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1.
Ann Med Surg (Lond) ; 81: 104397, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36147088

RESUMO

Introduction: The surgical safety checklist consists of three components: sign-in, performed before the induction of anesthesia; time-out, performed before skin incision; and sign-out, performed immediately after skin closure or before the patient leaves the operating theatre. This study aims to assess compliance with the World Health Organization (WHO) Surgical Safety Checklist (SSC) and explore the barriers facing in properly implementing the surgical safety checklist in operation theatres of a tertiary care hospital. Methodology: The observational clinical audit was conducted in Surgical Unit I, Benazir Bhutto Hospital, Rawalpindi, Pakistan. Compliance with the surgical safety checklist was observed before and after the educational intervention. After completion of the clinical audit operating theatre staff was asked about the barriers to compliance with the surgical safety checklist using an interview sheet. Mean, and standard deviation was calculated for quantitative variables, whereas frequencies and percentages were calculated for categorical variables using SPSS version 25.0. Results: Compliance with all the steps of the surgical safety checklist was improved after an educational intervention, with the highest improvement in compliance (66.7%) observed with the Sign-out step "Count of sponges and needles & instruments complete?" Moreover, filling of the patient board and documentation of procedure in the patient file were also improved. Lack of awareness and training to follow the surgical safety checklist was the commonest barrier to compliance with the surgical safety checklist. Conclusion: Implementing the surgical safety checklist will not only upgrade the patient safety measures but also integrate teamwork skills and improve the local departmental culture.

2.
3.
Front Psychiatry ; 13: 839542, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35795030

RESUMO

The COVID-19 pandemic has significantly affected the psychological stability of general population of Pakistan. However, research on the severity of COVID-19 induced depression, anxiety, and stress (DAS) in Pakistan is scarce. This paper thereby investigates the severity of COVID-19 induced DAS based on demographic, socioeconomic, and personal feeling variables by modeling DAS. Snowball sampling strategy was adopted to conduct online survey from July 03, 2021 to July 09, 2021. Out of 2,442, 2,069 responses from Karachi were included. Descriptive and inferential statistics (binary and multinomial logistic regression analysis) were performed using SPSS V21 (IBM, 2013) to identify significant determinants and their association with DAS severity. The result of this study indicates 27.8, 21.7, and 18.3% respondents suffer from severe and extremely severe states of depression, anxiety, and stress, respectively. Binary logistic regression revealed that age is a significant determinant with odds of having 4.72 (95% CI = 1.86-11.97) and 5.86 (95% CI = 2.26-15.2) times greater depression, and stress for respondents aged 19-26 years. Moreover, gender-based difference is also observed with females 1.34 (95% CI = 1.08-1.68) and 1.75 (95% CI = 1.40-2.20) times more likely to exhibit anxiety and stress than males. Furthermore, marital status is a significant determinant of depression with odds of having depression is 0.67 (95% CI = 0.48-0.93) times greater for married population. Multinomial logistic regression revealed that those who believe COVID-19 pandemic has affected them mentally, fear new COVID-19 cases and deaths, depressed due to imposition of lockdown, believe they will not survive COVID-19 infection, and spend more time on social media gathering COVID-19 updates suffer from extremely severe state of depression (OR mental-effect-of-pandemic = 3.70, OR new-COVID-19-cases-and-deaths = 2.20, OR imposition-of-lockdown = 17.77, OR survival-probability = 8.17, OR time-on-social-media = 9.01), anxiety (OR mental-effect-of-pandemic = 4.78, OR new-COVID-19-cases-and-deaths = 3.52, OR imposition-of-lockdown = 5.06, OR survival-probability = 8.86, OR time-on-social-media = 5.12) and stress (OR mental-effect-of-pandemic = 6.07, OR imposition-of-lockdown = 11.38, OR survival-probability = 15.66, OR time-on-social-media = 4.39). Information regarding DAS severity will serve as a platform for research centers and psychological clinics, to work collectively and provide technology-based treatment to reduce the burden on the limited number of psychologist and psychotherapist.

