Expected Values of Molecular Descriptors in Random Polyphenyl Chains

A chemical graph is a model used to indicate a chemical combination. In a molecular graph, vertices define atoms, and edges are represented as chemical bonds. A topological index is a single number to characterize the graph of a molecule. In this article, we study the topological properties of some special chains. The polyphenyl chains with hexagons are graphs of aromatic organic compounds. The key purpose of this article is to explore the expected value of Sombor, reduced Sombor, and average Sombor index for this category of organic compounds. It was investigated that the Sombor, reduced Sombor and average Sombor index revealed adequate discriminative potential of alkanes. It has been tested that these indicators can be used effectively in modeling chemical thermodynamic structures. The average value of the Sombor, reduced Sombor, and average Sombor index for the set of all spiro and random polyphenyl chains has been determined. Finally, the ratio between the expected values of these mentioned indices for both random chains has been resolved. Doi: 10.28991/ESJ-2022-06-01-012 Full Text: PD

Negative predictive value of ultrasound in predicting tumor-free margins in specimen sonography

OBJECTIVE: To evaluate the success of ultrasound in post-excision specimen visualization, and negative predictive value of ultrasound for estimation of tumor-free margins using histopathology as the gold standard. STUDY DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi, Pakistan, from May 2010 till January 2013. METHODOLOGY: Sonography of all breast nodules was done before and after exicision by two female radiologists with at least five years clinical experience. All surgeries were performed by the same referring breast surgeons. All nodules were non-palpable and had histopathology as well as specimen sonography performed at AKUH. Subjects were excluded, if histopathology was not available, post-procedure sonogram not done or done in another hospital and nodules that were not seen on ultrasound. After needle localization in 47 patients using ultrasound and in 7 patients using mammogram was done, sonogram was conducted in all 54 lesions. These were then assessed by ultrasound for detection of lesion and tumor-free margins in malignant lesion. Post-excision ultrasound was performed for the evaluation of lesion whether visualized or absent with localizing needle in situ, lesion dimensions, depth measurement between the superior margin of the lesion and its edge. RESULTS: All 54 lesions were present on post-exicison scan, out of which 28 were documented as malignant and 26 as benign. Ultrasound declared all specimens as tumor-free. On histopathology, two lesions were documented as having tumor-positive margins and were proven to be invasive lobular carcinoma. Therefore, the negative predictive value of the specimen sonography for margin detection was 26/28 (92.8%). CONCLUSION: Ultrasound of the excised breast tumor specimen is a simple and reliable technique for confirmation of the tumor-free margins in non-palpable breast lesions

Surgically resected gall bladder: Is histopathology needed for all?

Background. Laparoscopic cholecystectomy is considered to be gold standard for symptomatic gall stones. As a routine every specimen is sent for histopathological examination postoperatively. Incidentally finding gall bladder cancers in those specimens is around 0.5–1.1%. The aim of this study is to identify those preoperative and intraoperative factors in patients with incidental gall bladder cancer to reduce unnecessary work load on pathologist and cost of investigation particularly in a developing world. Methods. Retrospective records were analyzed from January 2005 to February 2015 in a surgical unit. Demographic data, preoperative imaging, peroperative findings, macroscopic appearance, and histopathological findings were noted. Gall bladder wall was considered to be thickened if ≥3 mm on preoperative imaging or surgeons comment (on operative findings) and histopathology report. AJCC TNM system was used to stage gall bladder cancer. Results. 973 patients underwent cholecystectomy for symptomatic gallstone disease. Gallbladder carcinoma was incidentally found in 11 cases. Macroscopic abnormalities of the gallbladder were found in all those 11 patients. In patients with a macroscopically normal gallbladder, there were no cases of gallbladder carcinoma. Conclusion. Preoperative and operative findings play a pivotal role in determining incidental chances of gall bladder malignancy

Trail without catheter after transurethral resection of prostate: clamp It or not?

