BACKGROUND: Upper gastrointestinal bleeding (UGIB) is a common, and potentially life threatening condition, which can be divided into variceal and non-variceal sources of bleeding. OBJECTIVE: To examine the validity o...BACKGROUND: Upper gastrointestinal bleeding (UGIB) is a common, and potentially life threatening condition, which can be divided into variceal and non-variceal sources of bleeding. OBJECTIVE: To examine the validity of the upper gastrointestinal bleeding etiology score compared to the current gold standard, the emergency Esophagogastroduodenos-copy (EGD), for determining the etiology of UGIB. METHODOLOGY: 101 patients presenting with upper gastrointestinal bleeding presented in the emergency department of Capital Hospital, Islamabad between February 2010 and March 2012 were in- cluded in this cross-sectional study. The upper gastrointestinal bleeding score was computed for each case by accounting for the clinical parameters of previous diagnosis of cirrhosis or signs of chronic liver disease × 3.1, presence of red vomitus × 1.5, and red N/G aspirate × 1.2. Each parameter was given a score of 1 if present, and 0 if absent, with a total score ≥3.1 favoring variceal bleed, and a score of <3.1 indicating non-variceal bleeding as a cause of UGIB. Esophago-gastroduodenoscopy was performed within 72 hours of presentation. RESULTS: The mean ± SD age of the patients was 50.2 ± 14.1 years ranging from 18 to 80 years. Out of 101 patients, 56% were males while the remaining 44% were females. The sensitivity of the UGIB score was 78.2% and the specificity was 84.3%. The positive predictive value (PPV) was 91.5% and negative predictive value (NPV) was 64.2%. The overall diagnostic accuracy of UGIB score in determining variceal bleeding was found to be 80.2%. CONCLUSION: Variceal bleeding is a common cause of UGIB in Pakistan. UGIB etiology score is a highly sensitive and specific clinical tool in determining the etiology of UGIB as either variceal or non-variceal bleeding.展开更多
BACKGROUND: Cirrhotic Cardiomyopathy is a relatively ill-characterized condition, which is often under-diagnosed due to absence of defined diagnostic criteria. ECG showing corrected QT Interval prolongation is the mos...BACKGROUND: Cirrhotic Cardiomyopathy is a relatively ill-characterized condition, which is often under-diagnosed due to absence of defined diagnostic criteria. ECG showing corrected QT Interval prolongation is the most suitable available option for diagnosis of this condition. OBJECTIVE: To determine the frequency of corrected QT interval prolongation in patients with liver cirrhosis. METHODOLOGY: Patients (n = 166) with confirmed cirrhosis, 30 years or older, presented in the outpatient and emergency department of medicine at Capital Hospital Islamabad between 1 October 2011 and 30 September 2012, were enrolled in this cross-sectional study after taking consent. ECG was done using calibrated ECG machine, and the QT Interval was measured. Corrected QT was calculated using Bazett’s formula and a QTc of more than 0.44 seconds was considered as being prolonged. RESULTS: The mean age of the patients was 57.05 ± 12.03 years. The corrected QT Interval varied from 337 ms to 560 ms. The mean QTc Interval was 429.92 ms ± 45.11. QTc was prolonged in 41 out of 166 patients (24.7%). Frequency of QTc prolongation was 4.5% in Child Pugh Grade A, 23.2% in Child Pugh Grade B, and 32.0% in Child Pugh Grade C. Association of Child Pugh Scoring with QTc prolongation was determined and found to be statistically significant (P < 0.05). CONCLUSION: QTc interval was prolonged in 24.7% of cirrhotic patients in our study. There was a significant increase in frequency with worsening of Child Pugh Grade, thereby indicating an association between QTc prolongation and the severity of cirrhosis.展开更多
BACKGROUND: Pyogenic and amoebic liver abscesses are rare, potentially lethal conditions. In this study, we aimed to examine the clinical and pathological differences between them. METHODS: Patients with confirmed liv...BACKGROUND: Pyogenic and amoebic liver abscesses are rare, potentially lethal conditions. In this study, we aimed to examine the clinical and pathological differences between them. METHODS: Patients with confirmed liver abscesses were divided into two groups: the pyogenic (n = 47) and amoebic group (n = 21), which were analyzed for differences in clinical and laboratory findings. RESULTS: Amoebic liver abscesses presented most frequently in young adults (14 - 30 years;71%), whereas pyogenic liver abscesses were most commonly observed in adults 41 - 50 years (49%). Indirect hemagglutination test revealed a 100% positive response in the amoebic group, whereas 68% of the pyogenic group presented with blood/pus culture. Multiple abscesses were observed in 66% and 24% of patients in the pyogenic and amoebic group, respectively. CONCLUSIONS: Pyogenic abscesses were commonly observed in older patients, and were associated with features such as markedly deranged liver function test, higher prothrombin time, and multiple abscesses, compared to amoebic abscess. Early and improved diagnoses and differentiation between the two conditions, followed by the correct treatment, can help prevent serious complications and lead to an overall improved mortality rate.展开更多
