PROTECTIVE ROLE OF BREASTFEEDING IN CHILDREN WITH CELIAC DISEASE.

Background; The prevalence of thyroid disease is likely increased among chidren with celiac disease (CD). In addition, exposure to gluten-free treatment may be associated with a risk of thyroid disease, but this association remains controversial. Objective; To Determine the frequency of Prolonged breastfeeding in children with celiac disease at a tertiary care hospital.  Material and Methods; Children with celiac disease (as given in operational definition) were enrolled and their mothers was inquired regarding history of breastfeeding in their child. All the data was entered and analyzed using SPSS-18. Results; Of these 160 study cases, 67 (41.9 %) were male patients while 93 (58.1 %) were female patients. Mean age of our study cases was 51.19 ± 11.25 months (with minimum age of our study cases was 12 months while maximum age was 60 months). Of these 160 study cases, 92 (57.5 %) belonged to rural areas and 68 (42.5 %) belonged to urban areas. Monthly family income up to Rs. 35000 was noted in 68 (42.5%) while more than Rs. 35000 was noted in 92 (57.5%) of our study cases. Mean disease duration of celiac disease was 5.23 ± 4.21 months and 117 (73.1%) had disease duration up to 6 months. Mean duration of breastfeeding was 18.23 ± 5.43 months and prolonged breastfeeding was noted in 124 (77.5%). Conclusion; Prolonged breastfeeding frequency was poor in children with celiac disease in our study. Prolonged breastfeeding was significantly associated with age, disease duration, ethnicity and maternal literacy. A mass campaign to create awareness regarding benefits of breastfeeding should be launched at national electronic and print media. Clinicians treating children having celiac disease should educate the mothers for breastfeeding benefits so as to decrease disease morbidity which will save them future hardships and improve quality of life of such patients. Keywords; Celiac Disease, Breastfeeding, Prolonged. DOI: 10.7176/JMPB/54-19 Publication date: April 30th 2019

On Weighted Nwikpe Distribution: Properties and Applications

In this article, two-parameter continuous distribution is introduced. The proposed distribution is obtained by using a weight technique and is referred to as weighted Nwikpe distribution. This distribution is a generalization of baseline distribution that is Nwikpe distribution. Some structural properties of the distribution are derived. These are density function, distribution function, and reliability function, hazard rate function, moments, moment generating function, entropies, order statistics, Bonferroni and Lorenz curves. The method of maximum likelihood estimation has been established for investigating the parameters of the model. The behaviour of the parameters of the distribution is examined by a simulation study. Real data set is used to determine whether the weighted Nwikpe distribution is better than other well-known distributions in modeling data or not

Comparison between Right and Left Hemisphere Lesion of Stroke Patients for Functional Gait Assessment

Objective: To compared the functional gait among left and right hemisphere lesion patients of stroke. Methods: This cross sectional comparative study included 126 patients with right and left sided hemispheric lesion. The study was conducted from December 2019 to March 2020. Patients were selected consecutively from different hospitals and rehabilitation centers of Lahore, Pakistan on the basis of inclusion & exclusion criteria. Functional gait assessment (FGA) scale was used to measure functional gait performance and disturbance related to balance in stroke patients. Independent sample t-test was used for comparison of functional gait between left and right hemispheric lesions. A p-value ≤ .05 was taken statistically significant. Results: A total of 126 patients of stroke with right and left sided hemisphere lesion were assessed for functional gait assessment. The mean age of patients in group A and B was 54.19±8.54 years and 51.46±8.57 years, respectively. The mean weight of patients in group A and B was 61.95±8.82 kg and 58.67±5.83 kg, respectively. Functional gait assessment mean score in group A was 12.56±2.60 and in group B was 15.59±4.17 points with p-value of 0.001. There was a significant difference of FGA scores present between the two groups. Conclusions: The study concluded that ambulatory functions differ with respect to site of hemisphere lesion. The site of hemisphere lesion impact on patient's functional gait has statistically significant

Nanomaterials for the Diagnosis and Treatment of Inflammatory Arthritis

Nanomaterials have received increasing attention due to their unique chemical and physical properties for the treatment of rheumatoid arthritis (RA), the most common complex multifactorial joint-associated autoimmune inflammatory disorder. RA is characterized by an inflammation of the synovium with increased production of proinflammatory cytokines (IL-1, IL-6, IL-8, and IL-10) and by the destruction of the articular cartilage and bone, and it is associated with the development of cardiovascular disorders such as heart attack and stroke. While a number of imaging tools allow for the monitoring and diagnosis of inflammatory arthritis, and despite ongoing work to enhance their sensitivity and precision, the proper assessment of RA remains difficult particularly in the early stages of the disease. Our goal here is to describe the benefits of applying various nanomaterials as next-generation RA imaging and detection tools using contrast agents and nanosensors and as improved drug delivery systems for the effective treatment of the disease

