Dopaminergic agents: back to the basics – a small review

Parkinson’s disease is one of the most common neurodegenerative diseases. The motor system is eventually damaged which affects the voluntary movements in a patient. It leads to the death of vital nerve cells in the brain. Women have lesser prevalence due to the hormone called Estrogen which has been playing a significant role in human body. Most of the treatments focus on the balance of Dopamine in the brain which is done with the help of levodopa but the side effects seen in the patients were mild nausea, loss of appetite, heart burn, diarrhea, and many more.  The cause of the disease is still unknown but its occurrence is mainly because of genetic and environmental factors. This review focuses on the combination therapy of levodopa and Carbidopa to treat the symptoms of Parkinson’s disease

Novel drug delivery system: a promising approach in management of schizophrenia – a review

Schizophrenia is a syndromic condition which is characterized by a set of signs and symptoms like delusions. It is severe non-curable illness of the brain. If not controlled and treated properly, it can lead to severe consequences. One can control these delusions by means of treatment, by using Conventional therapy or Novel therapy. There are various advantages of Novel system over Conventional system. This review focuses on understanding Novel system and its advantages over Conventional system

Assessing retention and motivation of public health-care providers (particularly female providers) in rural Pakistan

The main objectives of this project in Pakistan were to explore the core issue of availability of health providers, especially female providers who are required for provision of maternal and neonatal healthcare, and to determine the range of factors that either constrain or motivate providers to serve in key positions in public facilities in rural areas. The study, conducted by the Population Council with funding from the Maternal and Newborn Health Programme ‐ Research and Advocacy Fund, identifies a number of problems faced by healthcare providers working in the public healthcare system in Pakistan and makes the following recommendations for consideration by policymakers: 1) ensure implementation of a “Human Resource for Health Management” system; 2) enforce strict adherence to organizational policies on recruitment, transfer, and promotion; 3) improve the physical work environment and ensure the availability of equipment, medicine, and supplies; and 4) put in place a national private practice regulation policy

Outer Surface Protein C Typing of Borrelia burgdorferi in the Tick Populations of the Upper Susquehanna River Basin, New York

Lyme disease, the most common zoonotic disease in the United States, is caused by the spirochete Borrelia burgdorferi. In order to manage and confront the notable rise in Lyme disease cases, it is crucial to cultivate a deeper understanding of B. burgdorferi and its genes. The outer surface protein C (ospC) gene is highly polymorphic and commonly used as a genetic marker due to its crucial role in establishing mammalian infection. We report novel data on the prevalence of B. burgdorferi ospC genotypes in the infected tick populations of the Upper Susquehanna River Basin of New York State. DNA extracted from 266 Ixodes scapularis, the blacklegged ticks, were tested for the presence of ospC gene and the positive samples were subjected to sequencing. The specific ospC genotype was identified for 56 positive samples which were infected with B. burgdorferi representing a single ospC genotype. A total of 12 ospC genotypes were identified in the 56 ticks, with genotypes I, K, and A being the most prevalent across the Upper Susquehanna River Basin with little variation among the six counties. The frequency distribution of ospC variants in this region is significantly different from the few previously studied regions in the Northeast. This research will have implications in the public health sector by providing assessment for Lyme disease risk in the Upper Susquehanna River Basin and insight into strain specific vaccines based on OspC. Further research can be done into the dispersion pattern of B. burgdorferi within the Upper Susquehanna River Basin, while also replicating this study for other regions

Performance Analysis in Vitro Method of Antimicrobial Activity in Different Commercial Antibiotics

This study was motivated by the fact that certain food poisonings and harmful microorganisms in ethanol and water determine roselle (Hibiscus sabdariffa), rosemary (Rosmarinus officinalis), clove (Syzygium aromaticum), and thyme (Thymus vulgaris). is to exhibit the capacity to eliminate Least inhibitory focuses (MICs) of different plant extricates against Gram-positive microorganisms (Bacillus cereus, Staphylococcus aureus), Gram-negative microscopic organisms (Escherichia coli, Enteritidis, Vibrio parahaemolyticus, Pseudomonas aeruginosa) and parasites (Candida albicans) and antibacterial impacts were explored. It is dissolved and measured using the agar well dispersion technique. The concentrate showed antimicrobial efficacy against the microorganisms and yeast used in the tests. Both pHint reduction and cell layer hyperpolarization indicated that the plant extract had a profound effect on the membranes of Gram-positive and Gram-negative microorganisms. Overall, plant extracts have significant potential as unique regular food additives due to their antibacterial properties