Background: Depression is relatively prevalent in chronic kidney disease (CKD) patients. Knowing the frequency of depression in these patients, the association with variables such as stage of disease, education, and i...Background: Depression is relatively prevalent in chronic kidney disease (CKD) patients. Knowing the frequency of depression in these patients, the association with variables such as stage of disease, education, and income status may be helpful in devising strategies for better management. Methods: We examined 315 patients diagnosed with CKD presented in the outpatient and emergency department of medicine at Capital Hospital, Islamabad, Pakistan. Depression was diagnosed according to the Hamilton Depression Rating Scale of depressive episode. Results: In the dialysis group, 83.8% were depression positive, while in the pre-dialysis group only 61.3% of patients were given the same diagnosis (P < 0.05). A significant association was moreover found between depression and education status (P < 0.05), but not for income status. Conclusions: Considering the high incidence of depression in CKD patients, screenings should be routinely performed in order to identify and treat depression in its early stages for these patients.展开更多
The urbanization process of the urban centers in the Amazon occurred quickly and without planning. Belém, one of the main cities in the region, suffers from intense flooding due to urbanization growth and the dis...The urbanization process of the urban centers in the Amazon occurred quickly and without planning. Belém, one of the main cities in the region, suffers from intense flooding due to urbanization growth and the disorderly occupation of floodplains. The objective was to evaluate the producing of pervious concrete that meets the mechanical and hydraulic performance criteria for permeable pavement molded on site and to simulate the replacement of the entire public walkway system of a hydrographic basin in Belém in order to verify if this measure would alter the permeability of the basin and meet minimum requirements of at least 25% permeable area. The properties of three mixtures of pervious concrete with aggregates of different grading were evaluated. The permeability and flexural strength of all blends were higher than the minimum required for use as a permeable pavement for light vehicle traffic. The simulation showed that replacement of the public walkway by permeable pavement increased the permeable area of the watershed from 19 to 23%, changing from a poor condition to an acceptable level. The results indicate the potential to improve the performance of drainage systems through the wider use of permeable pavement associated with traditional structural measures.展开更多
The recovery of yttrium is proposed by applying a solid-liquid extraction process using di-2-ethyl hexylphosphoric acid(D2EHPA) as extracting agent.The extracting agents were supported on a macro porous polymeric resi...The recovery of yttrium is proposed by applying a solid-liquid extraction process using di-2-ethyl hexylphosphoric acid(D2EHPA) as extracting agent.The extracting agents were supported on a macro porous polymeric resin XAD-7(solid phase).Yttrium ions extraction and discharge tests were performed,firstly from a synthetic aqueous solution of 100 mg/L Y(liquid phase) at 25℃ with stirring.The effects of pH of aqueous solutions bearing yttrium,volume fraction of extracting agents and the solid/liquid(S/L)ratio on the yttrium recovery were studied.The most favorable conditions for yttrium ions extraction are;20 vol% D_(2)EHPA functionalized resin,pH=1.5 and an S/L ratio of 10 mg/mL The discharge of yttrium ions was done under the same conditions of extraction stage,using a 2 mol/L [H_(2)SO_(4)] as stripping solution.Up to 80% yttrium is extracted,while 75% yttrium is recovered in the striping solution.In all experiments,the reaction equilibrium is reached after 20 min,and the kinetics for the extraction stage was determined as a second-order model.Also,experiments were carried out to discharge the yttriumloaded resins,and it has been determined that the best pH value to strip the Y ions is 1.5.Cyclic tests of extraction and discharge for yttrium ions show that the functionalized resin can work at least five cycles without decreasing its efficiency.Finally,the proposed process was tested in a real solution with Y ions fro m a waste fluorescent la mp powder leached in H_(2)SO_(4),demonstrating the ability to effectively recover yttrium,separating it from various metals from the studied residue.展开更多
