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