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1.
Ann Med Surg (Lond) ; 59: 234-236, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33088498

RESUMO

Introduction: Levothyroxine (T4) overdose is not frequently encountered and for the clinical signs to materialize, the ingested dose, the rate of conversion of T4 to T3 and chronicity of overdose can be held accountable. Case report: A 29-year-old female, a known case of hypothyroidism and adjustment disorder, under levothyroxine, propranolol and sertraline, intentionally ingested 2.5 mg of levothyroxine but remained asymptomatic with sudden surge in T4 in initial hours of ingestion which gradually started declining along with reciprocal change in TSH. However, the change in T3 was almost negligible. Discussion: T3, the active thyroid hormone, when in excess accounts for toxic effects. The duration during physiological process of deiodination and half life of hormone correlates with onset and duration of symptoms. Propranolol which blocks peripheral conversion of T4 to T3 and sertraline which is also reported to reduce the efficacy of levothyroxine, which is evident from low T3 in thyroid profile, must have led to patient being asymptomatic despite lack of early gastric decontamination. Conclusion: Levothyroxine overdose up to 4mg/day may be asymptomatic but in patients with concomitant neurotic or psychiatric illness, who intentionally take it, are also put on drugs like sertraline and propranolol, the effects of which on thyroid hormones must be contemplated for possible explanation of being asymptomatic.

2.
Rev Sci Instrum ; 91(9): 094901, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-33003813

RESUMO

Experimental determination of solidus and liquidus in reactive systems at very high-temperatures requires special equipment and is rather complex. In the present study, we describe setting up an experimental facility based on the "spot-technique." It was demonstrated that this setup could be used to measure phase transformation temperatures involving liquids in refractory systems that comprise reactive and radioactive components, in the range of 1273 K-2273 K, by using a thermo-optometric technique, namely, the "spot-technique." The equipment and the method were validated by measuring the melting points of high purity metals, namely, gold, copper, nickel, and zirconium. A measurement accuracy of ±2 K could be realized at temperatures as high as 2128 K. The solidus and liquidus temperatures of nuclear reactor fuels as well as some binary alloys were also measured by using this setup. The research involved in building this equipment and the key features of the equipment and method are described in detail.

3.
Sci Rep ; 10(1): 4956, 2020 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-32188901

RESUMO

Literature on earthquake impact on hospital admissions is lacking, particularly in low-resource settings. Our aim was to study the pattern of admissions before and after the 2015 earthquake in a tertiary hospital in Nepal. We used routine hospital data from 9,596 admissions, and defined four periods: pre-earthquake (pre-EQ), acute (EQ1), post-acute (EQ2), and post-earthquake (post-EQ). We compared length of hospital stay (LOS) across the study periods using negative binomial regressions. We used logistic regressions to study changes in probability of admission for diagnostic categories, and Generalized Additive Models to model the difference in number of admissions compared to pre-EQ baseline. LOS was longer in EQ1 than during pre-EQ, in particular for injury-related admissions. In EQ1, the odds of injury admissions increased, while they decreased for the majority of other diagnoses, with the odds of pregnancy-related admissions remaining low until post-EQ. The number of admissions dropped in EQ1 and EQ2, and returned to pre-EQ trends in post-EQ, accumulating 381 admissions lost (CI: 206-556). Our findings suggest that hospital disaster plans must not only foresee injury management after earthquakes, but also ensure accessibility, in particular for pregnant women, and promote a quick return to normality to prevent additional negative health outcomes.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Planejamento em Desastres/normas , Terremotos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Assistência à Saúde/tendências , Serviço Hospitalar de Emergência/tendências , Feminino , Humanos , Lactente , Recém-Nascido , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Nepal , Admissão do Paciente/tendências , Gravidez , Adulto Jovem
4.
Sci Rep ; 10(1): 430, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31949221