Abstract Background. There has been argument between clinical practitioners about clamping catheter or not prior to its removal after transurethral resection of prostate (TURP). We conducted a clinical trial to assess whether clamping has any role in early bladder tone recovery particularly in patients who undergo TURP. Methods. Randomized clinical trial was conducted at a tertiary care hospital, Karachi from January 2014 to July 2015. Eighty-six study participants who underwent TURP were randomly allocated into two groups of 43 participants each. In Group I, patient\u27s Foley catheter was not clamped prior to its removal and in Group II Foley catheter was clamped. Data of all subjects were analyzed using SPSS version 20. Results. There was no significant difference in age and weight of resected tissues between two groups. Among 4 patients in Group I who required recatheterization, 1 patient was discharged with catheter as compared to Group II in which 2 patients were discharged with catheter (P = 0.99). Only 1 patient (2.3%) in Group II had bleeding which required recatheterization. Length of stay was significantly affected by early and free removal of Foley catheter (P \u3c 0.001). Conclusion. The results of current study identified that clamping whether done or not had no significant impact on urinary retention

Burden of mental disorders by gender in Pakistan: analysis of Global Burden of Disease Study data for 1990–2019

Aims and method We aimed to examine the burden of mental disorders in Pakistan over the past three decades. We used the crude data of disability-adjusted life-years (DALYs) obtained from the Global Burden of Disease Study database (1990–2019) to represent burden. Data were retrieved on 26 January 2021. Data for adults of reproductive age (aged 15–49 years) were analysed to discuss and interpret the disease burden. An analysis was conducted on total DALYs separately for the genders for ten mental disorders reported in Pakistan. Results DALYs increased drastically with the onset of reproductive age. Depressive disorder was the most reported mental disorder, contributing 3.13% (95% CI 2.25–4.24) of total DALYs, and varied significantly between genders: females 3.89% (95% CI 2.73–5.29) versus males 2.37% (95% CI 1.62–3.25). Clinical implications A nationwide high-quality epidemiological surveillance system should be implemented to monitor mental disorders and offer culturally appropriate preventive services

Burden of mental disorders by gender in Pakistan: analysis of Global Burden of Disease Study data for 1990–2019

Aims and method We aimed to examine the burden of mental disorders in Pakistan over the past three decades. We used the crude data of disability-adjusted life-years (DALYs) obtained from the Global Burden of Disease Study database (1990–2019) to represent burden. Data were retrieved on 26 January 2021. Data for adults of reproductive age (aged 15–49 years) were analysed to discuss and interpret the disease burden. An analysis was conducted on total DALYs separately for the genders for ten mental disorders reported in Pakistan. Results DALYs increased drastically with the onset of reproductive age. Depressive disorder was the most reported mental disorder, contributing 3.13% (95% CI 2.25–4.24) of total DALYs, and varied significantly between genders: females 3.89% (95% CI 2.73–5.29) versus males 2.37% (95% CI 1.62–3.25). Clinical implications A nationwide high-quality epidemiological surveillance system should be implemented to monitor mental disorders and offer culturally appropriate preventive services

A Multicenter, Randomized, Placebo‐Controlled Trial of Atorvastatin for the Primary Prevention of Cardiovascular Events in Patients With Rheumatoid Arthritis

Objective: Rheumatoid arthritis (RA) is associated with increased cardiovascular event (CVE) risk. The impact of statins in RA is not established. We assessed whether atorvastatin is superior to placebo for the primary prevention of CVEs in RA patients. Methods: A randomized, double‐blind, placebo‐controlled trial was designed to detect a 32% CVE risk reduction based on an estimated 1.6% per annum event rate with 80% power at P 50 years or with a disease duration of >10 years who did not have clinical atherosclerosis, diabetes, or myopathy received atorvastatin 40 mg daily or matching placebo. The primary end point was a composite of cardiovascular death, myocardial infarction, stroke, transient ischemic attack, or any arterial revascularization. Secondary and tertiary end points included plasma lipids and safety. Results: A total of 3,002 patients (mean age 61 years; 74% female) were followed up for a median of 2.51 years (interquartile range [IQR] 1.90, 3.49 years) (7,827 patient‐years). The study was terminated early due to a lower than expected event rate (0.70% per annum). Of the 1,504 patients receiving atorvastatin, 24 (1.6%) experienced a primary end point, compared with 36 (2.4%) of the 1,498 receiving placebo (hazard ratio [HR] 0.66 [95% confidence interval (95% CI) 0.39, 1.11]; P = 0.115 and adjusted HR 0.60 [95% CI 0.32, 1.15]; P = 0.127). At trial end, patients receiving atorvastatin had a mean ± SD low‐density lipoprotein (LDL) cholesterol level 0.77 ± 0.04 mmoles/liter lower than those receiving placebo (P < 0.0001). C‐reactive protein level was also significantly lower in the atorvastatin group than the placebo group (median 2.59 mg/liter [IQR 0.94, 6.08] versus 3.60 mg/liter [IQR 1.47, 7.49]; P < 0.0001). CVE risk reduction per mmole/liter reduction in LDL cholesterol was 42% (95% CI −14%, 70%). The rates of adverse events in the atorvastatin group (n = 298 [19.8%]) and placebo group (n = 292 [19.5%]) were similar. Conclusion: Atorvastatin 40 mg daily is safe and results in a significantly greater reduction of LDL cholesterol level than placebo in patients with RA. The 34% CVE risk reduction is consistent with the Cholesterol Treatment Trialists’ Collaboration meta‐analysis of statin effects in other populations

