Effect of Smoking on Pharmacokinetics of Clopidogrel, an Antiplatelet Drug

Purpose: To assess the influence of smoking cigarettes on the pharmacokinetics of the antiplatelet drug, clopidogrel.Methods: Thirty four male patients, mean age and weight of 59.3 years and 81.1 kg, respectively, who underwent percutaneous coronary intervention (PCI), took part in the study. Each subject received an oral loading dose of 600 mg clopidogrel eight tablets, each 75 mg). Clopidogrel carboxylate plasma level was measured and non-compartmental analysis was used to determine peak plasma concentration (Cmax), time to achieve peak plasma concentration (Tmax), elimination half-life (t1/2e), and area under the curve (AUC0-∞). Other parameters measured include gamma-glutamyltransferase enzyme (GGT), low density lipoprotein cholesterol (LDL-cholesterol), blood urea nitrogen (BUN) and platelet count.Results: Nineteen patients were smokers (55.9 %). Smokers had higher levels of GGT compared to non-smokers (31.73 ± 14.42 vs. 21.63 ± 11.41 IU/L, p = 0.08) as well as higher levels of LDL-cholesterol (116.79 ± 42.08 vs. 87.07 ± 27.34 mg/dl, p = 0.041, respectively). Smokers had shorter half-life (smokers: 3.47 ± 1.9 h vs. non-smokers: 5.83 ± 4.09 h, p = 0.012). Smoking behavior had no influence on Cmax (p = 0.16), AUC0-∞ (p = 0.65) or Tmax (p = 0.91). In general, the pharmacokinetic parameters were characterized by considerable inter-individual variation (Cmax = 23.2 ± 8.79 μg/ml, coefficient of variation (CV) = 37.9 %), (Tmax = 1.71 ± 1.15 h, CV = 67.2 %), (AUC0-∞ = 120.97 ± 44.4 μg.h/ml, CV = 36.7 %) and (t1/2e = 4.57 ± 3.15 h, CV = 68.9 %).Conclusion: Smoking behavior may not be a significant determinant of the pharmacokinetics of clopidogrel following oral administration of 600 mg dose in patients undergoing PCI.Keywords: Antiplatelet, Clopidogrel, Pharmacokinetics, Smoking, Cigarett

Protective role of interferon against cytotoxcicity induced by rabies virus in mice

Rabies remains an important public health problem in the world due to uncontrolled enzootic rabies, lack of safe efficient vaccines and poor information on the risk of contracting rabies post animal exposure. The lethality and mutagenic potential of challenge virus standard (CVS) was evaluated in mice. Mice were intracerebrally infected (MIC) with low, medium and high viral LD50 (MICLD50). Mice were subjected to immunomodulation using interferon (IFN-2a) pre- infection. The infected groups pretreated with IFN- 2a showed a higher survival rate than the infected group. Statistically significant increase in structural and numerical chromosomal aberrations and a decreased mitotic activity of micebone marrow cells was observed post infection. Pretreatment of the infected groups with IFN -2a showed a marked and significant reduction of these cytogenetic changes. The increased survival rate and reduced cytogenetic changes suggest that protection induced by interferon against rabies virus activity could be, at least partially, attributable to blockage of the replication of CVS strain of rabies virus. It could be concluded that interferon can be used as an immune enhancer to the application ofvaccine administration

Sudanese Medical Students and Scientific Research

Background: Most of developing countries face problems in assessment of their public health practices. Gain of this knowledge is orchestrated by  research. Medical students can play an essential role in improving public database.Objective: to explore knowledge, attitude and skills of medical students in the Faculty of Medicine and Health Sciences (FMHS), Omdurman Islamic University (OIU) towards research.Materials and Methods: This is a descriptive, analytical, cross-sectional, institution-based study. A total of 442 students, equally from each batch participated in the study. Equal numbers of male andfemale were considered to eliminate gender and seniority bias. Structured pretested questionnaire was used for data collection. Data collected were fed to Statistical Package for Social Sciences(SPSS) version 15. Means, standard deviation and correlations were done where appropriate. Statistical  significance was taken at P =0.05.Results: The mean knowledge score was 37% and attitude was positive in 77.1% of the students. Only 18.3% had attended research methodology workshop. The rate of internet navigation is directly proportional to the social class. Only 14.7% knew the engines used for finding medical literature.Conclusion: The low knowledge score is due to lack of application of research in the academic curriculum; however, the students have a fairly positive attitude. The knowledge is expected to improve with the intended policy to include practical research in the curriculum.Key Words: Public health, academic curriculum, Suda