RESUMO

In this work, nanocomposites made of nanosized zirconia crystallized in situ in an amorphous silicon oxycarbo(nitride) (SiOC(N)) matrix have been designed through a precursor route for visible light photocatalytic applications. The relative volume fraction of the starting precursors and the pyrolysis temperatures not only influences the phase fraction of zirconia crystallites but also stabilizes the tetragonal crystal structure of zirconia (t-ZrO2) at room temperature. The presence of carbon in interstitial sites of zirconia and oxygen vacancy defects led to drastic reduction in the band gap (2.2 eV) of the nanocomposite. Apart from being a perfect host avoiding sintering of the active phase and providing mechanical stability, the amorphous matrix also reduces the recombination rate by forming heterojunctions with t-ZrO2. The reduction in band gap as well as the formation of heterojunctions aids in harnessing the visible light for photocatalytic activity.

5.
PLoS One ; 14(7): e0220016, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31318948

RESUMO

BACKGROUND: In 2015, an earthquake killing 9,000 and injuring 22,000 people hit Nepal. The Tribhuvan University Teaching Hospital (TUTH), a reference tertiary hospital, was operational immediately after the earthquake. We studied the profile of earthquake victims admitted in TUTH and assessed what factors could influence hospital length of stay. METHODS: An earthquake victim dataset was created based on patient records, with information on sex, age, date of admission and discharge, diagnosis, and surgical intervention. We performed an initial descriptive overview of the earthquake victims followed by a time-to-event analysis to compare length of hospital stay in different groups, using log rank test and cox regression to calculate Hazard Ratios. RESULTS: There were in total 501 admitted victims, with the peak of admissions occurring on the fifth day after the earthquake. About 89% had injury as main diagnosis, mostly in lower limbs, and 66% of all injuries were fractures. Nearly 69% of all patients underwent surgery. The median length of hospital stay was 10 days. Lower limb and trunk injuries had longer hospital stays than injuries in the head and neck (HR = 0.68, p = 0.009, and HR = 0.62 p = 0.005, respectively). Plastic surgeries had longer hospital stays than orthopaedic surgeries (HR = 0.57 p = 0.006). Having a crush injury and undergoing an amputation also increased time to discharge (HR = 0.57, p = 0.013, and HR = 0.65 p = 0.045 respectively). CONCLUSIONS: Hospital stay was particularly long in this sample in comparison to other studies on earthquake victims, indirectly indicating the high burden TUTH had to bear to treat these patients. To strengthen resilience, tertiary hospitals should have preparedness plans to cope with a large influx of injured patients after a large-scale disaster, in particular for the initial days when there is limited external aid.


Assuntos
Vítimas de Desastres/estatística & dados numéricos , Terremotos , Hospitalização , Centros de Atenção Terciária , Adolescente , Adulto , Criança , Pré-Escolar , Demografia , Vítimas de Desastres/história , Feminino , História do Século XXI , Humanos , Lactente , Recém-Nascido , Masculino , Registros Médicos , Pessoa de Meia-Idade , Nepal/epidemiologia , Modelos de Riscos Proporcionais , Adulto Jovem
6.
Indian J Endocrinol Metab ; 22(2): 196-199, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29911030

RESUMO

Background: Androgenetic alopecia (AGA) is the most common cause of hair loss. Although it is a medically benign condition, it can have a significant psychosocial impact on patients. "Metabolic syndrome" (MetS) is a collection of clinical signs that focus on cardiovascular and diabetes-related parameters. Despite the high burden of AGA and MetS in India, specific data on the participants are relatively sparse. Aim of the Study: The aim of is to study the association of AGA with MetS and its parameters. Materials and Methods: A case-control study was undertaken in a tertiary care hospital from December 2015 to November 2016 with 100 cases and controls in the age group of 20-50 years. Diagnosis of MetS was based on the National Cholesterol Education Program Adult Treatment Panel III. Independent t-test was used as a test of significance. Categorical data were assessed using Chi-square test of significance. P <0.05 was considered to be significant. Results: MetS was seen in 53% of cases and 17% of controls (P = 0.001). The mean serum triglyceride level (P = 0.015, P < 0.05), mean systolic blood pressure (P = 0.003, P < 0.05), high-density lipoprotein levels in males (P < 0.001), and waist circumference in males (P = 0.022, P < 0.05) were statistically significant in patients with androgenetic alopecia when compared to healthy controls. Conclusion: A higher prevalence of MetS was noted in androgenic alopecia. Early screening for MetS is beneficial in patients with androgenic alopecia.

7.
BMC Int Health Hum Rights ; 14: 21, 2014 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-24957575

RESUMO

BACKGROUND: The unnecessary and unsafe use of injections is common in developing countries like Nepal. Policymakers have an important role in promoting rational and safe injection use. Hence, the present study was carried out to explore the perception of health policymakers regarding safe injection practice in Nepal. METHODS: An exploratory qualitative study design was used in this study. Key policymakers from both the central and regional level were selected using purposive sampling. A semi-structured questionnaire advocated by the World Health Organization (WHO) was used after modifying the context. Interviews were conducted to clarify doubts and obtain additional information. The data was analyzed manually using deductive content analysis technique. RESULTS: In total, eleven policymakers participated. All unanimously agreed that injection safety is a problem and seven participants reported that injections are overused. They shared the opinion that injections are administered by various providers, including formal and informal health providers, and also quacks. Almost half the respondents reported that the National Drug Policy discourages injection overuse, while others reported that the policy contains no provisions regarding injection overuse. Most policymakers stated that only single-use disposable injection equipment is used to provide injection, while others thought that sterilizable glass syringe is also used. More than half of the participants believed that the quality of injection equipment available in the Nepalese market is not regulated by any government institution. Almost two-third of the policymakers stated that syringes and needles are not reused, while the rest thought syringes might be reused without sterilization in some parts of the country. Almost half of the respondents stated that illegal commercialization of used syringes exists in Nepal. Almost all respondents thought that health care institutions have a waste management plan, while more than half of them opined that such plans are limited to tertiary care hospitals located in the capital. CONCLUSIONS: The result of this study revealed a divergence of views among policymakers, even among those in the same ministry. Though there has been some effort from the government to increase the safety of injection practices, greater efforts are required, especially with regard to standardization of policies and procedures related to injection practice.


Assuntos
Assistência à Saúde , Conhecimentos, Atitudes e Prática em Saúde , Política de Saúde , Injeções/normas , Erros Médicos , Agulhas , Segurança , Comércio , Assistência à Saúde/métodos , Assistência à Saúde/normas , Países em Desenvolvimento , Equipamentos Descartáveis , Reutilização de Equipamento , Regulamentação Governamental , Instalações de Saúde/normas , Pessoal de Saúde , Humanos , Nepal , Percepção , Pesquisa Qualitativa , Medição de Risco , Esterilização , Inquéritos e Questionários , Seringas , Gerenciamento de Resíduos
8.
Int J Low Extrem Wounds ; 12(1): 44-9, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23446369

RESUMO

Calcific myonecrosis is a rare late complication of limb trauma characterized by liquefaction and dystrophic calcification of muscles in the single compartment, usually in the leg. This occurs many years after the trauma and is probably due to chronic compartment syndrome. We report 2 cases of calcific myonecrosis involving the anterior compartment of the leg that presented to us in an advanced stage of multiple sinuses discharging calcific material. Incision and drainage had been attempted at a local hospital prior to presentation at our hospital resulting in a non healing wound. Both patients had a history of antecedent trauma to the leg a few years ago. Patients were treated by thorough debridement of the involved muscles in the anterior compartment. Limited access dressing (LAD) was used to manage the dead space left after debridement. After application of the LAD, the wound was covered with split skin grafting. In both patients, healing of the cavity following debridement was facilitated by application of limited access dressing. While the wound completely healed, the disability due to extensive debridement of anterior compartment of the leg persisted. At the latest follow-up, the patients were asymptomatic without any recurrence. Thorough debridement of the compartment involved and application of LAD may be another option of treating calcific myonecrosis of the leg, which was initially considered a "do not touch" lesion. Morbidity due to surgery and need of repeated surgeries for recurrences should be kept in mind and regular follow-up should be considered.


Assuntos
Bandagens , Calcinose/terapia , Desbridamento/métodos , Músculo Esquelético/patologia , Necrose/terapia , Tratamento de Ferimentos com Pressão Negativa/métodos , Calcinose/diagnóstico , Calcinose/etiologia , Seguimentos , Humanos , Traumatismos da Perna/complicações , Masculino , Pessoa de Meia-Idade , Necrose/diagnóstico , Necrose/etiologia , Cicatrização
10.
Health Policy Plan ; 20(1): 60-6, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15689431

RESUMO

OBJECTIVE: This paper examines gender, caste and economic differentials in child mortality in the context of a cluster-randomized trial of vitamin A distribution, in order to determine whether or not the intervention narrowed these differentials. DESIGN: The study involved secondary analysis of data from a placebo-controlled randomized field trial of vitamin A supplements. The study took place between 1989-1991 in rural Sarlahi District of Nepal, with 30,059 children age 6 to 60 months. The main outcome measures were differences in mortality between boys and girls, between highest Hindu castes and others, and between the poorest quintile and the four other quintiles. RESULTS: Without vitamin A, girls in rural Nepal experience 26.1 deaths per 1000, which is 8.3 deaths more than the comparison population of boys. With vitamin A the mortality disadvantage of girls is nearly completely attenuated, at only 1.41 additional deaths per 1000 relative to boys. Vitamin A supplementation also narrowed mortality differentials among Hindu castes, but did not lower the concentration of mortality across quintiles of asset ownership. The vitamin A-related attenuation in mortality disadvantage from gender and caste is statistically significant. CONCLUSIONS: We conclude that universal supplementation with vitamin A narrowed differentials in child death across gender and caste in rural Nepal. Assuring high-coverage vitamin A distribution throughout Nepal could help reduce inequalities in child survival in this population.


Assuntos
Atitude Frente a Saúde/etnologia , Serviços de Saúde da Criança/estatística & dados numéricos , Mortalidade da Criança , Fenômenos Fisiológicos da Nutrição Infantil , Suplementos Nutricionais/provisão & distribução , Classe Social , Vitamina A/administração & dosagem , Vitamina A/provisão & distribução , Cegueira/prevenção & controle , Pré-Escolar , Planejamento em Saúde Comunitária , Feminino , Humanos , Lactente , Masculino , Nepal/epidemiologia , Placebos , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Fatores Socioeconômicos , Análise de Sobrevida , Resultado do Tratamento
11.
Plant Cell Rep ; 22(3): 188-94, 2003 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12920563

RESUMO

A protocol has been developed for somatic embryogenesis and plant regeneration of sisal (Agave sisalana Perr. ex. Engelm). Embryogenic callus cultures were initiated from young shoots raised in vitro from the stem portion of the bulbil on medium supplemented with 1-2 mg l(-1) kinetin (KN) and 0.2-0.5 mg l(-1) alpha-naphthaleneacetic acid plus KN or 1-1.5 mg l(-1 )benzylaminopurine (BAP) or 0.25-0.5 mg l(-1 )2,4-dichlorophenoxyacetic acid plus BAP or 0.5-1.0 mg l(-1) KN. Embryos at various developmental stages (globular-, heart- or torpedo-shaped) produced mature and germinating embryos on being transferred to a new medium containing 0-0.25 mg l(-1 )KN. After 28 days, a maximum of 76% germinated embryos was obtained on a medium supplemented with 0.1 mg l(-1) KN. The capacity for embryogenesis remained constant in the callus upon subculturing on the same medium for more than 48 months. Histological observations showed a distinct multicellular origin for most of the somatic embryos as they developed from epidermal, sub-epidermal and inside callus cells, while a few of them originated from a superficial callus cell. Plantlets regenerated from embryos were transferred to the field where their survival rate was 100%.