FORMULATION AND EVALUATION OF NANOEMULSION FOR TOPICAL APPLICATION

The aim of present research is to design and develop nanoemulsion of Econazole nitrate as effective treatment for tinea versicolor fungal disease. Econazole nitrate is an imidazole antifungal agent with broad spectrum activity. It belongs to BCS class II i.e. low soluble and highly permeable drug. Due to its poor solubility, it is incompletely absorbed after oral dosing and bioavailability varies among individuals. The drug efficacy of topical formulation can be limited by instability due to its poor solubility in the vehicle and low permeability. Therefore, to overcome these problems nanoemulsions have been designed. Topical nanoemulsion containing 1 % Econazole nitrate with different oils (oleic acid), surfactant (tween 20), co-surfactant (PEG 200, PEG 400) and distilled water. Various oil-in-water nanoemulsions are prepared by the spontaneous emulsification method. The nanoemulsion formulations that passed thermodynamic stability tests were characterized for appearance, pH, FTIR, viscosity, drug content, % drug entrapment efficiency and in-vitro drug release study of Econazole nitrate determined by Franz diffusion cell and stability study

Role of imaging in the management of thyroglossal duct cyst carcinomas (TGC-TIRADS): a single centre retrospective study over 16 years

IntroductionThyroglossal duct cyst (TGDC) is the most frequently encountered developmental anomaly in thyroid genesis with a reported incidence of 7% in the adult population. The cyst is known to develop anywhere along the pathway of thyroid descent but is more frequently seen in the infrahyoid neck in the midline. The incidence of malignancy in a TGDC is approximately 1%; a majority of these are papillary carcinomas. This study was conducted at a single tertiary care centre which spanned over a decade which adds practice changing evidence-based knowledge to existing literature on this rare entity. A comprehensive study which conclusively establishes the imaging features predictive of malignancy in TGDC carcinomas (TGDCa), the protocol for optimal management, clinical outcome and long-term survival of these patients is not available. Although TGDC carcinoma is thought to have an excellent prognosis, there is not enough data available on the long-term survival of these patients. The aim of this study was to identify whether neck ultrasound (US) can serve as an accurate imaging tool for the preoperative diagnosis of TGDC carcinomas.MethodsWe accessed the electronic medical records of 86 patients with TGDC between January 2005 to December 2021. Of these, 22 patients were detected with TGDC papillary carcinoma on histopathologic examination. Relevant imaging, treatment and follow up information for all cases of TGDC carcinoma were retrospectively reviewed. We compared US characteristics predictive of malignancy across outcomes groups; malignant vs benign using the Chi-square test. Based on the results, a TGC-TIRADS classification was proposed with calculation of the percentage likelihood of malignancy for each category.ResultsCompared to benign TGDCs, malignant TGDCs were more likely to present with following US characteristics: irregular or lobulated margins (90.40 vs. 38.10%), solid-cystic composition (61.90 vs. 17.07%), internal vascularity (47.62 vs. 4.88 %), internal calcification (76.19 vs. 7.32 %) (each p value < 0.005). Calcifications and internal vascularity were the most specific while irregular/lobulated margins were the most sensitive feature for malignancy. AUC under the ROC curve was 0.88. Allpatients were operated and were disease free at the end of 5 years or till the recent follow up.DiscussionUS is the imaging modality of choice for pre-operative diagnosis of TGDC carcinoma. Thepre-operative diagnosis and risk stratification of thyroglossal lesions will be aided by the application of the proposed TGC-TIRADS classification, for which the percentage likelihood of malignancy correlated well with the results in our study. Sistrunk procedure is adequate for isolated TGDC carcinoma; suspicious neck nodes on imaging also necessitates selective nodal dissection. Papillary carcinomas have an excellent prognosis with low incidence of disease recurrence

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Estimating global injuries morbidity and mortality : methods and data used in the Global Burden of Disease 2017 study

Background While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.Peer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries