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1.
Sci Rep ; 11(1): 16627, 2021 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-34404877

RESUMO

This communication presents analysis of gravity-driven flow of a thixotropic fluid containing both nanoparticles and gyrotactic microorganisms along a vertical surface. To further describe the transport phenomenon, special cases of active and passive controls of nanoparticles are investigated. The governing partial differential equations of momentum, energy, nanoparticles concentration, and density of gyrotactic microorganisms equations are converted and parameterized into system of ordinary differential equations and the series solutions are obtained through Optimal Homotopy Analysis Method (OHAM). The related important parameters are tested and shown on the velocity, temperature, concentration and density of motile microorganisms profiles. It is observed that for both cases of active and passive control of nanoparticles, incremental values of thermophoretic parameters corresponds to decrease in the velocity distributions and augment the temperature distributions.

2.
BJOG ; 128(11): 1762-1773, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34173998

RESUMO

OBJECTIVE: Stillbirths occur 10-20 times more frequently in low-income settings compared with high-income settings. We created a methodology to define the proportion of stillbirths that are potentially preventable in low-income settings and applied it to stillbirths in sites in India and Pakistan. DESIGN: Prospective observational study. SETTING: Three maternity hospitals in Davangere, India and a large public hospital in Karachi, Pakistan. POPULATION: All cases of stillbirth at ≥20 weeks of gestation occurring from July 2018 to February 2020 were screened for participation; 872 stillbirths were included in this analysis. METHODS: We prospectively defined the conditions and gestational ages that defined the stillbirth cases considered potentially preventable. Informed consent was sought from the parent(s) once the stillbirth was identified, either before or soon after delivery. All information available, including obstetric and medical history, clinical course, fetal heart sounds on admission, the presence of maceration as well as examination of the stillbirth after delivery, histology, and polymerase chain reaction for infectious pathogens of the placenta and various fetal tissues, was used to assess whether a stillbirth was potentially preventable. MAIN OUTCOME MEASURES: Whether a stillbirth was determined to be potentially preventable and the criteria for assignment to those categories. RESULTS: Of 984 enrolled, 872 stillbirths at ≥20 weeks of gestation met the inclusion criteria and were included; of these, 55.5% were deemed to be potentially preventable. Of the 649 stillbirths at ≥28 weeks of gestation and ≥1000 g birthweight, 73.5% were considered potentially preventable. The most common conditions associated with a potentially preventable stillbirth at ≥28 weeks of gestation and ≥1000 g birthweight were small for gestational age (SGA) (52.8%), maternal hypertension (50.2%), antepartum haemorrhage (31.4%) and death that occurred after hospital admission (15.7%). CONCLUSIONS: Most stillbirths in these sites were deemed preventable and were often associated with maternal hypertension, antepartum haemorrhage, SGA and intrapartum demise. TWEETABLE ABSTRACT: Most stillbirths are preventable by better care for women with hypertension, growth restriction and antepartum haemorrhage.


Assuntos
Morte Fetal/prevenção & controle , Cuidado Pré-Natal/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Natimorto/epidemiologia , Adulto , Feminino , Idade Gestacional , Humanos , Índia/epidemiologia , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Complicações do Trabalho de Parto/epidemiologia , Paquistão/epidemiologia , Gravidez , Cuidado Pré-Natal/normas , Estudos Prospectivos
3.
BMC Public Health ; 21(1): 952, 2021 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-34016085

RESUMO

BACKGROUND: Improving maternal health has been a primary goal of international health agencies for many years, with the aim of reducing maternal and child deaths and improving access to antenatal care (ANC) services, particularly in low-and-middle-income countries (LMICs). Health interventions with these aims have received more attention from a clinical effectiveness perspective than for cost impact and economic efficiency. METHODS: We collected data on resource use and costs as part of a large, multi-country study assessing the use of routine antenatal screening ultrasound (US) with the aim of considering the implications for economic efficiency. We assessed typical antenatal outpatient and hospital-based (facility) care for pregnant women, in general, with selective complication-related data collection in women participating in a large maternal health registry and clinical trial in five LMICs. We estimated average costs from a facility/health system perspective for outpatient and inpatient services. We converted all country-level currency cost estimates to 2015 United States dollars (USD). We compared average costs across countries for ANC visits, deliveries, higher-risk pregnancies, and complications, and conducted sensitivity analyses. RESULTS: Our study included sites in five countries representing different regions. Overall, the relative cost of individual ANC and delivery-related healthcare use was consistent among countries, generally corresponding to country-specific income levels. ANC outpatient visit cost estimates per patient among countries ranged from 15 to 30 USD, based on average counts for visits with and without US. Estimates for antenatal screening US visits were more costly than non-US visits. Costs associated with higher-risk pregnancies were influenced by rates of hospital delivery by cesarean section (mean per person delivery cost estimate range: 25-65 USD). CONCLUSIONS: Despite substantial differences among countries in infrastructures and health system capacity, there were similarities in resource allocation, delivery location, and country-level challenges. Overall, there was no clear suggestion that adding antenatal screening US would result in either major cost savings or major cost increases. However, antenatal screening US would have higher training and maintenance costs. Given the lack of clinical effectiveness evidence and greater resource constraints of LMICs, it is unlikely that introducing antenatal screening US would be economically efficient in these settings--on the demand side (i.e., patients) or supply side (i.e., healthcare providers). TRIAL REGISTRATION: Trial number: NCT01990625 (First posted: November 21, 2013 on https://clinicaltrials.gov ).


