19 research outputs found
Letter to the Editor regarding the Article ‘A Pilot Study of Symptoms of Major Depressive Disorder in Medical Students at an Osteopathic Medical School Before and After High-Stakes Examinations’ [Letter]
No full textMahdi Sadeghi,1 Fatima Wasti,2 Syeda Anum Zahra3 1Kings College London, London, UK; 2Royal Berkshire NHS Foundation Trust, Berkshire, UK; 3Imperial College NHS Trust, London, U
Health Expenditures, Institutional Quality and Economic Growth
No full textInternational audienceThe study aims to determine the effect of health expenditures on economic growth while taking into account the quality of health institutions, keeping in view the fact that it’s not just the level, rather quality of expenditures or institutions that matters. Our hypothesis was where institutions are better health investment in health brings more economic growth as compared to those with low quality institutions. To attain that objective the standard neo-classical Solow Growth Model at steady-state level was taken as theoretical framework and made a production function adding institutional quality proxied by government effectiveness along with other variables like health expenditure, primary education completion rate, population growth etc. For estimation purposes, data for the sample of 20 South, East Asian and Pacific developing countries was used for the period 1995-2017. It was found that if health expenditures adjusted for the quality of government expenditures increase by 100%, then the economic growth will increase by 5%
Neutralization of Naja naja venom by green and chemically synthesized titanium dioxide nanoparticles
No full textSnake envenomation affects millions of people worldwide especially rural population in developing countries. High production cost, poor accessibility and side-effects associated with antivenom treatment call for newer approaches. Nanoparticles could provide alternative therapy due to their biocompatibility, ease of production and stability. In this study, Titanium (IV) isopropoxide was reduced to make TiO _2 nanoparticles by chemical and green synthesis method utilizing potato peels and neem leaves extract. The synthesized particles were characterized by Scanning Electron Microscope, Electron Dispersive X-ray Spectroscopy and Fourier Transform Infrared Spectroscopy. The synthesized nanoparticles are spherical in shape with sizes ranging from 41–64 nm and molecules, such as polyphenols, flavonoids, and alkaloids in plant extracts act as reducing and capping agents. The nanoparticles were evaluated for in vitro venom neutralization assays against the Naja naja venom. The hemocompatibility assay showed that the TiO _2 NPs are non-toxic, indicating their safe use. The TiO _2 NPs were able to significantly inhibit venom induced hemolysis of RBCs and blood anticoagulation effect ( p -values ≤0.000). Overall, the study suggests that TiO _2 NPs could be effective in reducing the toxicity of Naja naja venom, providing a practical and cost-effective therapeutic option to be used as alternative treatments for snake envenomation
Paediatric porphyria and human hemin: A treatment challenge in a lower middle income country
No full textHere, we report a case of a 15-year-old girl who presented to the emergency department with symptoms of abdominal pain, nausea, vomiting and seizures. She was diagnosed with acute intermittent porphyria. Treatment was started by removing all porphogenic drugs, providing high glucose intake (oral and intravenous), which initially resulted in good clinical outcomes. However, she deteriorated again and also developed neurological manifestation (paraplegia) for which she required mechanical ventilation because of acute respiratory failure. This time she was initiated on human hemin for four consecutive days. After 2 days of therapy, her porphobilinogen levels decreased to 50% of the initial raised value. Increased lactic acid and blood urea nitrogen were the two side effects observed after the treatment, with no apparent signs of acute kidney injury. To the best of our knowledge, in paediatric population, this is the first reported case of treatment of acute intermittent porphyria with human hemin in Pakistan
Analgesic and Anti-Inflammatory Effects of Phaseolus vulgaris L. Fixed Oil in Rodents
No full text The seeds of Phaseolus vulgaris are known as common beans or kidney beans. The dry seeds are eaten as pulse and are enriched with protein, fiber, starch, B vitamins (B1, B6, B9), iron, potassium and selenium. Beans also contain about 1-2 % of fixed oil. Phaseolus vulgaris is linked with anticancer, antihyperlipidemic, hypoglycemic and antioxidant actions. The fixed oil of Phaseolus vulgaris (PVFO) seeds is extracted with hexane and used in this study to assess acute oral toxicity, analgesic (by acetic acid induced writhing, hot plate and tail flick tests in mice) and anti-inflammatory (by carrageenan induced paw edema in rats) actions. Four groups were made (n=6): Group-I: Normal Saline Control (2ml/kg), Group-II: PVFO (2ml/kg), Group-III: PVFO (4ml/kg) and Group-IV: Standard Acetyl salicylic acid (ASA 300 mg/kg). PVFO in 2ml/kg and 4ml/kg dose demonstrated analgesic and anti-inflammatory activities but in hot plate results were unreliable as here significant activity started after 90 minutes. For toxicity test 5ml/kg dose was administered orally in mice and no toxicity symptoms were observed. It is therefore concluded that PVFO is safe for oral use up to 5ml/kg and may possess analgesic and anti-inflammatory actions.</jats:p
