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1.
Niger J Clin Pract ; 27(5): 643-646, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38842714

RESUMO

BACKGROUND: Mayer-Rokitansky-Kuster-Hauser (MRKH) Syndrome, the second important cause of primary amenorrhea, is characterized by complete mullerian agenesis in the presence of normal karyotype and normal functioning ovaries. Incidence is one in 4500 females. Treatment options include surgical and non-surgical methods. Surgical treatment by creating a neovagina between bladder and rectum is preferred as it gives immediate results. AIM: To evaluate the anatomical and functional outcomes of modified vaginoplasty procedures conducted in our institution. METHODS: An ambispective cohort study was conducted in the Department of Obstetrics and Gynaecology, at a tertiary care hospital and included 10 cases of MRKH syndrome, who underwent surgical treatment in our department. Postoperative outcome was noted. Sexual function was evaluated using the Female Sexual Function Index (FSFI) score. RESULTS: The mean duration of surgery was 40 minutes. The average blood loss during surgery in patients undergoing vaginoplasty was 60 ml. The mean length of the neovagina as measured 1 month after surgery was 7.9 cms. FSFI score was >30 in eight patients. Two patients were lost to follow-up. CONCLUSION: Modified McIndoe vaginoplasty is a simple, safe, and cost-effective procedure in the hands of experts. Only mature patients willing to follow the instructions and planning to get married soon should undergo this surgery.


Assuntos
Transtornos 46, XX do Desenvolvimento Sexual , Anormalidades Congênitas , Ductos Paramesonéfricos , Centros de Atenção Terciária , Vagina , Humanos , Feminino , Vagina/cirurgia , Vagina/anormalidades , Ductos Paramesonéfricos/anormalidades , Ductos Paramesonéfricos/cirurgia , Transtornos 46, XX do Desenvolvimento Sexual/cirurgia , Adulto , Adolescente , Anormalidades Congênitas/cirurgia , Adulto Jovem , Procedimentos de Cirurgia Plástica/métodos , Resultado do Tratamento , Procedimentos Cirúrgicos em Ginecologia/métodos , Estudos de Coortes , Estudos Prospectivos
2.
Hosp Pharm ; 57(1): 121-129, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35521006

RESUMO

Introduction: Little is known about outcomes associated with enoxaparin versus unfractionated heparin (UFH) for venous thromboembolism (VTE) prophylaxis in abdominal surgery patients in U.S. clinical practice. The purpose of this study was to compare VTE, all-cause mortality, PE-related in-hospital mortality, and hospital costs during abdominal surgery hospitalization and the 90 days post-discharge between patients who received enoxaparin versus UFH prophylaxis. Materials and Methods: Using the Premier Healthcare Database, abdominal surgery patients who received at least 1 day of VTE prophylaxis with enoxaparin or UFH were identified between January 1, 2010 and September 30, 2016. Clinical outcomes were assessed using multivariable logistic regression models and cost outcomes were assessed using generalized linear models. Results: Of 363,669 patients identified, 59% received enoxaparin and 41% UFH. In adjusted analyses, there were statistically significant lower odds of VTE (OR 0.80; 95% CI 0.65-0.97), all-cause mortality (OR 0.67; 95% CI 0.60-0.75), and major bleeding (OR 0.88; 95% CI 0.82-0.94) during the hospitalization for enoxaparin versus UFH, but no differences during the 90-days post-discharge or for PE-related mortality. There was a statistically significant lower total hospital cost with enoxaparin versus UFH during index hospitalization ($8,913 vs $9,017, P < .0001), but not post-discharge ($3,342 vs $3,368, P = .42). Unadjusted rates of heparin-induced thrombocytopenia (index:0.1% vs 0.3%; post-discharge: 0.02% vs 0.06%) were reported for enoxaparin and UFH, respectively. Conclusion: In contemporary U.S. hospital practice, statistically significant lower odds of VTE, all-cause mortality and major bleeding with enoxaparin versus UFH prophylaxis were found during abdominal surgery hospitalizations.

