Tag: nevin manimala

Seizure. 2021 Jul 13;91:339-345. doi: 10.1016/j.seizure.2021.07.012. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the efficiency and safety profiles of levetiracetam and (fos)phenytoin (phenytoin or fosphenytoin) for second-line treatment of seizures by performing a meta-analysis of RCTs.

METHODS: We systematically searched PubMed, Embase, Cochrane, FDA.gov, and ClinicalTrials.gov for RCTs (published before July 31, 2020; no language restrictions). Two independent reviewers screened abstracts and titles against inclusion and exclusion criteria published previously in the PROSPERO: CRD42020202736. Eleven studies fulfilled the established criteria. We assessed pooled data by using a random-effects model. Quality analysis was performed by using version 2 of the Cochrane risk-of-bias tool (RoB 2). RevMan v.5.3 was used to perform statistical analyses, and publication bias (egger’s test) was assessed with Stata MP v.14.0.

RESULTS: Levetiracetam was similar to (fos)phenytoin in seizure termination rate (risk ratio [RR] 0.94; 95% CI 0.87 to 1.01), time of seizure termination (mean difference [MD] 0.44; -0.60 to 1.49), and drug resistance ([RR] 1.12, 0.86 to 1.45). The safety outcome showed a significant statistical difference between fosphenytoin group and levetiracetam group ([RR] 1.44, 1.14 to 1.81), while there was no significant difference observed between phenytoin treatment and levetiracetam treatment ([RR] 1.26, 0.99 to 1.60).

CONCLUSION: Levetiracetam was similar to (fos)phenytoin in cessation rate convulsive status epilepticus, and drug resistance, while it was superior (fos)phenytoin in pooled safety outcome. Further exploration is still needed as to whether it is the first choice for second-line drugs.

PMID:34284302 | DOI:10.1016/j.seizure.2021.07.012

Epidemics. 2021 Jul 13;36:100483. doi: 10.1016/j.epidem.2021.100483. Online ahead of print.

ABSTRACT

INTRODUCTION: Most countries are dependent on nonpharmaceutical public health interventions such as social distancing, contact tracing, and case isolation to mitigate COVID-19 spread until medicines or vaccines widely available. Minimal research has been performed on the independent and combined impact of each of these interventions based on empirical case data.

METHODS: We obtained data from all confirmed COVID-19 cases from January 7th to February 22nd 2020 in Zhejiang Province, China, to fit an age-stratified compartmental model using human contact information before and during the outbreak. The effectiveness of social distancing, contact tracing, and case isolation was studied and compared in simulation. We also simulated a two-phase reopening scenario to assess whether various strategies combining nonpharmaceutical interventions are likely to achieve population-level control of a second-wave epidemic.

RESULTS: Our study sample included 1,218 symptomatic cases with COVID-19, of which 664 had no inter-province travel history. Results suggest that 36.5 % (95 % CI, 12.8-57.1) of contacts were quarantined, and approximately five days (95 % CI, 2.2-11.0) were needed to detect and isolate a case. As contact networks would increase after societal and economic reopening, avoiding a second wave without strengthening nonpharmaceutical interventions compared to the first wave it would be exceedingly difficult.

CONCLUSIONS: Continuous attention and further improvement of nonpharmaceutical interventions are needed in second-wave prevention. Specifically, contact tracing merits further attention.

PMID:34284227 | DOI:10.1016/j.epidem.2021.100483

Clin Neurophysiol. 2021 Jun 12;132(9):2163-2175. doi: 10.1016/j.clinph.2021.05.020. Online ahead of print.

ABSTRACT

OBJECTIVE: Many studies have examined the effectiveness of transcranial direct current stimulation (tDCS) on human pain perception in both healthy populations and pain patients. Nevertheless, studies have yielded conflicting results, likely due to differences in stimulation parameters, experimental paradigms, and outcome measures. Human experimental pain models that utilize indices of pain in response to well-controlled noxious stimuli can avoid many confounds present in clinical data. This study aimed to assess the robustness of tDCS effects on experimental pain perception among healthy populations.

METHODS: We conducted three meta-analyses that analyzed tDCS effects on ratings of perceived pain intensity to suprathreshold noxious stimuli, pain threshold and tolerance.

