Fingolimod plays role in attenuation of myocardial injury related to experimental model of cardiac arrest and extracorporeal life support resuscitation

Background: Sudden cardiac arrest is a major global health concern, and survival of patients with ischemia-reperfusion injury is a leading cause of myocardial dysfunction. The mechanism of this phenomenon is not well understood because of the complex pathophysiological nature of the disease. Aim of the study was to investigate the cardioprotective role of fingolimod in an in vivo model of cardiac arrest and resuscitation.Methods: In this study, an in vivo rat model of cardiac arrest using extracorporeal membrane oxygenation resuscitation monitored by invasive hemodynamic measurement was developed. At the beginning of extracorporeal life support (ECLS), animals were randomly treated with fingolimod (Group A, n = 30) or saline (Group B, n = 30). Half of the animals in each group (Group A1 and B1, n = 15 each) were sacrificed after 1 h, and the remaining animals (Group A2 and B2) after 24 h of reperfusion. Blood and myocardial tissues were collected for analysis of cardiac features, inflammatory biomarkers, and cell signaling pathways.Results: Treatment with fingolimod resulted in activation of survival pathways resulting into reduced inflammation, myocardial oxidative stress and apoptosis of cardiomyocytes. This led to significant improvement in systolic and diastolic functions of the left ventricle and improved contractility index.Conclusions: Sphingosine1phosphate receptor activation with fingolimod improved cardiac function after cardiac arrest supported with ECLS. Present study findings strongly support a cardioprotective role of fingolimod through sphingosine-1-phosphate receptor activation during reperfusion after circulatory arrest

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Lung function in Pakistani wood workers

The lung function impairment is the most common respiratory problem in industrial plants and their vicinity. Therefore, the purpose was to study the affects of wood dust and its duration of exposure on lung function. This was a matched cross-sectional study of Spirometry in 46 non-smoking wood workers with age range 20 – 60 years, who worked without the benefit of wood dust control ventilation or respiratory protective devices. Pulmonary function test was performed by using an electronic Spirometer. Significant reduction was observed in the mean values of Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), and Maximum Voluntary Ventilation (MVV) in wood workers relative to their matched controls. This impairment was increased with the duration of exposure to wood industries. It is concluded that lung function in wood workers is impaired and stratification of results shows a dose-response effect of years of wood dust exposure on lung function

Effects of duration of exposure to wood dust on peak expiratory flow rate among workers in small scale wood industries

Abstract Objectives: Occupational and environmental lung diseases are one of major problems of clinical medicine. Several occupations are associated with adverse health effects, and the lung is one of the parts of the body most vulnerable to airborne hazards. Exposure to gas, fume, and dust can lead to occupational lung diseases. The objective of the study was to assess the effects of wood dust and the duration of exposure on peak expiratory flow rate (PEFR) and additionally, to minimize possible health risks for wood workers by providing them with information about wood dust related hazards. Methods: The present study was conducted under the supervision of the Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia during the year 2002. It was designed as a matched case-control cross-sectional study of spirometry in forty six non-smoking wood workers, aged 20-60 years, who worked without the benefit of wood dust control ventilation or respiratory protective devices. PEFR measurements were performed using an electronic spirometer. Results: The present study results demonstrated that in wood workers exposed for longer periods than 8 years, PEFR was significantly reduced as compared with their matched controls. Conclusion: Based on the results of the present study, we conclude that PEFR in wood workers is impaired and the stratification of results shows a doseresponse effect of years of wood dust exposure on its value

Art. 1.1475/ringraziamenti

Abstract. -OBJECTIVE: In Ramadan, Muslim adults fast from sunrise to sunset for a period of a month. Due to paucity of data it seems that, diabetes mellitus during Ramadan is underestimated and the statistics are not a reflection of the actual reality. The aim this study is to highlight the staggering demographics in the diabetic Muslim population and emphasize its ramifications on fasting during Ramadan. METHODS: In this study, we identified 37 published studies through a systematic database searches including ISI-Web of Science and PubMed. We searched the related literature by using the key words Diabetes Mellitus, Ramadan Fasting, Ramadan Fasting complications. Studies in which Diabetes Mellitus, Ramadan Fasting was discussed were included in the study. No limitations on publication status, study design or language of publication were obligatory. Finally we included 19 publications and remaining 18 were excluded. RESULTS: Today's emerging diabetes hotspots in Muslim majority countries are the Middle East, Western Pacific, Sub-Saharan Africa and SouthEast Asia. Poverty, lack of education, poor healthcare, minimum available data and inappropriate guidance for the diabetic patients are the major risk factors resulting in serious complication during fasting in the month of Ramadan. CONCLUSIONS: Still there are big gaps in the management of diabetic patients during Ramadan, the care of diabetic patients is fragmented and it is felt that diabetes during Ramadan is underestimated, under-investigated and needs more attention. It is vital to empower the healthcare workers and the patients in the frontlines with the appropriate information about Ramadan fasting in diabetic patients. Diabetic patients who fast during Ramadan should be adequately investigated and engaged in a structured Ramadan-focused diabetes education to undertake the fast safely