Assuntos
Agave/embriologia , Agave/crescimento & desenvolvimento , Agave/fisiologia , Raízes de Plantas/crescimento & desenvolvimento , Raízes de Plantas/fisiologia , Brotos de Planta/crescimento & desenvolvimento , Brotos de Planta/fisiologia , Estruturas Vegetais/crescimento & desenvolvimento , Estruturas Vegetais/fisiologia , Regeneração
12.
J Nat Prod ; 62(6): 817-20, 1999 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10395494

RESUMO

Of several lichen metabolites isolated from Parmelia nepalensis and Parmelia tinctorum, the didepsides atranorin (4) and diffractaic acid (5), as well as (+)-protolichesterinic acid (7), inhibited LTB4 biosynthesis in polymorphonuclear leukocytes. Ethyl hematommate (3) and (+)-usnic acid (1) were only weak inhibitors, while methyl beta-orcinolcarboxylate (2) and gyrophoric acid (6) were inactive at concentrations up to 60 microM. Redox properties of the compounds were evaluated in terms of inhibition of nonenzymatic lipid peroxidation in model membranes, reactivity against the stable free radical 2,2-diphenyl-1-picrylhydrazyl, and deoxyribose degradation as a measure of hydroxyl-radical generation. The results revealed that lichen metabolites neither acted as antioxidants against the peroxidation process in model membranes nor did they scavenge or produce free radicals, suggesting that the inhibitory effects on LTB4 biosynthesis was due to specific enzyme interaction rather than a nonspecific redox mechanism.


Assuntos
Leucócitos/metabolismo , Leucotrieno B4/biossíntese , Líquens/química , Picratos , Animais , Bepridil/análogos & derivados , Compostos de Bifenilo , Bovinos , Desoxirribose/química , Radicais Livres , Técnicas In Vitro , Leucócitos/efeitos dos fármacos , Líquens/metabolismo , Peroxidação de Lipídeos , Oxirredução , Fosfolipídeos/química
13.
J Nat Prod ; 62(6): 821-3, 1999 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10395495

RESUMO

The sensitivity of the human keratinocyte cell line HaCaT to several lichen metabolites isolated from Parmelia nepalensis and Parmelia tinctorum was evaluated. The tridepside gyrophoric acid (6), the dibenzofuran derivative (+)-usnic acid (1), and the didepside diffractaic acid (5) were potent antiproliferative agents and inhibited cell growth, with IC50 values of 1.7, 2.1, and 2.6 microM, respectively. Methyl beta-orcinolcarboxylate (2), ethyl hematommate (3), the didepside atranorin (4), and (+)-protolichesterinic acid (7) did not influence keratinocyte growth at concentrations of 5 microM. Keratinocytes were further tested for their susceptibility to the action of the potent antiproliferative agents on plasma membrane integrity. The release of lactate dehydrogenase activity into the culture medium was unchanged as compared to controls, documenting that the activity of gyrophoric acid (6), (+)-usnic acid (1), and diffractaic acid (5) was due to cytostatic rather than cytotoxic effects.


Assuntos
Anisóis/farmacologia , Antineoplásicos/isolamento & purificação , Benzoatos/farmacologia , Benzofuranos/farmacologia , Hidroxibenzoatos/farmacologia , Queratinócitos/efeitos dos fármacos , Líquens/química , Anisóis/isolamento & purificação , Antineoplásicos/farmacologia , Ácido Araquidônico/metabolismo , Benzoatos/isolamento & purificação , Benzofuranos/isolamento & purificação , Divisão Celular/efeitos dos fármacos , Humanos , Hidroxibenzoatos/isolamento & purificação , Queratinócitos/enzimologia , L-Lactato Desidrogenase/metabolismo , Líquens/metabolismo , Lipoxigenase/metabolismo , Células Tumorais Cultivadas
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