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1.
Braz J Biol ; 83: e246727, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34468521

RESUMO

Unavailability of probiotics in fish digestive system fingerlings is unable to digest and absorb their food properly. The current research was conducted to investigate the influence of probiotics added Linseed meal based (LMB) diet on hematology and carcass composition of Labeo rohita juveniles. Hematological parameters are essential diagnostics used to estimate the health status of fish. The usage of probiotics for fish health improvement is becoming common due to the higher demand for environment-friendly culture system in water. Linseed meal was used as a test ingredient to prepare six experimental test diets by adding probiotics (0, 1, 2, 3, 4 and 5 g/kg) and 1% indigestible chromic oxide for seventy days. According to their live wet weight, five percent feed was given to fingerlings twice a day. Fish blood and carcass samples (Whole body) were taken for hematological and carcass analysis at the end of the experiment. The highest carcass composition (crude protein; 18.72%, crude fat; 8.80% and gross energy; 2.31 kcal/g) was observed in fish fed with test diet II supplemented with probiotics (2 g/kg). Moreover, maximum RBCs number (2.62× 106mm-3), WBCs (7.84×103mm-3), PCV (24.61), platelets (63.85) and hemoglobin (7.87) had also been reported in the fish fingerlings fed on 2 g/kg of probiotics supplemented diet. Results indicated that probiotics supplementation has a critical role in improvement of fingerlings' body composition and hematological indices. Present findings showed that probiotics supplementation at 2 g/kg level in linseed by-product-based diet was very useful for enhancing the overall performance of L. rohita fingerlings.


Assuntos
Cyprinidae , Linho , Probióticos , Ração Animal/análise , Animais , Dieta/veterinária
2.
J Eur Acad Dermatol Venereol ; 35(9): 1750-1764, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34245180

RESUMO

This guideline on mucous membrane pemphigoid (MMP) has been elaborated by the Task Force for Autoimmune Blistering Diseases of the European Academy of Dermatology and Venereology (EADV) with a contribution of physicians from all relevant disciplines and patient organizations. It is a S3 consensus-based guideline encompassing a systematic review of the literature until June 2019 in the MEDLINE and EMBASE databases. This first part covers methodology, the clinical definition of MMP, epidemiology, MMP subtypes, immunopathological characteristics, disease assessment and outcome scores. MMP describes a group of autoimmune skin and mucous membrane blistering diseases, characterized by a chronic course and by predominant involvement of the mucous membranes, such as the oral, ocular, nasal, nasopharyngeal, anogenital, laryngeal and oesophageal mucosa. MMP patients may present with mono- or multisite involvement. Patients' autoantibodies have been shown to be predominantly directed against BP180 (also called BPAG2, type XVII collagen), BP230, laminin 332 and type VII collagen, components of junctional adhesion complexes promoting epithelial stromal attachment in stratified epithelia. Various disease assessment scores are available, including the Mucous Membrane Pemphigoid Disease Area Index (MMPDAI), the Autoimmune Bullous Skin disorder Intensity Score (ABSIS), the 'Cicatrising Conjunctivitis Assessment Tool' and the Oral Disease Severity Score (ODSS). Patient-reported outcome measurements (PROMs), including DLQI, ABQOL and TABQOL, can be used for assessment of quality of life to evaluate the effectiveness of therapeutic interventions and monitor disease course.


Assuntos
Dermatologia , Penfigoide Mucomembranoso Benigno , Penfigoide Bolhoso , Venereologia , Autoanticorpos , Autoantígenos , Humanos , Membrana Mucosa , Penfigoide Mucomembranoso Benigno/diagnóstico , Penfigoide Mucomembranoso Benigno/terapia , Qualidade de Vida , Revisões Sistemáticas como Assunto
3.
J Eur Acad Dermatol Venereol ; 35(10): 1926-1948, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34309078

RESUMO

This guideline has been initiated by the task force Autoimmune Blistering Diseases of the European Academy of Dermatology and Venereology, including physicians from all relevant disciplines and patient organizations. It is a S3 consensus-based guideline that systematically reviewed the literature on mucous membrane pemphigoid (MMP) in the MEDLINE and EMBASE databases until June 2019, with no limitations on language. While the first part of this guideline addressed methodology, as well as epidemiology, terminology, aetiology, clinical presentation and outcome measures in MMP, the second part presents the diagnostics and management of MMP. MMP should be suspected in cases with predominant mucosal lesions. Direct immunofluorescence microscopy to detect tissue-bound IgG, IgA and/or complement C3, combined with serological testing for circulating autoantibodies are recommended. In most patients, serum autoantibodies are present only in low levels and in variable proportions, depending on the clinical sites involved. Circulating autoantibodies are determined by indirect IF assays using tissue substrates, or ELISA using different recombinant forms of the target antigens or immunoblotting using different substrates. The major target antigen in MMP is type XVII collagen (BP180), although in 10-25% of patients laminin 332 is recognized. In 25-30% of MMP patients with anti-laminin 332 reactivity, malignancies have been associated. As first-line treatment of mild/moderate MMP, dapsone, methotrexate or tetracyclines and/or topical corticosteroids are recommended. For severe MMP, dapsone and oral or intravenous cyclophosphamide and/or oral corticosteroids are recommended as first-line regimens. Additional recommendations are given, tailored to treatment of single-site MMP such as oral, ocular, laryngeal, oesophageal and genital MMP, as well as the diagnosis of ocular MMP. Treatment recommendations are limited by the complete lack of high-quality randomized controlled trials.


Assuntos
Dermatologia , Penfigoide Mucomembranoso Benigno , Penfigoide Bolhoso , Venereologia , Autoanticorpos , Autoantígenos , Humanos , Membrana Mucosa , Penfigoide Mucomembranoso Benigno/diagnóstico , Penfigoide Mucomembranoso Benigno/tratamento farmacológico
4.
Appl Radiat Isot ; 174: 109771, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34048992

RESUMO

Present study concerns the key thermoluminescence (TL) properties of photonic crystal fibres (PCFs), seeking development of alternatively structured TL materials that are able to offer a advantages over existing passive dosimeters. In terms of their internal structure and light guiding properties the PCFs, collapsed and structured, differ significantly from that of conventional optical fibres. To investigate the dosimetric parameters of the PCFs use was made of a linear accelerator producing a 6 MV photon beam, delivering doses ranging from 0.5 Gy to 8 Gy. The parameters studied included TL response, linearity index, glow curves, relative sensitivity and TL signal fading, the results being compared against those obtained using TLD-100 chips. At 4 Gy photon dose the Ge-doped collapsed PCFs were found to provide a response 27 × that of structured PCF, also giving a TL yield similar to that of standard TLD-100 chips. Over post-irradiation periods of 15 and 30 days collapsed PCF TL signal fading were 8% and 17% respectively, with corresponding values of 37% and 64% for the structured PCF. Trapping parameters including the order of kinetics (b), activation energy (E) and frequency factor (s-1) were assessed with Chen's peak shape method. Lifetime of trapping centre was found to be (2.36 E+03) s and (9.03 E +01) s regarding the collapsed and structured PCF respectively with 6 Gy of photon beam. For the Ge-doped collapsed PCF, the high TL yield, sensitivity and low fading provide the basis of a highly promising system of TLD for radiotherapy applications.

