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Dermatomycoses in Pakistan; an urgent need for National Surveillance Programs
No full textDespite the rising burden of fungal infections across the globe, the World Health Organization's efforts remained questionable in fungal infection-related projects. Most of the developing countries consequently lost focus on the need for assessment and establishment of national surveillance set up or advanced technology hubs against mycological infections. The current study aimed to the determination of the local burden of cutaneous fungal infections in 2019-2021. Among 497 suspected fungal cultures, 22.5% depicted fungal growth. Among males, the prevalence of dermatomycosis was 0.75 times higher than in females. Penicillium species followed by Epidermophyton and Candida species were common among subjects of < 30 years of age. The Aspergillus spp, Penicillium spp, mucormycosis agents, and Candida albicans infections were more common among subjects 30 to 60 years of age. Aspergillus species were more commonly observed among patients > 60 of age. 22.2% of the fungal infections were Penicillium species, 9% of the infections were Aspergillus species, followed by 4.4% of Epidermophyton, mucormycosis, Candida species, and Candida albicans respectively. There is an urgent need for the establishment of national policy for the prevention of fungal disease
A study on cyber financial frauds in the district of Jamtara, Jharkhand
No full textThe study has been undertaken to investigate the determination of digital financial fraud (cyber fraud) in Jamtara district of Jharkhand (the hub of cyber fraudsters) the basic tools & techniques which are used by the offenders and to find out the socio-economic condition of their social life & find the new challenging in cybercrime investigation and to find out the more secure way of digital financial flow, by using survey research method and work on secondary as well primary data which was related to this study, cybercrime especially financial fraud becomes the new challenging task for law enforcement agencies.Digital financial frauds are being within an undefined jurisdiction so it becomes more difficult to investigate the cases and due to other different public as well private sectors of service providers like the telecom companies and the banks are unable to make the defensive system for their customer also. This is the main reason for delays in cyber-related case investigation and a very low conviction rate in cyber-related cases
Novel extractive visible spectrophotometric method for determination of antihypertensive drug irbesartan with sulfonephthalein acid dyes in tablets
No full textIrbesartan (IRB) is one of the drugs used for the treatment of hypertension. The present work develops and validates two methods for the evaluation of irbesartan in bulk and tablets. Sulfonephthalein acid dyes, bromophenol blue (BPB), and bromocresol purple (BCP) were used to produce stable yellow ion-association complexes with the basic drug IRB in dry chloroform. The colored products are quantified spectrophotometrically at their corresponding λmax. The relation between the absorbed signal and the drug concentration was linear up to 45.0 μg mL-1 (n = 6, r ≥ 0.9998). LOD reaches 40 ng mL-1. The composition of the ion associates was found 1:1 by Job’s and mole ratio methods. Application of the suggested methods to dosage forms is presented with percentage recoveries ranging from 99.33% to 101.67%. The results of the analysis were validated statistically and compared with the official method. No interference was observed from common pharmaceutical adjuvants
Cardiac metastases from merkel cell cancer: A case report and review of literature
No full textA 61 - year-old physically fit and athletic man presented to his dermatologist with a 10 mm raised, dark lesion on the left side of his neck. A complete skin examination did not show any other abnormal areas of skin. Pathology was found consistent with Merkel cell cancer, and the patient was referred to surgery for a wide local excision and sentinel lymph node biopsy. A PET scan did not show any other areas of concern. At surgery, one of two sentinel lymph nodes was found to be involved with Merkel cell cancer and the patient received postoperative radiation
Food applications of Aloe species: A review
