RESUMO
The canonical autophagy pathway in mammalian cells sequesters diverse cytoplasmic cargo within the double membrane autophagosomes that eventually convert into degradative compartments via fusion with endolysosomal intermediates. Here, we report that autophagosomal membranes show permeability in cells lacking principal ATG8 proteins (mATG8s) and are unable to mature into autolysosomes. Using a combination of methods including a novel in vitro assay to measure membrane sealing, we uncovered a previously unappreciated function of mATG8s to maintain autophagosomal membranes in a sealed state. The mATG8 proteins GABARAP and LC3A bind to key ESCRT-I components contributing, along with other ESCRTs, to the integrity and imperviousness of autophagic membranes. Autophagic organelles in cells lacking mATG8s are permeant, are arrested as amphisomes, and do not progress to functional autolysosomes. Thus, autophagosomal organelles need to be maintained in a sealed state in order to become lytic autolysosomes.
Assuntos
Autofagia , Proteínas Associadas aos Microtúbulos , Animais , Humanos , Família da Proteína 8 Relacionada à Autofagia/genética , Família da Proteína 8 Relacionada à Autofagia/metabolismo , Proteínas Associadas aos Microtúbulos/genética , Proteínas Associadas aos Microtúbulos/metabolismo , Autofagossomos/metabolismo , Complexos Endossomais de Distribuição Requeridos para Transporte/metabolismo , MamíferosRESUMO
OBJECTIVE: To assess the diagnostic features of acromegaly, and analyse its management outcomes over a 15-year period in a tertiary care setting. METHODS: The descriptive, cohort, retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of adult patients of either gender diagnosed with acromegaly based on biochemical and radiological evidence between January 2005 and December 2019. Data was retrieved from the medical records. Data was analysed using SPSS 19. RESULTS: Of the 84 subjects, 54(64.3%) were males and 30(35.7%) were female. The overall mean age was 38.69±13.52 years. The patients presented 5.43±4.3 years after the onset of symptoms, with somatic growth features, such as enlarged hands and feet which was the most common complaint 81(96.4%). Of all the patients, 73(86.9%) underwent trans-sphenoidal surgery for the removal of the pituitary adenoma, while 11(13.1%) opted out of the surgical option. Further, 9(12.3%) patients showed biochemical and radiological remission 6 months post-surgery. Out of the remaining 64(87.7%) patients, 38(59.4%) received radiosurgery or radiotherapy, 15(23.4%) underwent repeat trans-sphenoidal surgery, and 11(17.2%) chose medical treatment. CONCLUSIONS: Majority of patients failed to achieve remission after trans-sphenoidal surgery, which is the first line of treatment. Radiotherapy/repeat surgery was generally the options taken by those with persistent disease.
Assuntos
Acromegalia , Centros de Atenção Terciária , Humanos , Feminino , Masculino , Acromegalia/terapia , Acromegalia/diagnóstico , Acromegalia/epidemiologia , Paquistão/epidemiologia , Adulto , Estudos Retrospectivos , Pessoa de Meia-Idade , Adenoma/terapia , Adenoma/diagnóstico , Adenoma/cirurgia , Adenoma/epidemiologia , Neoplasias Hipofisárias/terapia , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/cirurgia , Resultado do Tratamento , Adulto Jovem , Radiocirurgia/métodosRESUMO
Fifth-generation (5G) networks offer high-speed data transmission with low latency, increased base station volume, improved quality of service (QoS), and massive multiple-input-multiple-output (M-MIMO) channels compared to 4G long-term evolution (LTE) networks. However, the COVID-19 pandemic has disrupted the achievement of mobility and handover (HO) in 5G networks due to significant changes in intelligent devices and high-definition (HD) multimedia applications. Consequently, the current cellular network faces challenges in propagating high-capacity data with improved speed, QoS, latency, and efficient HO and mobility management. This comprehensive survey paper specifically focuses on HO and mobility management issues within 5G heterogeneous networks (HetNets). The paper thoroughly examines the existing literature and investigates key performance indicators (KPIs) and solutions for HO and mobility-related challenges while considering applied standards. Additionally, it evaluates the performance of current models in addressing HO and mobility management issues, taking into account factors such as energy efficiency, reliability, latency, and scalability. Finally, this paper identifies significant challenges associated with HO and mobility management in existing research models and provides detailed evaluations of their solutions along with recommendations for future research.