Nanotechnology in Bladder Cancer: Diagnosis and Treatment

Bladder cancer (BC) is the second most common cancer of the urinary tract in men and the fourth most common cancer in women, and its incidence rises with age. There are many conventional methods for diagnosis and treatment of BC. There are some current biomarkers and clinical tests for the diagnosis and treatment of BC. For example, radiotherapy combined with chemotherapy and surgical, but residual tumor cells mostly cause tumor recurrence. In addition, chemotherapy after transurethral resection causes high side effects, and lack of selectivity, and low sensitivity in sensing. Therefore, it is essential to improve new procedures for the diagnosis and treatment of BC. Nanotechnology has recently sparked an interest in a variety of areas, including medicine, chemistry, physics, and biology. Nanoparticles (NP) have been used in tumor therapies as appropriate tools for enhancing drug delivery efficacy and enabling therapeutic performance. It is noteworthy, nanomaterial could be reduced the limitation of conventional cancer diagnosis and treatments. Since, the major disadvantages of therapeutic drugs are their insolubility in an aqueous solvent, for instance, paclitaxel (PTX) is one of the important therapeutic agents utilized to treating BC, due to its ability to prevent cancer cell growth. However, its major problem is the poor solubility, which has confirmed to be a challenge when improving stable formulations for BC treatment. In order to reduce this challenge, anti-cancer drugs can be loaded into NPs that can improve water solubility. In our review, we state several nanosystem, which can effective and useful for the diagnosis, treatment of BC. We investigate the function of metal NPs, polymeric NPs, liposomes, and exosomes accompanied therapeutic agents for BC Therapy, and then focused on the potential of nanotechnology to improve conventional approaches in sensing

Does Celebrity Endorsement Influence the Corporate Loyalty: Mediating Role of Corporate Credibility?

Celebrity endorsement in product marketing and advertising is one of the most important factors in companies’ promotion strategies. Celebrities as one of the major tools in advertising can lead to encouraging consumers to use specific products and corporate loyalty because of their special and unique abilities or characteristics. The purpose of this study is to examine the effect of celebrity endorsement on corporate loyalty by concentrating on the mediating role of corporate credibility. Questionnaire survey method was adopted for data collection and data have been collected by applying simple random sampling technique. Study result revealed that the celebrity endorsement has a positive effect on corporate credibility and corporate loyalty. Moreover, corporate credibility has a positive effect on corporate loyalty. Moreover, corporate credibility significantly mediates the relationship between celebrity endorsement and corporate loyalty. At the end of this article, obstruction of this study, implementation, and outlines for another research also provided

Transcutaneous auricular vagus nerve stimulation with concurrent upper limb repetitive task practice for poststroke motor recovery: A pilot study.

Invasive vagus nerve stimulation (VNS) has the potential to enhance the effects of physiotherapy for upper limb motor recovery after stroke. Noninvasive, transcutaneous auricular branch VNS (taVNS) may have similar benefits, but this has not been evaluated in stroke recovery. We sought to determine the feasibility of taVNS delivered alongside upper limb repetitive task-specific practice after stroke and its effects on a range of outcome measures evaluating limb function. Thirteen participants at more than 3 months postischemic stroke with residual upper limb dysfunction were recruited from the community of Sheffield, United Kingdom (October-December 2016). Participants underwent 18 × 1-hour sessions over 6 weeks in which they made 30-50 repetitions of 8-10 arm movements concurrently with taVNS (NEMOS; Cerbomed, Erlangen, Germany, 25 Hz, .1-millisecond pulse width) at maximum tolerated intensity (mA). An electrocardiogram and rehabilitation outcome scores were obtained at each visit. Qualitative interviews determined the acceptability of taVNS to participants. Median time after stroke was 1.16 years, and baseline median/interquartile range upper limb Fugl-Meyer (UFM) score was 63 (54.5-99.5). Participants attended 92% of the planned treatment sessions. Three participants reported side effects, mainly fatigue, but all performed mean of more than 300 arm repetitions per session with no serious adverse events. There was a significant change in the UFM score with a mean increase per participant of 17.1 points (standard deviation 7.8). taVNS is feasible and well-tolerated alongside upper limb repetitive movements in poststroke rehabilitation. The motor improvements observed justify a phase 2 trial in patients with residual arm weakness. [Abstract copyright: Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Effects of mental imagery on lower limb function in sub-acute stage of stroke patients; a randomized controlled trial