4.
Medicine (Baltimore) ; 101(17): e29049, 2022 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-35512065

RESUMO

INTRODUCTION: Histone deacetylases (HDACs) have emerged as important therapeutic targets for various diseases, such as cancer and neurological disorders. Although a majority of HDAC inhibitors use hydroxamic acids as zinc binding groups, hydroxamic acid zinc-binding groups suffer from poor bioavailability and nonspecific metal-binding properties, necessitating a new zinc-binding group. Salicylic acid and its derivatives, well-known for their therapeutic value, have also been reported to chelate zinc ions in a bidentate fashion. This drew our attention towards replacing hydroxamic acid with salicylamide as a zinc-binding group. METHODS: In this study, for the first time, compound 5 possessing a novel salicylamide zinc-binding group was synthesized and evaluated biologically for its ability to inhibit various HDAC isoforms and induce acetylation upon α-tubulin and histone H3 among MDA-MB-231 cells. RESULTS: Compound 5 exhibits selective inhibition against class I HDAC isoforms (HDAC1, 2, and 3) over class II and IV HDAC isoforms (HDAC4, 6, and 11). The exposure of MDA-MB-231 cells to compound 5 efficiently induced the acetylation of more histone H3 than α-tubulin, suggesting that compound 5 is a class I selective HDAC inhibitor. Moreover, the molecular docking study indicated that the salicylamide zinc-binding group of compound 5 coordinates the active zinc ion of class I HDAC2 in a bidentate fashion. CONCLUSION: Overall, salicylamide represents a novel zinc-binding group for the development of class I selective HDAC inhibitors. GRAPHICAL ABSTRACT: (http://links.lww.com/MD/G668).


Assuntos
Inibidores de Histona Desacetilases , Histonas , Histona Desacetilase 1/metabolismo , Inibidores de Histona Desacetilases/farmacologia , Inibidores de Histona Desacetilases/uso terapêutico , Histona Desacetilases/metabolismo , Humanos , Ácidos Hidroxâmicos/farmacologia , Simulação de Acoplamento Molecular , Isoformas de Proteínas , Salicilamidas , Tubulina (Proteína) , Zinco/farmacologia
5.
Ther Adv Ophthalmol ; 14: 25158414211070880, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35282003

RESUMO

Idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome is a rare spectrum of retinal vasculitis, aneurysms, and neuroretinitis affecting young individuals in their third decade. Most of our current knowledge is based on case reports, case series, and a handful of collaborative studies. There is much diversity in treatment approaches and outcomes in the reported literature. We have aggregated published case reports and case series into quantitative and narrative synthesis to draw evidence-based conclusions toward clinical features, atypical and rare findings, systemic associations, disease course, and treatment outcomes. The analysis suggested the disease mostly affects young individuals with a female predilection. Anterior chamber and vitreous inflammation are common than previously believed. The most prevalent pattern of retinal vasculitis in IRVAN eyes is mixed vasculitis, followed by arteritis and phlebitis. Most eyes at the time of presentation have capillary nonperfusion and require treatment. Most eyes retain good visual acuity; however, treatment is required to maintain visual function. Intravitreal antivascular endothelial growth factors administered as an adjunct to retinal laser photocoagulation are more likely to improve visual outcomes. Besides, we have discussed the different hypotheses on the etiopathogenesis of the disease and stronger evidence suggests an inflammatory origin of the disease.