Assuntos
COVID-19 , Humanos , Pandemias , Reprodutibilidade dos Testes , Inteligência , MultimídiaRESUMO
Radon and its progenies found in water indicate the existence of seismically active faults in the region. However, exposure to high levels of radon can also result in radiation-related health risks. This study focuses on radon-based active tectonic studies along the Muzaffarabad Fault in the core of the Hazara-Kashmir Syntaxis (HKS), NW Himalayas, Pakistan. In this study, spring water samples were collected along roadside of Jhelum Valley and in close proximity to the Muzaffarabad Fault in Pakistan using Radon Thoron Monitor (RTM1688-2). The results of the study showed that the radon concentrations in the water samples ranged from 1.895 to 17.097 Bq/l. The study found that the highest radon concentration was observed in the samples collected closest to the fault, while the lowest concentration was observed in the samples collected further away. The statistical analysis between the radon concentration and the distance from the fault showed a strong inverse relationship (R2=0.73). The study also found that 68% of the sampling sites had radon concentrations that exceeded the maximum contamination level (MCL) set by the US Environmental Protection Agency (EPA). The higher radon concentrations in the springs water suggest the probability of earthquake, which in turn poses potential health risks for the local population. The findings suggest that the measurement of radon concentration in water can be used as a tool for identifying seismically active faults in the region.
Assuntos
Terremotos , Monitoramento de Radiação , Radônio , Poluentes Radioativos da Água , Radônio/análise , Água/análise , Paquistão , Poluentes Radioativos da Água/análiseRESUMO
Vehicular Named Data Networking (VNDN) is one of the potential and future networking architectures that allow Connected and Autonomous Vehicles (CAV) to exchange data by simply disseminating the content over the network. VNDN only supports a pull-based data forwarding model, where the content information is forwarded upon request. However, in critical situations, it is essential to design a push-based data forwarding model in order to broadcast the critical data packets without any requests. One of the challenges of push-based data forwarding in VNDN is the broadcasting effect, which occurs when every vehicle broadcasts critical information over the network. For instance, in emergency situations such as accidents, road hazards, and bad weather conditions, the producer generates a critical data packet and broadcasts it to all the nearby vehicles. Subsequently, all vehicles broadcast the same critical data packet to each other, which leads to a broadcast storm on the network. Therefore, this paper proposes a Fuzzy Logic-based Push Data Forwarding (FLPDF) scheme to mitigate the broadcast storm effect. The novelty of this paper is the suggestion and application of a fuzzy logic approach to mitigate the critical data broadcast storm effect in VNDN. In the proposed scheme, vehicles are grouped into clusters using the K-means clustering algorithm, and then Cluster Heads (CHs) are selected using a fuzzy logic approach. A CH is uniquely responsible for broadcasting the critical data packets to all other vehicles in a cluster. A Gateway (GW) has the role of forwarding the critical data packets to the nearest clusters via their GWs. The simulation results show that the proposed scheme outperforms the naive method in terms of transmitted data packets and efficiency. The proposed scheme generates five times fewer data packets and achieves six times higher efficiency than the naive scheme.
RESUMO
Pituitary gonadotroph adenomas are common but very rarely do they secrete biologically active luteinizing hormone (LH) and follicle-stimulating hormone (FSH). There have been case studies reporting high sex hormones (testosterone/estrogen) in the presence of high or normal LH and FSH. Here we report two cases (with their consent) who presented with visual disturbance and headache at a tertiary care hospital (Aga Khan university hospital) Karachi, Pakistan. Brain imaging revealed a pituitary macroadenoma. Further workup was consistent with pituitary gonadotroph adenoma with high FSH (case 1) and normal LH/FSH (case 2) and elevated serum testosterone in both cases. Transsphenoidal resection was performed and the tissue sample histopathology confirmed pituitary adenoma. Postoperatively, improvement in hormonal profile was observed along with a resolution of visual disturbances and headaches. Thus, functional gonadotroph adenoma should be considered in the presence of elevated testosterone/estrogen and normal or elevated follicle-stimulating hormone (FSH)/ luteinizing hormone (LH). Early diagnosis leads to a better outcome.