Vitamin A deficiency remains a severe global health issue,which creates a need to biofortify crops with provitamin A carotenoids(PACs).Expanding plant cell capacity for synthesis and storing of PACs outside the plasti...Vitamin A deficiency remains a severe global health issue,which creates a need to biofortify crops with provitamin A carotenoids(PACs).Expanding plant cell capacity for synthesis and storing of PACs outside the plastids is a promising biofortification strategy that has been little explored.Here,we engineered PAC formation and sequestration in the cytosol of Nicotiana benthamiana leaves,Arabidopsis seeds,and citrus callus cells,using a fungal(Neurospora crassa)carotenoid pathway that consists of only three enzymes converting C5 isopentenyl building blocks formed from mevalonic acid into PACs,including β-carotene.This strategy led to the accumulation of significant amounts of phytoene and γ-and β-carotene,in addition to fungal,health-promoting carotenes with 13 conjugated double bonds,such as the PAC torulene,in the cytosol.Increasing the isopentenyl diphosphate pool by adding a truncated Arabidopsis hydroxymethylglutaryl-coenzyme A reductase substantially increased cytosolic carotene production.Engineered carotenes accumulate in cytosolic lipid droplets(CLDs),which represent a novel sequestering sink for storing these pigments in plant cytosol.Importantly,β-carotene accumulated in the cytosol of citrus callus cells was more light stable compared to compared with plastidialβ-carotene.Moreover,engineering cytosolic carotene formation increased the number of large-sized CLDs and the levels of β-apocarotenoids,including retinal,the aldehyde corresponding to vitamin A.Collectively,our study opens up the possibility of exploiting the high-flux mevalonic acid pathway for PAC biosynthesis and enhancing carotenoid sink capacity in green and non-green plant tissues,especially in lipid-storing seeds,and thus paves the way for further optimization of carotenoid biofortification in crops.展开更多
Polymeric nanoparticles of poly(methyl methacrylate)were obtained by emulsion polymerization techniques in a proce ss of two stages.The particles were functionalized with acrylic acid,curcumin,and fumaramide and three...Polymeric nanoparticles of poly(methyl methacrylate)were obtained by emulsion polymerization techniques in a proce ss of two stages.The particles were functionalized with acrylic acid,curcumin,and fumaramide and three series of polymeric particles were obtained.The incorporation of functional groups was confirmed by Fourier transform-infrared spectrosocopy(FT-IR)and ultraviolet-visible(UV-Vis)methods.The spherical morphology of particles with an average diameter of 100 nm was observed by scartning electron microscopy(SEM).The polymeric materials were used for recovery of[Eu]from synthetic solutions.The nanoparticles show excellent chelation capacity to trap rare-earth ions,because they recover more than 85%of[Eu]at pH of 2.The images of SEM after extraction process show arrays between particles with larger average particle sizes to 1.5 um.In addition,the particles have a good stripping capacity,exceeding 50%of it,maintaining their homogeneity in morphology and good stability in dispersion for the recovery and stripping processes.A pseudo-second model order is obtained for the extraction and stripping processes while the best results of stripping process are obtained at pH of 6.展开更多
文摘BACKGROUND: Upper gastrointestinal bleeding (UGIB) is a common, and potentially life threatening condition, which can be divided into variceal and non-variceal sources of bleeding. OBJECTIVE: To examine the validity of the upper gastrointestinal bleeding etiology score compared to the current gold standard, the emergency Esophagogastroduodenos-copy (EGD), for determining the etiology of UGIB. METHODOLOGY: 101 patients presenting with upper gastrointestinal bleeding presented in the emergency department of Capital Hospital, Islamabad between February 2010 and March 2012 were in- cluded in this cross-sectional study. The upper gastrointestinal bleeding score was computed for each case by accounting for the clinical parameters of previous diagnosis of cirrhosis or signs of chronic liver disease × 3.1, presence of red vomitus × 1.5, and red N/G aspirate × 1.2. Each parameter was given a score of 1 if present, and 0 if absent, with a total score ≥3.1 favoring variceal bleed, and a score of <3.1 indicating non-variceal bleeding as a cause of UGIB. Esophago-gastroduodenoscopy was performed within 72 hours of presentation. RESULTS: The mean ± SD age of the patients was 50.2 ± 14.1 years ranging from 18 to 80 years. Out of 101 patients, 56% were males while the remaining 44% were females. The sensitivity of the UGIB score was 78.2% and the specificity was 84.3%. The positive predictive value (PPV) was 91.5% and negative predictive value (NPV) was 64.2%. The overall diagnostic accuracy of UGIB score in determining variceal bleeding was found to be 80.2%. CONCLUSION: Variceal bleeding is a common cause of UGIB in Pakistan. UGIB etiology score is a highly sensitive and specific clinical tool in determining the etiology of UGIB as either variceal or non-variceal bleeding.
