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1.
Natl Med J India ; 34(3): 167-170, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34825549

RESUMO

Background All medical graduates must know how to stabilize and manage critically ill patients. A 2-day intensive course, called the acute critical care course (ACCC), was conducted to train interns in technical and non-technical skills for managing a patient whose condition is deteriorating. This analysis aims to assess the feasibility and effectiveness of ACCC for interns. Methods We developed and conducted the ACCC to train interns. It included lectures and skill stations. Twenty-four interns participated in the course. Immediate, post-course, quantitative and qualitative feedback was taken online. Qualitative information was also collected verbally and later by email. These data were analysed both quantitatively and qualitatively. Thematic analysis was used to identify, analyse and report the patterns of responses and behaviour. Results The average score for the utility of the course was 4.7 and for the skill stations it was 4.6 on a scale of 5. The qualitative analysis of the feedback emphasized the need for the course before the clinical posting and more skill-based modules rather than lectures. The interactive style of teaching and training in communication using role-play was appreciated. Few suggestions to improve the course were provided. Conclusions Implementing the ACCC needed simulation, interactive discussions, role-play, modified Pendleton's feedback, and reflective exercise that form the basis of a range of educational principles. The blended learning set of objectives of ACCC were the pillars for this successful internship training programme.

2.
Clin Neurol Neurosurg ; 211: 107019, 2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34775257

RESUMO

STUDY DESIGN: Retrospective Cross-Sectional Radiographic Study. OBJECTIVE: This study aims to describe novel radiographic markers of sacropelvic morphology to further define the static and dynamic relationship between the pelvis and the spine, via the analysis of two postures - standing and sitting. SUMMARY OF BACKGROUND DATA: There is increasing evidence underlining the importance of spinopelvic radiographic parameters in the holistic management of sagittal spinal deformity given the close relationship between pelvic morphology and spinal profile. METHODS: This is a retrospective radiographic study of patients who presented with the first episode of isolated mechanical, low back pain of fewer than 3 months' duration. All patients underwent whole spine radiographs using EOS technology in both standing and relaxed sitting postures. Six novel distance measurements (H1, H2, H3, V1, V2, DD) to determine pelvic dimensions, and 3 novel angles (A, B, C) to determine sacral morphology were described. RESULTS: A total of 64 males (58.2%) and 46 females (41.8%) with a mean age of 42.8 ± 18.6 (range:17-81) years old was studied. Between standing and relaxed sitting postures, differences were observed in all sagittal radiographic parameters. Multivariate analysis showed that standing LL< 500 (p = 0.008), standing V1 > 13 cm(p = 0.040), and angle B> 800(p = 0.002) are predictive of PI< 500, standing TK< 300 (p = 0.003) and PI< 500 (p = 0.006) are predictive of LL< 500, and standing PT< 170(p = 0.034), standing H3 ≥ 4 cm (p = 0.030), standing angle C< 420 (p = 0.003), sitting SS≥ 60 (p = 0.002), and sitting PT < 450 (p = 0.013) are predictive of change in LL below mean difference of 420 between standing and relaxed sitting. CONCLUSIONS: Apart from the known correlation between TK, LL and PI, low PI was found to be associated with a tall pelvis and a straight sacrum (angle B). Association between a small coccygeal inclination angle (angle C) and smaller change in LL between standing and relaxed sitting may have clinical relevance.

3.
J Mol Model ; 27(11): 336, 2021 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-34719724

RESUMO

Trace determination of Zr(IV) was carried out by its complexation with a newly synthesized chromone derivative, 3-hydroxy-2-tolyl-4H-chromen-4-one (HToC) for the formation of a 1:4 (M:L) yellow-colored complex from the bicarbonate medium maintained at pH 7.90-8.13. The complex was extractable into the non-aqueous organic solvents showing maximum and stable color intensity in dichloromethane in the wavelength range 414-430 nm. The complex obeyed Beer's law showing linearity of calibration curve in the range 0.0-1.1 µg Zr(IV) ml-1 with an optimum range of determination as 0.44-1.0 ppm Zr(IV) detected from the Ringbom plot. Molar absorptivity, specific absorptivity, and Sandell's sensitivity of thus prepared complex were ascertained, respectively as 4.1971 × 104 l mol-1 cm-1, 0.4601 ml g-1 cm-1, and 0.0022 µg Zr(IV) cm-2 at 420 nm. The linear regression equation being [Formula: see text] (Y = absorbance, X = µg Zr(IV) ml-1) with the correlation coefficient of 0.9977 and detection limit of the procedure as 0.0729 µg ml-1. Theoretical calculations were used to determine and compare structural and bonding properties of the Zr(IV)-HToC complex along with justification of the donor sites provided by ligand for complexation with respect to the metal. The consequences obtained were highly cogent with standard deviation of ± 0.0021 absorbance unit. The procedure was applied to various synthetic (some analogous to cooperate and nickel zirconium) and technical (reverberatory flue dust and water) samples with satisfactory results.