6.
SN Compr Clin Med ; 4(1): 29, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35036848

RESUMO

The purpose of this study is to report eyelid myokymia in patients recently recovered from COVID-19 disease. A cohort of 15 patients who developed eyelid myokymia during or immediate post-recovery of systemic disease were evaluated. Demographic, clinical characteristics, effect of age, and hospitalization on the disease course were studied. The disease course was evaluated every month for 3 months period. All, except 2, patients had complete resolution of lid myokymia within 3 months of onset. Median [IQR] myokymia recovery time was 42 [31,60] days. Age and duration of hospitalization had a significant linear relationship with myokymia recovery time. Recovery was delayed by 2.64 days with every 1-year increment in age and by 6.19 days with every additional day of hospital stay. Recovery time was independent of severity of systemic disease (P = .055) and gender (P = 0.2). Eyelid myokymia can be a possible manifestation of COVID-19 recovery phase. While myokymia recovers gradually in all these patients, older age and a longer duration of hospitalization are associated with slower recovery.

7.
Ocul Immunol Inflamm ; 30(2): 417-423, 2022 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32809905

RESUMO

OBJECTIVE: To assess the reliability and validity of gray level co-occurrence matrices (GLCM) in the quantification of choriocapillaris and describe GLCM features in normal and eyes with resolved acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and serpiginous choroiditis (SC). METHODS: In this, multicenter, reliability, validity and comparative study; OCTA was performed on eyes with resolved APMPPE and SC and normal individuals. CC texture classification, low flow area measurements and GLCM feature extraction were performed. RESULTS: A total of 13 normal, 8 APMPPE and 15 SC eyes were analyzed. All GLCM parameters demonstrated an excellent reliability. GLCM parameters were differently distributed across the three groups. Decision-tree based on the random forest predictive model provided an overall accuracy of 86% in classifying the three groups using GLCM features. CONCLUSION: These data demonstrated an excellent reliability and validity of GLCM features in quantifying the choriocapillaris in healthy and diseased eyes.


Assuntos
Corioidite , Doenças da Túnica Conjuntiva , Síndrome dos Pontos Brancos , Corioide , Corioidite/diagnóstico , Angiofluoresceinografia/métodos , Humanos , Coroidite Multifocal , Reprodutibilidade dos Testes , Tomografia de Coerência Óptica/métodos
8.
Int Health ; 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34618895

RESUMO

The constantly mutating severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) does not appear to be slowing down any time soon. All countries, particularly developing countries, must adapt and strategically plan their way of life around the pandemic, while doing everything possible to keep the mortality rate and spread of the newly emerging variants as low as possible, in order to avoid a further blow to the economy and way of life. Pakistan is one such developing country that is currently battling the dangerous delta strain of SARS-COV-2 with limited resources and has recently seen the emergence of an equally transmissible and highly infectious epsilon strain. This is a concerning situation considering that Pakistan's already overburdened health system and faltering economy cannot withstand another dangerous SARS-COV-2 variant attack. This article highlights some strategies for the country to fortify its defences to prevent the epsilon variant from spreading before it is too late, and emphasises that while identifying potential immune evasion mechanisms in SARS-COV-2 variants is critical in the fight against COVID-19, it is also critical to develop methods of efficient and cost-effective detection to identify an early outbreak and then vigilantly and systematically plan area lockdowns before any hope of conquering this pandemic is lost.

9.
J Pak Med Assoc ; 71(3): 1051-1054, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34057981

RESUMO

Medical error reporting is essential in creating a culture of accountability in our healthcare system. The aim of this study was to evaluate the frequency of reporting errors by surgeons in our setup and to analyse the factors resulting in under-reporting of medical errors. A total of 96 practicing surgeons at Mayo Hospital, Lahore were surveyed between the months of February, 2018 to June 2018 on their beliefs regarding the reporting of medical errors by means of a specifically designed questionnaire. This study revealed that 71 (74%) respondents had committed a medical error but only 16 (16.6%) of them reported those errors. Major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to disclosure of error. Eighty-four (87.5%) believed that increase in reporting medical errors would contribute to a better system. Most surgeons had a positive view towards the process but believed that the reporting system was ineffective.


