Rajesh Varma
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High-frequency modeling of dissolved oxygen and net ecosystem metabolism using STELLA
No full textThis paper proposes a high-frequency process model for estimating Dissolved Oxygen (DO) and net ecosystem metabolism (NEM) in streams. The model was implemented by using STELLA to predict DO concentrations at one-minute intervals downstream of a 150-m headwater reach of the Abant Creek (Bolu, Turkey). NEM was also predicted at each interval by using a two-station method along the reach. DO, water temperature and other environmental variables used in the model were measured during 17 months between August 2015 and December 2016. The model was run for a day representing every month of the year. Model parameters were calibrated and validated according to mean absolute error (MAE) between measured and simulated values of DO and NEM. The results showed that the model appeared to be promising in terms of high-frequency estimations of DO.</p
Impacts of radical prostatectomy with emphasis on physical and psycho-socio-emotional declines: An integrative review
No full textIntroduction: Prostatectomy oncological surgery is necessary for the continuity of life, but it has physical consequences (momentary inability to drive, erectile dysfunction), emotional (anxiety about the diagnosis and the consequences of treatment, depression) and psychosocial (feeling of impotence, failure, loss of status in society), which may or may not be transitory. Objective: to identify, through an integrative literature review, the biopsychosocial impacts of Radical Prostatectomy. Methodology: This is an integrative literature review, which included articles related to the proposed theme, published between the years 2012 to 2022, available in full, without language restriction; in addition to theses, dissertations and monographs. For this, the PRISMA guidelines were used, as well as the PICO strategy for the best delineation of the research question and research theme. Results and discussions: In view of the discussion, the study can respond to the objections raised by this research, and can show that the culture of masculinity, with regard to virility, strength, and better performance, composes risk factors for possible impacts on Quality of Life of men undergoing radical prostatectomy. These factors are intrinsically associated with the majority of relationships and characteristics represented by a man. Final considerations: Psychoeducation and general guidelines on sexual and mental health should be carried out to patients who undergo radical therapies, such as radical prostatectomy, so that these patients can achieve coping strategies that make them feel better, contributing directly to the best quality of life, functional capacity, and their social relationships. </p
Gum, sap and canker-colloid carcinoma -pancreas
No full textColloid carcinoma pancreas is an infiltrative ductal epithelial neoplasm of the pancreas characteristically denominating a preponderant (> 80%) component of enlarged pools of extracellular stromal mucin pervaded with suspended neoplastic cells. Colloid carcinoma pancreas is a microsatellite stable tumefaction and exhibits KRAS genetic mutation confined to codon 12. Tumefaction is posited to arise from the inverse polarization of cells with stromal mucin glycoproteins facing the intrinsic cellular surface. Cogent clinical symptoms such as abdominal or epigastric pain, pancreatitis, diarrhoea, hyperbilirubinemia or loss of weight are discerned. Tumefaction emerges as an enlarged, well-demarcated lesion with a mean diameter of 5 centimetres and a solid, firm, gelatinous cut surface. Neoplasm is predominantly comprised of enlarged, extracellular accumulates of stromal mucin with minimal carcinoma cells suspended within extra-cellular mucin pools. Cuboidal or columnar epithelial cells configure cribriform or stellate cellular clusters or miniature tubules and strips of columnar cells along with signet ring cells.</p
Endoscopic-assisted calvarial vault remodeling without postoperative helmets for treating infants with sagittal synostosis
No full textObjective: Various endoscopically assisted minimally invasive surgical procedures have been described for the management of isolated nonsyndromic sagittal synostosis. All these techniques necessitate the use of postoperative helmets without immediate correction of the head shape. Here, we document the safety and sustainable acceptable outcomes of an endoscopic minimally invasive approach with full barrel staving without using a postoperative cranial helmet.Methods: A single-institution cohort analysis was performed on five patients who underwent endoscopically assisted minimally invasive calvarial vault remodeling without using a postoperative helmet for isolated nonsyndromic sagittal synostosis between 2017 and 2022. Variables analyzed were age at the time of surgery, gender, Estimated Blood Loss (EBL), operative time, postoperative complications, and pre-and postoperative Cephalic Index (CI).Results: Three male and two female infants were treated at our hospital in 2017–2022 with a mean follow-up of 32.6 months. At the time of the surgery, the mean age was ±3.5 months (range 10–58 months), the mean weight was 4.54 kg (standard deviation, SD ± 1.56), the mean EBL was 34.6 ml (range 20 ml – 54 ml) and mean surgical time from skin incision to dressing application was 120.7 min. The mean CI for all patients was 66.88 ± 4 (SD) preoperatively vs. 81.52 ± 2.38 (SD) postoperatively (p < 0.001 by paired Student’s t - test). There were no deaths or intraoperative complications.Conclusions: We present a novel endoscopically assisted minimally invasive procedure without using a postoperative helmet. This was a safe and efficacious procedure for isolated sagittal craniosynostosis, with improvements in CI at a mean follow-up of 32.6 months.</p
Targeting interleukin-4 and interleukin-13 in the treatment of severe eosinophilic asthma