A Rare Presentation of Colon Carcinoma Metastasis Within a Meningioma: A Case Report and Literature Review
No full textColon carcinoma with brain metastasis is a rare presentation. This presentation is more unusual and unique when the single brain metastatic lesion has two different types of tumors. This rare phenomenon is known as a tumor-to-tumor metastasis. A meningioma usually hosts lung and breast cancers within it. However, colon carcinoma metastasis into meningiomas has rarely been reported. An 86-year-old man presented with neurological symptoms and was found to have a brain mass. The search for primary lesions was negative as the chest, abdomen, and pelvis CT scan was insignificant. When the brain lesion\u27s pathology revealed a composite mass of adenocarcinoma and a meningioma, further investigation with a colonoscopy revealed a colonic mass as the primary metastasis lesion. This unique presentation and pathology emphasize the importance of a comprehensive investigative approach to finding the primary lesions and consideration of such a phenomenon in these lesions
A Survey on Biosafety Practices in Lab Personnel in 12 Selected Areas of Karachi, Pakistan
No full textThe objective of this study was to realize the degree of biosafety precautions and measures recorded among different Private Hospitals and Diagnostic labs personnel situated in different areas of Karachi, Pakistan. One thirty two private hospital based laboratory technicians were selected from all 12 selected areas in Karachi. The laboratory technicians were interviewed then a survey form was completed by the interviewer. The survey was conducted in 3 months duration from May 2017 to July 2017. The total number of members in this study was 132, of which 85 were males and 47 were females. Results presented that 65% of the laboratory technicians did not use any type of PPE and 35% of the respondents recapped used syringes frequently while 25% recapped occasionally. For avoiding the reuse of syringes, Pakistani governments recommend that they be cut before discarding; however, only 65% of the respondents followed the given procedure. Even though mouth pipetting is considered outdated, 45% of the technicians continue to do so for numerous purposes. Results of this survey established an absence of awareness about good and proper lab practices and lab biosafety measures among lab technicians in Karachi, Pakistan
Prognostic Significance of Baseline Neutrophil to Lymphocyte Ratio and Lymphocyte to C-reactive Protein Ratio in COVID-19 Patients
No full textObjective: Neutrophil-to-lymphocyte and lymphocyte-to-C-reactive protein ratios are important prognostic indicators for disease severity measurement among coronavirus patients. To predict the disease severity, CURB-65 scores, and outcome after 14 days of admission using two proxy biomarkers (neutrophil lymphocyte and lymphocyte C-reactive protein ratios) in COVID-19 patients.
Methodology: A prospective study was done at the Department of Medicine, Pakistan Ordinance Factory (POF) hospital, Wah Cantt, Pakistan, from April to August 2022. A total of 123 coronavirus patients were included. Patients with clinical manifestations, decreased lymphocyte and leukocyte counts, imaging characteristics of pneumonia, etiological evidence of a positive real time PCR test of blood or respiratory samples, and viral gene sequencing similar to known COVID-19 were measured. Patients underwent laboratory measurements and imaging analysis for biomarker indications. The analysis of the data was conducted using SPSS version 23.
Results: The patients mean age was 53.83±16.2 years. Among 123 COVID-19 patients, 80 (65%) were males and 43 (35%) were females. It was found to have high NLR and low LCR in severe disease (p = 0.05, p = 0.01). NLR and LCR showed 11% variance for disease severity (β = 0.143, p = 0.00, and β = -0.293, p = 0.01). NLR and LCR showed 29% variance for CURB 65 scores (β = 0.48, p = 0.634, and β = -0.159, p = 0.08). NLR and LCR showed 22% variance for outcome after 14 days of admission (β=-0.53, p=0.562, & β=-0.132, p=0.149).
Conclusion: Neutrophil to lymphocyte and lymphocyte to C-reactive protein ratios are effective prognostic biomarkers for measuring the severity of disease in COVID-19 patients. High neutrophil-to-lymphocyte and low lymphocyte-to-C-reactive protein ratios significantly predict disease severity
Global, regional, and national mortality due to unintentional carbon monoxide poisoning, 2000–2021: results from the Global Burden of Disease Study 2021
No full textBackground
Unintentional carbon monoxide poisoning is a largely preventable cause of death that has received insufficient attention. We aimed to conduct a comprehensive global analysis of the demographic, temporal, and geographical patterns of fatal unintentional carbon monoxide poisoning from 2000 to 2021.