5.
Indian J Pediatr ; 88(7): 656-662, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33675027

RESUMO

OBJECTIVE: To evaluate pituitary volume and iron overload in beta thalassemia major, with the objective of assessing the reliability of this method in predicting hypogonadism. METHODS: 3T MRI was used to measure pituitary R2 and T2* in 57 beta thalassemia major patients and 30 controls. Anterior pituitary volume was evaluated by MRI planimetry. Cardiac, hepatic, and pancreatic iron overload were also assessed using MRI T2*. Mean serum ferritin was estimated by sandwich immuno-assay. Short stature was defined as height < 3 rd percentile for age, and clinical hypogonadism defined as absence of secondary sexual characteristics at ages ≥ 13 y for females and ≥ 14 y for males. RESULTS: Short stature was present in 32 patients (56.1%). Of the 47 patients in the pubertal age group, 11(23.4%) had hypogonadism. Serum ferritin correlated positively with pituitary R2 (p = 0.004) and negatively with anterior pituitary volume (p = 0.006), whereas pituitary R2 correlated negatively with cardiac T2* (p = 0.001). Patients with hypogonadism had lower pituitary R2 (p = 0.186), T2* (p = 0.048), and anterior pituitary volumes (p = 0.012) compared to those with normal sexual maturity. Regardless of stature, no significant difference was observed between pituitary R2 (p = 0.267) and T2* (p = 0.451). Mean pituitary R2 in patients (78.99 Hz) was higher than in controls (20.8 Hz) (p = 0.0001). Anterior pituitary volume was lower in patients (264.83 mm3) than in controls (380.87 mm3) (p = 0.0001). A threshold value of 22.85 Hz for pituitary R2 gave a sensitivity of 84.2% and a specificity of 73.3% in distinguishing pituitary iron content of patients from controls, with an area of 0.864 under the ROC curve. CONCLUSIONS: 3T MRI is a reliable method to detect pituitary iron overload and predict risk of hypogonadism in beta Thalassemia.


Assuntos
Sobrecarga de Ferro , Talassemia , Talassemia beta , Feminino , Humanos , Sobrecarga de Ferro/diagnóstico por imagem , Sobrecarga de Ferro/etiologia , Fígado , Imageamento por Ressonância Magnética , Masculino , Hipófise/diagnóstico por imagem , Reprodutibilidade dos Testes , Talassemia beta/complicações , Talassemia beta/diagnóstico por imagem
7.
Medicine (Baltimore) ; 99(11): e19566, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176115

RESUMO

Chemotherapy may cause ovarian toxicity and infertility. Cancer patients are usually overwhelmed, and focus exclusively on cancer diagnosis and may not pay attention to fertility-related issues. In this paper we look at the rate of amenorrhea and fertility counseling among such young patients.Premenopausal women with early-stage breast cancer treated with adjuvant or neoadjuvant chemotherapy were recruited. Amenorrhea was defined as absence of menstruation for ≥12 months after the completion of chemotherapy.A total of 94 patients met the eligibility criteria and were included in this analysis. Median age at diagnosis was 35.7 (range, 22-44) years. Seventy-nine (85.9%) respondents were counseled about amenorrhea and 37 (40.2%) were considering having children. Long-term amenorrhea was reported by 51 (54.3%) patients. The addition of taxanes to anthracyclines, in 2 different regimens, increased the risk of amenorrhea to 69.2% and 66.7% compared to 38.9% with anthracycline-alone, P < .0001. Longer duration of chemotherapy (≥24 weeks) might also be associated with higher rate of amenorrhea (67.7%) compared to 43.4% in those who had shorter duration (<24 weeks), P = .031.The addition of taxanes to anthracycline-based chemotherapy increased the risk of amenorrhea. However, shorter duration of chemotherapy, even with taxanes, may lower such risk. Our study highlights the importance of fertility counseling to improve fertility preservation rates. Given the importance of taxanes, shorter regimens are associated with lower amenorrhea rates and should be preferred over longer ones.


Assuntos
Amenorreia/induzido quimicamente , Antraciclinas/efeitos adversos , Antineoplásicos/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Preservação da Fertilidade , Taxoides/efeitos adversos , Adulto , Neoplasias da Mama/patologia , Quimioterapia Adjuvante/efeitos adversos , Aconselhamento , Feminino , Humanos , Jordânia , Estadiamento de Neoplasias , Estudos Retrospectivos , Adulto Jovem
8.
Clin Exp Dermatol ; 44(7): 721-727, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31099084

RESUMO

Pemphigoid diseases are autoimmune subepidermal blistering diseases affecting the skin and mucous membranes, which are caused by autoantibodies targeting structural hemidesmosomal proteins or hemidesmosome-associated proteins. Variants of pemphigoid can be differentiated based on targeted antigens and clinical aspects. In this review, we will discuss pemphigoid variants that predominantly affect the skin, and provide clinicians with clues to diagnosis.