Assuntos
Erros Médicos , Cirurgiões , Atitude , Humanos , Inquéritos e Questionários , Centros de Atenção Terciária
10.
Teach Learn Med ; : 1-7, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33789559

RESUMO

PHENOMENON: Clinical teachers' identity formation is understudied in developing countries like Pakistan. Despite producing thousands of international medical graduates per year, Pakistani medical education is still in its infancy. The application of Western medical education methods and theories is beset by unique socio-cultural challenges. These must be identified and addressed to ease our physicians' transition from clinician to teacher and maximize their teaching output in a resource-limited setting. APPROACH: Eight clinical teachers were interviewed from Combined Military Hospital Kharian, Punjab, Pakistan in July 2020. Semi-structured questionnaires were used, and interviews were audio-taped to generate transcripts. These were analyzed qualitatively and coded, developing themes regarding barriers to identity formation. FINDINGS: Six themes reflected possible barriers to identity formation and fell under two domains: individual and systemic issues. At the individual level these themes were: conflicting priorities, lack of autonomy, and language barriers. Systemic issues were found to be: disconnect between educationists and teachers, the absence of incentives, and lack of institutional support. INSIGHT: Identifying barriers to identity formation can aid clinical teachers' development and encourage discourse around providing increased institutional support to teachers to overcome said barriers. Both the individual and the institute are stakeholders in the process of identity formation and dialogue between the two can lead to improved teaching outcomes.

11.
Appl Psychophysiol Biofeedback ; 46(2): 183-194, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33877492

RESUMO

Neurofeedback (NF) training based on alpha upregulation has been widely used on patient and healthy populations. However, active voluntary modulation of central or widespread posterior alpha in response to central alpha feedback is still ambiguous. The objective of this study is to confirm whether patients learn to truly increase alpha power and to determine if patients modulate central or widespread alpha power when alpha feedback is provided from central brain region. This EEG-based NF study was conducted on seven paraplegic patients with same injury type, pain location, and sensitization to ensure homogeneity. In addition to routine NF training sessions, various experiments were performed to compare alpha NF modulation received from C4 with alpha shift during cognitive tasks, occipital or parieto-occipital cortex, and Laplacian montage which is expected to separate localized alpha from widespread alpha, to attain objectives. Moreover, imaginary coherence analysis in alpha band was also performed to check whether C4 training site is coupled with other brain regions and to confirm whether activity at training site leads/lags the activity of other brain regions. The results indicate widespread alpha modulation in patients during regular NF sessions (p < 0.05) with large effect size (> 0.8), sufficiently high statistical power (> 80%), and a narrower confidence interval (CI) in response to NF provided from the central brain region reflecting less uncertainty and higher precision. However, small effect size obtained with Laplacian montage require patients to be trained with Laplacian feedback to achieve a reliable conclusion regarding localized alpha modulation. The outcomes of this study are not only limited to validate true alpha modulation in response to central alpha feedback but also to explore the mechanism of central alpha NF training.


Assuntos
Eletroencefalografia , Neurorretroalimentação , Encéfalo , Humanos , Aprendizagem , Regulação para Cima
12.
Semin Ophthalmol ; 36(7): 531-540, 2021 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-33780299

RESUMO

Background: von Hippel-Lindau (VHL) syndrome is a multisystem neoplastic disorder involving eyes, central nervous system, kidneys, spine, and other tissues. A retinal capillary hemangioma (RCH) is the earliest manifestation of the VHL disease in most cases.Areas covered:This paper aims to provide an up-to-date review of the current literature about von Hippel-Lindau syndrome. Molecular background, systemic and ocular features of the diseases as well as the utility of newer imaging modalities in diagnosis and monitoring of ocular VHL disease have been described. Besides, we have discussed newer treatment modalities and therapeutic targets.Conclusion: Modern imaging technologies like optical coherence tomography and optical coherence tomography angiography are tools of the trade, in making an appropriate diagnosis and monitoring disease activity and response to treatment. Peripheral RCH may be treated using laser photocoagulation in tumors up to 3000 µm. Vascular endothelial growth factor suppression can help in reducing tumor activity and stabilize the tumor size; however, it does not regress the RCH.