Assuntos
Cesárea , Países em Desenvolvimento , Criança , Feminino , Humanos , Pobreza , Gravidez , Gestantes , Cuidado Pré-Natal
4.
Z Gesundh Wiss ; : 1-8, 2021 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-33968602

RESUMO

Background and objectives: The World Health Organization (WHO) announced the appearance of a new coronavirus disease in Hubei province, China, to be a public health emergency of international concern. The objectives of this study can be highlighted through classifying the information sources for identifying protective practices, death probability, gender-death associations probability and education level. Methodology: This is a descriptive design study conducted among the Kurdistan Region/Iraq population via an online application between 1 March and 1 May 2020. Three hundred twenty people participated in this questionnaire study. The data were collected through an online form, relying upon a self-report questionnaire. The questionnaire had three main parts. The first part is related to the socio-demographic characteristics of the sample, including gender, age, family status, address status and education level. The second part involves the items related to precautionary measures using none, sometimes, and always. The last part contains items related to death probability owing to other causes and this includes five categories: extremely low, low, intermediate, high and extremely high. The validity and reliability of this questionnaire were revised by the panel of experts before the data collection. Results: The outcomes of the study revealed that the majority, ca. 73%, of the Kurdistan Region/Iraq population depended on TV to obtain information about COVID-19. Also, this investigation showed that there is a substantial association between participants with infection prevention and control practices relevant to COVID-19. Moreover, according to this study, there is a significant relationship between the death probability and COVID-19. Concurrently, there is not any significant association between other causes, namely cancer, heart diseases, diabetes and road traffic accidents, and the death probability. Conclusion: This study showed that for the majority of the Kurdistan Region/Iraq population the most reliable source of information for any COVID-19 related updates is the TV broadcast. This study also indicated that there is strong association for the majority of individuals regarding their practices for prevention from COVID-19 and death probability with COVID-19. However, there is not any substantial association between the epidemic and the other deadly calamities and the death probability.

5.
Comput Methods Programs Biomed ; 203: 106044, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33756187

RESUMO

BACKGROUND AND OBJECTIVE: Arterial diseases would lead to several serious disorders in the cardiovascular system such as atherosclerosis. These disorders are mainly caused by the presence of fatty deposits, cholesterol and lipoproteins inside blood vessel. This paper deals with the analysis of non-Newtonian magnetic blood flow in an inclined stenosed artery. METHODS: The Casson fluid was used to model the blood that flows under the influences of uniformly distributed magnetic field and oscillating pressure gradient. The governing fractional differential equations were expressed using the Caputo Fabrizio fractional derivative without singular kernel. RESULTS: The analytical solutions of velocities for non-Newtonian model were then calculated by means of Laplace and finite Hankel transforms. These velocities were then presented graphically. The result shows that the velocity increases with respect to Reynolds number and Casson parameter, while decreases when Hartmann number increases. CONCLUSIONS: Casson blood was treated as the non-Newtonian fluid. The MHD blood flow was accelerated by pressure gradient. These findings are beneficial for studying atherosclerosis therapy, the diagnosis and therapeutic treatment of some medical problems.


Assuntos
Aterosclerose , Modelos Cardiovasculares , Artérias , Velocidade do Fluxo Sanguíneo , Constrição Patológica , Hemodinâmica , Humanos
6.
BJOG ; 128(9): 1487-1496, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33629490