文摘BACKGROUND: Cirrhotic Cardiomyopathy is a relatively ill-characterized condition, which is often under-diagnosed due to absence of defined diagnostic criteria. ECG showing corrected QT Interval prolongation is the most suitable available option for diagnosis of this condition. OBJECTIVE: To determine the frequency of corrected QT interval prolongation in patients with liver cirrhosis. METHODOLOGY: Patients (n = 166) with confirmed cirrhosis, 30 years or older, presented in the outpatient and emergency department of medicine at Capital Hospital Islamabad between 1 October 2011 and 30 September 2012, were enrolled in this cross-sectional study after taking consent. ECG was done using calibrated ECG machine, and the QT Interval was measured. Corrected QT was calculated using Bazett’s formula and a QTc of more than 0.44 seconds was considered as being prolonged. RESULTS: The mean age of the patients was 57.05 ± 12.03 years. The corrected QT Interval varied from 337 ms to 560 ms. The mean QTc Interval was 429.92 ms ± 45.11. QTc was prolonged in 41 out of 166 patients (24.7%). Frequency of QTc prolongation was 4.5% in Child Pugh Grade A, 23.2% in Child Pugh Grade B, and 32.0% in Child Pugh Grade C. Association of Child Pugh Scoring with QTc prolongation was determined and found to be statistically significant (P < 0.05). CONCLUSION: QTc interval was prolonged in 24.7% of cirrhotic patients in our study. There was a significant increase in frequency with worsening of Child Pugh Grade, thereby indicating an association between QTc prolongation and the severity of cirrhosis.
文摘BACKGROUND: Pyogenic and amoebic liver abscesses are rare, potentially lethal conditions. In this study, we aimed to examine the clinical and pathological differences between them. METHODS: Patients with confirmed liver abscesses were divided into two groups: the pyogenic (n = 47) and amoebic group (n = 21), which were analyzed for differences in clinical and laboratory findings. RESULTS: Amoebic liver abscesses presented most frequently in young adults (14 - 30 years;71%), whereas pyogenic liver abscesses were most commonly observed in adults 41 - 50 years (49%). Indirect hemagglutination test revealed a 100% positive response in the amoebic group, whereas 68% of the pyogenic group presented with blood/pus culture. Multiple abscesses were observed in 66% and 24% of patients in the pyogenic and amoebic group, respectively. CONCLUSIONS: Pyogenic abscesses were commonly observed in older patients, and were associated with features such as markedly deranged liver function test, higher prothrombin time, and multiple abscesses, compared to amoebic abscess. Early and improved diagnoses and differentiation between the two conditions, followed by the correct treatment, can help prevent serious complications and lead to an overall improved mortality rate.
文摘Background: Depression is relatively prevalent in chronic kidney disease (CKD) patients. Knowing the frequency of depression in these patients, the association with variables such as stage of disease, education, and income status may be helpful in devising strategies for better management. Methods: We examined 315 patients diagnosed with CKD presented in the outpatient and emergency department of medicine at Capital Hospital, Islamabad, Pakistan. Depression was diagnosed according to the Hamilton Depression Rating Scale of depressive episode. Results: In the dialysis group, 83.8% were depression positive, while in the pre-dialysis group only 61.3% of patients were given the same diagnosis (P < 0.05). A significant association was moreover found between depression and education status (P < 0.05), but not for income status. Conclusions: Considering the high incidence of depression in CKD patients, screenings should be routinely performed in order to identify and treat depression in its early stages for these patients.
文摘The urbanization process of the urban centers in the Amazon occurred quickly and without planning. Belém, one of the main cities in the region, suffers from intense flooding due to urbanization growth and the disorderly occupation of floodplains. The objective was to evaluate the producing of pervious concrete that meets the mechanical and hydraulic performance criteria for permeable pavement molded on site and to simulate the replacement of the entire public walkway system of a hydrographic basin in Belém in order to verify if this measure would alter the permeability of the basin and meet minimum requirements of at least 25% permeable area. The properties of three mixtures of pervious concrete with aggregates of different grading were evaluated. The permeability and flexural strength of all blends were higher than the minimum required for use as a permeable pavement for light vehicle traffic. The simulation showed that replacement of the public walkway by permeable pavement increased the permeable area of the watershed from 19 to 23%, changing from a poor condition to an acceptable level. The results indicate the potential to improve the performance of drainage systems through the wider use of permeable pavement associated with traditional structural measures.