Assuntos
Hemangioblastoma , Neoplasias da Retina , Doença de von Hippel-Lindau , Humanos , Neoplasias da Retina/diagnóstico , Neoplasias da Retina/terapia , Tomografia de Coerência Óptica , Fator A de Crescimento do Endotélio Vascular , Doença de von Hippel-Lindau/complicações
13.
AIMS Public Health ; 8(1): 90-99, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33575409

RESUMO

Psychological distress is a generic term which refers to "feeling of emotional strain" that affects our normal mental and physical functioning. The aim of this study is to investigate the psychological distress perceived by the Pakistani students living in quarantine and to determine risk and protective factors, including knowledge of COVD-19, among this population. It is a descriptive cross-sectional study conducted from February to May 2020. Students enrolled at different colleges and universities of Pakistan participated in this survey. One-way analysis of variance (ANOVA) is computed for comparing knowledge scores of participants having different levels of psychological distress. A total of 937 participants completed the survey questionnaire, with slightly more male respondents (60.6%) than female (39.4%). The average age of survey participants is 22.0 years (SD = 3.01), with majority (76.2%) belonging to urban areas. The mean COVID-19 knowledge score is 8.91 (SD = 1.69, range: 1-12), suggesting an overall 74.25% precision rate for this knowledge test for individual participant. The participants scored least knowledge regarding the disease transmission, showing a percentage correctness of only 40%. Majority of the participants (57.3%) are likely to be well, while others (42.7%) have shown symptoms of mental distress. The analysis reveals that participants with moderate mental distress (M = 8.81, SD = 2.37) and those with severe mental distress (M = 8.75, SD = 2.69) scored lower than participants who were likely to be well (M = 9.49, SD = 1.71). Our study concludes that a higher knowledge base regarding the disease will help to mitigate distress levels. Our study suggests that in order to deal with this pandemic effectively, the knowledge regarding COVID-19 should be properly conveyed to general public. It is need of the hour to address mental issues of the population aggressively along with providing awareness about COVID-19.

14.
Eye (Lond) ; 35(2): 425-432, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32291404

RESUMO

BACKGROUND/OBJECTIVES: To analyze the ophthalmic characteristics of congenital prepapillary vascular loop (PVL) and to propose a new morphologic classification dividing the loops into six types. SUBJECTS/METHODS: Collaborative multinational multicentre retrospective study of PVL cases. RESULTS: There was a total of 49 cases (61 eyes), 37 unilateral (75.5%) and 12 bilateral (24.5%), 32 arterial type (65.3%) and 18 venous type (36.7%) (one patient had either kind in each eye). The mean number of loops per eye was 2.7 (range, 1-7). The loops were asymptomatic in 42 cases (85.7%). Other findings included: the presence of cilioretinal artery (14 cases), retinal vascular tortuosity (26 cases), amaurosis fugax (1 case), branch retinal artery occlusion (1 case) and vitreous haemorrhage (3 cases). Six morphologic loop types could be discerned based on elevation (flat vs. elevated), shape (figure of 8 or corkscrew with hyaline sheath), number (multiple or single), location (central or peripheral), lumen size (arterial vs. arteriolar) and presence of vascular tortuosity or vitreous traction. CONCLUSIONS: PVL are usually asymptomatic and can be divided into six morphologic types with different pathogenesis during early embryogenesis.