Innovative solutions in last mile delivery: concepts, practices, challenges, and future directions

In the last decade, e-commerce has been growing consistently. Fostered by the covid pandemic, online retail has grown exponentially, particularly in industries including food, clothing, groceries and many others. This growth in online retailing activities has raised critical logistic challenges, especially in the last leg of the distribution, commonly referred to as the Last Mile. For instance, traditional truck-based home delivery has reached its limit within metropolitan areas and can no longer be an effective delivery method. Driven by technological progress, several other logistic solutions have been deployed as innovative alternatives to deliver parcels. This includes delivery by drones, smart parcel stations, robots, and crowdsourcing, among others. In this setting, this paper aims to provide a comprehensive review and analysis of the latest trends in last-mile delivery solutions from both industry and academic perspectives (see Figure 1 for overview). We use a content analysis literature review to analyse over 80 relevant publications, derive the necessary features of the latest innovation in the last mile delivery, and point out their different maturity levels and the related theoretical and operational challenges

Vortex deformation and breaking in superconductors: A microscopic description

Vortex breaking has been traditionally studied for nonuniform critical current densities, although it may also appear due to nonuniform pinning force distributions. In this article we study the case of a high-pinning/low-pinning/high-pinning layered structure. We have developed an elastic model for describing the deformation of a vortex in these systems in the presence of a uniform transport current density $J$ for any arbitrary orientation of the transport current and the magnetic field. If $J$ is above a certain critical value, $J_c$, the vortex breaks and a finite effective resistance appears. Our model can be applied to some experimental configurations where vortex breaking naturally exists. This is the case for YBa$_2$Cu$_3$O$_{7-x}$ (YBCO) low angle grain boundaries and films on vicinal substrates, where the breaking is experienced by Abrikosov-Josephson vortices (AJV) and Josephson string vortices (SV), respectively. With our model, we have experimentally extracted some intrinsic parameters of the AJV and SV, such as the line tension $\epsilon_l$ and compared it to existing predictions based on the vortex structure.Comment: 11 figures in 13 files; minor changes after printing proof

Lead exposure in adult males in urban Transvaal Province, South Africa during the apartheid era

Human exposure to lead is a substantial public health hazard worldwide and is particularly problematic in the Republic of South Africa given the country’s late cessation of leaded petrol. Lead exposure is associated with a number of serious health issues and diseases including developmental and cognitive deficiency, hypertension and heart disease. Understanding the distribution of lifetime lead burden within a given population is critical for reducing exposure rates. Femoral bone from 101 deceased adult males living in urban Transvaal Province (now Gauteng Province), South Africa between 1960 and 1998 were analyzed for lead concentration by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Of the 72 black and 29 white individuals sampled, chronic lead exposure was apparent in nearly all individuals. White males showed significantly higher median bone lead concentration (ME = 10.04 µg·g−1), than black males (ME = 3.80 µg·g−1) despite higher socioeconomic status. Bone lead concentration covaries significantly, though weakly, with individual age. There was no significant temporal trend in bone lead concentration. These results indicate that long-term low to moderate lead exposure is the historical norm among South African males. Unexpectedly, this research indicates that white males in the sample population were more highly exposed to lead

Prognostic value of morphology and hormone receptor status in breast cancer - a population based study

We analysed the 5-year relative survival among 4473 breast cancer cases diagnosed in 1990-1992 from cancer registries in Estonia, France, Italy, Spain, the Netherlands and the UK. Among eight categories based on ICD-O codes (infiltrating ductal carcinoma, lobular plus mixed carcinoma, comedocarcinoma, 'special types', medullary carcinoma, not otherwise specified (NOS) carcinoma, other carcinoma and cancer without microscopic confirmation), the 5-year relative survival ranged from 66% (95% CI 61-71) for NOS carcinoma to 95% (95% CI 90-100) for special types (tubular, apocrine, cribriform, papillary, mucinous and signet ring cell); 27% (95% CI 18-36) for cases without microscopic confirmation. Differences in 5-year relative survival by tumor morphology and hormone receptor status were modelled using a multiple regression approach based on generalised linear models. Morphology and hormone receptor status were confirmed as significant survival predictors in this population-based study, even after adjusting for age and stage at diagnosis