RESUMO

OBJECTIVE: Limited data are available from low- and middle-income countries (LMICs) on the relationship of haemoglobin levels to adverse outcomes at different times during pregnancy. We evaluated the association of haemoglobin levels in nulliparous women at two times in pregnancy with pregnancy outcomes. DESIGN: ASPIRIN Trial data were used to study the association between haemoglobin levels measured at 6+0 -13+6  weeks and 26+0 -30+0  weeks of gestation with fetal and neonatal outcomes. SETTING: Obstetric care facilities in Pakistan, India, Kenya, Zambia, The Democratic Republic of the Congo and Guatemala. POPULATION: A total of 11 976 pregnant women. METHODS: Generalised linear models were used to obtain adjusted relative risks and 95% CI for adverse outcomes. MAIN OUTCOME MEASURES: Preterm birth, stillbirth, neonatal death, small for gestational age (SGA) and birthweight <2500 g. RESULTS: The mean haemoglobin levels at 6+0 -13+6  weeks and at 26-30 weeks of gestation were 116 g/l (SD 17) and 107 g/l (SD 15), respectively. In general, pregnancy outcomes were better with increasing haemoglobin. At 6+0 -13+6  weeks of gestation, stillbirth, SGA and birthweight <2500 g, were significantly associated with haemoglobin of 70-89 g/l compared with haemoglobin of 110-129 g/l The relationships of adverse pregnancy outcomes with various haemoglobin levels were more marked at 26-30 weeks of gestation. CONCLUSIONS: Both lower and some higher haemoglobin concentrations are associated with adverse fetal and neonatal outcomes at 6+0 -13+6  weeks and at 26-30 weeks of gestation, although the relationship with low haemoglobin levels appears more consistent and generally stronger. TWEETABLE ABSTRACT: Both lower and some higher haemoglobin concentrations were associated with adverse fetal and neonatal outcomes at 6-13 weeks and 26-30 weeks of gestation.


Assuntos
Hemoglobinas/análise , Recém-Nascido Pequeno para a Idade Gestacional , Morte Perinatal , Nascimento Prematuro/epidemiologia , Natimorto/epidemiologia , Adulto , Países em Desenvolvimento , Índices de Eritrócitos , Feminino , Idade Gestacional , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Fatores de Risco
7.
Environ Manage ; 67(2): 324-341, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33410919

RESUMO

Water utilities in arid regions deal with multifaceted issues of natural groundwater contamination, high treatment costs, and low water rates. These utilities rely on intermittent supplies resulting in numerous water quality failures at source, treatment, distribution, and in-house plumbing systems. The present research presents an inclusive risk assessment methodology for managing water quality from source to tap. Three-year monitoring data for turbidity, TDS, pH, iron, ammonia, nitrates, residual chlorine, Coliform group, E. coli, and Fecal Streptococci identified the root causes of failures. The cause-effect relationships in the form of a fault tree were solved using multiple failure modes and effect analysis (FMEA) to handle both the Boolean operations. The fuzzy sets addressed the uncertainties associated with data limitations in calculating exceedance probabilities (Pe) and vagueness in expert opinion for subjective evaluation of severity and detectability. The methodology was applied on a smaller system serving 18,000 consumers in Qassim, Saudi Arabia. Potable supplied water underwent reoccurrence of TDS (Pe = 20%), turbidity (Pe = 10%), and Fe (Pe = 2%) failures in distribution that further increased up to 44%, 33%, and 11% at the consumer end. The Pe for residual chlorine failure soared up to 89%. Economic controls reduced the cumulative risk to 50%, while the shift to continuous supply can limit the remaining failures under the acceptable risk. The framework will help utilities manage water quality in intermittent systems from source to tap in Saudi Arabia, the Gulf, and elsewhere.


Assuntos
Água Potável , Abastecimento de Água , Escherichia coli , Medição de Risco , Qualidade da Água
8.
Environ Sci Pollut Res Int ; 27(15): 18287-18302, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32185731

RESUMO

Dissolved organic matter (DOM) has been recognized as a serious water quality problem in natural water bodies receiving pollution loads from point and nonpoint sources. The present study investigates the spatiotemporal variability of DOM composition in the Kushiro River and its tributaries (Eastern Hokkaido, Japan) impacted by the Kushiro wetland. Water samples were collected in the wet and dry seasons from several locations of the river and analyzed for DOM characteristics by UV-visible and excitation-emission matrix fluorescence spectroscopy techniques and by developing water quality index. Rather than the spatial effect, significant seasonal impacts on DOM pollution in the Kushiro River were observed. Overall concentrations of DOM decreased during the dry season. The increase of specific ultraviolet absorbance in the dry season indicated an increasing trend of humification, aromaticity and molecular weight of DOM. Five fluorescent peaks, including peaks A, C, M, B, and T were predicted by EEM spectra. Peaks A and C were found to be the most dominating peaks in both the seasons and indicated enrichment of humic-like matters in river water. The intensities of poly-aromatic humic substances as well as DOM components of microbial origin increase in the wet season and proteins like autochthonous DOM increase during the dry season. The study recognized the contribution of freshly produced DOM component by the decomposition of wetland plants in wet season and effect of snowfall in the dry season. Analysis of three fluorescence indices revealed that the river water primarily contains terrestrially dominated DOM. A significant impact of the adjacent WWTPs and wetland to the river water DOM were also observed. The water quality index of river water DOM showed low to medium levels of DOM pollution in the Kushiro River.