Assuntos
Anormalidades do Olho , Malformações Vasculares , Humanos , Vasos Retinianos/anormalidades , Estudos Retrospectivos , Malformações Vasculares/diagnóstico
15.
J Neurosci Rural Pract ; 10(3): 417-422, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31595113

RESUMO

Background As stroke is a catastrophic illness, knowing its risk factors, early signs and symptoms, and management strategies could potentially prevent morbidity and mortality among the people. Objectives The aim of this study is to determine the public cognizance of risk factors, signs and symptoms, and early treatment options available for stroke with particular emphases on thrombolysis, and its window period. Materials and Methods A cross-sectional telephonic interview-based survey was conducted in the states of Punjab, Haryana, and Himachal Pradesh of North India from August 2017 to December 2017. Results Of 350 respondents those participated in the survey with a mean age ± standard deviation of 39.93 ± 13.41  years, hypertension was found to be the most common risk factor among the study participants ( n = 205, 58.57%) and 28.85% of the study participants were not aware of the risk factors, whereas 46% of the participants were not aware of warning signs of stroke. The window period of thrombolysis was compared with gender, and it was found that the higher number of male participants ( n = 49) adduced the right window of thrombolysis (0-4.5  hours) as compared with the female participants ( n = 26). Conclusions Survey results suggested that there exists scant information about risk factors, alarming signs, and early treatment approaches among community adults toward stroke. In this regard, there is an immense need to conduct awareness camps related to stroke to educate the vulnerable public.

16.
Ophthalmic Surg Lasers Imaging Retina ; 50(9): 566-572, 2019 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-31589754

RESUMO

BACKGROUND AND OBJECTIVE: To evaluate the flow characteristics and textural properties of choriocapillaris (CC) on optical coherence tomography angiography in eyes with resolved inflammatory choriocapillaropathies and Vogt-Koyanagi-Harada (VKH) disease. PATIENTS AND METHODS: A cohort of eyes with healed acute posterior multifocal placoid pigment epitheliopathy (APMPPE), serpiginous choroiditis (SC), and VKH disease were included. A 3 mm × 3 mm OCT angiogram of CC was acquired and graded for flow characteristics and textural properties. RESULTS: This study included 16 patients. Texture was heterogeneous in all eyes in the SC and VKH groups, and in four eyes (40%) in the APMPPE group. Most of the eyes with VKH disease had severe low flow, whereas most of the SC and APMPPE eyes demonstrated mild low flow. Heal duration had a strong negative correlation with severity of CC low flow and a weak, statistically nonsignificant correlation with texture heterogeneity. CONCLUSION: Despite the resolution of active inflammation, partial CC hypoperfusion and texture disruptions persist for longer durations and may resolve in a time dependent manner. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:566-572.].


Assuntos
Corioide/fisiopatologia , Coroidite Multifocal/fisiopatologia , Síndrome Uveomeningoencefálica/fisiopatologia , Síndrome dos Pontos Brancos/fisiopatologia , Adulto , Angiografia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Coroidite Multifocal/diagnóstico por imagem , Fluxo Sanguíneo Regional , Estudos Retrospectivos , Tomografia de Coerência Óptica , Síndrome Uveomeningoencefálica/diagnóstico por imagem , Síndrome dos Pontos Brancos/diagnóstico por imagem
17.
Cureus ; 11(7): e5072, 2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31516783

RESUMO

Introduction The personality of a human being consists of his behavior, cognition, emotional abilities, and interaction with his surroundings. The personality of an individual is modified by his ability for social perception, life experiences, and training. The pattern of study in which a person acquires education has a great influence on their personality. Objective To compare the personality traits and academic performance of boarders and non-boarders studying in a medical university. Material and methods It is a comparative, descriptive cross-sectional study done at Rawalpindi Medical University, Pakistan. The duration of the study was from January 2019 to April 2019. A questionnaire was randomly distributed among the students of Rawalpindi Medical University and filled under supervision. The questionnaire had two parts: (1) Academic performance information and (2) Big Five inventory (BFI-40). Only MBBS students of Rawalpindi Medical University were included. For statistical analysis, the independent t-test was applied using the Windows IBM Statistical Package for the Social Sciences Version 22 (SPSS, IBM Corp., Armonk, NY, US). The statistically significant value was taken as 0.05. Results Out of 300 questionnaires distributed, 287 were properly filled, giving a response rate of 95.6%. The Cronbach's alpha value was .750. The mean age was 20.87±1.344. There were 216 (75.1%) male and 71 (24.9%) females. One-hundred eighty-three (63.8%) were boarders and 104 (36.2%) were non-boarders. The mean scores of extraversion, agreeableness, and conscientiousness were higher for boarders while the mean scores of neuroticism and openness were higher for non-boarders. High average percentages in professional exams were common in non-boarders while boarders were taking more supplementary exams comparatively. Conclusion Self-discipline, surgency from external activities/situations, and getting along with others are common traits among boarders. On the other hand, non-boarders are more creative but emotionally unstable. The academic status of boarders is comparatively poor. Thus, the hostel administration should be particularly concerned about the activities of boarders, and parents should be aware of their child's academic status. Teachers should pay special attention to the character development of students.

