Microbial Contamination in Drinking Water of Saggiyan-Lahore, Pakistan

The present study was carried to evaluate the physico-chemical parameters and microbial contamination of drinking water in the area of Saggiyan, Lahore. The tested water samples (S1-S30) were found to contain 199.6-402 mg/L TDS, 196-260 ppm EC, 196-260 ppm Hardness, 0.8-17 NTU turbidity, 169-290 mg/L alkalinity, 0-0.1 ppb arsenic and 0-0.1 ppm fluoride contents. 95% of the water samples were found contaminated with fecal coliforms while 27% of the samples had shown the presence of E. coli. Though the physico-chemical parameters of most water samples were found in the safe limits of WHO, however, the presence of microbial contamination rendered it non-suitable for drinking purposes

Synthesis, characterization and application of novel MnO and CuO impregnated biochar composites to sequester arsenic (As) from water: Modeling, thermodynamics and reusability

© 2020 Elsevier B.V. The present study aimed at enhancing the adsorption potential of novel nanocomposites of Sesbania bispinosa biochar (SBC) with copper oxide (SBC/CuO) and manganese oxide nanoparticles (SBC/MnO) for the efficient and inexpensive removal of environmentally concerned contaminant arsenic (As) from contaminated water at batch scale. The scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy, energy dispersive X-ray (EDX), X-ray diffraction (XRD) and point of zero charge (PZC) analyses proved successful impregnation of the metallic nanoparticles on SBC surface. The results revealed the maximum As removal (96 %) and adsorption (12.47 mg/g) by SBC/CuO composite at 10 mg As/L, optimum pH-4, dose 1.0 g/L and ambient temperature (25 ± 1.5 °C) as compared with SBC (7.33 mg/g) and SBC/MnO (7.34 mg/g). Among four types of adsorption isotherms, Freundlich isotherm demonstrated best fit with R2 \u3e 0.997. While pseudo second-order kinetic model revealed better agreement with kinetic experimental data as matched with other kinetic models. The thermodynamic results depicted that As adsorption on the as-synthesized adsorbents was endothermic and spontaneous in nature with increased randomness. The SBC/CuO displayed excellent reusability and stability over four adsorption/desorption cycles and proved that the as-synthesized SBC/CuO composite may be the efficient adsorbent for practical removal of As from contaminated water

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Neurotransmitters in hiccups

Hiccups are the sudden involuntary contractions of the diaphragm and intercostal muscles. They are generally benign and self-limited, however, in some cases they are chronic and debilitating. There are approximately 4000 admissions for hiccups each year in the United States. The hiccup reflex arc is composed of three components: (1) an afferent limb including the phrenic, vagus, and sympathetic nerves, (2) the central processing unit in the midbrain, and (3) the efferent limb carrying motor fibers to the diaphragm and intercostal muscles. Hiccups may be idiopathic, organic, psychogenic, or medication-induced. Data obtained largely from case studies of hiccups either induced by or treated with medications have led to hypotheses on the neurotransmitters involved. The central neurotransmitters implicated in hiccups include GABA, dopamine, and serotonin, while the peripheral neurotransmitters are epinephrine, norepinephrine, acetylcholine, and histamine. Further studies are needed to characterize the nature of neurotransmitters at each anatomical level of the reflex arc to better target hiccups pharmacologically

Unicorn: Anomalous Double Ostium Left Main Coronary Artery With Intra-Mural Connection - Diagnosed with Multi-Modality Imaging

Case report of a unicorn: anomalous double ostium left main coronary artery with common intra-mural connection. Three-dimensional virtual endo-luminal angioscopy and catheter-based imaging confirmed the diagnosis, subsequently avoiding cardiac surgical intervention. </jats:p

The impact of late ADHD diagnosis on mental health outcomes in females

Introduction: ADHD presents with long-term symptoms of inattention and hyperactivity-impulsivity that impact one's daily functioning. Compared to girls, boys are twice as likely to be diagnosed with ADHD. Females are more likely to present with symptoms of inattention than hyperactivity, causing their symptoms to be less noticeable in childhood. Due to being diagnosed later, many females experience detrimental impacts from unmanaged ADHD symptoms. Because of the challenges undiagnosed women face, our study hypothesized that later ADHD diagnoses for women contribute to poorer mental health outcomes and an increased risk of developing comorbid conditions. Methods: The National Longitudinal Study of Adolescent and Adult Health (Add Health) Wave IV dataset includes n = 486 males with ADHD and n = 278 females with ADHD, divided into age intervals 1–16 and 17–32. Study participants were stratified by age, gender, and rates of depression and anxiety. Crosstabulation measured the frequency at which each gender was diagnosed at a particular period. Results: There were n = 542 participants in the 1–16 age interval and n = 222 in the 17–32 age interval. The 1–16 interval (younger) had a gender gap of 2.41, with n = 383 males and n = 159 females. The 17–32 interval (older) had a gender gap of 0.87, with n = 103 males and n = 119 females. Females in the younger group had slightly higher rates of mental health comorbidities. In the older group, females had higher rates of anxiety/panic disorder, while males had higher rates of depression. Conclusions: The 17–32 interval had more women than men. Thus, compared to men, women were more likely to receive an ADHD diagnosis at a later age. Rates of comorbid depression and anxiety/panic disorder also varied based on the age of diagnosis and gender. Our study highlights the need to improve the process of diagnosing ADHD in girls