Assuntos
Rios , Áreas Alagadas , Substâncias Húmicas/análise , Japão , Espectrometria de Fluorescência , Qualidade da Água
9.
Comput Methods Programs Biomed ; 184: 105123, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31627154

RESUMO

OBJECTIVE: A theoretical analysis is presented to study the bio-nanofluid with copper as medication agent for atherosclerotic bifurcated artery with flexible walls. DESIGN/APPROACH: The circulatory framework in human body is comprised of a system of veins that incorporate the bifurcation in this way the impact of copper nanoparticles on parent, at apex and on daughter artery regions (in the wake of being bifurcated) is watched. Streaming of blood along vessel segment is recognized to be newtonian. The consistent idea of the atherosclerotic arterial wall is additionally considered to make relationship with permeability aspects with arterial wall thickness. Copper nanoparticles are utilized to reduce the atherosclertic lesions for bifurcated stenotic artery. FINDINGS: The designed equations along with the experimental values of copper nanoparticles and blood are utilized for theoretical investigation. Moreover, hemodynamics impacts are also figure out to examine the flow of blood for atherosclertic artery. Comparison between parent and daughter artery is plotted through velocity profile. To see the theoretical assistance of this copper mediated model in biomedical field, graphical illustration is presented. At the end, noticed that the inclusion of copper nanoparticles enhances the velocity significantly both for parent as well as daughter artery. CONCLUSIONS: The circulation of blood is considered to be different from pressure between portions of atherosclerotic and non-atherosclerotic artery. Shear stress is reduces by changing the bifurcation angle for daughter artery while trend is reversed for parent artery. The size of inner circularting bolus decreases by changing compliant parameter for parent artery while shape is changed for daughter artery.


Assuntos
Artérias/patologia , Aterosclerose/tratamento farmacológico , Cobre/química , Nanopartículas Metálicas/uso terapêutico , Aterosclerose/patologia , Velocidade do Fluxo Sanguíneo , Complacência (Medida de Distensibilidade) , Humanos , Nanopartículas Metálicas/química
10.
Trop Biomed ; 37(2): 482-488, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33612817

RESUMO

Bacterial mediated Silver nanoparticles is considered as an emerging Ecofriendly approach to eradicate human pathogens. This paper aims to provide the biological approach for the synthesis of silver nanoparticles from indigenously isolated bacteria. This study will be beneficial to control the nosocomial infections triggered by MRSA (Methicillin-resistant Staphylococcus aureus). The current study is the extracellular synthesis of silver nanoparticles by using the cell free filtrate of bacterial strains isolated from the soil. The optimization study was also carried out to obtain the maximum production of silver nanoparticles. Nanoparticles were confirmed and characterized by UV-Vis spectroscopy and Transmission Electron Microscopy (TEM) having the plasmon resonance peak between 420-450nm with 10-60nm in size range and most were spherical in shape. Synthesized silver nanoparticles showed a potential antibacterial activity against MRSA (Methicillin Resistant Staphylococcus aureus) in-vitro study. This is the green approach for the production of AgNPs, as there was no previous work done on the synthesis of silver nanoparticles by bacteria in this region of Southern Punjab, Pakistan and these nanoparticles can be used to treat nosocomial infection. These silver nanoparticles can be used in effective disease management as antimicrobial agent.


Assuntos
Antibacterianos/farmacologia , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Prata/farmacologia , Nanopartículas Metálicas/química , Microscopia Eletrônica de Transmissão , Tamanho da Partícula , Microbiologia do Solo
11.
Inflammopharmacology ; 27(1): 89-98, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29728874

RESUMO

Hepatocellular carcinoma is emerging as one of the most common forms of cancer resulting in thousands of death worldwide. The purpose of this study was to screen nimesulide for anticancer activity in chemically induced hepatocellular carcinoma in Wistar rats as well as in BEL 7402 and HEP G2 cell lines. HCC in rats was induced by administering a single dose of diethyl nitrosamine (150 mg/kg) intraperitoneally. Duration of the in vivo study was 12 weeks and the anticancer potential was further confirmed by in vitro cell line study. Administration of DENA in Wistar rats significantly elevated the levels of serum biochemical parameters and α-feto protein. Treatment with different dose of nimesulide significantly decreased the markedly raised serum levels of biochemical parameters as well as maintained the histology of the liver tissues nearly similar to the normal. Further study of hepatocytes enzymes showed that treatment with nimesulide also improved the antioxidant enzyme levels. Our study also examined the cytotoxicity and DNA synthesis inhibition by nimesulide in BEL 7402 and Hep G2 cell lines. Cell viability was assessed by [3H]-thymidine uptake procedure. The results obtained by in vitro cell line study, histopathological and biochemical data concluded that nimesulide, a preferential COX-2 inhibitor, has anticancer activity, which is by first reducing the formation of reactive oxygen species and second by inhibiting the PGE2 effect via Wnt signaling pathway (cell invasion, angiogenesis, and cell proliferation).