Assuntos
Adenoma , Gonadotrofos , Neoplasias Hipofisárias , Humanos , Masculino , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/cirurgia , Gonadotrofos/patologia , Adenoma/complicações , Adenoma/diagnóstico , Adenoma/cirurgia , Hormônio Foliculoestimulante , Hormônio Luteinizante , Testosterona , Transtornos da Visão , Cefaleia/complicações , EstrogêniosRESUMO
Primary Thyroid Lymphoma (PTL) is a rare disease, mostly affecting middle-to-old aged females. It has a strong association with pre-existing thyroiditis, which increases the risk of its development. The disease has been studied in detail in the Western populations. However, there is lack of data for south Asians, especially in Pakistani population. This study was carried out to learn more about the disease characteristics in our area. This was a retrospective study where we reviewed four diagnosed and/or treated cases of primary thyroid Lymphoma at tertiary care hospital of Pakistan (Aga Khan University Hospital), Karachi, Pakistan. Each patient's medical record was reviewed and studied. The participants' average age was 62.8±10.12 years,, with two males and two females. The histology of all of the patients was compatible with the Diffuse B cell Lymphoma subtype. One patient died as a result of complications, one patient was lost to follow up, and the remaining two patients are doing well with no active complaints and are being followed up on a regular basis.
Assuntos
Linfoma , Neoplasias da Glândula Tireoide , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países em Desenvolvimento , Linfoma/epidemiologia , Linfoma/terapia , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/terapiaRESUMO
The objective of the study was to evaluate the effect of forage to concentrate ratio (F:C) on growth performance and feeding behavior of Thalli lambs. For this purpose, twenty-one male Thalli lambs with initial live body weight (26.30 ± 3.02 kg) were selected and divided into three experimental groups in a randomized complete block design. The experimental duration was 12 weeks. The experimental diets were F:C (100:0), F:C (80:20), and F:C (60:40). Alfalfa hay was used as forage source. Lambs fed F:C (60:40) and F:C (80:20) diets showed higher dry matter intake (DMI), total dry matter intake (TDMI), organic matter intake (OMI), weight gain, growth rate, better feed conversion ratio, and feed efficiency as compared to the lambs fed F:C (100:0) (P < 0.05). The results also showed that crude protein (CP), ether extract (EE), and total digestible nutrient (TDN) intake were maximum in F:C (60:40)-fed lambs (P < 0.05). However, higher crude fiber (CF), neutral detergent fiber (NDF), and acid detergent fiber (ADF) intakes were seen in the F:C (100:0)-fed lambs (P < 0.05). The results of nutrient digestibilities revealed the improved OM, DM, CP, and ADF digestibilities in lambs fed with F:C (60:40) and F:C (80:20) (P < 0.05). The digestibility of NDF and CF were not affected by the all-dietary treatments (P > 0.05). Behavior results explored that eating time, and chewing time was higher in F:C (100:0)-fed lambs (P < 0.05), while standing time, lying time, and abnormal behavior were increased in lambs fed with F:C (60:40) and F:C (80:20) (P < 0.05). Based on the results, it is concluded that the addition of concentrate at 20% and 40% improves growth performance and increases DMI, TDMI, OMI, and nutrient digestibility. However, standing time, lying time, and abnormal behavior increase by feeding of the 20% and 40% concentrate. Therefore, it is suggested that the concentrate should be supplied in restricted amounts to improve lambs' welfare and normal behavior without influencing their performance.
Assuntos
Ração Animal , Digestão , Animais , Peso Corporal , Detergentes , Dieta/veterinária , Fibras na Dieta/metabolismo , Comportamento Alimentar , Masculino , Ovinos , Carneiro DomésticoRESUMO
Objectives: To evaluate the clinical and biochemical effects of (SGLT2) inhibitors as a fourth oral anti-diabetic drug in patients with Type-2 diabetes mellitus (T2DM). Methods: In a tertiary hospital in Karachi, Pakistan, a retrospective assessment of patient medical records was conducted from January 1, 2017 to December 31, 2020.A total of one hundred patients (mean age [Standard Deviation]: 53.8 [9.63] years) with poorly controlled T2DM were included. Data was collected before the SGLT-2 inhibitor was added, as well as three and six months after the medicine was started. Weight, BMI, blood pressure (BP), HbA1c, SGPT, and Creatinine were measured at the start and during the study. Results: There was a significant reduction in HbA1c (p-value < 0.001) with a mean reduction (MR) of 0.81+1.02% at three months and 1.07+1.11% at six months. A mean weight reduction (p-value < 0.001) of 1.83+2.32 kg at three months and 4.02+6.04 kg at 6 months, respectively, was recorded. A mean BMI reduction of 0.69+0.95 kgm-2 at three months and 2.13+3.41 kgm-2 at six months of follow up, respectively were recorded. A systolic blood pressure (SBP) also showed a significant reduction (p-value < 0.05) with a MR of 5.9+15.76 mmHg at three months and 6.37+18.33 mmHg at 6 months, respectively. Non-significant variation in creatinine and SGPT was also noted. Conclusions: SGLT-2 is an effective oral anti-diabetic medicine that can help individuals with diabetes who are currently using glucose-lowering oral anti-diabetic medications. These medications can help diabetic patients stick to their regimen.
RESUMO
Hodgkin's Lymphoma is a cancer affecting the lymphatic system. There are two subtypes of Hodgkin's Lymphoma: Nodular lymphocyte predominant (NLPHL) and classical Hodgkin's Lymphoma which has further four types. It has a bimodal distribution and is more common among males. The most common presentation is painless swelling in the neck, armpit or groin region. Associated Symptoms include night sweats, unintentional weight loss, fever, persistent cough or dyspnea. Involvement of the gastrointestinal tract is a rare occurrence. Diagnosis is based on hematological, radiological and histochemical studies. Here we report a rare presentation of a 47-year-old male who presented with symptoms of loose stools, weight loss and fever. CT scan and abdominal lymph node biopsy findings were consistent with a lymphoproliferative disorder Patient was being managed in the line of malabsorption syndrome with possible underlying malignancy but his condition deterioted before the histological diagnosis was confirmed. Thus, this report highlights the importance having a consideration for Hodgkin's lymphoma in the management of chronic diarrhea.
RESUMO
Datura metel has been recommended in several human disorders including a remedy for liver toxicity. The current study was designed to evaluate the hepatoprotective effect of methanolic extract of D. metel in animal model. Acute toxicity of methanolic crude extract of Datura metel (MEDM) was studied in animals in various doses 500-2000 mg/kg. Mice of either sex were divided into groups (n=6). One group received normal saline intraperitonially as negative control, while other gentamicin 100mg/kg for 8 days as positive control. 3rd group received 50mg/kg silymarin as standard, 4th group received 100mg/kg of MEDM, 5th group received 200mg/kg MEDM while 6th group received 300mg/kg MEDM and gentamicin 100mg/kg for 8 days. The blood samples were collected on 9th day and the animals were then dissected and the liver of all the animals were isolated. MEDM was found safe in acute toxicity test at various doses up to 2000 mg/kg. The levels of serum glutamic pyruvic transaminase and alkaline phosphatase were elevated significantly with gentamicin treatment which significantly down-regulated by MEDM (100, 200 and 300 mg/kg) in a dose dependent manner.. The histological examination showed that the MEDM has markedly treated the inflammatory infiltrate, fatty changes and congested blood vessels which were induced by gentamicin. The findings of our study thus proved the absolute of MEDM in acute toxicity test; followed by significant hepatoprotective effect in gentamicin induced hepatotoxic mice.
Assuntos
Doença Hepática Induzida por Substâncias e Drogas/prevenção & controle , Datura metel/química , Fígado/efeitos dos fármacos , Extratos Vegetais/farmacologia , Alanina Transaminase/sangue , Alanina Transaminase/metabolismo , Fosfatase Alcalina/sangue , Fosfatase Alcalina/metabolismo , Animais , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Avaliação Pré-Clínica de Medicamentos , Feminino , Gentamicinas , Fígado/metabolismo , Fígado/patologia , Masculino , Metanol/química , Camundongos , Fitoterapia/métodos , Extratos Vegetais/química , Substâncias Protetoras/química , Substâncias Protetoras/farmacologia , Testes de Toxicidade Aguda/métodosRESUMO
Dryopteris ramosa (D. ramosa) is one of the most traded medicinally important plants of Himalayan region. Apart from other uses, D. ramosa is traditionally also used to treat gastric ulcers and as a laxative. The present study was designed to investigate the role of methanolic crude extract of Dryopteris Ramosa (MEDR) in acute toxicity, against loperamide induced constipated mice model, antiulcer effect of methanolic extract of D. Ramosa and cholinomimetic like effect of methanolic extract of D. Ramosa. The crude extract was investigated for the presence of active compounds (secondary metabolites) such as alkaloids, flavonoids, carbohydrates, glycosides, terpenoids, phenolic compounds, saponins, and tannins following the standard methods. The antiulcer effect was investigated in mice using the ethanol induced ulcer model at various doses i.e. 50 mg/kg, 100 mg/kg and 200 mg/kg doses. Constipation was induced in the mice via loperamide (3mg/kg body weight). The control group received normal saline. Different doses of plant extracts (50, 100, 150 and 200 mg/kg body weight/day) were administered for 7 days. Various parameters like feeding characteristics, gastrointestinal transit ratio, body weight, fecal properties and the possible mechanism of action of D. Ramosa on intestinal motility were monitored. Various Phytochemicals like saponins, glycosides, flavonoids, tannins, phenols, carbohydrate, alkaloids and triterpenes were found in D. Ramosa. The acute toxicity study showed that MEDR was associated with no mortality except mild and moderate sedation at the highest tested doses (1500 and 2000 mg/kg). MEDR also showed significant antiulcer activity against ethanol-induced ulcerogenesis. The extract enhanced the intestinal motility, normalized the body weight of constipated mice and increased the fecal volume which are indications of laxative property of the herb. The 200 mg/kg body weight dose of the extract was found effective. The presence of various Phytochemicals such as flavonoids, glycosides and tannins might be responsible for the antiulcer activity of D. Ramosa. This study provides the scientific background for the folkloric use of D. Ramosa as antiulcer agent. The laxative action of the extract compares positively with Duphalac, (standard laxative drug). These findings have therefore evidence scientific background to the folkloric use of the herb as a laxative agent.
Assuntos
Constipação Intestinal/prevenção & controle , Dryopteris/química , Laxantes/farmacologia , Extratos Vegetais/farmacologia , Plantas Medicinais/química , Úlcera Gástrica/prevenção & controle , Alcaloides/farmacologia , Animais , Constipação Intestinal/induzido quimicamente , Etanol , Flavonoides/farmacologia , Motilidade Gastrointestinal/efeitos dos fármacos , Laxantes/química , Loperamida , Metanol/química , Camundongos , Fitoterapia/métodos , Extratos Vegetais/química , Extratos Vegetais/toxicidade , Saponinas/farmacologia , Úlcera Gástrica/induzido quimicamente , Taninos/farmacologia , Testes de Toxicidade Aguda/métodosRESUMO
BACKGROUND AND OBJECTIVE: Acromegaly is a chronic disorder resulting from excessive secretion of growth hormone and (GH) and insulin-like growth factor 1 (IGF-1) and is associated with several comorbidities. These complications contribute significantly to morbidity and mortality associated with this condition thus early diagnosis leads to better outcomes. There have been studies in other countries to assess the comorbidities associated with acromegaly. However, we do not have any recent data with regards to Pakistan. So, in order to demonstrate the prevalence of demographics, hormonal disorders, and other complications associated with acromegaly we conducted this study. METHODS: It is a retrospective review of patients' records presented to the tertiary care Hospital, Karachi, Pakistan for the diagnosis and management of acromegaly and the complications associated with this condition between the time periods 2000 till 2020. A total of 89 patients fulfilled the inclusion criteria of acromegaly and were included in the study. Comorbid conditions were described based on current guidelines. Patient baseline characteristics were recorded along with other complications arising during treatment. RESULTS: Eighty-nine patients were included. 64% were male, over 70% were older than 30 years old and more than 40% of patients had BMI greater than 30. HTN, pre-hypertension, and CCF were reported in 35.95%, 3.37%, and 6.74%. Diabetes mellitus, hypocortisolism, hypothyroidism, hypogonadism, and hyperprolactinemia were reported in 39.32%, 38.20%, 37.07%, 34.46%, and 16.85% of cases. The prevalence of osteoarthritis, blood disorder, skin changes, thyroid cancer, and spinal stenosis was found out to be around 1.12% each. CONCLUSIONS: Acromegaly is associated with cardiovascular and endocrinal disorders. Screening for these disorders at the time of diagnosis can lead to early management and better outcomes translating into decreased mortality.
