The role of decompressive craniectomy in the context of severe traumatic brain injury: summary of results and analysis of the confidence level of conclusions from systematic reviews and meta-analyses.

Introduction: Traumatic brain injury (TBI) is a global epidemic. The incidence of TBI in low and middle-income countries (LMICs) is three times greater than in high-income countries (HICs). Decompressive craniectomy (DC) is a surgical procedure to reduce intracranial pressure (ICP) and prevent secondary injury. Multiple comparative studies, and several randomized controlled trials (RCTs) have been conducted to investigate the influence of DC for patients with severe TBI on outcomes such as mortality, ICP, neurological outcomes, and intensive care unit (ICU) and hospital length of stay. The results of these studies are inconsistent. Systematic reviews and meta-analyses have been conducted in an effort to aggregate the data from the individual studies, and perhaps derive reliable conclusions. The purpose of this project was to conduct a review of the reviews about the effectiveness of DC to improve outcomes. Methods: We conducted a systematic search of the literature to identify reviews and meta-analyses that met our pre-determined criteria. We used the AMSTAR 2 instrument to assess the quality of each of the included reviews, and determine the level of confidence. Results: Of 973 citations from the original search, five publications were included in our review. Four of them included meta-analyses. For mortality, three reviews found a positive effect of DC compared to medical management and two found no significant difference between groups. The four reviews that measured neurological outcome found no benefit of DC. The two reviews that assessed ICP both found DC to be beneficial in reducing ICP. DC demonstrated a significant reduction in ICU length of stay in the one study that measured it, and a significant reduction in hospital length of stay in the two studies that measured it. According to the AMSTAR 2 criteria, the five reviews ranged in levels of confidence from low to critically low. Conclusion: Systematic reviews and meta-analyses are important approaches for aggregating information from multiple studies. Clinicians rely of these methods for concise interpretation of scientific literature. Standards for quality of systematic reviews and meta-analyses have been established to support the quality of the reviews being produced. In the case of DC, more attention must be paid to quality standards, in the generation of both individual studies and reviews

In Vitro Antioxidant and In Vivo Hepatoprotective Activity of Leave Extract of Raphanus Sativus in Rats Using CCL4 Model

Background: Raphanus sativus is reported to have a variety of biological activities. This work screened the hepato-protective and antioxidant activity of ethanol (ERS), and aqueous (ARS), extracts of leaves of Raphanus sativus in Carbon tetrachloride (CCl4), model in rats.Material and Methods: The extracts were subjected to antioxidant tests (Total reducing power and Total phenolic content), and preliminary phytochemical screening. A pilot study was done on 100 and 300 mg/kg extracts, form which 300 mg was chosen for further experiments. The albino rats (200-250 grams), were divided into 5 groups of 6 animals each (n=6). There were three control groups comprising of normal control (normal saline -1ml/kg), negative control group (CCl4 1ml/kg in olive oil in a ratio of 1:1 v/v), and positive control group (Silymarin 50mg/kg). The Test drugs were given in a dose of 300 mg/kg for both ERS and ARS extract for 7 days. Biochemical parameters (AST, ALT, Alkaline phosphatase, Total Bilirubin), histo-pathological examination of liver and in vivo antioxidant tests [CAT, GSH and MDA] were done.Results: The phytochemical study showed the presence of flavanoids, terpenoids, alkaloids, saponins and sterols. A dose dependent increase in the oxidative potential was observed in both the extracts with total phenolic content 70.1 and 44.4 GAE/g extract for ERS and ARS respectively. ERS 300mg/kg showed a significant (p<0.001) increase in levels of AST, ALT and alkaline phosphatase as compared to negative control (percentage hepatoprotection =45.3%) while ARS 300 mg/kg (p<.01) group showed 30% hepatoprotection. The GSH (p<0.001) and CAT (p<0.05) in ERS and ARS were significantly increased while MDA levels were decreased (P< 0.01), as compared negative control. The findings were confirmed histo-pathological examination.Conclusion: The ethanol and aqueous extract of Raphanus sativus have partial hepatoprotection against CCl4 toxicity.Key words: Raphanus sativus, hepatoprotection, CCl4, antioxidant

Effect of carbofuran on the diversity and mean abundance of ground spiders

The effect of carbofuran on the diversity, richness, evenness and abundance of ground spiders is documented in the present study. Two fields (control and treated) were selected in district Kasur during 2008 and 2009. Pitfall traps were used to collect ground spiders. A total of 1629 specimens of spiders, belonging to 8 families, 16 genera and 24 species were recoded from control field while 1173 specimens belonging to 8 families, 14 genera and 20 species were recorded from the treated field. The most dominant family and species in both the fields were Lycosidae and Lycosa terrestris, respectively. Family Lycosidae accounted more than 90% of the total spider sample. Diversity, richness and evenness of ground spiders in the treated and untreated field did not differ. However, the abundance of dominat spiders declined significantly in the carbofuran treated field. It is concluded that the use of carbofuran is a serious threat to the ground spiders, the important group of biological control agents. So, the use of carbofuran should be minimized in the fields.Key words: Ground spiders, carbofuran, natural predators, pest reduction

Genetics of drought tolerance at seedling and maturity stages in Zea mays L.