Assuntos
Antineoplásicos/farmacologia , Carcinoma Hepatocelular/tratamento farmacológico , DNA/metabolismo , Neoplasias Hepáticas/tratamento farmacológico , Sulfonamidas/farmacologia , Animais , Antioxidantes/farmacologia , Carcinoma Hepatocelular/metabolismo , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Feminino , Células Hep G2 , Humanos , Fígado/efeitos dos fármacos , Fígado/metabolismo , Neoplasias Hepáticas/metabolismo , Masculino , Ratos , Ratos Wistar , Espécies Reativas de Oxigênio/metabolismo
12.
BJOG ; 126(6): 737-743, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30554474

RESUMO

OBJECTIVE: To describe the association of maternal anaemia with maternal, fetal, and neonatal outcomes. DESIGN: Prospective cohort study. SETTING: Rural India and Pakistan. POPULATION: Pregnant women residing in the study catchment area. METHODS: We performed an analysis of a prospective pregnancy registry in which haemoglobin is commonly obtained as well as maternal, fetal, and neonatal outcomes for 42 days post-delivery. Women 40 years or older who delivered before 20 weeks or had a haemoglobin level of <3.0 g/dl were excluded. Our primary exposure was maternal anaemia, which was categorised in keeping with World Health Organization criteria based on a normal (≥11 g/dl), mild (>10-10.9 g/dl), moderate (7-9.9 g/dl) or severe (<7 g/dl). haemoglobin level. The primary maternal outcome was maternal death, the primary fetal outcome was stillbirth, and the primary neonatal outcome was neonatal mortality <28 days. RESULTS: A total of 92 247 deliveries and 93 107 infants were included, of which 87.8% were born to mothers who were anaemic (mild 37.9%, moderate 49.1%, and severe 0.7%). Maternal mortality (number per 100 000) was not associated with anaemia: normal 124, mild 106, moderate 135, and severe 325 (P = 0.64). Fetal and neonatal mortality was associated with severe anaemia: stillbirth rate (n/1000)-normal 27.7, mild 25.8, moderate 30.1, and severe 90.9; P < 0.0001; 28-day neonatal mortality (n/1000)-normal 24.7, mild 22.9, moderate 28.1, and severe 72.6 (P < 0.0001). Severe maternal anaemia was also associated with low birthweight (<2500 and <1500 g), preterm birth, and postpartum haemorrhage. CONCLUSION: Severe maternal anaemia is associated with higher risks of poor maternal, fetal, and neonatal outcomes but other degrees of anaemia are not. Interventions directed at preventing severe anaemia in pregnant women should be considered. TWEETABLE ABSTRACT: Severe maternal anaemia is associated with adverse fetal and neonatal outcomes in low/middle-income countries.


Assuntos
Anemia , Hemorragia Pós-Parto , Complicações Hematológicas na Gravidez , Nascimento Prematuro , Cuidado Pré-Natal , Adulto , Anemia/sangue , Anemia/complicações , Anemia/diagnóstico , Anemia/epidemiologia , Estudos de Coortes , Feminino , Humanos , Índia/epidemiologia , Lactente , Mortalidade Infantil , Recém-Nascido , Mortalidade Materna , Paquistão/epidemiologia , Hemorragia Pós-Parto/diagnóstico , Hemorragia Pós-Parto/epidemiologia , Gravidez , Complicações Hematológicas na Gravidez/sangue , Complicações Hematológicas na Gravidez/diagnóstico , Complicações Hematológicas na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/prevenção & controle , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/estatística & dados numéricos , Estudos Prospectivos , Natimorto
13.
Microb Pathog ; 123: 377-384, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30053605

RESUMO

Camel Anaplasmosis is caused by members of family Anaplasmatacae, a tick transmitted, obligate intracellular bacteria. The etiological bacteria are transmitted by ixodid tick species. The species have multi host range distribution that is why it is crucial to diagnose it timely. The aim of present study was to investigate the molecular epidemiology i.e. prevalence and risk factors analysis of camel anaplasmosis. Furthermore, variations in hematological standards were also evaluated. The study found an overall 13.33% prevalence in camels. The confirmation of PCR positive samples for Anaplasma spp. was made through sequencing, the study isolatesshowed high homology with Iranian, Chinese, Philippines and South African isolates of Anaplasmatacae (Accession numbers'; KX765882, KP062964, KY242456, LC007100 and U54806) on BLAST queries. The phylogenetic analysis revealedthree study isolates of present study clustered with each other and the cluster was found closer to Chinese isolate of A. phagocytophilum (KY242456), A. marginale (KU586048), and Mongolian isolates of A. ovis (LC194134). Two of the isolates resembled Iranian isolate of Candidatus Anaplasmacamelii (KX765882), while one isolate resembled with Chinese isolates of A. Platys (KX987336) and Croatian isolates of A. Platys (KY114935). The key risk factors odds ratio (OR>1) identified for occurrence of camel anaplasmosis using regression model found sex and age of animal, previous tick history, tick infestation and tick control status, housing type, cracks in walls, rearing system and other species in surrounding as the key risk factors. The hematological parameters like lymphocytes, monocytes, granulocytes and platelets count were significantly decreased (p < 0.05) in diseased camels than healthy. This is the first ever molecular data on camel anaplasmosis in Pakistan. The disease should be monitored unceasingly as the etiologies have multi host distribution. Prompt attention should be offered to animals because neutropenia, lymphopenia and thrombocytopenia can exacerbate the disease by making the animal predisposed to otherdiseases.


Assuntos
Anaplasma/classificação , Anaplasma/genética , Anaplasma/patogenicidade , Anaplasmose/epidemiologia , Anaplasmose/microbiologia , Camelus/microbiologia , Epidemiologia Molecular , Filogenia , Fatores Etários , Anaplasma/isolamento & purificação , Anaplasmose/sangue , Anaplasmose/genética , Doenças dos Animais/epidemiologia , Animais , DNA Bacteriano/sangue , Testes Hematológicos , Linfopenia , Neutropenia , Paquistão/epidemiologia , Prevalência , RNA Ribossômico 16S/genética , Análise de Regressão , Fatores de Risco , Homologia de Sequência do Ácido Nucleico , Fatores Sexuais , Trombocitopenia , Carrapatos/microbiologia
14.
Int J Tuberc Lung Dis ; 22(8): 851-857, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-29991392

RESUMO

SETTING: Many children with tuberculosis (TB) remain undiagnosed due to the absence of services, lack of child-friendly diagnostics and underappreciation of TB as a common cause of childhood illness. OBJECTIVE: To show the impact of systematic verbal screening and contact tracing with appropriate management services on TB case finding in pediatric populations. DESIGN: Between October 2014 and March 2016, children were verbally screened at the pediatric out-patient departments of four public hospitals in Jamshoro District, Pakistan. Children with symptoms or risk of TB were referred for clinical evaluation and free chest X-ray and bacteriological tests. Children with TB were started on treatment and their care givers asked to bring household members to the hospital for screening. RESULTS: Over 105 000 children were verbally screened and 5880 presumptive childhood TB patients were identified; 1417 children (prevalence 1.3%) were diagnosed with TB; 43% were female. The median age was 5 years; 82% had pulmonary TB. An additional 390 children with TB were diagnosed through contact tracing. These activities resulted in a three-fold increase in pediatric TB case notifications. CONCLUSION: Systematic verbal screening with clinical evaluation and free diagnostics can identify children with TB who may otherwise be missed in rural health settings.


Assuntos
Busca de Comunicante/métodos , Programas de Rastreamento/métodos , Tuberculose/diagnóstico , Adolescente , Criança , Pré-Escolar , Características da Família , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Programas de Rastreamento/economia , Paquistão/epidemiologia , Radiografia Torácica/economia , População Rural , Tuberculose/epidemiologia
15.
J Thromb Haemost ; 16(10): 2083-2096, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30007118

RESUMO

Essentials Reactive oxygen species (ROS) generation by NOX2 plays a critical role in platelet activation. Rac1 regulation of NOX2 is important for ROS generation. Small molecule inhibitor of the Rac1-p67phox interaction prevents platelet activation. Pharmacologic targeting of Rac1-NOX2 axis can be a viable approach for antithrombotic therapy. SUMMARY: Background Platelets from patients with X-linked chronic granulomatous disease or mice deficient in nicotinamide adenine dinucleotide (phosphate) (NAD(P)H) oxidase isoform NOX2 exhibit diminished reactive oxygen species (ROS) generation and platelet activation. Binding of Rac1 GTPase to p67phox plays a critical role in NOX2 activation by facilitating the assembly of the NOX2 enzyme complex. Objective We tested the hypothesis that Phox-I, a rationally designed small molecule inhibitor of Rac-p67phox interaction, may serve as an antithrombosis agent by suppressing ROS production and platelet activation. Results Collagen-related peptide (CRP) induced ROS generation in a time-dependent manner. Platelets from Rac1-/- mice or human platelets treated with NSC23766, a specific Rac inhibitor, produced significantly less ROS in response to CRP. Treatment of platelets with Phox-I inhibited diverse CRP-induced responses, including: (i) ROS generation; (ii) release of P-selectin; (iii) secretion of ATP; (iv) platelet aggregation; and (v) phosphorylation of Akt. Similarly, incubation of platelets with Phox-I inhibited thrombin-induced: (i) secretion of ATP; (ii) platelet aggregation; (iii) rise in cytosolic calcium; and (iv) phosphorylation of Akt. In mouse models, intraperitoneal administration of Phox-I inhibited: (i) collagen-induced platelet aggregation without affecting the tail bleeding time and (ii) in vivo platelet adhesion/accumulation at the laser injury sites on the saphenous vein without affecting the time for complete cessation of blood loss. Conclusions Small molecule targeting of the Rac1-p67phox interaction may present an antithrombosis regimen by preventing GPVI- and non-GPVI-mediated NOX2 activation, ROS generation and platelet function without affecting the bleeding time.


