ADVERSE DRUG REACTION REPORTS IN MALAYSIA: COMPARISON OF CAUSALITY ASSESSMENTS

Causality assessment of reported adverse drug reactions (ADR) is an important component o

Efficacy and Safety of Methotrexate in Articular and Cutaneous Manifestations of systemic Lupus Erythematosus

Aim:  A prospective open-label study comparing the efficacy and safety of methotrexate (MTX) and chloroquine (CQ) in articular and cutaneous manifestations of systemic lupus erythematosus (SLE). Methods:  Consecutive SLE patients were randomly assigned to either 10 mg MTX weekly or 150 mg CQ daily during 24 weeks. Outcome measures were: numbers of swollen and tender joints, duration of morning stiffness, visual analog scale (VAS) for articular pain, physician global assessment index, patient global assessment index, SLE Disease Activity Index (SLEDAI), disappearance of skin rash and erythrocyte sedimentation rate (ESR). Results:  Forty-one patients consented to participate, 15 were allocated in the MTX group and 26 in the CQ group. Two patients on MTX dropped out due to side-effects and two in the CQ group, one due to side-effects and one due to inefficacy. Baseline demographic, clinical and laboratory parameters of the two groups were nearly identical. In both groups the clinical and laboratory parameters improved significantly over 24 weeks, except the ESR in the MTX group. The results of the outcome measures at the end of the trial did not differ significantly between the two groups, except morning stiffness (P < 0.05 in favor of the MTX group) and ESR (P < 0.01 in favor of the CQ group). Rise of serum alanine aminotransferase was observed in two cases in the MTX group and in none in the CQ group. Conclusion:  Low-dose MTX appears to be as effective as CQ in patients with articular and cutaneous manifestations of SLE, having an acceptable toxicity profile. Results of this prospective study need to be confirmed in a larger study

Cross-cultural adaptation and validation of a Bengali version of the modified fibromyalgia impact questionnaire

Background Currently, no validated instruments are available to measure the health status of Bangladeshi patients with fibromyalgia (FM). The aims of this study were to cross-culturally adapt the modified Fibromyalgia Impact Questionnaire (FIQ) into Bengali (B-FIQ) and to test its validity and reliability in Bangladeshi patients with FM. Methods The FIQ was translated following cross-cultural adaptation guidelines and pretested in 30 female patients with FM. Next, the adapted B-FIQ was physician-administered to 102 consecutive female FM patients together with the Health Assessment Questionnaire (HAQ), selected subscales of the SF-36, and visual analog scales for current clinical symptoms. A tender point count (TPC) was performed by an experienced rheumatologist. Forty randomly selected patients completed the B-FIQ again after 7 days. Two control groups of 50 healthy people and 50 rheumatoid arthritis (RA) patients also completed the B-FIQ. Results For the final B-FIQ, five physical function sub-items were replaced with culturally appropriate equivalents. Internal consistency was adequate for both the 11-item physical function subscale (α = 0.73) and the total scale (α = 0.83). With exception of the physical function subscale, expected correlations were generally observed between the B-FIQ items and selected subscales of the SF-36, HAQ, clinical symptoms, and TPC. The B-FIQ was able to discriminate between FM patients and healthy controls and between FM patients and RA patients. Test-retest reliability was adequate for the physical function subscale (r = 0.86) and individual items (r = 0.73-0.86), except anxiety (r = 0.27) and morning tiredness (r = 0.64). Conclusion This study supports the reliability and validity of the B-FIQ as a measure of functional disability and health status in Bangladeshi women with F

Screening for Ascochyta Blight Resistance in Chickpea (Cicer arietinum L.)