4.
Natl Med J India ; 34(2): 92-94, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34599121

RESUMO

Background: . Effective patient-doctor communication is a key component of patient-centred care, which is one of the six pillars of quality healthcare delivery. Structured and effective communication skills training for healthcare providers is the need of hour in medical education. We assessed the efficacy of role play and simulation in developing communication skills. Methods: . As a key component of an acute critical care course (ACCC), communication skills are taught using role play models and simulation. Live feedback is critical in learning during this course as per the principles of adult learning (andragogy). Quantitative and qualitative data were collected to assess the efficacy of ACCC. Results: . The 19th ACCC was introduced to interns at the All India Institute of Medical Sciences, New Delhi in December 2018. The teaching methodology and objective-oriented structured training in ACCC were much appreciated for training in human factors with emphasis on communication. A positive response was obtained from the candidates 3 weeks after they completed the course to assess whether interns are able to make use of this training in their day-to-day clinical practice amounting to a reliable evidence level of Kirkpatrick's 'return of investment'. Conclusion: . The use of 'role play' to teach communication skills is effective and superior to lecture-based teaching. Further structured and interactive programmes in communication skills training will improve patient care, relatives' satisfaction and the image of medical profession.


Assuntos
Educação Médica , Relações Médico-Paciente , Competência Clínica , Comunicação , Cuidados Críticos , Humanos
5.
J Membr Biol ; 254(5-6): 459-462, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34480589

RESUMO

Increasing interest has recently focused on determining whether quercetin may exert anti-aging properties or not? The objective of this study was determination of Na+, K+ -ATPase activity in quercetin-treated red blood cells during human aging. The study was carried out on human blood samples. The subjects were divided into different age groups, young, middle, and old. The effects of quercetin were evaluated by determining Na+, K+ -ATPase activity by co-incubating the red blood cells in presence of quercetin (10-6 M to 10-3 M final concentration). Quercetin causes 15% increase in Na+, K+ -ATPase activity at 10-4 M and 17% at 10-3 M as compared to the young control age group. The effect was insignificant at 10-5 M (7%) and 10-6 M (5%) in the young age group. Quercetin showed significant increase at 10-6 M to 10-3 M in Na+, K+ -ATPase activity as compared to the middle control age group. A significant increase in Na+, K+ -ATPase activity was observed at all concentrations [10-6 M (31%), 10-5 M (39%), 10-4 M (51%), and 10-3 M (61%)] in elderly population. We believe that these findings will help in further research against oxidative stress in red blood cells.

6.
Cureus ; 13(8): e17036, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34522515

RESUMO

Randomized controlled trials (RCTs) provide the best quality evidence to steer patient care in the field of clinical nutrition. However, designing and conducting an RCT, analyzing data, interpreting and reporting its findings is rather complex for young researchers working in the field of clinical nutrition. This review article attempts to educate early researchers by offering a simple step by step guide on planning the key aspects (randomization, allocation concealment, blinding, outcome measures) of a trial, and highlighting the practical considerations (ethical clearance, trial registry, patient recruitment, trial monitoring) to be kept in mind while conducting a trial contextualised to clinical nutrition settings.

7.
J Neural Eng ; 18(5)2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34384052

RESUMO

Objective.Error-related potentials (ErrPs) are elicited in the human brain following an error's perception. Recently, ErrPs have been observed in a novel task situation, i.e. when stroke patients perform upper-limb rehabilitation exercises. These ErrPs can be used to developassist-as-needed(AAN) robotic stroke rehabilitation systems. However, to date, there is no reported research on assessing the feasibility of using the ErrPs to implement the AAN approach. Hence, in this study, we evaluated and compared the single-trial classification of novel ErrPs using various classical machine learning and deep learning approaches.Approach.Electroencephalogram data of 13 stroke patients recorded while performing an upper-limb physical rehabilitation exercise were used. Two classification approaches, one combining the xDAWN spatial filtering and support vector machines, and the other using a convolutional neural network-based double transfer learning, were utilized.Main results.Results showed that the ErrPs could be detected with a mean area under the receiver operating characteristics curve of 0.838, and a mean accuracy of 0.842, 0.257 above the chance level (p< 0.05), for a within-subject classification. The results indicated the feasibility of using ErrP signals in real-time AAN robot therapy with evidence from the conducted latency analysis, cross-subject classification, and three-class asynchronous classification.Significance.The findings presented support our proposed approach of using ErrPs as a measure to trigger and/or modulate as required the robotic assistance in a real-timehuman-in-the-looprobotic stroke rehabilitation system.