RESUMO
Datura metel is traditionally used as a remedy for renal toxicity. However, the nephroprotection has not been scientifically validated yet. To evaluate the nephroprotective like effect of methanolic extract of D. metel in gentamicin induced mice model, mice of either sex were divided into groups. One group received normal saline as negative control. The 2nd group received gentamicin 100mg/kg for 8 days as positive control, 3rd group received 50mg/kg silymarin as standard, while the reaming groups received 100, 200 and 300 mg/kg of MEDM and gentamicin 100mg/kg, for 8 days. The blood and urine samples were collected on 9th day, animals were then dissected and whole kidneys were removed and preserved in formalin for later histological examinations. The level of serum creatinine, blood urea nitrogen, urine creatinine and urine urea were significantly (P<0.05) elevated and the renal MDA level was also elevated significantly (P<0.05) by gentamicin in mice. After the treatment of test animals with MEDM, the elevated level of serum and urine biomarkers by gentamicin were reversed by MEDM. The nephroprotective effect was found in dose dependent manner. As the MEDM significantly protected the nephrotoxicity via its antioxidant effect. The findings of our study thus proved the scientific background for the nephroprotective effect of MEDM.
Assuntos
Datura metel/química , Gentamicinas/efeitos adversos , Nefropatias/induzido quimicamente , Nefropatias/patologia , Extratos Vegetais/uso terapêutico , Substâncias Protetoras/uso terapêutico , Animais , Nitrogênio da Ureia Sanguínea , Creatinina/sangue , Creatinina/urina , Modelos Animais de Doenças , Feminino , Rim/efeitos dos fármacos , Rim/patologia , Nefropatias/sangue , Nefropatias/urina , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Camundongos , Compostos Fitoquímicos/análise , Compostos Fitoquímicos/farmacologia , Compostos Fitoquímicos/uso terapêutico , Extratos Vegetais/farmacologia , Substâncias Protetoras/farmacologia , Ureia/urinaRESUMO
In this paper, taking fractional derivative due to Caputo and Fabrizo, we have investigated a biological model of smoking type. By using Sumudu transform and Picard successive iterative technique, we develop the iterative solutions for the considered model. Furthermore, some results related to uniqueness of the equilibrium solution and its stability are discussed utilizing the techniques of nonlinear functional analysis. The dynamics of iterative solutions for various compartments of the model are plotted with the help of Matlab.
Assuntos
Fumar , Algoritmos , Ex-Fumantes , Humanos , Modelos Biológicos , não Fumantes , FumantesRESUMO
OBJECTIVE: To estimate the prevalence of asthma in children aged <10 years, and to identify important risk factors for asthma.. METHODS: The case-control study was conducted at Mardan Medical Complex and District Head Quarters Hospital, Mardan, Pakistan, from June to September 2017. Data was collected from paediatric patients of asthma as well as healthy controls through a self-designed questionnaire. SPSS 19 was used for data analysis. RESULTS: Of the 647 subjects, 349(54%) were asthmatic cases and 298(46%) were controls. Among the cases, 201(57.6%) were females, while 148(42.4%) were males. There were 332(51%) subjects whose fathers were smokers, and of them 224(67%) had asthma and 125(37%) were non-asthmatic. Overall, 323(50%) subjects had carpet in their rooms, and of them 221(68%) had asthma. Among other risk factors, subjects aged <5 years had 1.49 time more likely to have asthma with (odds ratio: 1.49, 95% confidence interval: 0.963-1.988). CONCLUSIONS: Female gender, fathers' smoking, having carpet in the room and age <5 year were found to be the main risk factors associated with asthma.