Assuntos
Epidermólise Bolhosa Adquirida/diagnóstico , Dermatose Linear Bolhosa por IgA/diagnóstico , Penfigoide Gestacional/diagnóstico , Penfigoide Bolhoso/diagnóstico , Feminino , Humanos , Gravidez
9.
Malays Orthop J ; 13(1): 36-41, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31001382

RESUMO

Introduction: Tibia is the most common long bone fractured due its vulnerable subcutaneous location and most often associated with acquired complications of delayed union or non-union due to infection. Amongst the various treatment options to treat them, the Ilizarov external fixator application is considered superior due to its multiple advantages. The objective of this study was to analyse the role of Ilizarov fixation in infected tibial non-union, as well as to assess bony union and associated functional outcomes. Materials and Methods: A retrospective review was conducted for the duration between 1st January 2005 to 31st December 2016. Total of fifty-one patients with tibial non-union associated with infection who treated with the Ilizarov fixator were included in the study. Patient records were reviewed for union of bone, bone and functional outcomes and complications. Results: The most common organism for infection was identified to be Staphylococcus Aureus. At the time of final follow-up all patients had achieved union except two, one of whom had to undergo amputation due to non-union and sepsis. Majority of the patients had an excellent score as per ASAMI grading system for bone and function results. The most common complication noted was pin track infections. Conclusion: In our experience, Ilizarov external fixator is better suited for infected non-union of tibia because it can provide a stable mechanical environment, bone transport, correct deformities, and enable weight bearing and hence we recommend its use for the same.

10.
Indian Pediatr ; 56(1): 41-44, 2019 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30806360

RESUMO

OBJECTIVE: To describe a novel wrist deformity in b-thalassemia major patients, and their radiographic and magnetic resonance imaging findings. METHODS: 30 patients with b-thalassemia major who were noticed to have ulnar deviation at wrist joint were evaluated for previous history of medications, serum ferritin levels, presence of pain and swelling at the wrist joint, and the duration of iron chelation therapy. Radiographs of wrist and limited magnetic resonance imaging (MRI) sequences were obtained in 30 and 15 patients, respectively. RESULTS: Radiographs revealed varying severity of distal ulnar shortening, distal radial slanting and presence of soft tissue distal to the ulna. MRI showed similar deformities along with abnormal marrow signal at distal ulnar ends; in 8 patients, a soft tissue distal to the distal end of ulna was noted. CONCLUSIONS: Varying severity of radiological abnormalities, predominantly affecting the distal ulna, are present in children and adolescents with b-thalassemia receiving oral chelation therapy.


Assuntos
Terapia por Quelação/efeitos adversos , Quelantes de Ferro/efeitos adversos , Artropatias , Punho , Talassemia beta/tratamento farmacológico , Adolescente , Criança , Feminino , Humanos , Ferro , Quelantes de Ferro/uso terapêutico , Artropatias/induzido quimicamente , Artropatias/diagnóstico por imagem , Artropatias/patologia , Masculino , Ulna/diagnóstico por imagem , Ulna/efeitos dos fármacos , Ulna/patologia , Punho/diagnóstico por imagem , Punho/patologia
11.
J Intern Med ; 285(6): 653-669, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30762274

RESUMO

BACKGROUND AND OBJECTIVES: The 52-week, randomized, double-blind, noninferiority, government-funded NOR-SWITCH trial demonstrated that switching from infliximab originator to less expensive biosimilar CT-P13 was not inferior to continued treatment with infliximab originator. The NOR-SWITCH extension trial aimed to assess efficacy, safety and immunogenicity in patients on CT-P13 throughout the 78-week study period (maintenance group) versus patients switched to CT-P13 at week 52 (switch group). The primary outcome was disease worsening during follow-up based on disease-specific composite measures. METHODS: Patients were recruited from 24 Norwegian hospitals, 380 of 438 patients who completed the main study: 197 in the maintenance group and 183 in the switch group. In the full analysis set, 127 (33%) had Crohn's disease, 80 (21%) ulcerative colitis, 67 (18%) spondyloarthritis, 55 (15%) rheumatoid arthritis, 20 (5%) psoriatic arthritis and 31 (8%) chronic plaque psoriasis. RESULTS: Baseline characteristics were similar in the two groups at the time of switching (week 52). Disease worsening occurred in 32 (16.8%) patients in the maintenance group vs. 20 (11.6%) in the switch group (per-protocol set). Adjusted risk difference was 5.9% (95% CI -1.1 to 12.9). Frequency of adverse events, anti-drug antibodies, changes in generic disease variables and disease-specific composite measures were comparable between arms. The study was inadequately powered to detect noninferiority within individual diseases. CONCLUSION: The NOR-SWITCH extension showed no difference in safety and efficacy between patients who maintained CT-P13 and patients who switched from originator infliximab to CT-P13, supporting that switching from originator infliximab to CT-P13 is safe and efficacious.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Artrite/tratamento farmacológico , Colite Ulcerativa/tratamento farmacológico , Infliximab/uso terapêutico , Psoríase/tratamento farmacológico , Adulto , Anticorpos Monoclonais/efeitos adversos , Método Duplo-Cego , Substituição de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Fatores de Tempo , Resultado do Tratamento
12.
Diabetes Metab Syndr ; 13(1): 62-67, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30641777

RESUMO

Insulin resistance (IR) is the corner stone of metabolic obesity. This cross-sectional analytical study was aimed to find out the frequency of IR in non-diabetic adult individuals of different obesity phenotypes that would help to implement preventive measures to avoid the cardiometabolic catastrophes. METHODS: Total 955 nondiabetic adult individuals were selected and categorized into six metabolic phenotypes by metabolic syndrome criteria in each BMI group (18.5-24.9-normal weight, 25-29.9-overweight, ≥30-obese). From them, metabolically obese normal weight, metabolically obese overweight, metabolically healthy obese and metabolically unhealthy obese were selected as Obesity phenotypes (N = 616). RESULTS: The frequency of IR was found to be very high (60.2%) in total nondiabetic adult obese individuals (N = 616). Highest frequency of IR was found in MUO phenotype (76.3%), lowest frequency of IR was found in MONW phenotype (37.1%) and frequency of IR in MOOW and MHO phenotypes found to be identical but significantly (p < 0.0001) less than MUO and significantly (p < 0.0001) more than MONW phenotype. Among the obesity phenotypes, females were more insulin resistant than males (67.5% vs 48.1% respectively, p < 0.05). Frequency of IR found significantly (p < 0.05) more in female than male in all obesity phenotypes except in MUO phenotype where males found to show significantly (p < 0.05) higher frequency than females. Frequency of IR was significantly higher in younger (20-39 yrs) age group than 40-60 yrs age group (63.2% vs 53.5% respectively, p < 0.05). CONCLUSION: IR is alarmingly high (60.2%) in nondiabetic adult obese individuals. Among different obesity phenotypes, it is highest (76.3%) in MUO and lowest (37.1%) in MONW.


Assuntos
Resistência à Insulina , Síndrome Metabólica/etiologia , Obesidade/complicações , Adulto , Bangladesh/epidemiologia , Biomarcadores/análise , Índice de Massa Corporal , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Obesidade/classificação , Fenótipo , Prognóstico , Adulto Jovem
13.
Malays Orthop J ; 12(3): 24-30, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30555643

RESUMO

Introduction: Ankle arthrodesis using the Ilizarov technique provides high union rate with the added benefits of early weight-bearing, and the unique advantage of its ability to promote regeneration of soft tissue around the bone, including skin, muscle and neuro-vascular structures, and its versatility to allow correction of the position of the foot by adjusting the frame post-operatively as needed. We describe our experience with this technique and the functional outcomes in our patients. Materials and Methods: This retrospective study was conducted in 20 ankle fusion cases using the Ilizarov method between the years 2007 and 2017. We defined success in treatment by loss of preoperative symptoms and radiological union on plain radiographs of the ankle. Results: Fusion was achieved in all patients (100%). Immediate post-operative ambulation was with full weight bearing (FWB) in 16 (83%) of the participants and non-weight bearing (NWB) in 3 patients (17%). Post-procedure 11 patients (67%) of the participants who were full weight bearing required some form of support for walking for 2-3 weeks. Post-operatively three patients had pin tract infection requiring intravenous antibiotics. Radiological union took range of 6-12 weeks, mean union time was 8 weeks. Only one patient required bone grafting due to bone loss. Average follow-up period was 10-45 months. Conclusion: The Ilizarov technique has a high union rate and leads to general favourable clinical outcome and may be considered for any ankle arthrodesis but is especially useful in complex cases such as for revisions, soft-tissue compromise, infection and in patients with risk for non-union. Early weight bearing is an extra benefit.

14.
Vaccine ; 36(29): 4375-4382, 2018 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-29880243

RESUMO

Hajj pilgrims are susceptible to several serious infections and are required to receive multiple vaccinations. Polysaccharide-protein conjugate vaccines contain carrier proteins such as tetanus toxoid (TT), diphtheria toxoid or a mutant of diphtheria toxoid (CRM197). These carrier proteins may interact with other conjugate or combination vaccines containing tetanus or diphtheria on concurrent or sequential administration. We examined the immune interaction of separate and concomitant administration of a tetanus/diphtheria/acellular pertussis (Tdap) vaccine with a TT-conjugated quadrivalent meningococcal vaccine (MCV4) (coadministered with 13-valent pneumococcal CRM197-conjugate vaccine [PCV13]) in adult Australian pilgrims before attending Hajj in 2015. We randomly assigned each participant to one of three vaccination schedules. Group 1 received Tdap 3-4 weeks before receiving MCV4 coadministered with PCV13. Group 2 received all three vaccines concomitantly. Group 3 received MCV4 and PCV13 3-4 weeks before Tdap. Blood samples were collected at baseline, at each vaccination visit and 3-4 weeks after vaccination and tested for response to meningococcal serogroups C, W and Y using a serum bactericidal antibody (rSBA) assay with baby rabbit complement, and to diphtheria and tetanus toxoid, measuring IgG antibodies by ELISA. Participants completed symptom diaries after each vaccination. A total of 166 participants aged 18-64 (median 42) years were recruited, of whom 160 completed the study. Compared to the other groups, Group 1 (given Tdap first) had significantly lower proportion of subjects achieving a ≥4-fold rise in rSBA for serogroup W. No difference was detected across the three groups in achieving protection threshold (rSBA ≥8 post vaccination) or SBA geometric mean titre (GMT) post vaccination. Group 3, which was given MCV4/PCV13 first, had high levels of antibody against diphtheria and tetanus than the other groups, when tested prior to receipt of Tdap; Only the anti-tetanus responses remained significantly higher after Tdap administration. No serious adverse events were reported. In conclusion, when multiple vaccination is required for Hajj pilgrims, administering Tdap concurrently with MCV4/PCV13 produces adequate immune responses, and avoids meningococcal immune interference, in the convenience of a single consultation. However, giving Tdap 3-4 weeks after MCV4/PCV13 has the advantage of an enhanced tetanus toxoid response. The trial is Trials Registry (ANZCTR): ACTRN12613000536763.


Assuntos
Anticorpos Antibacterianos/sangue , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Esquemas de Imunização , Vacinas Meningocócicas/administração & dosagem , Vacinas Meningocócicas/imunologia , Vacinas Pneumocócicas/administração & dosagem , Polissacarídeos Bacterianos/imunologia , Adolescente , Adulto , Animais , Formação de Anticorpos , Austrália , Aglomeração , Feminino , Humanos , Masculino , Infecções Meningocócicas/prevenção & controle , Pessoa de Meia-Idade , Religião , Doença Relacionada a Viagens , Adulto Jovem
15.
Agric Syst ; 163: 36-44, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29861535

RESUMO

Bangladesh faces huge challenges in achieving food security due to its high population, diet changes, and limited room for expanding cropland and cropping intensity. The objective of this study is to assess the degree to which Bangladesh can be self-sufficient in terms of domestic maize, rice and wheat production by the years 2030 and 2050 by closing the existing gap (Yg) between yield potential (Yp) and actual farm yield (Ya), accounting for possible changes in cropland area. Yield potential and yield gaps were calculated for the three crops using well-validated crop models and site-specific weather, management and soil data, and upscaled to the whole country. We assessed potential grain production in the years 2030 and 2050 for six land use change scenarios (general decrease in arable land; declining ground water tables in the north; cropping of fallow areas in the south; effect of sea level rise; increased cropping intensity; and larger share of cash crops) and three levels of Yg closure (1: no yield increase; 2: Yg closure at a level equivalent to 50% (50% Yg closure); 3: Yg closure to a level of 85% of Yp (irrigated crops) and 80% of water-limited yield potential or Yw (rainfed crops) (full Yg closure)). In addition, changes in demand with low and high population growth rates, and substitution of rice by maize in future diets were also examined. Total aggregated demand of the three cereals (in milled rice equivalents) in 2030 and 2050, based on the UN median population variant, is projected to be 21 and 24% higher than in 2010. Current Yg represent 50% (irrigated rice), 48-63% (rainfed rice), 49% (irrigated wheat), 40% (rainfed wheat), 46% (irrigated maize), and 44% (rainfed maize) of their Yp or Yw. With 50% Yg closure and for various land use changes, self-sufficiency ratio will be > 1 for rice in 2030 and about one in 2050 but well below one for maize and wheat in both 2030 and 2050. With full Yg closure, self-sufficiency ratios will be well above one for rice and all three cereals jointly but below one for maize and wheat for all scenarios, except for the scenario with drastic decrease in boro rice area to allow for area expansion for cash crops. Full Yg closure of all cereals is needed to compensate for area decreases and demand increases, and then even some maize and large amounts of wheat imports will be required to satisfy demand in future. The results of this analysis have important implications for Bangladesh and other countries with high population growth rate, shrinking arable land due to rapid urbanization, and highly vulnerable to climate change.

17.
Mymensingh Med J ; 27(2): 275-279, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29769490

RESUMO

Eclampsia is a common problem in pregnancy in Bangladesh. It is a severe form of preeclampsia which affects 5 to 7% of pregnancies is a significant cause of maternal & neonatal morbidity & mortality. Pre-eclampsia when complicated with generalized tonic-clonic convulsions and/or coma is called eclampsia. The term eclampsia is derived from a Greek word, meaning "like a flash of lightening". It may occur quite abruptly, without any warning manifestations. Eclampsia is a major cause of maternal mortality & morbidity as well as foetal loss worldwide, particularly in the third world. Appropriate measures & effective treatment of eclamptic patient in proper time reduce maternal mortality & morbidity. The mainstay of treatment of eclampsia is delivery of the foetus. Two methods are usually applied for delivery of foetus in eclampsia i.e. vaginal delivery & caesarean delivery. This study was done in the department of Gynae & Obs and department of Anaesthesiology, Mymensingh Medical College Hospital from 1st January 2016 to 30th June 2016 to observe the incidence, complications (morbidity) & mortality of eclamptic patients & which method (vaginal delivery versus caesarean delivery by spinal anaesthesia) is safe, better for the eclamptic patients as well as foetal mortality. Successful vaginal delivery is dependant on complex interactions of three variables (3 P) that is power (uterine contraction), passenger (foetus) & passage (birth canal) but power is less effective in eclamptic patient than normal partuents. Vaginal delivery requires prolong times compared with cesarean delivery. Anaesthetic technique is also an important factor for maternal mortality & morbidity of caesarean delivery. Spinal anaesthesia is widely regarded as a reasonable anaesthetic option for caesarean delivery in eclamptic patients. Currently the safety of spinal anaesthesia is well established and it can provide better obstetrical outcome when chosen properly. In this observation caesarean delivery by spinal anesthesia is safer, less complications, less maternal & neonatal mortality than vaginal delivery in eclamptic patients.