Ten chickpea lines CM1966/93, CMC77S, CM843/98, CM1223/98, CM1441/98, CM2070/98, CC 104/99, CC106/99, CC124/00 were found highly resistant to Ascochyta blight with disease rating of 2 followed by 34 lines that were resistant and 21 lines were tolerant. None was found immune to blight. The highly resistant lines have exhibited higher level of resistance against blight as compared to earlier released varieties (CM72, CM88 and CM2000)

Carotid artery Disease Assessed by Color Doppler Flow Imaging: Comparison Between Diabetic and Non-Diabetic Patients

Background: Carotid artery disease is most often seen in hypertensive patients and in patients with diabetes mellitus. More than 50% stenosis of extra cranial internal carotid arteries is linked with about 8–15% of ischemic strokes. The incidence of carotid artery stenosis (CAS) among diabetic patients is rising as compared to non-diabetic patients.  Methods: A cross-sectional study was performed on 120 patients, out of whom 60 were diabetic and 60 non-diabetics with clinically suspected carotid artery disease.  The study was conducted at the university ultrasound clinic in Green Town by Doppler ultrasonography using the Toshiba XARIO XG, which features a linear probe of 5-7.5 MHz frequency. The data was analyzed with the help of SPSS version 25.0. Variables like age, gender, diabetes, and Intima-media thickness (IMT) were reported and the mean ± standard deviation of Pulsatility Index, Resistive Index, Peak Systolic Velocity, and End Diastolic Velocity were calculated with a significant p-value, which is less than 0.05. An independent t-test was applied to compare Doppler indices in diabetic and non-diabetic subjects.Results: Data was collected from 120 patients. IMT of right and left carotid artery, PI and RI of right carotid were observed to be statistically significant in diabetic and non-diabetic.Conclusions: This study concluded that there is a significant correlation found between carotid artery disease and diabetes. Through ultrasonography, the presence of plaque and stenosis was found in more diabetic patients than in non-diabetic patients.Keywords: Ultrasonography; Carotid artery disease; Carotid artery stenosis; Carotid plaque; Vascular ultrasound; Diabetes   

Screening for Ascochyta blight resistance in chickpea (Cicer arietinum L.)

Ten chickpea lines CM1966/93, CMC77S, CM843/98, CM1223/98, CM1441/98, CM2070/98, CC 104/99, CC106/99, CC107/99, CC124/00 were found highly resistant to Ascochyta blight with disease rating of 2 followed by 34 lines that were resistant and 21 lines were tolerant. None was found immune to blight. The highly resistant lines have exhibited higher level of resistance against blight as compared to earlier released varieties (CM72, CM88 and CM2000)

Case Report: It's not always about the veins; intervention of bilateral May–Thurner Syndrome secondary to iliac aneurysm

May–Thurner Syndrome (MTS) remains evasive because of the insidiousness and variable etiologies by which it can manifest. In this study, we examine a unique presentation of MTS resulting from compression of both common iliac veins by a right common iliac artery aneurysm that required complex endovascular venous and arterial intervention

Numerical simulation of lid driven flow in a curved corrugated porous cavity filled with CuO-water in the presence of heat generation/absorption

In this article, numerical simulation is performed for mixed convection lid-driven flow of CuO-water nanofluid enclosed in a curved corrugated. Cylindrical obstacles having three different constraints: (adiabatic, cold, and heated) at its surface are considered. Internal heat generation/absorption and uniform heat is provided at the vertical wall of the cavity. The bottom wall is insulated, and the curve surfaces are maintained with cold temperature. Mathematically equations are developed from physical problems and solved through Galerkin weighted residual method of FEM formulation. The effect of various Reynold number (), Darcy number (), solid volume fraction of nanoparticles (), heat generation/absorption coefficient () and various cylindrical obstacle on velocity, Nusselt number, molecular movements and the flow structure has been studied. Nusselt number increases for high Darcy number due to the convection in lid cavity. For high Reynold number generally Nusselt numbers decrease or remain the same at the wall with an increase of nanoparticles in porous medium. There significant effect of heat sink coefficient on temperature profile and Nusselt number decreases with increasing of Q