Assuntos
Interfaces Cérebro-Computador , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Encéfalo , Eletroencefalografia , Humanos , Acidente Vascular Cerebral/diagnóstico , Máquina de Vetores de Suporte
8.
BMJ Open Qual ; 10(Suppl 1)2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34344738

RESUMO

BACKGROUND: Airway management is a life-saving procedure in the emergency department (ED). Hypoxia during rapid sequence intubation (RSI) is associated with high morbidity and mortality. AIM: To decrease the median time of intubation (time from administration of paralytic agent to the successful passage of endotracheal tube) by 40% from baseline 300 s in patients undergoing RSI in the ED. METHODS: A multidisciplinary quality improvement team worked to improve the airway management. The bottle necks identified using process mapping and fish bone analysis were lack of formal training of residents and nursing officers, and communication gap between residents and nursing officers. Change ideas focused on training residents in laryngoscopy and intubation and nursing officers in facilitating airway management by preparation of drugs and equipment; on-site awareness of logistical issues to the residents and nursing officers, introducing airway drug checklist and ensuring availability of difficult airway equipment. RESULTS: After implementation of change ideas there was a significant reduction in intubation time. At the end of first Plan-Do-Study-Act (PDSA) cycle median intubation time was 165 s (IQR 125 s). By the end of last PDSA cycle, median intubation time reduced to 157 s (IQR 66 s). A shift was obtained on the run chart with a new median time of 141.5 s from mid-PDSA 1. The 8-week data after the end of PDSA 3 showed sustainability with median time of 126 s (IQR 42 s). CONCLUSION: A well organised team effort, simple change ideas such as structured training of residents and nursing officers, introduction of airway drug checklist and improved communication can decrease the intubation time in a chaotic ED.


Assuntos
Manuseio das Vias Aéreas , Intubação Intratraqueal , Lista de Checagem , Serviço Hospitalar de Emergência , Humanos , Melhoria de Qualidade
9.
BMJ Open Qual ; 10(Suppl 1)2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34344745

RESUMO

INTRODUCTION: Failure of early identification of sepsis in the emergency department (ED) leads to significant delays in antibiotic administration which adversely affects patient outcomes. AIM: The primary objective of our Quality Improvement (QI) project was to reduce the door-to-antibiotic time (DTAT) by 30% from the preintervention in patients with suspected sepsis. Secondary objectives were to increase the blood culture collection rate by 30% from preintervention, investigate the predictors of improving DTAT and study the effect of these interventions on 24-hour in-hospital mortality. METHODS: This QI project was conducted in the ED of a tertiary care teaching hospital of North India; the ED receives approximately 400 patients per day. Adult patients with suspected sepsis presenting to our ED were included in the study, between January 2019 and December 2020. The study was divided into three phases; preintervention phase (100 patients), intervention phase (100 patients) and postintervention phase (93 patients). DTAT and blood cultures prior to antibiotic administration was recorded for all patients. Blood culture yield and 24-hour in-hospital mortality were also recorded using standard data templates. Change ideas planned by the Sepsis QI Team were implemented after conducting plan-do-study-act cycles. RESULTS: The median DTAT reduced from 155 min in preintervention phase to 78 min in postintervention phase. Drawing of blood cultures prior to antibiotic administration improved by 67%. Application of novel screening tool at triage was found to be an independent predictor of reduced DTAT. CONCLUSION: Our QI project identified the existing lacunae in implementation of the sepsis bundle which were dealt with in a stepwise manner. The sepsis screening tool and on-site training improved care of patients with sepsis. A similar approach can be used to deal with complex quality issues in other high-volume low-resource settings.