Assuntos
Plaquetas/efeitos dos fármacos , Inibidores Enzimáticos/farmacologia , Fibrinolíticos/farmacologia , NADPH Oxidase 2/antagonistas & inibidores , Neuropeptídeos/antagonistas & inibidores , Inibidores da Agregação Plaquetária/farmacologia , Agregação Plaquetária/efeitos dos fármacos , Espécies Reativas de Oxigênio/sangue , Proteínas rac1 de Ligação ao GTP/antagonistas & inibidores , Animais , Plaquetas/enzimologia , Sinalização do Cálcio/efeitos dos fármacos , Proteínas de Transporte/farmacologia , Humanos , Camundongos Knockout , NADPH Oxidase 2/sangue , Neuropeptídeos/sangue , Neuropeptídeos/genética , Peptídeos/farmacologia , Glicoproteínas da Membrana de Plaquetas/metabolismo , Trombina/farmacologia , Proteínas rac1 de Ligação ao GTP/sangue , Proteínas rac1 de Ligação ao GTP/genética
16.
BJOG ; 125(12): 1591-1599, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29782696

RESUMO

OBJECTIVE: Ultrasound is widely regarded as an important adjunct to antenatal care (ANC) to guide practice and reduce perinatal mortality. We assessed the impact of ANC ultrasound use at health centres in resource-limited countries. DESIGN: Cluster randomised trial. SETTING: Clusters within five countries (Democratic Republic of Congo, Guatemala, Kenya, Pakistan, and Zambia) METHODS: Clusters were randomised to standard ANC or standard care plus two ultrasounds and referral for complications. The study trained providers in intervention clusters to perform basic obstetric ultrasounds. MAIN OUTCOME MEASURES: The primary outcome was a composite of maternal mortality, maternal near-miss mortality, stillbirth, and neonatal mortality. RESULTS: During the 24-month trial, 28 intervention and 28 control clusters had 24 263 and 23 160 births, respectively; 78% in the intervention clusters received at least one study ultrasound; 60% received two. The prevalence of conditions noted including twins, placenta previa, and abnormal lie was within expected ranges. 9% were referred for an ultrasound-diagnosed condition, and 71% attended the referral. The ANC (RR 1.0 95% CI 1.00, 1.01) and hospital delivery rates for complicated pregnancies (RR 1.03 95% CI 0.89, 1.20) did not differ between intervention and control clusters nor did the composite outcome (RR 1.09 95% CI 0.97, 1.23) or its individual components. CONCLUSIONS: Despite availability of ultrasound at ANC in the intervention clusters, neither ANC nor hospital delivery for complicated pregnancies increased. The composite outcome and the individual components were not reduced. TWEETABLE ABSTRACT: Antenatal care ultrasound did not improve a composite outcome that included maternal, fetal, and neonatal mortality.


Assuntos
Serviços de Saúde Materno-Infantil , Área Carente de Assistência Médica , Assistência Perinatal , Complicações na Gravidez/diagnóstico por imagem , Ultrassonografia Pré-Natal , Adolescente , Adulto , Análise por Conglomerados , Países em Desenvolvimento , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Masculino , Mortalidade Materna , Gravidez , Complicações na Gravidez/mortalidade , Adulto Jovem
17.
J Integr Neurosci ; 17(3-4): 503-523, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29710731

RESUMO

In this work, a comparative study of seven well-known mathematical techniques for the coupled Burgers' equations is reported. The techniques involve in this comparison are as follows: Laplace transform Adomian decomposition method, Laplace transform homotopy perturbation method, Variational iteration method, Variational iteration decomposition method, Variational iteration homotopy perturbation method, the optimal homotopy asymptotic method, and OHAM with Daftardar-Jafari polynomial. Here we considered a practical example which consists of coupled Burgers' equations with the kinematic viscosity ε=1. Convergence and stability analysis is a major part of this analysis. After a careful observation, it is found that the variational iteration method has faster convergence than all the remaining methods. Adomian decomposition method and Homotopy perturbation method show weaker stability in comparison with other involved techniques.

18.
J Integr Neurosci ; 17(3-4): 525-546, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29710732

RESUMO

The flow of magnetohydrodynamic Carreau liquid with the Brownian moment, thermophoresis and cross diffusion effects is investigated numerically. The buoyancy persuades on the flow is contemplated in such a way that the surface is neither perpendicular/horizontal nor wedge/cone. This is very helpful in the design of jet-engine. The equations govern the flow are transmuted using acceptable similarity variables and numerically solved by recruiting Runge-Kutta based Newtons method. The graphical results are obtained to discuss the stimulus of flow, thermal and concentration fields for different parameters of interest. The wall friction, local Nusselt and Sherwood numbers are examined with the assistance of tables. It is noticed that the parabolic flow is controlled by the buoyant forces developed by the temperature difference. Since the flow is laminar, the Reynolds number considered as <1000. This study has applicable in man-made products and various industries like pumps and oil purification, petroleum production, power engineering and chemical engineering processes.