Assuntos
Cesárea , Parto Obstétrico , Eclampsia , Raquianestesia , Bangladesh , Eclampsia/terapia , Feminino , Humanos , Gravidez
18.
Appl Radiat Isot ; 141: 176-181, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29673719

RESUMO

In previous work we investigated the real-time radioluminescence (RL) yield of Ge-doped silica fibres and Al2O3 nanodot media, sensing electron- and x-ray energies and intensities at values familiarly obtained in external beam radiotherapy. The observation of an appreciable low-dose sensitivity has given rise to the realisation that there is strong potential for use of RL dosimetry in diagnostic radiology. Herein use has been made of P-doped silica optical fibre, 2 mm diameter, also including a 271 µm cylindrical doped core. With developing needs for versatile x-ray imaging dosimetry, preliminary investigations have been made covering the range of diagnostic x-ray tube potentials 30 kVp to 120 kVp, demonstrating linearity of RL with kVp as well as in terms of the current-time (mAs) product. RL yields also accord with the inverse-square law. Given typical radiographic-examination exposure durations from tens- to a few hundred milliseconds, particular value is found in the ability to record the influence of x-ray generator performance on the growth and decay of beam intensity, from initiation to termination.


Assuntos
Exposição Ocupacional/análise , Exposição à Radiação/análise , Dosimetria Termoluminescente/métodos , Humanos , Exposição Ocupacional/efeitos adversos , Fibras Ópticas , Exposição à Radiação/efeitos adversos , Radiografia/efeitos adversos , Dióxido de Silício , Dosimetria Termoluminescente/instrumentação , Dosimetria Termoluminescente/estatística & dados numéricos
19.
J Hosp Infect ; 100(2): 152-158, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29559231

RESUMO

BACKGROUND: Hand hygiene compliance among healthcare workers (HCWs) in intensive care units (ICUs) is disconcertingly low. AIM: To identify the effective intervention(s) for increasing HH compliance among HCWs in adult ICUs. METHODS: Two major electronic databases, OVID Medline and CINAHL, were searched by using a combination of MeSH terms and text words (e.g. hand hygiene, hand washing, compliance, adher*, improve*, develop* and intensive care unit) for relevant articles. This was supplemented by Google Scholar and hand searching of included bibliographies. Data from identified articles were then abstracted, quality-assessed, and combined into a summary effect. FINDINGS: Of 89 titles and abstracts that were identified, 14 articles were finally included. Overall study quality was good. However, variations in design, setting, sample size, and intervention(s) tested precluded a meta-analysis; hence a narrative synthesis was conducted. The interventions included education, observation, provision of supplies, improving access and directive support; tested singly or in combination; resulted in positive outcomes in all but one study. A combination of administrative support, 'supplies', education and training, reminders, surveillance, and performance feedback raised the compliance from a baseline of 51.5% to a record 80.1%; but no set of intervention(s) could improve the compliance to the desired near-100% level. CONCLUSION: Available data suggest that multi-modal interventions are effective in raising the compliance to a 'plateau' level but not up to the desired standard. Methodologically appropriate trials of combined interventions could enhance the evidence about interventions to improve hand hygiene compliance among ICU staff.


Assuntos
Fidelidade a Diretrizes , Higiene das Mãos , Pessoal de Saúde , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Humanos , Unidades de Terapia Intensiva
20.
Appl Radiat Isot ; 138: 65-72, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28427834

RESUMO

Using tailor-made sub-mm dimension doped-silica fibres, thermoluminescent dosimetric studies have been performed for α-emitting sources of 223RaCl2 (the basis of the Bayer Healthcare product Xofigo®). The use of 223RaCl2 in the palliative treatment of bone metastases resulting from late-stage castration-resistant prostate cancer focuses on its favourable uptake in metabolically active bone metastases. Such treatment benefits from the high linear energy transfer (LET) and associated short path length (<100µm) of the α-particles emitted by 223Ra and its decay progeny. In seeking to provide for in vitro dosimetry of the α-particles originating from the 223Ra decay series, investigation has been made of the TL yield of various forms of Ge-doped SiO2 fibres, including photonic crystal fibre (PCF) collapsed, PCF uncollapsed, flat and single-mode fibres. Irradiations of the fibres were performed at the UK National Physical Laboratory (NPL). Notable features are the considerable sensitivity of the dosimeters and an effective atomic number Zeff approaching that of bone, the glass fibres offering the added advantage of being able to be placed directly into liquid. The outcome of present research is expected to inform development of doped fibre dosimeters of versatile utility, including for applications as detailed herein.

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