3.
Water Environ Res ; 90(2): 101-109, 2018 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-28600862

RESUMO

This paper presents the biophysical impact of various interventions made under watershed development programs, in terms of the creation of additional water resources, and resultant changes in land use and cropping patterns in the Bundelkhand region of Madhya Pradesh State, India. Both primary and secondary data gathered from randomly selected watersheds and their corresponding control villages were used in this study. Analysis revealed that emphasis was given primarily to the creation of water resources potential during implementation of the programs, which led to augmentation of surface and groundwater availability for both irrigation and non-agricultural purposes. In addition, other land based interventions for soil and moisture conservation, plantation activities, and so forth, were taken up on both arable and nonarable land, which helped to improve land slope and land use, cropping pattern, agricultural productivity, and vegetation cover.


Assuntos
Agricultura/métodos , Conservação dos Recursos Naturais/métodos , Recursos Hídricos/provisão & distribuição , Abastecimento de Água/métodos , Índia , Solo , Abastecimento de Água/estatística & dados numéricos
4.
Am J Transplant ; 17(8): 2129-2138, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28188678

RESUMO

Prophylactic ureteric stenting in renal transplantation reduces major urological complications; however, morbidity is related to the indwelling duration of a stent. We aimed to determine the optimal duration for stents in this clinical setting. Patients (aged 2-75 years) from six UK hospitals who were undergoing renal transplantation were recruited and randomly assigned to either early stent removal at 5 days (without cystoscopy) or late removal at 6 weeks after transplantation (with cystoscopy). The primary outcome was a composite of stent-related complications defined as pain, visible hematuria, migration, fragmentation, and urinary tract infections (UTIs) within 3 mo of transplantation. Between May 2010 and Nov 2013, we randomly assigned 227 participants, with 205 included in the final analysis of the primary outcome. Stent-related complications were significantly higher in the late versus early stent removal groups (36 of 126 [28.6%] vs. 6 of 79 [7.6%]; p < 0.001). The majority of stent complications consisted of UTIs, with an incidence of 31 of 126 (24.6%) in the late group compared with 6 of 79 (7.6%) in the early group (p = 0.004). We found early stent removal on day 5 significantly reduced stent-related complications and improved quality of life in the first 3 mo after transplantation (ISRCTN09184595).


Assuntos
Remoção de Dispositivo , Transplante de Rim/efeitos adversos , Complicações Pós-Operatórias/prevenção & controle , Qualidade de Vida , Stents/efeitos adversos , Ureter/cirurgia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Seguimentos , Taxa de Filtração Glomerular , Rejeição de Enxerto/etiologia , Rejeição de Enxerto/prevenção & controle , Sobrevivência de Enxerto , Humanos , Falência Renal Crônica/cirurgia , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Fatores de Tempo , Transplantados , Infecções Urinárias/prevenção & controle , Adulto Jovem
5.
Am J Transplant ; 16(12): 3443-3457, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27328267

RESUMO

We and others have previously described signatures of tolerance in kidney transplantation showing the differential expression of B cell-related genes and the relative expansions of B cell subsets. However, in all of these studies, the index group-namely, the tolerant recipients-were not receiving immunosuppression (IS) treatment, unlike the rest of the comparator groups. We aimed to assess the confounding effect of these regimens and develop a novel IS-independent signature of tolerance. Analyzing gene expression in three independent kidney transplant patient cohorts (232 recipients and 14 tolerant patients), we have established that the expression of the previously reported signature was biased by IS regimens, which also influenced transitional B cells. We have defined and validated a new gene expression signature that is independent of drug effects and also differentiates tolerant patients from healthy controls (cross-validated area under the receiver operating characteristic curve [AUC] = 0.81). In a prospective cohort, we have demonstrated that the new signature remained stable before and after steroid withdrawal. In addition, we report on a validated and highly accurate gene expression signature that can be reliably used to identify patients suitable for IS reduction (approximately 12% of stable patients), irrespective of the IS drugs they are receiving. Only a similar approach will make the conduct of pilot clinical trials for IS minimization safe and hence allow critical improvements in kidney posttransplant management.