18.
Int J Pharm ; 560: 136-143, 2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-30753932

RESUMO

The objective of current study was to develop solid lipid nanoparticles-loaded with simvastatin (SIM-SLNs) and investigate their in vivo anti-hyperlipidemic activity in poloxamer-induced hyperlipidemia model. Nano-template engineering technique was used to prepare SIM-SLNs with palmityl alcohol as lipid core and a mixture of Tween 40/Span 40/Myrj 52 to stabilize the core. The prepared SIM-SLNs were evaluated for physicochemical parameters including particle diameter, surface charge, morphology, incorporation efficiency, thermal behaviour and crystallinity. In vitro release profile of SIM-SLNs in simulated gastric and intestinal fluids was evaluated by using dialysis bag technique and anti-hyperlipidemic activity was assessed in hyperlipidemia rat model. SIM-SLNs revealed uniform particle size with spherical morphology, zeta potential of -24.9 mV and high incorporation efficiency (∼85%). Thermal behaviour and crystallinity studies demonstrated successful incorporation of SIM in the lipid core and its conversion to amorphous form. SIM-SLNs demonstrated a sustained SIM release from the lipid core of nanoparticles. SIM-SLNs significantly reduced the elevated serum lipids as indicated by ∼3.9 and ∼1.5-times decreased total cholesterol compared to those of untreated control and SIM dispersion treated hyperlipidemic rats. In conclusion, SIM-SLNs showed a great promise for improving the therapeutic outcomes of SIM via its effective oral delivery.


Assuntos
Hiperlipidemias/tratamento farmacológico , Hipolipemiantes/administração & dosagem , Nanopartículas , Sinvastatina/administração & dosagem , Administração Oral , Animais , Cristalização , Preparações de Ação Retardada , Modelos Animais de Doenças , Portadores de Fármacos/química , Sistemas de Liberação de Medicamentos , Liberação Controlada de Fármacos , Hipolipemiantes/farmacologia , Lipídeos/química , Masculino , Tamanho da Partícula , Ratos , Ratos Sprague-Dawley , Sinvastatina/farmacologia
19.
Circ Res ; 121(11): 1224-1236, 2017 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-28923792

RESUMO

RATIONALE: Autologous stem cell therapy using human c-Kit+ cardiac progenitor cells (hCPCs) is a promising therapeutic approach for treatment of heart failure (HF). However, hCPCs derived from aged patients with HF with genetic predispositions and comorbidities of chronic diseases exhibit poor proliferative and migratory capabilities, which impair overall reparative potential for injured myocardium. Therefore, empowering functionally compromised hCPCs with proregenerative molecules ex vivo is crucial for improving the therapeutic outcome in patients with HF. OBJECTIVE: To improve hCPC proliferation and migration responses that are critical for regeneration by targeting proregenerative P2Y2 nucleotide receptor (P2Y2R) activated by extracellular ATP and UTP molecules released following injury/stress. METHODS AND RESULTS: c-Kit+ hCPCs were isolated from cardiac tissue of patients with HF undergoing left ventricular assist device implantation surgery. Correlations between P2 nucleotide receptor expression and hCPC growth kinetics revealed downregulation of select P2 receptors, including P2Y2R, in slow-growing hCPCs compared with fast growers. hCPC proliferation and migration significantly improved by overexpressing or stimulating P2Y2R. Mechanistically, P2Y2R-induced proliferation and migration were dependent on activation of YAP (yes-associated protein)-the downstream effector of Hippo signaling pathway. CONCLUSIONS: Proliferation and migration of functionally impaired hCPCs are enhanced by P2Y2R-mediated YAP activation, revealing a novel link between extracellular nucleotides released during injury/stress and Hippo signaling-a central regulator of cardiac regeneration. Functional correlations exist between hCPC phenotypic properties and P2 purinergic receptor expression. Lack of P2Y2R and other crucial purinergic stress detectors could compromise hCPC responsiveness to presence of extracellular stress signals. These findings set the stage for subsequent studies to assess purinergic signaling modulation as a potential strategy to improve therapeutic outcome for use of hCPCs in patients with HF.


