Rajesh Varma
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5017 research outputs found
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COVID-19 infection in an intensive care unit in Tunisia: Risk factors of mortality
No full textIntroduction: Identification of COVID-19 patients at high risk of mortality is crucial to improve patient management. Our study aimed to identify mortality risk factors at the COVID-19 Intensive Care Unit (ICU), in Mahdia.Methods: We conducted a prospective study including patients admitted to the COVID-19 ICU at University Hospital Tahar Sfar Mahdia (September 2020 to February 2021). We used “The RAPID CORE CASE REPORT FORM” developed by the World Health Organization.Results: A total of 119 patients were included (60.5% male). The average age was 61.9 ± 12 years. During their stay, 51.8% of them had invasive ventilation, 31.3 % required vasopressors intake and 50.9% required a prone position. The mortality rate was 47.1%. Severe acute respiratory distress syndrome and Health Care Associated Infections (HAI) were associated with a higher risk of mortality (64.9% vs 17.8%; p < 0.001 and 81.1% vs 18.2 %; p < 0.001 respectively). Mortality was higher among intubated patients (79.7% vs 14.5%; p < 0.001). The mean Acute Physiology and Chronic Health Evaluation II (APACHII) score were higher in deaths than in survivors ((15.02 ± 7.6 vs 10.63 ± 5.31; p = 0.02). Low oxygen saturation on admission was associated with a higher risk of mortality (91.1% ± 6.44 vs 86% ± 11.25; p = 0.004). Binary logistic regression showed increased odds of mortality with health-acquired infection (OR, 7.96 [95% CI, 2.28 - 27.7], severe acute respiratory distress syndrome (OR, 4.04 [95% CI, 1.11 - 14.73]) and invasive ventilation (OR, 12.23 [95% CI, 3.31 – 45.2]).Conclusion: Interventions preventing the risk factors are needed to improve the prognosis of Covid-19 patients.</p
Cloverleaf plasma cell nuclei in multiple myeloma
No full textA 65-year-old man was diagnosed with multiple myeloma (IgG-Lambda) and was treated with high-dose dexamethasone as induction therapy followed by thalidomide-based regimens. About 18 months after the initial diagnosis, the patient presented a first relapse which was treated with the LCD protocol (Lenalidomide, Cyclophosphamide, Dexamethasone).</p
Hemophagocytic lymphohistiocytosis secondary to epstein-barr virus reactivation in a patient with COVID-19
No full textHemophagocytic lymphohistiocytosis (HLH) in coronavirus disease 2019 (COVID-19) is a recognized complication of severe illness. However, this phenomenon has been reported most often in the setting of acute infection. Here we present a case of a patient with a history of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection that subsequently developed HLH weeks after treatment of COVID-19 and discharges from the hospital. Upon re-admission, work-up demonstrated the patient was experiencing Epstein-Barr virus (EBV) reactivation. As EBV infection is a known etiological trigger of HLH, this case provides an alternative mechanism for HLH seen in patients with a history of COVID-19 infection who present after the resolution of acute symptomatology. </p
Participatory evaluation of Linseed (Linum usitatissimum L.) varieties under farmers training center at Dodola District of West Arsi Zone, Oromia Regional State, Ethiopia
No full textThe study was carried out in the Dodola district of West Arsi Zone, Oromia regional state, Ethiopia. The aim of this study was to evaluate the performance and farmers varieties preference of Linseed at Alantu kebele within the Farmers Training Center (FTC) demonstration plot of Dodola district of West Arsi Zone. Along with their management practices under the Farmers Training Center (FTC) field to enhance farmers’ knowledge and skill on Linseed production performance. The verities used to demonstrate were, improved Linseed varieties namely Kuma, Yadano, Bekoji-14, Kulumsa-1, Kassa-2, and Local check.According to the results, an average yield of 22qt/ha, 22.4 qt/ha 15.6 qt/ha, 19.2q/ha,13.2q/ha, and 9.2q/ha /was harvested from Kuma, Yadano, Bekoji-14, Kulumsa-1, Kassa-2, and Local check Varieties respectively. Yadano variety had a 143.5 %yield advantage over the local check and Kuma had a 139.1% yield advantage over the local check and the variety Kulumsa-1 had a negative 108.7%% yield advantage over the local check and variety Bekoji-14 had 69.6% over the local check and the variety Kassa-2 had 43.5% yield advantage over the local check. The result of the criteria set by the farmers themselves showed that the varieties Yadano, Kuma, Kulumsa-1, Bekoji-14, Kassa-2, and the Local check ranked 1st,2nd,3rd,4th,5th, and 6th respectively.Based on the result of farmers preference ranking and the yield advantages of the Linseed varieties the tested under FTC met the requirements for the recommendation, Therefore, the Authors conclude that the first three (3) varieties namely Yadano, Kuma, and Kulumsa-1 varieties were recommended for the study areas and other areas with similar agro-ecological conditions in the South eastern districts of West Arsi zone as the first, second and third Linseed varieties options respectively. Whereas the remaining 3 (three) varieties namely Bekoji14, and Kassa-2 including the local variety were not recommended due to low productivity in the study area.</p
To evaluate the anti-diabetic effects of Salvia cabulica ethanolic extract on alloxan-induced diabetic rabbits
No full textObjective: This study aimed to investigate the hypoglycemic effects of Salvia cabulica ethanolic extract on alloxan-induced diabetic rabbits. Method: During the plant’s extraction, the dried plant was soaked in ethanol for 14 days at room temperature and filtered. The dark green gummy filtrate was obtained by using a rotary evaporator at 40oC. Rabbits with fasting glucose levels of more than 250 mg/dL were considered diabetic. These rabbits were treated with aqueous plant extract in different doses (250 mg and 500 mg) respectively. Results: The fasting blood glucose level (BGL) mean was 293 ± 25.65 in diabetic control group D-I compared to the normal control group A 99 ± 6.16 after the 48 hours of diabetes induction. The fasting blood glucose level (BGL) in group D-II was 192 ± 17.06, group D-III 93.515.95and group D-IV was 89.33 ± 7.79. There was a significant decrease in blood glucose among the group III and IV treated with plant extract at 250 mg/kg and 500 mg/kg, respectivelyConclusion: The plant Salvia cabulica has potential hypoglycemic activity. Therefore, the medicinal plant can be used as a folklore herbal drug in the treatment of diabetes locally.</p