Assuntos
Biomarcadores/metabolismo , Rejeição de Enxerto/diagnóstico , Sobrevivência de Enxerto/imunologia , Tolerância Imunológica/imunologia , Imunossupressores/uso terapêutico , Transplante de Rim/efeitos adversos , Adulto , Idoso , Linfócitos B/efeitos dos fármacos , Linfócitos B/imunologia , Linfócitos B/metabolismo , Estudos de Casos e Controles , Feminino , Seguimentos , Taxa de Filtração Glomerular , Rejeição de Enxerto/tratamento farmacológico , Rejeição de Enxerto/etiologia , Rejeição de Enxerto/metabolismo , Sobrevivência de Enxerto/efeitos dos fármacos , Humanos , Tolerância Imunológica/efeitos dos fármacos , Falência Renal Crônica/complicações , Falência Renal Crônica/cirurgia , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Fatores de Risco
6.
Child Care Health Dev ; 41(1): 67-75, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24827413

RESUMO

BACKGROUND: Long-term childhood conditions are often managed by hospital-based multidisciplinary teams (MDTs) of professionals with discipline specific expertise of a condition, in partnership with parents. However, little evidence exists on professional-parent interactions in this context. An exploration of professionals' accounts of the way they individually and collectively teach parents to manage their child's clinical care at home is, therefore, important for meeting parents' needs, informing policy and educating novice professionals. Using chronic kidney disease as an exemplar this paper reports on one aspect of a study of interactions between professionals and parents in a network of 12 children's kidney units in Britain. METHODS: We conducted semi-structured, qualitative interviews with a convenience sample of 112 professionals (clinical-psychologists, dietitians, doctors, nurses, pharmacists, play-workers, therapists and social workers), exploring accounts of their parent-educative activity. We analysed data using framework and the concept of distributed expertise. RESULTS: Four themes emerged that related to the way expertise was distributed within and across teams: (i) recognizing each other's' expertise, (ii) sharing expertise within the MDT, (iii) language interpretation, and (iv) acting as brokers. Two different professional identifications were also seen to co-exist within MDTs, with participants using the term 'we' both as the intra-professional 'we' (relating to the professional identity) when describing expertise within a disciplinary group (for example: 'As dietitians we aim to give tailored advice to optimize children's growth'), and the inter-professional 'we' (a 'team-identification'), when discussing expertise within the team (for example: 'We work as a team and make sure we're all happy with every aspect of their training before they go home'). CONCLUSIONS: This study highlights the dual identifications implicit in 'being professional' in this context (to the team and to one's profession) as well as the unique role that each member of a team contributes to children's care. Our methodology and results have the potential to be transferred to teams managing other conditions.


Assuntos
Pais/educação , Equipe de Assistência ao Paciente/organização & administração , Relações Profissional-Família , Insuficiência Renal Crônica/terapia , Atitude do Pessoal de Saúde , Criança , Humanos , Relações Interprofissionais , Entrevistas como Assunto , Pais/psicologia , Equipe de Assistência ao Paciente/normas , Pesquisa Qualitativa , Insuficiência Renal Crônica/fisiopatologia , Apoio Social , Reino Unido
7.
Kathmandu Univ Med J (KUMJ) ; 12(48): 288-91, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-26333585

RESUMO

Gestational trophoblastic neoplasms (GTN) are proliferative degenerative disorders of placental elements and include complete or partial mole (90%), invasivemole (5-8%), choriocarcinoma (1-2%) and placental site tumor (1-2%). Chorioadenoma destruens is a trophoblastic tumor, characterized by myometrial invasion through direct extension or via venous channels. We present a case of invasive mole eroding uterus and uterine vasculature, causing sudden rupture of uterus with massive haemoperitoneum mimicking ectopic pregnancy. A 20 year old G1P0 at 6 weeks gestation presented in Casualty of Kasturba Hospital complaining of severe acute onset lower abdominal pain for one hour. Clinical examination revealed shock. Sonography suggested ectopic pregnancy and immediate exploratory laparotomy was decided. On laparotomy, 2000cc of haemoperitoneum was noted. Grape like vesicles protruding through fundal perforation with profuse active bleeding was seen. Bleeding persisted despite evacuation. Step wise uterine devascularisation failed to achieve haemostasis. Total abdominal hysterectomy was performed as a life saving measure.