Impact of unstable environment on the brain drain of highly skilled professionals, healthcare workers, researchers, and research productivity in Pakistan

Background: The geo-strategic position of Pakistan on the world map is incredibly important and idyllic as the country is considered the gateway to central Asia. Pakistan has faced political instability for the last three decades, causing a brain drain and adversely affecting socioeconomic growth. This study aims to investigate the impact of an unstable environment on the brain drain of highly skilled professionals, healthcare workers, researchers, and research productivity in Pakistan from January 2000 to December 2022. Material and Methods: The data were recorded from the World Bank, the Higher Education Commission (HEC) Pakistan, the Pakistan Medical and Dental Council (PMDC), the Bureau of Emigration and Overseas Employment (BEOS), Pakistan, Academic Ranking of World Universities (ARWU), and Web of Science Clarivate Analytics. Initially, 32 documents were selected in this study, and finally, eight fact sheets, official government websites, and international organizations were included. Results: The result revealed that due to political instability, in 2022 about 832,339 highly qualified and accomplished experts headed abroad, among them 17976 (2.15%) were highly qualified and 20865 (2.50%) were highly competent professionals. These include accountants 7197 (0.86%), engineers 6,093 (0.73%), agricultural experts 3,110 (0.37%), doctors 2,464 (0.29%), computer experts 2,147 (0.25%), nurses and paramedics 1768 (0.21%), technicians 23347 (2.80%), electricians 20322 (2.44%), and schools and university faculty 1004 (0.12%). Pakistan has a total of 380 Higher Education Commission-indexed academic journals, among them 11 (2.89%) academic journals were indexed in the Web of Science and 23 journals were placed in the Web of Science emerging indexing. Among these journals, only one journal surpassed the impact factor of more than 2.0. The quartile ranking of Pakistani journals is 01 journal in Q2; 02 in Q3; and the remaining 08 journals in Q4. From August 1947 to December 2022, Pakistan produced a total of 259249 research articles, and from January 2000 to December 2022, the number of articles published was 248457 (95.83%). Since the last 22 years, the trend of research publications was continuously increased; however, the rising trend decreased in 2022 with a declined rate of 1263 (3.42%). Conclusion: The unstable sociopolitical environment in Pakistan caused a brain drain of highly qualified and skilled professionals and impaired the global standing of universities, academic journals, and research productivity in Pakistan. Pakistan must resolve the instability and establish sustainable policies to minimize the brain drain of highly qualified and skilled experts and convalesce their academic institutes and their research productivity for the development of the nation

Turnitin: Is it a text matching or plagiarism detection tool?

The institutional integrity constitutes the bases of scientific activity. The frequent incidences of similarity, plagiarism, and retraction cases created the space for frequent use of similarity and plagiarism detecting tools. Turnitin is software that identifies the matched material by checking the electronically submitted documents against its database of academic publications, internet, and previously submitted documents. Turnitin provides a “similarity index,” which does not mean plagiarism. The prevalence of plagiarism could not reduce tremendously in the presence of many paid and un-paid plagiarism detecting tools because of the assortment of reasons such as poor research and citation skills, language problems, underdeveloped academic skills, etc., This paper may provide an adequate feedback to the students, researchers, and faculty members in understanding the difference between similarity index and plagiarism

Pathophysiology of a scientific paper

Scientific paper writing for science journals is highly adroit, competitive, and laborious process. Scientific writing has a constant design, which is confounding for apprentice science writers. The huge amount of impediments is associated with scientific writing which may be reduced by applying some practices and guidelines. The basic structure of scientific articles mainly comprises of the title, abstract, keywords, introduction, methods, results, discussion, conclusion, acknowledgments, and references. The pathophysiological aspects which minimize the chances of publication of an academic paper are rarely discussed in the literature. Early career of physicians and researchers is not well acquainted with the components of scientific paper. This study established an approach to understand the basic characteristics of pathophysiology of scientific writing