No full textPlants have a high concentration of biologically active molecules. Aloe plants tend to store water and important chemical constituents in their swollen and succulent leaves due to their ability to survive in hot and dry conditions, which makes them a unique source of phytochemicals. The Aloe leaf contains more than 200 nutritional substances, including vitamins, minerals, amino acids, and active enzymes. These constituents are analyzed as phytochemical screening (qualitative analysis) or proximate and mineral content analyses (quantitative analysis). Aloe is used as a food product and beverage ingredient. Functional and nutraceutical foods, edible coatings/films, Aloe species as cooked vegetables, and raw eating of Aloe species are how the Aloe plant is considered in food applications. The researchers reported edible Aloes for several species. However, it is not mean that all species of Aloe are edible. It is not only the leaves of Aloe that have nutritional values also other parts of the plant do. The study evaluated the nutritional value of Aloe flowers and their possible use as edible flowers. Aloe species are increasingly being incorporated into different health drinks, foods, and beverages due to the beneficial biological activities of the phytochemicals
Associations of arterial stiffness with left ventricular mass index and carotid intima-media thickness in the hypertensives
No full textBackground: Arterial stiffness has been considered an independent predictor of cardiovascular disease in addition to the traditionally known cardiovascular risk factors. Objectives: This study aimed to investigate the associations between arterial stiffness with left ventricular mass index and carotid intima-media thickness in the hypertensives. Methods: A descriptive cross-sectional study compared a control group in 210 study subjects (105 hypertensives and 105 normotensives). Measuring left ventricular mass index by echocardiography and carotid intima-media thickness by carotid doppler ultrasonography. Pulse wave velocity was measured using the Agedio B900 device and the Agedio K520 application. The manual method was measured by the ankle-brachial index.Results: There was a statistically significant positive correlation between pulse wave velocity and age (r = 0.922, p < 0.001). The ankle-brachial index had a statistically significant positive correlation at a weak level with left ventricular mass index and carotid intima-media thickness, in which the coefficient r was equal to 0.219 (p < 0.05) and 0.250 (p < 0,001), respectively. Pulse wave velocity also had a statistically significant positive correlation at a weak level with left ventricular mass index and carotid intima-media thickness, in which the coefficient r was equal to 0.188 (p < 0.05) and 0.289 (p < 0,001), respectively. Pulse wave velocity had a multivariable linear correlation with gender, pulse, mean blood pressure, and ankle-brachial index with statistical significance; and they were written in the form of the following equation: Pulse wave velocity (R2: 41.3%) = 0.641*(Gender) – 0.027*(Pulse) + 0.043*(Mean blood pressure) + 8.378*(Ankle-brachial index) – 3.254.Conclusion: Arterial stiffness was statistically correlated with left ventricular mass index and carotid intima-media thickness in the hypertensives. Through the above research results, we suggest that the hypertensives should be combined with the evaluation of hemodynamic parameters and arterial stiffness for contributing to the diagnosis and detection of cardiovascular complications, thereby improving the quality of monitoring and treatment in hypertensive patients
Clinical profile, etiology, outcome and new-onset diabetes: A SARI case series
No full textIntroduction: The world is currently facing the SARS-CoV-2 pandemic with evolving 2nd wave. The COVID-19 patients present most commonly with Severe Acute Respiratory Illness (SARI) in an emergency room with acute onset fever, cough, and breathlessness. However, not all SARI cases as per definition are due to COVID-19 infection, which is well proven in this case series of 113 cases of SARI. This is just the opposite of the other SARI series done in the pre-COVID-19 era. Also, no previous SARI case series data has shown significant association with Diabetes Mellitus, including new-onset diabetes thus figuring out the major Pathophysiological association of COVID-19 with glucose metabolism and has a bearing on the pathogenesis, treatment, and outcome of COVID-19 infection and perpetuity of pandemic of this magnitude. Here we raise concern for the first time about the growing association of an infectious pandemic with the lifestyle disorders which are non-communicable diseases but carry with them the potential of fertile soil for rapidly spreading epidemics.Aim and objective: To find out the etiology, clinical profile, treatment outcome, and mortality rate in different sub-groups of SARI cases in a tertiary care hospital and the incidence of new-onset Diabetes Mellitus in them and to investigate theoretically the hypothesis that maintaining normal glucose metabolism could prevent progression of a mild Flu-like illness (FLI) to a severe form of Severe Acute Respiratory Illness (SARI) and consequent complications such as Cytokine Storm Syndrome and Multi-Organ failure.Design: Retrospective, single-center case series of 113 SARI patients at a tertiary care hospital in Agra India between 1 March- 30 October 2020.Main outcome: The demographics, clinical, pathological, imaging, and treatment outcome data were collected. The SARI cases analyzed were defined as “Severe acute respiratory infections (SARIs) an acute respiratory illness of recent onset (within seven days) manifested by fever (≥38°C), cough and shortness of breath or difficulty in breathing requiring hospitalization and were sub-classified according to the primary etiology producing SARI in them. The findings were compiled and compared. Conclusion: Of the 113 patients of SARI – 32.7 %were associated with Diabetes, with 9.74% new-onset Diabetes and 26 % previously known Diabetes. This was mainly due to SARS-CoV-2 (24 Diabetics out of 52 COVID-19 cases- 46.1 %).The Average hospitalization stay of SARI cases was 10 days with a maximum in SARS-CoV-2 and a minimum stay of 5.22 days in Bacterial Pneumonia and 5.66 days in Koch’s Lungs.The death rate was maximum (4 out of 26) 15.3%. Hospitalized TB/Koch’s Lung patients who presented as SARI and 3.8% in Bacterial Pneumonia, 2.43% in SARS-CoV-2, and <1% in Sepsis.Those SARI cases who were euglycemic at the time of initial presentation recovered early and carried a good prognosis with less mortality as compared to those who were hyperglycemic on presentation. Also, those FLI cases who maintained euglycemia or did not have any other risk factor which predisposes them to stress (Diabetes, Prolonged fasting, Obesity, major organ disorder, Psychological disorder, and Cancer) did not progress to SARI as the endogenous steroid secretion and sympathetic activation did not occur, the intracellular pH levels remained in the alkaline range.10.18% of cases developed new-onset diabetes (a total of 11 cases) out of which 10 were in COVID-19. Thus 19.2% incidence of new-onset diabetes in SARS-CoV-2 and a prevalence of 26.9% in SARS-CoV-2, making total diabetes 46.1% in SARS-CoV-2, and out of all SARI cases, 26 % of patients developed pulmonary fibrosis with consequent long-term complications. In COVID-19 patients, it was seen only in diabetics SARS CoV-2 male patients, thus no death in non-diabetic females in COVID-19 in this case series
Menstrual cycle effects on sleep
No full textSleep and menstrual cycle both are normal physiological processes in women’s life but they are regulated by different centers. Sleep is a daily rhythm whereas the menstrual cycle lasts for 28 days. During this period the estrogen peaks twice. We have shown earlier that there is an inverse relationship between estrogen and the hormone melatonin which aids sleep. Because of this menstruating women will have sleep disorders
Complex cyanotic congenital heart disease presenting as congenital heart block in a Nigerian infant: case report and literature review
No full textBackground: The prevalence of cyanotic congenital heart diseases (CCHD) varies world wide. It accounts for a third of all congenital heart diseases. The common CCHD includes Tetralogy of Fallot(TOF), transposition of the great arteries (TGA), total anomalous pulmonary venous return (TAPVR), truncus arteriosus, and tricuspid atresia (TA). Less common variants include Ebstein’s anomaly, Hypoplastic left heart syndrome, pulmonary atresia, and single ventricle. Children of all ages can be are affected. The commonest presentation is cyanosis. Bradycardia and/or congenital heart block are rare presentations and mostly occur in the presence of an associated congenital atrioventricular block.Case report: We report a case of a 3-month-old female presenting with congenital heart block and bradycardia at 3 months of age and found to have complex cyanotic congenital heart disease on echocardiography.Conclusion: An infant presenting with bradycardia clinically should be screened for congenital heart defect as bradycardia may be an ominous sign of serious underlying cardiac defect
Impact of the COVID-19 infection on the “benign” nature of the illness of Schönlein-Henoch
No full textThe incidence of COVID-19 in children has been variable. Although now the number of infected children worldwide, and in particular nationally, is small, they are not protected from the infection. Moreover, in the most severe cases septic shock, metabolic acidosis, irreversible bleeding, and coagulation dysfunction have been registered.In February 2021 a 17-year-old boy showed for examination with complaints of pain in the upper part of the abdomen, accompanied by involvement of the ankle joints, the appearance of a rash on the lower extremities with the characteristic of hemorrhagic vasculitis, and a positive test for COVID-19. The characteristics of the skin purpura, the abdominal pain, and the arthralgia led us to the diagnosis of Schönlein-Henoch purpura. The verification of past COVID-19 infection was done by the established high titer of specific IgG antibodies. The clinical evolution of the disease went beyond its generally accepted benign nature - the first manifestation of the illness had been followed by four more relapses, which necessitated new hospitalizations and a change in the therapeutic approach.COVID-19 infection is the cause of a more aggressive course of vasculitis