Assuntos
Hemoperitônio/patologia , Mola Hidatiforme Invasiva/diagnóstico , Ruptura Espontânea/etiologia , Neoplasias Uterinas/diagnóstico , Adulto , Feminino , Humanos , Mola Hidatiforme Invasiva/patologia , Gravidez , Gravidez Ectópica/diagnóstico , Ruptura Espontânea/patologia , Neoplasias Uterinas/patologia
8.
Tsitol Genet ; 47(3): 3-13, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23821949

RESUMO

We report the first complete microsatellite genetic map of jute (Corchorus olitorius L.; 2n = 2x = 14) using an F6 recombinant inbred population. Of the 403 microsatellite markers screened, 82 were mapped on the seven linkage groups (LGs) that covered a total genetic distance of 799.9 cM, with an average marker interval of 10.7 cM. LG5 had the longest and LG7 the shortest genetic lengths, whereas LG1 had the maximum and LG7 the minimum number of markers. Segregation distortion of microsatellite loci was high (61%), with the majority of them (76%) skewed towards the female parent. Genomewide non-parametric single-marker analysis in combination with multiple quantitative trait loci (QTL)-models (MQM) mapping detected 26 definitive QTLs for bast fibre quality, yield and yield-related traits. These were unevenly distributed on six LGs, as colocalized clusters, at genomic sectors marked by 15 microsatellite loci. LG1 was the QTL-richest map sector, with the densest colocalized clusters of QTLs governing fibre yield, yield-related traits and tensile strength. Expectedly, favorable QTLs were derived from the desirable parents, except for nearly all of those of fibre fineness, which might be due to the creation of new gene combinations. Our results will be a good starting point for further genome analyses in jute.


Assuntos
Corchorus/genética , Ligação Genética , Repetições de Microssatélites/genética , Locos de Características Quantitativas/genética , Corchorus/crescimento & desenvolvimento , Marcadores Genéticos , Genoma de Planta , Estudo de Associação Genômica Ampla , Genótipo , Fenótipo , Recombinação Genética
9.
Kathmandu Univ Med J (KUMJ) ; 11(41): 54-9, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23774415

RESUMO

BACKGROUND: Analgesic effect of exercise is a well established fact; however available reports are contradictory on gender differences in pain perception following exercise stress test. OBJECTIVE: The current study is prospectively designed to evaluate and compare the effect of acute bout of sub-maximal exercise stress on cold pressor pain in normal adult males and females. METHOD: The experimental study design involved healthy adults (n= 41); females (n = 18) and males (n=23) aged between 18 to 25 years and included them into four sets of experiments: SET I (Control), "resting blood pressure, radial pulse and respiratory rate were recorded after 15 minutes of complete supine relaxation. SET II (Cold Pressor Pain Test): Pain Threshold, Pain Tolerance, and Pain Duration in seconds were taken. SET III (Exercise Stress Test): Sub-maximal exercise of 70 to 75% of maximum predicted heart rate was given for 6 minutes. SET IV (Cold Pressor Pain Test immediately after Exercise Stress Test): At 0 minute of recovery again the pain parameters; Pain Threshold, Pain Tolerance, and Pain Duration in seconds were taken. SET I, SET II were performed in order on the first day and SET III and SET IV on the second day to ensure only a single Cold Pressor Pain Test is performed in each day. RESULT: The data (Mean ± SD) analysis showed significant increased in pain threshold (males: 14.36 ± 10.6 Vs 21.47 ± 13 seconds, p< 0.001, females: 14.1 ± 11.5 Vs 23.81 ± 20.22 seconds, p<0.001) and pain tolerance time (males: 41.3 ± 19.31 Vs 54.1 ± 21.7 seconds, p<0.001) in both sexes after 6 min of acute bout of sub-maximal exercise stress test with comparable age, BMI and baseline resting values of pain parameters and pulse rate and blood pressure. The percentage increment pain tolerance time following the exercise stress in female is higher than male (78.6 Vs 68.9%). CONCLUSION: The result suggests that pain sensation decreases immediately after a brief period of exercise challenge irrespective of gender, and the analgesic effect of the acute bout of exercise in terms of pain tolerant time is more enhanced in females than males.