基金Project supported by Secretariat of Research and Postgraduate Studies National Polytechnic Institute (20221369 and 20231939)Consejo Nacional de Ciencia y Tecnologia CONACyT。
文摘The recovery of yttrium is proposed by applying a solid-liquid extraction process using di-2-ethyl hexylphosphoric acid(D2EHPA) as extracting agent.The extracting agents were supported on a macro porous polymeric resin XAD-7(solid phase).Yttrium ions extraction and discharge tests were performed,firstly from a synthetic aqueous solution of 100 mg/L Y(liquid phase) at 25℃ with stirring.The effects of pH of aqueous solutions bearing yttrium,volume fraction of extracting agents and the solid/liquid(S/L)ratio on the yttrium recovery were studied.The most favorable conditions for yttrium ions extraction are;20 vol% D_(2)EHPA functionalized resin,pH=1.5 and an S/L ratio of 10 mg/mL The discharge of yttrium ions was done under the same conditions of extraction stage,using a 2 mol/L [H_(2)SO_(4)] as stripping solution.Up to 80% yttrium is extracted,while 75% yttrium is recovered in the striping solution.In all experiments,the reaction equilibrium is reached after 20 min,and the kinetics for the extraction stage was determined as a second-order model.Also,experiments were carried out to discharge the yttriumloaded resins,and it has been determined that the best pH value to strip the Y ions is 1.5.Cyclic tests of extraction and discharge for yttrium ions show that the functionalized resin can work at least five cycles without decreasing its efficiency.Finally,the proposed process was tested in a real solution with Y ions fro m a waste fluorescent la mp powder leached in H_(2)SO_(4),demonstrating the ability to effectively recover yttrium,separating it from various metals from the studied residue.
基金supported by baseline funding and Competitive Research Grants(CRG 2017,CRG 2020)given to Salim Al-Babili from King Abdullah University of Science and Technology(KAUST).
文摘Vitamin A deficiency remains a severe global health issue,which creates a need to biofortify crops with provitamin A carotenoids(PACs).Expanding plant cell capacity for synthesis and storing of PACs outside the plastids is a promising biofortification strategy that has been little explored.Here,we engineered PAC formation and sequestration in the cytosol of Nicotiana benthamiana leaves,Arabidopsis seeds,and citrus callus cells,using a fungal(Neurospora crassa)carotenoid pathway that consists of only three enzymes converting C5 isopentenyl building blocks formed from mevalonic acid into PACs,including β-carotene.This strategy led to the accumulation of significant amounts of phytoene and γ-and β-carotene,in addition to fungal,health-promoting carotenes with 13 conjugated double bonds,such as the PAC torulene,in the cytosol.Increasing the isopentenyl diphosphate pool by adding a truncated Arabidopsis hydroxymethylglutaryl-coenzyme A reductase substantially increased cytosolic carotene production.Engineered carotenes accumulate in cytosolic lipid droplets(CLDs),which represent a novel sequestering sink for storing these pigments in plant cytosol.Importantly,β-carotene accumulated in the cytosol of citrus callus cells was more light stable compared to compared with plastidialβ-carotene.Moreover,engineering cytosolic carotene formation increased the number of large-sized CLDs and the levels of β-apocarotenoids,including retinal,the aldehyde corresponding to vitamin A.Collectively,our study opens up the possibility of exploiting the high-flux mevalonic acid pathway for PAC biosynthesis and enhancing carotenoid sink capacity in green and non-green plant tissues,especially in lipid-storing seeds,and thus paves the way for further optimization of carotenoid biofortification in crops.
基金Project supported by Secretaria de Investigación y Posgrado Instituto Politecnico Nacional(20221369,20231939,2027024,20230751)Consejo Nacional de Humanidades,Ciencia y Tecnologias CONAHCyT。
文摘Polymeric nanoparticles of poly(methyl methacrylate)were obtained by emulsion polymerization techniques in a proce ss of two stages.The particles were functionalized with acrylic acid,curcumin,and fumaramide and three series of polymeric particles were obtained.The incorporation of functional groups was confirmed by Fourier transform-infrared spectrosocopy(FT-IR)and ultraviolet-visible(UV-Vis)methods.The spherical morphology of particles with an average diameter of 100 nm was observed by scartning electron microscopy(SEM).The polymeric materials were used for recovery of[Eu]from synthetic solutions.The nanoparticles show excellent chelation capacity to trap rare-earth ions,because they recover more than 85%of[Eu]at pH of 2.The images of SEM after extraction process show arrays between particles with larger average particle sizes to 1.5 um.In addition,the particles have a good stripping capacity,exceeding 50%of it,maintaining their homogeneity in morphology and good stability in dispersion for the recovery and stripping processes.A pseudo-second model order is obtained for the extraction and stripping processes while the best results of stripping process are obtained at pH of 6.