RESULTS: The meta-analyses showed a statically significant tDCS effect on attenuating pain-intensity ratings to suprathreshold noxious stimuli. In contrast, tDCS effects on pain threshold and pain tolerance were statistically non-significant. Moderator analysis further suggested that stimulation parameters (active electrode size and current density) and experimental pain modality moderated the effectiveness of tDCS in attenuating pain-intensity ratings.

CONCLUSION: The effectiveness of tDCS on attenuating experimental pain perception depends on both stimulation parameters of tDCS and the modality of experimental pain.

SIGNIFICANCE: This study provides some theoretical basis for the application of tDCS in pain management.

PMID:34284252 | DOI:10.1016/j.clinph.2021.05.020

Eur J Obstet Gynecol Reprod Biol. 2021 Jul 4;264:76-82. doi: 10.1016/j.ejogrb.2021.06.047. Online ahead of print.

ABSTRACT

OBJECTIVES: Pregnancies and births following assisted reproductive treatment (ART) are related to an increased risk for adverse perinatal outcomes. The aim of this retrospective cohort study at a University Hospital with a tertiary perinatal center was the combined risk analysis of singleton and twin pregnancies after ART in comparison to spontaneously conceived pregnancies.

STUDY DESIGN: Maternal and fetal risks were analyzed in subgroups after spontaneous conception (N = 14,233) and ART (N = 785) during the 6-year study period from 2014 to 2019. Odds ratios for perinatal risks between the groups were calculated and adjusted for maternal age and gestational week at birth using a matched control analysis. Subgroups of preterm delivery were compared.

RESULTS: The overall maternofetal risks after ART are higher than after spontaneous conception. Maternal risks after ART are mainly related to higher maternal age (p < 0.001). Preterm delivery and neonatal complications are more frequent in twins than in singletons (p < 0.001), but no statistically significant differences were seen in comparison in the subgroup of twins due to conception. Higher maternal age and body mass index did not increase the risk of preterm birth in twin pregnancies.

CONCLUSIONS: Maternal risks in pregnancies after ART are mainly influenced by maternal age. The strongest risk factor in ART pregnancies is a multiple pregnancy. Every 5th pregnancy after ART was a twin pregnancy with higher risks for preterm delivery, maternal hospitalization and adverse neonatal outcome (p < 0.001). Advanced maternal age in ART cannot be altered, but twin pregnancies can be actively avoided using the single embryo transfer strategy.

PMID:34284271 | DOI:10.1016/j.ejogrb.2021.06.047

Cells Dev. 2021 Jul 17:203723. doi: 10.1016/j.cdev.2021.203723. Online ahead of print.

ABSTRACT

The neural tube is the precursor of the central nervous system. Its early formation and growth are known to be extremely biased along the anteroposterior (AP) axis. Several mechanisms including addition of cells from the tail bud, lateral pressure from surrounding tissues and oriented cell divisions have been proposed to contribute to this biased growth. Here we show that, contrary to what has been found in posterior regions encompassing the tail bud region, the growth of the anterior trunk neural tube is slower along the AP direction than in the other axes. We found that this is due to anchorage of the neural tube to the matrix which favors apicobasal elongation at the expense of AP growth. In addition, as the neural tube develops, we found a moderate slowdown of cell proliferation that could account for the overall reduction of the pace of 3D growth in the same time window. However, as we found no preferred orientation of cell division, changes in cell cycle pace are unlikely to directly contribute to the observed AP-hindered growth of neural tube. Overall, these data indicate that neural tube growth is not intrinsically positively biased along the AP axis. Rather it switches from AP-favored to AP-hindered regimes between the most posterior and anterior trunk neural tube regions.

PMID:34284169 | DOI:10.1016/j.cdev.2021.203723

Environ Pollut. 2021 Jul 16;288:117802. doi: 10.1016/j.envpol.2021.117802. Online ahead of print.

ABSTRACT

This study investigates changes in air quality conditions during the restricted COVID-19 lockdown period in 2020 across 21 metropolitan areas in the Middle East and how these relate to surface urban heat island (SUHI) characteristics. Based on satellite observations of atmospheric gases from Sentinel-5, results indicate significant reductions in the levels of atmospheric pollutants, particularly nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and carbon monoxide (CO). Air quality improved significantly during the middle phases of the lockdown (April and May), especially in small metropolitan cities like Amman, Beirut, and Jeddah, while it was less significant in “mega” cities like Cairo, Tehran, and Istanbul. For example, the concentrations of NO₂ in Amman, Beirut, and Jeddah decreased by -56.6%, -43.4%, and -32.3%, respectively, during April 2020, compared to April 2019. Rather, there was a small decrease in NO₂ levels in megacities like Tehran (-0.9%) and Cairo (-3.1%). Notably, during the lockdown period, there was a decrease in the mean intensity of nighttime SUHI, while the mean intensity of daytime SUHI experienced either an increase or a slight decrease across these locations. Together with the Gulf metropolitans (e.g. Kuwait, Dubai, and Muscat), the megacities (e.g. Tehran, Ankara, and Istanbul) exhibited anomalous increases in the intensity of daytime SUHI, which may exceed 2 °C. Statistical relationships were established to explore the association between changes in the mean intensity and the hotspot area in each metropolitan location during the lockdown. The findings indicate that the mean intensity of SUHI and the spatial extension of hotspot areas within each metropolitan had a statistically significant negative relationship, with Pearson’s r values generally exceeding – 0.55, especially for daytime SUHI. This negative dependency was evident for both daytime and nighttime SUHI during all months of the lockdown. Our findings demonstrate that the decrease in primary pollutant levels during the lockdown contributed to the decrease in the intensity of nighttime SUHIs in the Middle East, especially in April and May. Changes in the characteristics of SUHIs during the lockdown period should be interpreted in the context of long-term climate change, rather than just the consequence of restrictive measures. This is simply because short-term air quality improvements were insufficient to generate meaningful changes in the region’s urban climate.

PMID:34284210 | DOI:10.1016/j.envpol.2021.117802

Arch Endocrinol Metab. 2021 Jul 16:2359-3997000000391. doi: 10.20945/2359-3997000000391. Online ahead of print.

ABSTRACT

OBJECTIVE: Globally developing metabolic syndrome (MetS) prevalence as a major health problem can be related to multiple factors of genetic and environmental. Dimethylaminohydrolase 2 (DDAH2) is the main enzyme implicated in the cardiovascular system, which regulates the nitric oxide pathway. This study investigated the association of DDAH2 polymorphism -499C/G (rs805305) with the risk of MetS among the Azar-Cohort population.

METHODS: The occurrence of SNP rs805305 in the DDAH2 gene was tested using the PCR-RFLP method in 332 MetS cases and 294 healthy controls. Afterward, the association of the allele and genotypes with the risk of MetS and its components were examined.

RESULTS: The G allele and GC genotype were significantly associated with a reduced risk of MetS (P ≤ 0.001). Also, the dominant genetic model (GG+GC) significantly decreased the risk of MetS (P = 0.001), however, in sex subtypes MetS risk was significantly reduced in males before and in females after adjustment for age (P ≤ 0.02).

CONCLUSION: The -499C/G polymorphism of DDAH2 may play a protective role and reduce MetS risk among the Azar-Cohort population.

PMID:34283907 | DOI:10.20945/2359-3997000000391

Arch Endocrinol Metab. 2021 Jul 16:2359-3997000000370. doi: 10.20945/2359-3997000000370. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of the study was to assess the autoimmunity in first degrees relatives (FDR) of patients with type 1 diabetes (T1DM) and the progression to T1DM after 10 years of follow up in the Brazilian population.

METHODS: Non-diabetic FDR of T1DM patients were interviewed and blood was drawn for autoantibodies measurement (GADA, IA-2A, IAA, ZnT8A). Serum samples were analyzed by standard radioligand binding assays performed at the Federal University of Rio de Janeiro (GADA, IAA and IA2A), and at the Skäne University Hospital, Sweden (ZnT8A). The FDR were interviewed by phone after 10 years to determine if they had developed T1DM. Descriptive statistical analysis was performed and results were described as means and standard deviation (SD).

RESULTS: 81 individuals were analyzed. Thirteen subjects had positive autoantibodies associated with T1DM.10 were positive for 1 autoantibody and 3 subjects were positive for multiple autoantibodies (1 of them showed positivity for 2 autoantibodies – GADA, ZnT8A – and the other two were positive for 3 autoantibodies – GADA, IA2A, ZnT8A). The 3 subjects with multiple positive autoantibodies developed T1DM within 10 years.