Assuntos
Temperatura Baixa , Limiar da Dor/fisiologia , Dor/reabilitação , Resistência Física/fisiologia , Adolescente , Adulto , Teste de Esforço/métodos , Feminino , Seguimentos , Humanos , Masculino , Medição da Dor , Estudos Prospectivos , Valores de Referência , Distribuição por Sexo , Fatores Sexuais , Adulto Jovem
10.
Nature ; 442(7100): 287-90, 2006 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-16855587

RESUMO

The determination of melt distribution in the crust and the nature of the crust-mantle boundary (the 'Moho') is fundamental to the understanding of crustal accretion processes at oceanic spreading centres. Upper-crustal magma chambers have been imaged beneath fast- and intermediate-spreading centres but it has been difficult to image structures beneath these magma sills. Using three-dimensional seismic reflection images, here we report the presence of Moho reflections beneath a crustal magma chamber at the 9 degrees 03' N overlapping spreading centre, East Pacific Rise. Our observations highlight the formation of the Moho at zero-aged crust. Over a distance of less than 7 km along the ridge crest, a rapid increase in two-way travel time of seismic waves between the magma chamber and Moho reflections is observed, which we suggest is due to a melt anomaly in the lower crust. The amplitude versus offset variation of reflections from the magma chamber shows a coincident region of higher melt fraction overlying this anomalous region, supporting the conclusion of additional melt at depth.

11.
Homeopathy ; 101(1): 5-12, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22226309

RESUMO

OBJECTIVE: To compare the effectiveness of Homeopathy and Conventional therapy in Acute Otitis Media (AOM). METHOD: A randomized placebo-controlled parallel group pilot study of homeopathic vs conventional treatment for AOM was conducted in Jaipur, India. Patients were randomized by a computer generated random number list to receive either individualized homeopathic medicines in fifty millesimal (LM) potencies, or conventional treatment including analgesics, antipyretics and anti-inflammatory drugs. Patients who did not improve were prescribed antibiotics at the 3rd day. Outcomes were assessed by the Acute Otitis Media-Severity of Symptoms (AOM-SOS) Scale and Tympanic Membrane Examination over 21 days. RESULTS: 81 patients were included, 80 completed follow-up: 41 for conventional and 40 for homeopathic treatment. In the Conventional group, all 40 (100%) patients were cured, in the Homeopathy group, 38 (95%) patients were cured while 02 (5%) patients were lost to the last two follow-up. By the 3rd day of treatment, 4 patients were cured in Homeopathy group but in Conventional group only one patient was cured. In the Conventional group antibiotics were prescribed in 39 (97.5%), no antibiotics were required in the Homeopathy group. 85% of patients were prescribed six homeopathic medicines. CONCLUSION: Individualized homeopathy is an effective conventional treatment in AOM, there were no significant differences between groups in the main outcome. Symptomatic improvement was quicker in the Homeopathy group, and there was a large difference in antibiotic requirements, favouring homeopathy. Further work on a larger scale should be conducted.


Assuntos
Homeopatia , Otite Média/terapia , Humanos
12.
Homeopathy ; 101(2): 84-91, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22487367