Assuntos
Sepse , Adulto , Hospitais de Ensino , Humanos , Índia/epidemiologia , Sepse/diagnóstico , Sepse/tratamento farmacológico , Atenção Terciária à Saúde , Triagem
10.
Chem Rec ; 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34436813

RESUMO

Transition metal-catalyzed direct C-H bond functionalization is recognized as an efficient strategy to assemble heterocyclic frameworks. For this purpose, directing groups (DGs) installation on an organic molecule has remained a widely exploited strategy for the years. The installation of directing groups, especially for the amine, alcohol and thiol containing reactants and their removal after the reaction need additional steps. In this regard, the use of free amine, hydroxyl and sulfhydryl as directing groups in native form is advantageous and in recent times, these transformations have stirred undisputable advancements for applications to heterocycle synthesis. In this review, the aromatic sp2 -C attached free amine, hydroxyl and sulfhydryl as native functionalities are shown to be useful for the construction of five to seven-membered N-, O- and S-heterocycles.

11.
Asia Ocean J Nucl Med Biol ; 9(2): 173-176, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34250146

RESUMO

A 65-year-old man presented with intermittent abdominal pain for three months. Abdominal ultrasonography revealed a mass in the body of the pancreas. Moreover, abdominal contrast-enhancing computed tomography revealed a homogenously enhancing mass in the body of the pancreas. Scan findings were in favor of the neuroendocrine tumor, and the serum chromogranin level was slightly raised (111.9 ng/ml, normal <98). He had no history of vomiting, jaundice, melena, hematemesis, constipation, diarrhea, weight gain, weight loss, loss of appetite, and fever. He also had no symptoms related to the excessive production of catecholamines, such as hypertension. The patient was referred for Ga-68 DOTANOC positron emission tomography-computed tomography (Ga-68 DOTANOC PET-CT) for further evaluation. The scan was done to rule out metastatic disease or other synchronous lesions to plan surgical excision. The Ga-68 DOTANOC PET-CT revealed a pancreatic lesion with no other abdominal lesions. We noted multiple tracer avid soft tissue lesions on both sides of the neck that were not diagnosed previously. This case report demonstrates a rare case with multiple paragangliomas diagnosed by the Ga-68 DOTANOC PET-CT. This finding could lead to changes in patient management.

12.
J Emerg Med ; 61(3): 271-277, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34215472

RESUMO

BACKGROUND: Sympathetic crashing acute pulmonary edema (SCAPE) is a severe form of hypertensive acute heart failure with a dramatic presentation. Rapid identification and management in the emergency department (ED) is key to saving these patients and preventing morbidity associated with endotracheal intubation and intensive care treatment. Use of high-dose nitroglycerin (NTG) and noninvasive ventilation (NIV) has been advocated in management of such patients. OBJECTIVE: To study the feasibility and safety of high-dose NTG combined with NIV in SCAPE. METHODS: This was a prospective observational pilot study done in the ED of a tertiary care hospital. All patients were treated with high-dose NTG and NIV. The primary objective was to study the feasibility and safety of the SCAPE management protocol in terms of the outcome of the patient. Resolution of symptoms in 6 h and need for intubation were recorded as endpoints. Any complications associated with high-dose NTG were also recorded. RESULTS: A total of 25 patients were recruited. The mean bolus dose of NTG given was 872 µg, and mean cumulative dose, 35 mg. There was no incidence of hypotension after the bolus dose of nitroglycerin. Eleven patients had resolution of symptoms at 3 h of therapy. Twenty-four patients were discharged from the ED itself after a brief period of observation, and one patient was intubated and shifted to the intensive care unit. CONCLUSION: Use of our specific SCAPE treatment algorithm, which included high-dose NTG and NIV, was safe and provided rapid resolution of symptoms.


Assuntos
Insuficiência Cardíaca , Ventilação não Invasiva , Edema Pulmonar , Humanos , Nitroglicerina/uso terapêutico , Projetos Piloto , Estudos Prospectivos , Edema Pulmonar/tratamento farmacológico
13.
Int J Legal Med ; 2021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34292382

RESUMO

To explore the genomic diversity and forensic characterization of Naga tribes, Nagaland, haplotypes for 23 Y-STR markers have been analyzed. In this study, 203 unrelated male individuals residing in the Northeast Indian state of Nagaland were selected. A total of 203 unique haplotypes were observed. The value of gene diversity (GD) and discrimination capacity (DC) was observed as 0.999999998927955 and 1 respectively. Forensic interest parameters viz., power of discrimination (PD), polymorphic information content (PIC), and matching probability (PM) were found to be 0.999999998695503, 0.999999976671191, and 1.3 × 10-9 respectively, for the studied population. Inter-population comparison study showed that the Naga tribes were found to have a distinct gene pool which is reflected in the neighbor-joining tree, principle coordinate analysis, and heat map. This is the first genetic study on Naga tribes based on 23 Y-STR markers. The Y chromosomal STR data will be useful for forensic DNA application and will enrich the existing Indian Y-STR database.

14.
J Infect Public Health ; 14(7): 863-875, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34118736

RESUMO

The ongoing coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global public health problem. The SARS-CoV-2 triggers hyper-activation of inflammatory and immune responses resulting in cytokine storm and increased inflammatory responses on several organs like lungs, kidneys, intestine, and placenta. Although SARS-CoV-2 affects individuals of all age groups and physiological statuses, immune-compromised individuals such as pregnant women are considered as a highly vulnerable group. This review aims to raise the concerns of high risk of infection, morbidity and mortality of COVID-19 in pregnant women and provides critical reviews of pathophysiology and pathobiology of how SARS-CoV-2 infection potentially increases the severity and fatality during pregnancy. This article also provides a discussion of current evidence on vertical transmission of SARS-CoV-2 during pregnancy and breastfeeding. Lastly, guidelines on management, treatment, preventive, and mitigation strategies of SARS-CoV-2 infection during pregnancy and pregnancy-related conditions such as delivery and breastfeeding are discussed.


Assuntos
COVID-19 , Complicações Infecciosas na Gravidez , Feminino , Humanos , Transmissão Vertical de Doenças Infecciosas , Pandemias , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , SARS-CoV-2
15.
Int J Legal Med ; 135(6): 2307-2308, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34104982

RESUMO

In order to find out the genetic structure and characterize the forensic features of 23 autosomal STRs in the population of Assam, PowerPlex® Fusion 6C amplification kit was employed to genotype 292 unrelated individuals from Assam, India. A total of 79 different alleles were observed across 23 autosomal STRs with the corresponding frequency of alleles, which ranges from 0.002 to 0.406. Selected 23 loci were observed useful together with the highest value of combined discrimination power (CPD = 1), combined exclusion power (CPE = 0.999999999914), combined paternity index (CPI = 3.04 × 109), and all studied loci combined showing the lowest matching probability which is (CPM = 1.29 × 10-29). Additionally, in comparison with neighboring population, Assam population showed genetic closeness with Indian population. The genetic data of the present study will enrich the existing Indian autosomal DNA database and be useful for forensic and genealogical applications.

16.
Leg Med (Tokyo) ; 53: 101932, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34147822

RESUMO

Here we report the genomic history of Gurjars and framed the useful set of autosomal STRs for Gujjar population. We designed this study with a total number of 215 Gurjars from district Saharanpur (previously known as Gujarat due to presence of many Gujjar zamindars), Moradabad, Bulandshahr, Ghaziabad, Meerut, Noida and NCR Delhi. Locus SE33 was found the most polymorphic and discriminating marker for Gujjar population while locus TPOX is the least. Ancestral information of Gurjars was revealed by comparing the Gujjar's population data with 19 neighbouring populations. In Neighbor Joining (NJ) tree Gurjars were found closer to Gujjars of Jammu region, population of Rajasthan and Uttarkhand, due to the same stock of gene pool.


Assuntos
Genética Populacional , Repetições de Microssatélites , Frequência do Gene , Genômica , Humanos , Índia , Repetições de Microssatélites/genética
17.
Int J Legal Med ; 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059972

RESUMO

In the present study, DNA samples of 202 unrelated male individuals of Gurjar population were evaluated for the molecular diversity at 23 Y chromosomal Y-STR markers. Out of selected individuals, results showed 143 unique haplotypes. Highest degree of gene diversity (GD), polymorphic information content (PIC), and power of discrimination (PD) was observed as 0.7941, 0.7590, and 0.7902, respectively, for the locus DYS385a/b. Haplotype diversity (HD), gene diversity (GD), polymorphic information content (PIC), and power of discrimination (PD) was found to be 0.7079, 0.999999999989, 0.9999999996, and 0.999999999986, respectively, for the studied 23 Y-STR markers. Allele 11 of locus DYS392 was found to be the most frequent allele with the frequency of 0.762. In inter-population relationship, studied population showed genetic relatedness with the population of Jammu and Kashmir, India, and Ladakh, India. The haplotype data of the present study will not only enrich the existing Indian Y-STR data but will also be useful for forensic DNA application.