CONCLUSION: In Brazilian FDR of T1DM patients, the positivity for multiple autoantibodies indicate a greater chance of progression to T1DM, similar to observed in Caucasians. ZnT8A was helpful in the risk assessment for T1DM development.

PMID:34283897 | DOI:10.20945/2359-3997000000370

Arch Endocrinol Metab. 2021 Jul 16:2359-3997000000390. doi: 10.20945/2359-3997000000390. Online ahead of print.

ABSTRACT

OBJECTIVE: Diabetes mellitus (DM) has a high healthcare system cost worldwide. Educational strategies are important to improve self-care and control this disease. This study aimed to evaluate satisfaction and clinical efficacy of a Short Message Service (SMS) educational intervention in self-care and nutrition at a Brazilian university hospital.

METHODS: We conducted a trial of educational intervention and assigned eligible patients with DM to either receive weekly educational SMS for 6 months (intervention group [IG]) or no SMS at all (control group). A satisfaction questionnaire was applied before and after the intervention in both groups. Laboratory (fasting glucose, hemoglobin [Hb] A1c, total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein) and clinical (blood pressure) data were also collected. Data were analyzed using nonparametric tests with the Statistical Package for the Social Sciences.

RESULTS: We included 128 patients (64 in each group). Responses to the satisfaction questionnaire with self-care and healthcare professionals from 112 patients revealed an improvement in the perception of receiving information regarding helpful eating habits and in healthy eating behavior and an improvement in satisfaction with their diabetes care in the IG. In the post-intervention period, improved systolic blood pressure and HbA1c levels were observed in the IG as illustrated by delta % (post-intervention minus pre-intervention data divided by pre-intervention data multiplied by 100) reductions of 2.3% and 3.9%, respectively.

CONCLUSION: SMS intervention was useful as an educational tool for improving satisfaction and glycemic and blood pressure control of patients with DM observed at a Brazilian university hospital.

PMID:34283906 | DOI:10.20945/2359-3997000000390

PLoS One. 2021 Jul 20;16(7):e0254530. doi: 10.1371/journal.pone.0254530. eCollection 2021.

ABSTRACT

Brucellosis and Q fever are neglected zoonoses of global health importance, with unknown true prevalence in occupationally vulnerable settings, partly due to misdiagnosis for other febrile conditions and poor access to primary health care. We examined the seroprevalence of these diseases and associated factors amongst pastoralists and their cattle in Sokoto State, a hub of cattle and pastoral populations in Nigeria. Serum samples randomly collected from 137 pastoralists and 366 cattle from 27 herds in three selected Local Government Areas (LGAs) in the state were analysed for antibodies to Brucella abortus using Rose Bengal Plate Test (RBT) and competitive Enzyme-Linked Immunosorbent Assay (cELISA) as well as antibodies to Coxiella burnetti using indirect ELISA. Consenting pastoralists’ knowledge, perception and practices about the diseases were assessed using a semi-structured questionnaire. Data were analysed using descriptive statistics and bivariate analysis at p ≤ 0.05 level of significance. Brucellosis adjusted individual seroprevalence were 0.83% (95%CI: 0.04-4.59%) and 0% among pastoralists; 2.28% (95%CI: 1.16-4.43%) and 5.70% (95%CI: 3.68-8.74%) in cattle by RBT and cELISA, respectively. Adjusted herd-level seroprevalence for brucellosis were 23.20% (95%CI: 11.07-42.54%) and 42.00% (95%CI: 25.27-61.11%) by RBT and cELISA, respectively. For Q fever, higher seroprevalence of 62.57% (95%CI: 54.04-70.46%) and 2.98% (95%CI: 1.57-5.58%) were recorded amongst the pastoralists and their cattle, respectively. with adjusted herd-level seroprevalence of 40.36% (95%CI: 22.57-63.17%). The LGAs of sampling were significantly (OR: 0.2; 95%CI: 0.02-1.00) associated with Q fever infection, though marginal. The majority of the pastoralists had poor knowledge, perception and practices towards the diseases. This is the first study establishing the presence of brucellosis and Q fever at the human-animal interface in Sokoto State, Nigeria. The pastoralists’ poor knowledge, perception and practices about these diseases are worrisome and are important factors for consideration in disease control.

PMID:34283853 | DOI:10.1371/journal.pone.0254530