RESUMO

OBJECTIVE: The primary objective was to ascertain the therapeutic usefulness of homeopathic medicine in the management of chronic sinusitis (CS). MATERIALS AND METHODS: Multicentre observational study at Institutes and Units of the Central Council for Research in Homoeopathy, India. Symptoms were assessed using the chronic sinusitis assessment score (CSAS). 17 pre-defined homeopathic medicines were shortlisted for prescription on the basis of repertorisation for the pathological symptoms of CS. Regimes and adjustment of regimes in the event of a change of symptoms were pre-defined. The follow-up period was for 6 months. Statistical analysis was done using SPSS version 16. RESULTS: 628 patients suffering from CS confirmed on X-ray were enrolled from eight Institutes and Units of the Central Council for Research in Homoeopathy. All 550 patients with at least one follow-up assessment were analyzed. There was a statistically significant reduction in CSAS (P = 0.0001, Friedman test) after 3 and 6 months of treatment. Radiological appearances also improved. A total of 13 out of 17 pre-defined medicines were prescribed in 550 patients, Sil. (55.2% of 210), Calc. (62.5% of 98), Lyc. (69% of 55), Phos. (66.7% of 45) and Kali iod. (65% of 40) were found to be most useful having marked improvement. 4/17 medicines were never prescribed. No complications were observed during treatment. CONCLUSION: Homeopathic treatment may be effective for CS patients. Controlled trials are required for further validation.


Assuntos
Homeopatia/métodos , Sinusite/tratamento farmacológico , Adolescente , Adulto , Criança , Doença Crônica , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Radiografia , Sinusite/diagnóstico por imagem , Resultado do Tratamento , Adulto Jovem
13.
J Assoc Physicians India ; 59: 120-2, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21751653

RESUMO

A 28-year-old male had history of stiffness in limb muscles, with hypertrophy of most muscle groups and both action and percussion myotonia. We report a very interesting rare family of brothers and sister of myotonia congenita, conforming to autosomal recessive transmission (Becker's variety) with Herculean appearance.


Assuntos
Canais de Cloreto/genética , Debilidade Muscular/etiologia , Miotonia Congênita/diagnóstico , Miotonia Congênita/genética , Adulto , DNA/genética , Eletromiografia , Genes Recessivos , Humanos , Hipertrofia/patologia , Masculino , Debilidade Muscular/fisiopatologia , Músculo Esquelético/patologia , Músculo Esquelético/fisiopatologia , Mutação , Miotonia Congênita/tratamento farmacológico , Linhagem , Fenitoína/uso terapêutico , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Resultado do Tratamento
14.
J Postgrad Med ; 56(4): 307-16, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20935408

RESUMO

Multiple ring-enhancing lesions of the brain are one of the most commonly encountered abnormalities on neuroimaging. These can be caused by a variety of infectious, neoplastic, inflammatory or vascular diseases. Distinguishing non-neoplastic causes from neoplastic lesions is extremely important because a misdiagnosis can lead to unwarranted neurosurgery and exposure to toxic chemotherapy or potentially harmful brain irradiation. Diligent clinical evaluation and a battery of tests are required for making a definitive diagnosis. Newer advanced diagnostic techniques, such as diffusion-weighted magnetic resonance imaging (MRI), perfusion-weighted MRI, magnetic resonance spectroscopy, single-photon emission tomography and positron emission tomography may help in establishing the etiology. However, early brain biopsy is often needed because several of these diseases are potentially life-threatening.


Assuntos
Abscesso Encefálico/diagnóstico , Neoplasias Encefálicas/diagnóstico , Diagnóstico por Imagem/métodos , Neurocisticercose/diagnóstico , Tuberculoma/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Processamento de Imagem Assistida por Computador , Tomografia Computadorizada por Raios X
15.
J Postgrad Med ; 56(2): 146-9, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20622396

RESUMO

Tumefactive demyelinating lesion, a variant of multiple sclerosis, is a solitary large demyelinating lesion, which mimics cerebral neoplasm. Distinguishing tumefactive lesions from other etiologies of intracranial space-occupying lesions is essential to avoid inadvertent surgical or toxic chemotherapeutic interventions. We report two unusual cases of tumefactive demyelinating lesion. The first patient presented with recurrent right focal tonic-clonic seizures with secondary generalization of three-month duration. Her neurological examination was normal. Another patient presented with right homonymous hemianopia. In this patient, the diagnosis was established after biopsy of the lesion, which revealed perivascular lymphocytic infiltrate and aggregates of foam cells in white matter with relatively uninvolved grey matter, suggestive of tumefactive demyelinating lesion. Administration of intravenous methylprednisolone resulted in rapid clinical improvement in both the patients and the brain lesion decreased in size. Both, epilepsy and homonymous hemianopia, are unusual manifestations of tumefactive demyelinating lesions. In our cases, cerebral tumors were initial diagnoses. Presence of an open ring or incomplete ring lesions and other magnetic resonance characteristics helped in differentiating demyelinating lesions from other neoplastic and infective diseases of the brain. Differential diagnosis of tumefactive demyelinating lesions, at times, may prove to be a challenging task for the treating physician.