Methods
As part of the latest Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), unintentional carbon monoxide poisoning mortality was quantified using the GBD cause of death ensemble modelling strategy. Vital registration data and covariates with an epidemiological link to unintentional carbon monoxide poisoning informed the estimates of death counts and mortality rates for all locations, sexes, ages, and years included in the GBD. Years of life lost (YLLs) were estimated by multiplying deaths by remaining standard life expectancy at age of death. Population attributable fractions (PAFs) for unintentional carbon monoxide poisoning deaths due to occupational injuries and high alcohol use were estimated.
Findings
In 2021, the global mortality rate due to unintentional carbon monoxide poisoning was 0·366 per 100 000 (95% uncertainty interval 0·276–0·415), with 28 900 deaths (21 700–32 800) and 1·18 million YLLs (0·886–1·35) across all ages. Nearly 70% of deaths occurred in males (20 100 [15 800–24 000]), and the 50–54-year age group had the largest number of deaths (2210 [1660–2590]). The highest mortality rate was in those aged 85 years or older with 1·96 deaths (1·38–2·32) per 100 000. Eastern Europe had the highest age-standardised mortality rate at 2·12 deaths (1·98–2·30) per 100 000. Globally, there was a 53·5% (46·2–63·7) decrease in the age-standardised mortality rate from 2000 to 2021, although this decline was not uniform across regions. The overall PAFs for occupational injuries and high alcohol use were 13·6% (11·9–16·0) and 3·5% (1·4–6·2), respectively.
Interpretation
Improvements in unintentional carbon monoxide poisoning mortality rates have been inconsistent across regions and over time since 2000. Given that unintentional carbon monoxide poisoning is almost entirely preventable, policy-level interventions that lower the risk of carbon monoxide poisoning events should be prioritised, such as those that increase access to improved heating and cooking devices, reduce carbon monoxide emissions from generators, and mandate use of carbon monoxide alarms.publishedVersio
Global, regional, and national mortality due to unintentional carbon monoxide poisoning, 2000–2021: results from the Global Burden of Disease Study 2021
No full textBackground: Unintentional carbon monoxide poisoning is a largely preventable cause of death that has received insufficient attention. We aimed to conduct a comprehensive global analysis of the demographic, temporal, and geographical patterns of fatal unintentional carbon monoxide poisoning from 2000 to 2021. Methods: As part of the latest Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), unintentional carbon monoxide poisoning mortality was quantified using the GBD cause of death ensemble modelling strategy. Vital registration data and covariates with an epidemiological link to unintentional carbon monoxide poisoning informed the estimates of death counts and mortality rates for all locations, sexes, ages, and years included in the GBD. Years of life lost (YLLs) were estimated by multiplying deaths by remaining standard life expectancy at age of death. Population attributable fractions (PAFs) for unintentional carbon monoxide poisoning deaths due to occupational injuries and high alcohol use were estimated. Findings: In 2021, the global mortality rate due to unintentional carbon monoxide poisoning was 0·366 per 100 000 (95% uncertainty interval 0·276–0·415), with 28 900 deaths (21 700–32 800) and 1·18 million YLLs (0·886–1·35) across all ages. Nearly 70% of deaths occurred in males (20 100 [15 800–24 000]), and the 50–54-year age group had the largest number of deaths (2210 [1660–2590]). The highest mortality rate was in those aged 85 years or older with 1·96 deaths (1·38–2·32) per 100 000. Eastern Europe had the highest age-standardised mortality rate at 2·12 deaths (1·98–2·30) per 100 000. Globally, there was a 53·5% (46·2–63·7) decrease in the age-standardised mortality rate from 2000 to 2021, although this decline was not uniform across regions. The overall PAFs for occupational injuries and high alcohol use were 13·6% (11·9–16·0) and 3·5% (1·4–6·2), respectively. Interpretation: Improvements in unintentional carbon monoxide poisoning mortality rates have been inconsistent across regions and over time since 2000. Given that unintentional carbon monoxide poisoning is almost entirely preventable, policy-level interventions that lower the risk of carbon monoxide poisoning events should be prioritised, such as those that increase access to improved heating and cooking devices, reduce carbon monoxide emissions from generators, and mandate use of carbon monoxide alarms. Funding: Bill & Melinda Gates Foundatio