19.
BJOG ; 125(2): 131-138, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28139875

RESUMO

OBJECTIVE: We sought to classify causes of stillbirth for six low-middle-income countries using a prospectively defined algorithm. DESIGN: Prospective, observational study. SETTING: Communities in India, Pakistan, Guatemala, Democratic Republic of Congo, Zambia and Kenya. POPULATION: Pregnant women residing in defined study regions. METHODS: Basic data regarding conditions present during pregnancy and delivery were collected. Using these data, a computer-based hierarchal algorithm assigned cause of stillbirth. Causes included birth trauma, congenital anomaly, infection, asphyxia, and preterm birth, based on existing cause of death classifications and included contributing maternal conditions. MAIN OUTCOME MEASURES: Primary cause of stillbirth. RESULTS: Of 109 911 women who were enrolled and delivered (99% of those screened in pregnancy), 2847 had a stillbirth (a rate of 27.2 per 1000 births). Asphyxia was the cause of 46.6% of the stillbirths, followed by infection (20.8%), congenital anomalies (8.4%) and prematurity (6.6%). Among those caused by asphyxia, 38% had prolonged or obstructed labour, 19% antepartum haemorrhage and 18% pre-eclampsia/eclampsia. About two-thirds (67.4%) of the stillbirths did not have signs of maceration. CONCLUSIONS: Our algorithm determined cause of stillbirth from basic data obtained from lay-health providers. The major cause of stillbirth was fetal asphyxia associated with prolonged or obstructed labour, pre-eclampsia and antepartum haemorrhage. In the African sites, infection also was an important contributor to stillbirth. Using this algorithm, we documented cause of stillbirth and its trends to inform public health programs, using consistency, transparency, and comparability across time or regions with minimal burden on the healthcare system. TWEETABLE ABSTRACT: Major causes of stillbirth are asphyxia, pre-eclampsia and haemorrhage. Infections are important in Africa.


Assuntos
Algoritmos , Sistema de Registros , Natimorto/epidemiologia , África/epidemiologia , Ásia/epidemiologia , Países em Desenvolvimento , Feminino , Saúde Global , Guatemala/epidemiologia , Humanos , Serviços de Saúde Materno-Infantil , Gravidez , Complicações na Gravidez/epidemiologia , Estudos Prospectivos
20.
BJOG ; 125(9): 1137-1143, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29094456

RESUMO

OBJECTIVE: To describe the causes of maternal death in a population-based cohort in six low- and middle-income countries using a standardised, hierarchical, algorithmic cause of death (COD) methodology. DESIGN: A population-based, prospective observational study. SETTING: Seven sites in six low- to middle-income countries including the Democratic Republic of the Congo (DRC), Guatemala, India (two sites), Kenya, Pakistan and Zambia. POPULATION: All deaths among pregnant women resident in the study sites from 2014 to December 2016. METHODS: For women who died, we used a standardised questionnaire to collect clinical data regarding maternal conditions present during pregnancy and delivery. These data were analysed using a computer-based algorithm to assign cause of maternal death based on the International Classification of Disease-Maternal Mortality system (trauma, termination of pregnancy-related, eclampsia, haemorrhage, pregnancy-related infection and medical conditions). We also compared the COD results to healthcare-provider-assigned maternal COD. MAIN OUTCOME MEASURES: Assigned causes of maternal mortality. RESULTS: Among 158 205 women, there were 221 maternal deaths. The most common algorithm-assigned maternal COD were obstetric haemorrhage (38.6%), pregnancy-related infection (26.4%) and pre-eclampsia/eclampsia (18.2%). Agreement between algorithm-assigned COD and COD assigned by healthcare providers ranged from 75% for haemorrhage to 25% for medical causes coincident to pregnancy. CONCLUSIONS: The major maternal COD in the Global Network sites were haemorrhage, pregnancy-related infection and pre-eclampsia/eclampsia. This system could allow public health programmes in low- and middle-income countries to generate transparent and comparable data for maternal COD across time or regions. TWEETABLE ABSTRACT: An algorithmic system for determining maternal cause of death in low-resource settings is described.


Assuntos
Causas de Morte , Saúde Global/estatística & dados numéricos , Morte Materna/classificação , Complicações na Gravidez/mortalidade , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , República Democrática do Congo/epidemiologia , Países em Desenvolvimento , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Guatemala/epidemiologia , Humanos , Renda , Índia/epidemiologia , Quênia/epidemiologia , Morte Materna/etiologia , Mortalidade Materna , Paquistão/epidemiologia , Gravidez , Estudos Prospectivos , Sistema de Registros , Zâmbia/epidemiologia
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