Assuntos
Células-Tronco Adultas/metabolismo , Proliferação de Células , Miócitos Cardíacos/metabolismo , Receptores Purinérgicos P2Y2/metabolismo , Transdução de Sinais , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Trifosfato de Adenosina/farmacologia , Células-Tronco Adultas/efeitos dos fármacos , Idoso , Idoso de 80 Anos ou mais , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Feminino , Regulação da Expressão Gênica , Humanos , Cinética , Masculino , Pessoa de Meia-Idade , Miócitos Cardíacos/efeitos dos fármacos , Fenótipo , Fosfoproteínas/metabolismo , Proteínas Proto-Oncogênicas c-kit/metabolismo , Agonistas do Receptor Purinérgico P2Y/farmacologia , Receptores Purinérgicos P2Y2/efeitos dos fármacos , Receptores Purinérgicos P2Y2/genética , Regeneração , Transdução de Sinais/efeitos dos fármacos , Fatores de Transcrição , Transfecção , Uridina Trifosfato/farmacologia
20.
Optom Vis Sci ; 94(2): 265-269, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27779556

RESUMO

PURPOSE: To report a case of atypical serpiginous choroiditis with previously unreported findings on optical coherence tomographic angiography. CASE REPORT: A 35-year-old otherwise healthy man had a 1-week history of vision loss in his right eye. The visual acuity in right eye was counting fingers at 1 meter. Fundoscopy showed a classic peripapillary serpiginous lesion and a solitary macular lesion. Fundus fluorescein angiography revealed early hypofluorescence of active lesions with gradual increase in fluorescence across the phase of angiogram. Optical coherence tomography showed hyperreflectivity in outer retinal layers and loss of ellipsoid zone band. The patient was treated with oral prednisone and visual acuity returned to near normal. The inflammation recurred once the patient discontinued corticosteroid therapy. The flare-up was treated with intravenous methylprednisolone followed by oral steroids. Oral azathioprine was added as a steroid-sparing agent and oral prednisone was tapered slowly and discontinued. The visual acuity returned to normal with settlement of all lesions after initiating azathioprine. Optical coherence tomography showed reintegration of retinal anatomy. No recurrence was seen after discontinuation of corticosteroids. Optical coherence tomographic angiography in resolved serpiginous choroiditis was consistent with loss of choriocapillaris homogeneity. CONCLUSIONS: Serpiginous choroiditis may manifest with multifocal lesions and may be confused with relentless placoid chorioretinitis. However, it ends up in a typical geographic scar. Optical coherence tomography can be used to monitor the changes in retinal structure. Choriocapillaris changes as seen on optical coherence tomographic angiography may be a possible mechanism behind the development of choroidal neovascularization in later stages of the disease.


Assuntos
Corioide/patologia , Corioidite/diagnóstico , Angiofluoresceinografia , Imagem Multimodal/métodos , Oftalmoscopia , Tomografia de Coerência Óptica , Adulto , Corioidite/fisiopatologia , Fundo de Olho , Humanos , Masculino , Recidiva , Retina/patologia , Acuidade Visual
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