Assuntos
Doenças Desmielinizantes/patologia , Esclerose Múltipla/patologia , Convulsões/patologia , Biópsia , Doenças Desmielinizantes/complicações , Feminino , Humanos , Aumento da Imagem , Espectroscopia de Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Convulsões/complicações , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
16.
J Healthc Qual Res ; 35(3): 149-157, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32423850

RESUMO

BACKGROUND: Patient safety is a global concern, and anaesthesiologists are critically involved in patient safety-related measures and practices. Although anesthesia service has improved a lot over the last few decades, the information on the anesthesia practice and patient safety in India is lacking. The present survey was aimed to get the information on these aspects. METHODS: A cross-sectional, questionnaire-based survey including both postgraduate trainees and anaesthesiologists, working across the different hospitals of India was conducted during February-May 2019. Google form was used as the survey; responses were directly downloaded as an Excel file and calculated in absolute numbers and percentages. Autonomous teaching institutes (ATI) were taken as standard, and Fisher's exact test was used for comparisons; P<0.05 was considered significant. RESULTS: Six-hundred (86.1%) responses were included for analysis. Pulse oximetry and non-invasive blood pressure (NIBP) were available in nearly 99% set-ups, but end-tidal carbon-di-oxide (EtCO2), temperature, oxygen, and anesthesia gas analyzer were lacking. ATI and corporate teaching hospitals were having almost all standard monitoring, but patient safety-related advanced equipment and medications were not present in many of the hospitals. The lack was highest in both public and private non-teaching hospitals (P<0.0001). CONCLUSION: Patient safety and anesthesia-related services in India are unsatisfactory. Except for pulse oximetry and NIBP, the public and private sector non-teaching hospitals were lacking even the standard monitoring. Referral and top-level corporate and public sector institutes also have scope for improvement.


Assuntos
Anestesia , Anestesiologia , Pesquisas sobre Atenção à Saúde , Segurança do Paciente , Padrões de Prática Médica , Estudos Transversais , Humanos , Índia , Internet
17.
J Law Biosci ; 7(1): lsaa058, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32908675

RESUMO

As the COVID-19 pandemic continues to ravage the globe, many nations have started to relax stringent restrictions in an effort to restart the economy. While Member States of the European Union have approached reopening without the use of antibody testing for COVID-19, such testing may be central to a long-term, sustainable strategy for international travel, employment, and the allocation and monitoring of vaccines. As the use of antibody testing to dictate the enjoyment of individual freedom remains highly controversial, we describe its use in the context of three case studies (return to the workplace, travel and vaccination), applying the substantive legal balancing entailed in the proportionality principle. Differential treatment of individuals based on COVID-19 antibody test results can be justified through the proportionality principle, which offers a sound dividing line between a reasonable and legitimate response and an unjust and discriminatory response.