Assuntos
Asma/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Paquistão/epidemiologia , Pais , Fatores de Risco , FumarRESUMO
OBJECTIVE: To determine the trends of acute poisoning in terms of frequency, nature of poisoning agent, clinical presentation and its outcome. METHODS: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of patients who presented with poisoning between January 1989 and December 2010.The patients were randomly selected , and demographic, chemical information, clinical feature, treatment and outcome were analysed using SPSS 16. RESULTS: Of the total hospital admissions during the period, 3,189(0.3%) were cases of poisoning. Of them, medical records of 705(22%) cases were reviewed; 462(65.5%) adult and 243(34.5%) paediatric cases below 16 years of age. The overall median age was 21 years (interquartile range: 4-32 years)Moreover, 544(87%) were critical at the time of presentation. In 647(92%) cases, the poisoning occurred at home. Psychiatric drugs were found involved in 205(29%) cases, followed by prescription drugs 172(24.4%), pesticides 108(15.3%), hydrocarbons 71(10%), analgesics 59(8.7%), household toxins 59(8.7%), alcohol and drug abuse 21(2.97%) and others 47(6.67%). CONCLUSIONS: Poisoning was a serious cause of morbidity in children and young adults. Medications were the leading cause and home was the most common place of incident.
Assuntos
Intoxicação/epidemiologia , Centros de Atenção Terciária , Adolescente , Adulto , Criança , Pré-Escolar , Hospitalização , Hospitais Universitários , Humanos , Paquistão/epidemiologia , Estudos Retrospectivos , Adulto JovemRESUMO
This study aimed to develop films for potential delivery of omeprazole (OME) via the buccal mucosa of paediatric patients. Films were prepared using hydroxypropylmethylcellulose (HPMC), methylcellulose (MC), sodium alginate (SA), carrageenan (CA) and metolose (MET) with polyethylene glycol (PEG 400) as plasticiser, OME (model drug) and L-arg (stabiliser). Gels (1% w/w) were prepared at 40°C using water and ethanol with PEG 400 (0-1% w/w) and dried in an oven (40°C). Optimised formulations containing OME and L-arg (1:1, 1:2 and 1:3) were prepared to investigate the stabilisation of the drug. Tensile properties (Texture analysis, TA), physical form (differential scanning calorimetry, DSC; X-ray diffraction, XRD; thermogravimetric analysis, TGA) and surface topography (scanning electron microscopy, SEM) were investigated. Based on the TA results, SA and MET films were chosen for OME loading and stabilisation studies as they showed a good balance between flexibility and toughness. Plasticised MET films were uniform and smooth whilst unplasticised films demonstrated rough lumpy surfaces. SA films prepared from aqueous gels showed some lumps on the surface, whereas SA films prepared from ethanolic gels were smooth and uniform. Drug-loaded gels showed that OME was unstable and therefore required addition of L-arg. The DSC and XRD suggested molecular dispersion of drug within the polymeric matrix. Plasticised (0.5% w/w PEG 400) MET films prepared from ethanolic (20% v/v) gels and containing OME: L-arg 1:2 showed the most ideal characteristics (transparency, ease of peeling and flexibility) and was selected for further investigation.
Assuntos
Bochecha , Química Farmacêutica , Portadores de Fármacos , Omeprazol/administração & dosagem , Antiulcerosos , Varredura Diferencial de Calorimetria , Criança , Humanos , Microscopia Eletrônica de Varredura , Resistência à Tração , Termogravimetria , Difração de Raios XRESUMO
The case underscores the necessity of adaptable airway management strategies in aortic dissection surgeries complicated by carinal shift. Successful lung isolation was achieved using a single-lumen endotracheal tube after failed attempts with traditional methods and bronchial blockers.