High concentration of childhood deaths in the low-lying areas of Chakaria HDSS, Bangladesh: findings from a spatial analysis

Background: Despite significant reduction of childhood mortality in Bangladesh, large spatial variations persist. Identification of lower level spatial units with higher concentrations of deaths can be useful for strengthening services in these areas. This paper reports findings from a spatial analysis of deaths in Chakaria, a rural subdistrict, where a Health and Demographic Surveillance System has been in place since 1999. Chakaria is an INDEPTH member site. Methods: An analysis was done of 339 deaths among nearly 24,500 children under the age of five during 2005&#x2013;2008. One ward, the lowest level of administrative units, was the unit of spatial analysis. Data from 24 wards were analyzed. The Discrete Poisson Probability Model was used to identify the clustering of deaths. Results: Deaths were concentrated within 12 wards located in the low-lying deltaic flood plains of the Chakaria HDSS area. The risk of death in the low-lying areas was statistically, significantly higher, 1.5 times, than the non-low-lying areas (p&#60;0.02). Conclusion: Spatial analysis can be a useful tool for identifying high-risk mortality areas. An understanding of the risk factors prevalent in the low-lying areas can help design effective interventions to reduce mortality in these areas

The prevalence and clinical characteristics of nonradiographic axial spondyloarthritis among patients with inflammatory back pain in rheumatology practices: a multinational, multicenter study

BACKGROUND: Patients with ankylosing spondylitis (AS), who by definition have radiographic sacroiliitis, typically experience symptoms for a decade or more before being diagnosed. Yet, even patients without radiographic sacroiliitis (i.e., nonradiographic axial spondyloarthritis [nr-axSpA]) report a significant disease burden. The primary objective of this study was to estimate the prevalence and clinical characteristics of nr-axSpA among patients with inflammatory back pain (IBP) in rheumatology clinics in a number of countries across the world. A secondary objective was to estimate the prevalence of IBP among patients with chronic low back pain (CLBP). METHODS: Data were collected from 51 rheumatology outpatient clinics in 19 countries in Latin America, Africa, Europe, and Asia. As consecutive patients with CLBP (N = 2517) were seen by physicians at the sites, their clinical histories were evaluated to determine whether they met the new Assessment of SpondyloArthritis international Society criteria for IBP. For those who did, their available clinical history (e.g., family history, C-reactive protein [CRP] levels) was documented in a case report form to establish whether they met criteria for nr-axSpA, AS, or other IBP. Patients diagnosed with nr-axSpA or AS completed patient-reported outcome measures to assess disease activity and functional limitations. RESULTS: A total of 2517 patients with CLBP were identified across all sites. Of these, 974 (38.70 %) fulfilled the criteria for IBP. Among IBP patients, 29.10 % met criteria for nr-axSpA, and 53.72 % met criteria for AS. The prevalence of nr-axSpA varied significantly by region (p < 0.05), with the highest prevalence reported in Asia (36.46 %) and the lowest reported in Africa (16.02 %). Patients with nr-axSpA reported mean ± SD Ankylosing Spondylitis Disease Activity Scores based on erythrocyte sedimentation rate and CRP of 2.62 ± 1.17 and 2.52 ± 1.21, respectively, indicating high levels of disease activity (patients with AS reported corresponding scores of 2.97 ± 1.13 and 2.93 ± 1.18). Similarly, the overall Bath Ankylosing Spondylitis Disease Activity Index score of 4.03 ± 2.23 for patients with nr-axSpA (4.56 ± 2.17 for patients with AS) suggested suboptimal disease control. CONCLUSIONS: These results suggest that, in the centers that participated in the study, 29 % of patients with IBP met the criteria for nr-axSpA and 39 % of patients with CLBP had IBP. The disease burden in nr-axSpA is substantial and similar to that of AS, with both groups of patients experiencing inadequate disease control. These findings suggest the need for early detection of nr-axSpA and initiation of available treatment options to slow disease progression and improve patient well-being