No full textAsthma is a chronic inflammatory airway disease affecting about 300 million people and responsible for 500,000 deaths annually globally. Eosinophilic asthma is one of the most common phenotypes of asthma. It constitutes about 50% to 60% of all cases of asthma, and it is the most common phenotype in children presenting with severe acute asthma. The mechanism of eosinophilic asthma is chronic airway inflammation which leads to airway hyperresponsiveness, and remodeling due to the immunopathological effects of inflammatory cytokines. The duet cytokines interleukin-4 (IL-4) and IL-13 play the most central role in the pathophysiology of eosinophilic asthma. The two sister cytokines are slightly similar with a 25% homology, they share a common signaling IL-4Rα chain, and have identical biological effects. Their principal biological effect is the development of Th2 cells from naïve T helper type 0 (Th0) lymphocytes. Th2 cells produce several cytokines responsible for inducing airway eosinophilic inflammation. They induce the ε isotype switch and the switching of the B cell immunoglobulin (Ig) production from IgM to IgE. Furthermore, they stimulate eosinophil proliferation, and migration to the allergic airways and promote eosinophil survival by suppressing eosinophil apoptosis. Activated eosinophils secrete several cytotoxic cationic proteins which damage the airway epithelium, and amplify the inflammatory cascade and airway remodeling. Most patients with eosinophilic asthma can achieve control on a long-acting β2-agonist, inhaled corticosteroid, and a leukotriene receptor antagonist. However, about 3.6-10% do not achieve asthma control. These patients usually benefit from treatment with a biologic. Dupilumab is the only biologic targeting IL-4 and IL-13 approved for the treatment of moderate-to-severe eosinophilic asthma. Clinical trials have shown that treatment with dupilumab results in good asthma control, and significantly reduces moderate-to-severe exacerbation rates (p < 0.001). Additionally, treatment with dupilumab has been shown to significantly improve lung function (p < 0.001), and health-related quality of life, and allows patients to taper or discontinue corticosteroid treatment.</p
The importance of the ecology of infectious diseases in the context of Chytridiomycosis and COVID-19
No full textPathogenic microorganisms and viruses are components of ecosystems. They have constructed endemic interrelationships with specific host species throughout the history of coevolution The spillover of pathogens from natural habitats into other areas causes encounters between the pathogens and new hosts that have never evolved immunity or resistance. The result is a rapid spread of “Emerging Infectious Disease” (EID).During the acceleration of globalization, humans and societies have come to be the targets of infectious diseases caused by pathogens that have emerged from natural habitats. In the past few years, the newest EID, SARS-CoV-2, has spread throughout the world and has caused serious harm to human health and welfare.With the growing social concern about the risks of the EID pandemic, there has been discussion that the destruction of biodiversity and environmental changes are closely related to the EID pandemic. There is a need to rethink the importance of conserving biodiversity if humans are to control the risk of pathogenic viruses and live in harmony with them.</p
Case report of optimizer implantation to modulate cardiac contractility in patients with chronic heart failure and atrial fibrillation
No full textA cardiac contractility modulation device is a new treatment used in patients with heart failure. CCM therapy is associated with an increase in physical activity tolerance, improved quality of life, reduced hospitalizations due to heart failure, and reverse remodeling of the left ventricle in patients with systolic heart failure. In this case, the clinical benefit of cardiac contractility modulation in a patient with chronic heart failure, atrial fibrillation and postinfarction left ventricle aneurysm was reported. Development of postinfarction left ventricle aneurysm in patients with reduced ejection fraction is associated with a high risk of surgical complications. However, an adequate assessment of the functional reserve of the left ventricle myocardium and the choice of surgical correction method allows for receiving favorable outcomes of surgery. We present a case of a successful combination of interventional and surgical treatment of a patient with heart failure and post-infarction left ventricular aneurysm.</p
Characterization of recessively inherited X-Linked ichthyosis in Bajaur Agency
No full textBackground: Recessively inherited X-linked Ichthyosis (XLI) is the second most generic form of Ichthyosis and is characterized by scaly, dry, thickened, and mild erupted skin. It is caused by a mutation in the STS gene ensuing lower production of Steroid sulfatase. A current study was performed to characterize XLI and its complications in patients of Bajaur Agency, Pakistan. We also wanted to record critical factors affecting the progression of XLI. Methods: An Ichthyosis examination questionnaire was prepared and detailed information about the symptoms and management was recorded from 51 affected male patients of 17 families. Personal data such as age and gender were also recorded. Results: Our results indicate that 53% of the patients were collodion while other symptoms appeared in the first month after birth. Almost every part of the patient has symptoms of the disease; scales were found on the extensor and flexor muscles (98%) of limbs followed by the ears (82.53%). All the patients had normal nails, palms and soles. Conclusion: The age of the patients seems to have a significant effect on the color of the scales changing from white to brown to blackish. The disease progresses with the age and worsens in cold, dry seasons. The pedigrees of all families show that disease passes from generation to generation according to the classical X-linked recessive inheritance. We recommend early diagnosis and treatment for effective management of the condition. Further work is required to elucidate the genetic, biochemical, and environmental factors involved in the disease.</p
Prevalence and predictive factors of depression among medical health care workers and medical residents
No full textMental health is one of the 3 essential health columns which is defined according to WHO as "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity". Depression is one of the most common mental health. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), depression is defined as at least two weeks period with either or both depressed mood most of the time or anhedonia with 3 to 4 of the following (change of appetite, feeling of worthlessness, insomnia, diminished of concentration, psychomotor agitation, fatigue, or thought of death or suicide) and should not be attributed to drugs or another medical condition. </p
Biomedical evaluation of green tea herbal liquid with bama miniature pigs
No full textTraditional Chinese Medicine (TCM) is widely used in health preservation and non-radical treatment because of its relatively gentle therapeutic effect, which is reflected in many products. Especially in atomization therapy, TCM shows its strong potential. This experiment focused on analyzing the extract of green tea (tea polyphenols) in a nebulizer, which is very similar to e-cigarettes. After intravenous injection of relevant drugs into small experimental pigs, the results of blood tests and the HE staining of organ sections showed no abnormalities in the experimental group. Since the dose of intravenous injection is much larger than that of nebulized inhalation, the safety of the product was verified by the experiment. The relevant analysis results obtained in this experiment will be used for comparison with subsequent, longer-term (more than 3 months) injection experiments.</p