On the anticancer clinical activity of perillyl alcohol and limonene: A critical assessment of the outcomes
No full textMonoterpenes with p-menthane structure (perillyl series) can inhibit
Ras-proteins prenylation involved in carcinogenesis processes. To
evaluate the safety and efficacy of perillyl alcohol (POH) and limonene
to treat any type of human cancer, we conducted a systematic review of
clinical studies found in seven biomedical bibliographic databases and
four clinical trial registries. After screening titles, abstracts, and
full texts for inclusion/exclusion criteria, one study on limonene
(oral) and 19 on POH administered by oral (13), dermal (2), or
intranasal-instillation routes (4), comprising phase I or I/II trials,
were included in the review. The quality of included studies was
assessed as well. No randomized and controlled phase-III trial was
performed or is in progress. A critical appraisal of study results
suggested that both compounds are safe after oral ingestion, dermal
application, or nasal instillation. Overall, phase II studies showed no
evidence of anticancer activity. Nasal instillation of POH, however,
apparently prolonged the overall survival of patients with glioblastoma.
Randomized and controlled (phase III) clinical studies are necessary to
confirm these findings. </p
Shy-Dragger Syndrome – An underdiagnosed sad reality?
No full textMultiple System Atrophy (MSA) regards a group of neurodegenerative diseases sharing the same physiopathology. It is a rare group of diseases and often represents a diagnostic challenge for clinicians. Mild symptoms are present at the onset of the disease and are often neglected by patients. The case report describes a 62-year-old female with multiple episodes of syncope with 3 months evolutions. Anamnesis revealed sleep apnoea and urinary incontinence. In order to perform complementary exams, the patient was admitted to the medical ward. Autoimunnity results were negative discarding this etiology; 24-hour arterial pressure monitoring revealed a severe fluctuation of tensional values capable of explaining syncope. Other exams revealed no pathological alterations responsible for the patient complaints. Multiple System Atrophy diagnosis was made after exclusion of other possible aetiological causes for the patient’s symptoms. More prevalent diseases such as Parkinson’s Disease, atypical Parkinsonic syndromes, and pure autonomic failure, among others may replicate the same symptoms. Diagnosing the patient with Multiple System Atrophy represented a challenge because of its rarity and clinical complexity. Being a disease with poor outcomes and representing necessary lifestyle changes to the patients and family life, an early and exact diagnosis may provide time and more life quality, within the disease limitations.Internists are often presented with complex patients being obligated to gather all pieces, and put them together, so that de puzzle may be deciphered.Learning points- Multiple systems atrophy is a rare incapacitating disease and it is believed to be underdiagnosed;- Complex diseases often present mild nonlimiting symptoms that patients might tend to neglect.</p
Adaptation to climate change in Africa
No full textWhether we like it or not, ours will be a century where the governance and economic agenda will be dominated by the task of adapting to climate change. With the early effects of climate change already starkly visible, and their escalations over the coming decades already locked in, adaptation is no longer a choice but an imperative. And nowhere in the world is there a greater urgency to set out a coherent and comprehensive agenda for adaptation, we believe, than in Africa.</p
Limnological characterization of the sources of Volga, Dnieper & Western Dvina (Daugava)
No full textSprings are important habitats and determine the characteristics of headwater streams. However, they are rarely studied and usually not included in monitoring programs. Our study characterizes the sources of three large rivers and contributes to the knowledge about the biggest East European drainage divide. The catchment area is characterized by dense forests, which are rich in swamps and mires. The paludified catchment is typical for the rivers in this region and it is also determining the physicochemistry of the water. We provide a first dataset about the physicochemical conditions of the sources of Volga, Dnieper, and Western Dvina, which should build a basis for further analyses of the springs of these large rivers. We suggest that monitoring the sources of the large rivers in the Valdai hills should be considered as an extension of the existing monitoring programs. </p
Review on postharvest quality and handling of apple
No full textApple is a climacteric temperate fruit with high market demand providing essential components to the body. Nowadays, apple production is increasing every year especially in EU member countries are the highest producer. Hence, this paper reviews the postharvest quality and associated changes during handling. Usually, farmers face difficulty in estimating the right harvesting time though Different methods exist to test the maturity stage such as counting the days after full bloom, color change, firmness test, measuring soluble sugar, starch iodine test and Streif index. Depending on different factors, farmers can choose the best maturity estimation method in various locations. Postharvest diseases of apples makeup a major part of the economic losses incurred during apple production. Annual losses of many fruits, including apple, vary from 5 to 35% and for developing countries, it ranges between 20%-50%. The most common causes are poor harvesting methods, transportation and storage methods which can open access for fungal growth species such as Botrytis species. B. cinerea is one of the most important of the species with unique characteristics causing the highest losses.</p