Shortage of irrigation water at critical growth stages of maize is limiting its production worldwide. Breeding drought-tolerant cultivars is one possible solution while identification of potential genotypes is crucial for genetic improvement. To assess genetic variation for seedling-stage drought tolerance, we tested 40 inbred lines in a completely randomized design under glasshouse conditions. From these, two contrasting inbred lines were used to develop six basic generations (P1, P2, F1, F2, BC1F1, BC2F2). These populations were then evaluated in a triplicated factorial randomized complete block design under non-stressed and drought-stressed conditions. For statistical analyses, a nested block design was employed to ignore the replication effects. Significant differences (p≤0.01) were recorded among the genotypes for investigated seedling-traits. Absolute values of fresh root length, fresh root weight, and dry root weight lead to select two genotypes, one tolerant (WFTMS) and one susceptible (Q66). Estimates of heritability, genetic advance, and genotypic correlation coefficients were higher and significant for most of the seedling-traits. Generation variance analysis revealed additive gene action. Narrow-sense heritability [F2 ≥ 65; F∞ ≥ 79] revealed the same results. Generation mean analysis signified additive genetic effects in the inheritance of cob girth, non-additive for plant height, grains per ear row and grain yield per plant, and environmental for ear leaf area, cob length, grain rows per ear, biomass per plant, and 100-grain weight under drought-stressed conditions. For conferring drought-tolerance in maize, breeders can adopt the recombinant breeding strategy to pyramid the desirable genes

Adoption of JMM practices – A key to performance improvement of a local automotive industry

It is imperative for a manufacturing company all over the world to constantly look for ways to increase productivity and at the same time to lower cost to secure a competitive position. It is recognized that practices associated with Japanese Manufacturing Management (JMM) can yield a superior competitive advantage in terms of productivity, quality and provide overall successful business performance. This paper discusses the transfer of the best practices of the JMM locally and analyses the impact of adoption and adaptation of the management system as an in-depth case study conducted in a Malaysian automotive company. This study is to identify what are the changes in terms of the philosophy and practices undertaken by the company and ascertain the impact of the JMM on its manufacturing and financial performances. The elements of business performance from the viewpoint of manufacturing are based on safety, Parts Per Million (PPM), in-line Defect per Unit (DPU), First Time Quality (FTQ), cycle time, productivity, efficiency and stock level. The results show a positive impact to the automotive plant manufacturing performance. For example, safety index has reduced to 0 major accident occurrences. The PPM and In-line DPU have improved by 98% and 91% respectively whereas the FTQ has improved by 167%. Cycle time has reduced from 20 to 6 minutes and productivity increased up to 43% whilst the efficiency reached at 99.9%. The stock level was reduced from half month to 3 days after the adoption of the JMM. The revenue has increased up to 92%, the percentage of expenses has reduced from 11.04% to 3.06% giving an improvement of 72% whilst the net profit has increased from 5.33% to 8.15%. The Return of Asset (RoA) and Return of Equity (RoE) also showed slight improvement despite the effects from the restructuring exercise, Tsunami calamity and fluctuation in Japanese exchange rate

Investigation of extraction yields of exfoliated graphene in deionized water from organic solvents

Organic solvent is suitable for the exfoliation of graphene. However, for the end application of exfoliated graphene it needs to extract and re-disperse to the required media. Extraction of exfoliated graphene from organic solvents to a polar solvent is a crucial challenge in graphene synthesis. The principal objective of this study is to examine the concentration yields of exfoliated graphene extraction and make a comparison of the estimated percentage concentrations of graphene in between organic solvents and deionized water (DW). Exfoliated graphene from the solvents N-Methyl-2-Pyrrolidone (NMP) and N, N-dimethylformamide (DMF) were taken. The extraction of exfoliated graphene was conducted by membrane filter using a vacuum filtration system. Concentration of exfoliated graphene solvents were estimated using Beer’s law by preparing separate standard graphs. It is seen that concentrations of exfoliated graphene in DW from both NMP and DMF solvents for all the centrifugation was reduced. These reductions were found to be varied from ~ 21 to 25.5%. Morphology analysis using TEM and FESEM images reveals that the few layers of graphene staked in the sonication assisted liquid phase exfoliated (LPE) graphene in both of NMP and DMF solvents. Very minor levels of aggregation occurred and very slight sedimentation appeared after centrifugation of 30 day