Introduction: Stroke is the most common type of cerebrovascular injury caused by sudden decrease in blood supply that can lead to weaknesses and other associated problems. Many treatment options are available for stroke with promising results. This trial was designed to explore the role of mental imagery (visual) in the sub-acute stage, considering the stroke patient, especially in evaluating its effects on the lower extremities. Material & Methods: An experimental randomized controlled trial was performed from July to August 2018 in physiotherapy departments of National Hospital and Aadil Hospital Defence Lahore. A total of 80 patients having sub-acute stroke with strong perceptions having a score of 25 or more in the Mini Mental Score Exam and a 3 +/5 manual muscle testing grade system in the lower extremity were taken using non-probability consecutive sampling procedure. All the patients were divided into 2 groups randomly. Conservative treatment including strengthening and balance training were given to one group and conservative treatment with addition of visual imagery to the second group. Independent t-test was used to assess significant differences between the two groups. Results: Comparison of Berg Balance Scale at pre-intervention between the experimental group and the controlled group was not significant, 13.76 ± 2.85 vs 13.84 ± 3.26 (p=0.927), respectively. After intervention the effects of treatment were significant in both groups, 18.64 ± 2.33 vs 17.80 ± 2.94(p=0.007), respectively. Comparison of Time Up and Go test at pre-intervention between groups was not significant, 6.28 ± 1.86 vs 6.68 ± 0.99(p=0.347), respectively. The intervention effects after treatment in both groups were significant, 1.84 ± 1.28 vs 3.56 ± 1.26 (p=0.001), respectively. Conclusion: It is concluded that mental imagery along with conservative treatment plays a vital role in construction of neural circuit in sub-acute stroke patients

Functional, cognitive and psychological outcomes, and recurrent vascular events in Pakistani stroke survivors: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>There is little direct data describing the outcomes and recurrent vascular morbidity and mortality of stroke survivors from low and middle income countries like Pakistan. This study describes functional, cognitive and vascular morbidity and mortality of Pakistani stroke survivors discharged from a dedicated stroke center within a nonprofit tertiary care hospital based in a multiethnic city with a population of more than 20 million.</p> <p>Methods</p> <p>Patients with stroke, aged > 18 years, discharged alive from a tertiary care centre were contacted via telephone and a cross sectional study was conducted. All the discharges were contacted. Patients or their legal surrogate were interviewed regarding functional, cognitive and psychological outcomes and recurrent vascular events using standardized, pretested and translated scales. A verbal autopsy was carried out for patients who had died after discharge. Stroke subtype and risk factors data was collected from the medical records. Subdural hemorrhages, traumatic ICH, subarachnoid hemorrhage, iatrogenic stroke within hospital and all other diagnoses that presented like stroke but were subsequently found not to have stroke were also excluded. Composites were created for functional outcome variable and depression. Data were analyzed using logistic regression.</p> <p>Results</p> <p>309 subjects were interviewed at a median of 5.5 months post discharge. 12.3% of the patients had died, mostly from recurrent vascular events or stroke complications. Poor functional outcome defined as Modified Rankin Score (mRS) of > 2 and a Barthel Index (BI) score of < 90 was seen in 51%. Older age (Adj-OR-2.1, <it>p </it>= 0.01), moderate to severe dementia (Adj-OR-19.1, <it>p </it>< 0.001), Diabetes (Adj-OR-2.1, <it>p </it>= 0.02) and multiple post stroke complications (Adj-OR-3.6, <it>p </it>= 0.02) were independent predictors of poor functional outcome. Cognitive outcomes were poor in 42% and predictors of moderate to severe dementia were depression (Adj-OR-6.86, <it>p </it>< 0.001), multiple post stroke complications (Adj-OR-4.58, <it>p </it>= 0.01), presence of bed sores (Adj-OR-17.13, <it>p </it>= 0.01) and history of atrial fibrillation (Adj-OR-5.12, <it>p </it>< 0.001).</p> <p>Conclusions</p> <p>Pakistani stroke survivors have poor outcomes in the community, mostly from preventable complications. Despite advanced disability, the principal caretakers were family rarely supported by health care personnel, highlighting the need to develop robust home care support for caregivers in these challenging resource poor settings.</p

Long non-coding RNAs and their targets as potential biomarkers in breast cancer.

Breast cancer is among the lethal types of cancer with a high mortality rate, globally. Its high prevalence can be controlled through improved analysis and identification of disease-specific biomarkers. Recently, long non-coding RNAs (lncRNAs) have been reported as key contributors of carcinogenesis and regulate various cellular pathways through post-transcriptional regulatory mechanisms. The specific aim of this study was to identify the novel interactions of aberrantly expressed genetic components in breast cancer by applying integrative analysis of publicly available expression profiles of both lncRNAs and mRNAs. Differential expression patterns were identified by comparing the breast cancer expression profiles of samples with controls. Significant co-expression networks were identified through WGCNA analysis. WGCNA is a systems biology approach used to elucidate the pattern of correlation between genes across microarray samples. It is also used to identify the highly correlated modules. The results obtained from this study revealed significantly differentially expressed and co-expressed lncRNAs and their cis- and trans-regulating mRNA targets which include RP11-108F13.2 targeting TAF5L, RPL23AP2 targeting CYP4F3, CYP4F8 and AL022324.2 targeting LRP5L, AL022324.3, and Z99916.3, respectively. Moreover, pathway analysis revealed the involvement of identified mRNAs and lncRNAs in major cell signalling pathways, and target mRNAs expression is also validated through cohort data. Thus, the identified lncRNAs and their target mRNAs represent novel biomarkers that could serve as potential therapeutics for breast cancer and their roles could also be further validated through wet labs to employ them as potential therapeutic targets in future