18.
Struct Dyn ; 7(5): 054301, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32953941

RESUMO

We present the experimental end-station TRIXS dedicated to time-resolved soft x-ray resonant inelastic x-ray scattering (RIXS) experiments on solid samples at the free-electron laser FLASH. Using monochromatized ultrashort femtosecond XUV/soft x-ray photon pulses in combination with a synchronized optical laser in a pump-probe scheme, the TRIXS setup allows measuring sub-picosecond time-resolved high-resolution RIXS spectra in the energy range from 35 eV to 210 eV, thus spanning the M-edge (M1 and M2,3) absorption resonances of 3d transition metals and N4,5-edges of rare earth elements. A Kirkpatrick-Baez refocusing mirror system at the first branch of the plane grating monochromator beamline (PG1) provides a focus of (6 × 6) µm2 (FWHM) at the sample. The RIXS spectrometer reaches an energy resolution of 35-160 meV over the entire spectral range. The optical laser system based on a chirped pulse optical parametric amplifier provides approximately 100 fs (FWHM) long photon pulses at the fundamental wavelength of 800 nm and a fluence of 120 mJ/cm2 at a sample for optical pump-XUV probe measurements. Furthermore, optical frequency conversion enables experiments at 400 nm or 267 nm with a fluence of 80 and 30 mJ/cm2, respectively. Some of the first (pump-probe) RIXS spectra measured with this setup are shown. The measured time resolution for time-resolved RIXS measurements has been characterized as 287 fs (FWHM) for the used energy resolution.

19.
Indian J Physiol Pharmacol ; 53(1): 55-60, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19810577

RESUMO

A reliable and cost-effective animal model for human obesity with its manifested disorders is yet to be established in the context of increased morbidity and mortality due to obesity and its related problems. Therefore, an attempt was made to produce obesity in locally available British Angora Rabbits (BAR) and examine the effect on metabolic and cardiovascular parameters. Adult male BARs weighing nearly 2 kg were randomly divided into two groups, one of the groups was fed with high fat diet (HFD) ad libitum for 10 weeks and the control group received standard normal rabbit chow for same period. Body weight, skinfold thickness, serum cholesterol, serum glucose and resting heart rate were measured before and after the dietary regimens. After 10 weeks, HFD group of rabbits demonstrated significant (P < 0.05) increase in body weight (+24%) and skinfold thickness (+37%). The gain in body weight was positively correlated to skinfold thickness (r = 0.61). Serum cholesterol, serum glucose and resting heart rate were also increased by 46%, 52% and 15%, respectively. Whereas no such increases in any of these parameters were observed in control group of rabbits. Our results suggest that obesity can be produced in BARs by feeding HFD. The obesity manifests with cardiovascular and metabolic changes. It is proposed that this may serve as a valid and reliable model of experimental obesity.


Assuntos
Gorduras na Dieta/efeitos adversos , Modelos Animais de Doenças , Obesidade/etiologia , Animais , Glicemia/metabolismo , Peso Corporal/fisiologia , Colesterol/sangue , Frequência Cardíaca/fisiologia , Masculino , Obesidade/metabolismo , Obesidade/fisiopatologia , Coelhos , Dobras Cutâneas
20.
Indian J Physiol Pharmacol ; 53(1): 83-7, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19810581

RESUMO

Obesity is known to alter various physiological parameters including the pain sensitivity. There are conflicting reports on the pain sensitivity in obesity. In this context, the present study was aimed to investigate the tonic pain response in obese rabbit model. To achieve this aim, two groups of adult male British Angora rabbits were used. One of the groups was fed with standard rabbit chow and served as control. The other group was fed high fat diet (HFD) for 10 weeks to produce obesity. The standard formalin test was performed at the start and after 10 weeks of dietary regimen in both the groups. Timed behavioral responses (limping, elevation of paw, licking, biting, grooming etc.) were categorized and quantified with the help of standard pain rating scale. The total average pain rating score decreased significantly from 2.01 +/- 0.02 to 1.47 +/- 0.08 (P < 0.05) in HFD group after 10 weeks of dietary regimen, whereas there was no change in the control group. A significant negative correlation was observed between body weight and pain rating score in HFD group of rabbits (P < 0.05, r = -0.62). Results suggest that obesity attenuates the tonic pain responses induced by formalin in British Angora rabbits.


Assuntos
Obesidade/psicologia , Limiar da Dor , Dor/psicologia , Animais , Comportamento Animal , Peso Corporal , Gorduras na Dieta , Modelos Animais de Doenças , Formaldeído , Masculino , Obesidade/complicações , Obesidade/etiologia , Dor/induzido quimicamente , Dor/complicações , Medição da Dor/métodos , Coelhos , Distribuição Aleatória
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