Sustainability of Scientific Journals in the Developing World With Special Reference to Bangladesh

The study explores sustainability of scientific journal publication in Bangladesh. Forty-three journal editors were interviewed, and 66 current journals were physically examined for production quality, regularity of publication, and availability at concerned libraries. Findings revealed that 68% of the journals were published late, 30% had inconsistencies in typesetting, and 14% were indexed. Most journals were found either excellent or of good quality in terms of printing (85%), binding (77%), paper (92%), and graphic reproduction (76%). Most journals were not available in major libraries under study. Of the 43 editors, 28 (35%) reported a cost recovery of 1-45% from subscriptions, advertisements, and sales. About 74.4% of the editors did not consider their journals at risk. Although 86% of the editors were confident that their journals would be sustained in the long run, 37.3% could not give any convincing logic in support of their statement. Major problems include lack of skilled staff, finance, quality articles and institutional support, and lengthy peer review process. Only one journal editor was found to be a full-time editor having training in editing and publication. One-half (51%) of the editors reported have training in editing, while four had publication training. Most editors (79%) were interested in acquiring training in editing and publication. Institutional support and backup, enthusiasm and zeal of editors, unmet need for standard local journals, constant flow of funds and articles, and skilled manpower are instrumental for sustainability of science journals in Bangladesh

COVID-19 & Pregnancy Complication During Early Pandemic: A Narrative Review

Background: Coronaviruses have caused 3 outbreaks in the past 2 decades. The novel one is SARS-COV-2, which causes COVID-19. Pregnant women have somewhat altered immune state, which may make them more vulnerable to COVID-19 and its complications. Extensive research is needed to better understand the clinical course of COVID-19 in this population. Objective: This review article discusses the comparison of previous coronaviruses’ outbreaks, clinical presentations, and complications in pregnant women and newborns. Study Design: We conducted literature search for case series and case reports about pregnancy outcomes in pregnant women with COVID-19 during the early phase of pandemic. Results: In case series, 37 of 129(28.6%) pregnant women with COVID-19 disease had preterm delivery and 14 of 67 pregnant women had fetal distress. The rate of preterm labor in normal pregnant women who are healthy and not infected with any virus worldwide is approximately 11%. Conclusion: Based on the articles reviewed, preterm delivery appears to be the most common complication in COVID-19 pregnant patients. Other complications include fetal distress, stillbirth, ICU admission and severe disease leading to fetal demise and maternal mortality. Pregnancy outcomes seem to be better with Covid-19 compared to SARs and MERS. However, most of these publications are from the early part of the pandemic when protocols for care for pregnant women were being worked out and comprehensive knowledge of the disease process in pregnant women was still in developing stage

Risk factors for multidrug-resistant tuberculosis in urban Pakistan: A multicenter case-control study

Objective: To evaluate risk factors for multidrug-resistant tuberculosis (MDR-TB) in an urban setting of Pakistan.DESIGN AND Methods: In this multicenter case-control study, patients aged 15years old or older with sputum culture and sensitivity (C/S) diagnosed with pulmonary MDR-TB were defined as cases, whereas patients aged 15years old or older with sputum C/S diagnosed and susceptible to pulmonary TB were regarded as controls. Fifty cases and 75 controls were enrolled from three tertiary-care hospitals in Karachi.Results: Multivariable logistic regression models showed that cases were more likely to have had a TB patient in the house prior to the diagnosis of MDR-TB (adjusted odds ratio [ORadj]=3.1, 95% confidence interval [CI]: 1.2, 8.3) or had a history of prior TB treatment (ORadj=4.2, 95% CI: 1.1, 15.4). Furthermore, cases compared with controls tended to be male (ORadj=3.6, 95% CI: 1.4, 9.7), 15-25years of age (ORadj=3.7, 95% CI: 1.2, 11.3), of Sindhi ethnicity (adjusted OR=9.1, 95% CI: 1.9, 43.4) or with low educational attainment (ORadj OR=5.5, 95% CI: 1.7-17.6, for no formal schooling; ORadj=3.8, 95% CI: 1.1-14.1, 1 for 1-5 school years).CONCLUSIONS: A TB patient in the house or a history of prior TB treatment was strongly associated with MDR-TB in this study. Furthermore, younger age, male gender, Sindhi ethnicity and poor educational attainment entailed a high risk for MDR-TB. Targeted educational intervention for patients and their contacts may minimize the noncompliance with prescribed TB treatment and lessen MDR-TB magnitude in settings like Karachi