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

Antioxidant Potential, DNA Protection, and HPLC-DAD Analysis of Neglected Medicinal Jurinea dolomiaea Roots

Jurinea dolomiaea Boiss., family Compositae, is a medicinally important plant of alpine region. Its tuberous roots are used in various ailments in folk medicine. This study was undertaken to estimate total phenolic (TPC) and total flavonoid contents (TFC) and to determine anti-free radical potential by diverse in vitro antioxidant assays. Crude methanol extract (JDME) was fractionated into n-hexane (JDHE), chloroform (JDCE), ethyl acetate (JDEE), n-butanol (JDBE), and aqueous (JDAE) fractions. The results indicated that JDEE and JDCE constituted the highest amount of TFC (807±7.2 mg rutin equivalent/g sample) and TPC (757±9.4 mg gallic acid equivalent/g sample), respectively. Significant correlation of TFC with IC50 values was recorded for •OH (R2=0.91), H2O2 (R2=0.82), and ABTS (R2=0.82) assay. It could be made clear that JDEE was the most potent in antioxidant activity as compared to others, with generally lower IC50 values for DPPH (41.1±1.0 μg/mL), ABTS (46.7±0.6 μg/mL), H2O2 (42.2±0.9 μg/mL), •OH (61.1±1.1 μg/mL), O2- (152±1.1 μg/mL), and antilipid peroxidation (54.3±1.6 μg/mL). HPLC chromatogram of JDEE revealed the presence of catechin, caffeic acid, and rutin. The results indicated the antioxidant activities of J. dolomiaea roots and merit further investigations for their use in oxidative stress related disorders

The evaluation of personality of epileptic patients by using Cloninger's Temperament and Character Inventory

Objective: There is little research evaluating the personality of epileptic patients dimensionally in the literature. In this study we aimed to evaluate the personality traits of epileptic patients and compare them healthy controls by using Cloninger's Temperament and Character Inventory (TCI). Methods: Seventy-eight consecutive epileptic outpatients and 85 healthy controls were included. Both groups were given TCI after evaluation by SCID I, SCID II and HAM-D. The data were analyzed with regard the group differences with t test (parametric condition) or Mann-Whitney U tests by using computer program. Results: The epileptic group were found significantly different (p<0.005) regarding TCI parameters; shyness, harm avoidance, persistence, self-forgetfulness, transpersonal identification, spiritual acceptance and self-transcendence. Accordingly, epileptic patients can be defined as pessimistic, fearful, shy, fatigable, lazy, underachiever, pragmatist, unimaginative, controlling, materialistic and possessive individuals compared to the control group. 23% of the epileptic group has had at least one DSM Axis I disorder. The most common diagnose was depression (n=10, 56%). Detected 37% (n=29) DSM-IV Axis II diagnosis of which 59% (n=17) consisted of cluster C personality disorders within the same group. Discussion: Our results showed that epileptic patients were differentiated with regard the TCI parameters compared to the healthy controls. Our results indicate that epileptics are more fearful, impersistent (easily discouraged) and concrete (lower in ST, less insightful and intuitive). To find out causal relationship between these differentiation and epilepsy, follow up studies in a larger sample are needed. (Anatolian Journal of Psychiatry 2011; 12:13-23