18.
J Family Med Prim Care ; 10(1): 542-549, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34017785

RESUMO

Background and Objectives: As the number of COVID-19 cases keeps on rising, a better awareness of the nature and severity of the disease will aid in clinical decision-making and management. Hence, this study was conducted to find the predictors of mortality and the need for mechanical ventilation in COVID-19 patients. Methods: This was a single centre, prospective observational study conducted in a tertiary care centre in north India. We included patients with influenza like illness who tested positive for COVID-19. Information regarding patient demography, symptoms, and vital signs on presentation, laboratory values, chest imaging findings, and disease severity was collected by the emergency physician. QSOFA score and National early warning score (NEWS) score were calculated using initial vital signs. Each patient was followed up till discharge or death. Results: We included 116 COVID-19 patients with 33 patients having mild, 46 patients with severe and 37 patients with critical disease. The median age of our patients was 47 years (39-59) with 63% males. About 58% of patients had at least one comorbidity and shortness of breath was the most common presenting feature. The patients with severe and critical disease had a significantly higher respiratory rate and heart rate as compared to mild disease (p < 0.05). SpO2 of those with critical disease was significantly lower as compared to those with mild disease. Mechanical ventilation was required in around 36% of patients which included 67% of patients with critical disease. The overall mortality was 51% with 90% among critical disease. Lower SpO2 and GCS were the only parameters that showed a significant association with mortality and need for mechanical ventilation. The receiver operating characteristics analysis showed NEWS score as a better predictor of mortality and need for mechanical ventilation as compared to qSOFA score. Conclusion: NEWS and qSOFA scores are useful tools in predicting fatal outcomes in COVID patients with NEWS score being a better score than qSOFA.

19.
Pestic Biochem Physiol ; 175: 104813, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33993954

RESUMO

The study explores the pesticidal efficacy, mode of action, and safety limit profile of essential oils-based formulation using the combination of Myristica fragrans (M), Bunium persicum (B), and Zanthoxylum alatum (Z) (1:1:1 v/v/v) and their nanoformulation (Ne-MBZ) against the Callosobruchus chinensis, Aspergillus flavus and aflatoxin B1 production. Linalool, γ-terpinene, and cuminaldehyde were identified as the major compounds of the formulation (MBZ) by Gas chromatography-mass spectrometry (GC-MS). Nanoencapsulation of developed formulation (Ne-MBZ) was prepared using chitosan and characterized by scanning electron microscopy (SEM), X-ray diffraction analysis (XRD), and Fourier transform infrared spectroscopy (FTIR). The pesticidal efficacy of nanoformulation (Ne-MBZ) against C. chinensis IC50 (0.14 µl/ml), A. flavus (0.8 µl/ml) and AFB1 (0.8 µl/ml) was significantly higher in both in-vitro and in-situ conditions than the sum of their individual revealing a notable synergistic effect. Besides, the detailed mode of pesticidal action and safety limit profile were explored using biochemical, in-silico and ADMET (absorption, distribution, metabolism, excretion, and toxicity) approaches.


Assuntos
Apiaceae , Óleos Voláteis , Praguicidas , Animais , Antifúngicos , Aspergillus flavus , Óleos Voláteis/toxicidade
20.
Rev Cardiovasc Med ; 22(1): 147-158, 2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33792256

RESUMO

Sudden cardiac death (SCD) is an unexpected sudden death due to a heart condition, that occurs within one hour of symptoms onset. SCD is a leading cause of death in western countries, and is responsible for the majority of deaths from cardiovascular disease. Moreover, SCD accounts for mortality in approximately half of all coronary heart disease patients. Nevertheless, the recent advancements made in screening, prevention, treatment, and management of the underlying causes has decreased this number. In this article, we sought to review established and new modes of screening patients at risk for SCD, treatment and prevention of SCD, and the role of new technologies in the field. Further, we delineate the current epidemiologic trends and pathogenesis. In particular, we describe the advancement in molecular autopsy and genetic testing, the role of target temperature management, extracorporeal membrane oxygenation (ECMO), cardiopulmonary resuscitation (CPR), and transvenous and subcutaneous implantable cardioverter devices (ICDs).


Assuntos
Morte Súbita Cardíaca , Desfibriladores Implantáveis , Morte Súbita Cardíaca/epidemiologia , Morte Súbita Cardíaca/etiologia , Morte Súbita Cardíaca/prevenção & controle , Humanos
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