Determination of Arsenic Content of Available Traditional Medicines in Malaysia using Hydride Generation Atomic Absorption Spectrometry

Purpose: To determine the content of arsenic (As) in some locally available traditional medicines in the East Coast region of Malaysia.Methods: The determination of As was conducted using hydride generation-atomic absorption spectrometry (HG-AAS). Sample preparation entailed mineral acid digestion using hydrochloric acid and nitric acid mixture in a ratio of 1:3. Sixty samples were collected from different locations including shops and open markets in East Coast region of Malaysia, namely, Pahang, Terengganu and Kelantan states. Most of these preparations were not registered with Malaysian drug authority.Results: Out of sixty traditional medicine samples, twenty six contained As in a concentration range of 0.2150 - 1.3254 ppm. As for the rest, they were below the limit of quantification (LOQ).Conclusion: Traditional medicine samples available in the east coast region of Malaysia contain levels of arsenic that can adversely affect health upon consumption.Keywords: Traditional medicine, Arsenic, Hydride Generation –Atomic Absorption Spectrometer HGAAS

Varicocele Surgery Improves Sperm Count in Infertile Oligospermic Patients and so Improves Fertility; A Study in a Tertiary Care Hospital

The objective of this study was to find out the role of varicocele surgery in oligospermic infertile patients. It was a prospective and descriptive study carried out in Surgical Unit-I, Abbasi Shaheed Hospital and Karachi Medical and Dental College (KMDC), Karachi from April 2004 to March 2014. In this study, all patients of infertility due to low sperm count having bilateral varicocele were included while those patients having azoospermia or patients with unilateral varicocele were excluded. All patients were clinically assessed for bilateral varicocele and confirmed by ultrasonography of scrotum and relevant investigations were done. Patients were prepared for varicocele surgery and ligation of pampiniform plexus done. Semenanalysis were done during follow up and results were analyzed on SPSS version 14. Total fifty seven patients (n=57) were included in which age range was 20 to 30 years in 33.3%, 31 to 40 years in 42.1%, 41 to 50 years in 19.3% and 51 years to onwards in 05.3% patients only. Chronic smoking was found in 68.4% patients while 31.6% were nonsmokers. Normal testes was found in 77.19% while 22.81% had smaller (atrophied) testes. Very low sperm count was in 15.79%, 50.88% had low sperm count and 33.33% had near normal sperm count. All patients were operated for bilateral varicocele and discharged. Follow-up semen analysis showed improvement and semen analysis became normal in 19.3% after six months, 21.05% after nine months and 36.84% after one year of surgery while 22.81% had no improvement even after one year of surgery. Thus, patients with bilateral varicocele having low sperm count showed improvement in sperm count after varicocele surgery and so infertile patients may become fertile after varicocele surgery

Smart data packet ad hoc routing protocol

This paper introduces a smart data packet routing protocol (SMART) based on swarm technology for mobile ad hoc networks. The main challenge facing a routing protocol is to cope with the dynamic environment of mobile ad hoc networks. The problem of finding best route between communication end points in such networks is an NP problem. Swarm algorithm is one of the methods used solve such a problem. However, copping with the dynamic environment will demand the use of a lot of training iterations. We present a new infrastructure where data packets are smart enough to guide themselves through best available route in the network. This approach uses distributed swarm learning approach which will minimize convergence time by using smart data packets. This will decrease the number of control packets in the network as well as it provides continues learning which in turn provides better reaction to changes in the network environment. The learning information is distributed throughout the nodes of the network. This information can be used and updated by successive packets in order to maintain and find better routes. This protocol is a hybrid Ant Colony Optimization (ACO) and river formation dynamics (RFD) swarm algorithms protocol. ACO is used to set up multi-path routes to destination at the initialization, while RFD mainly used as a base algorithm for the routing protocol. RFD offers many advantages toward implementing this approach. The main two reasons of using RFD are the small amount of information that required to be added to the packets (12 bytes in our approach) and the main idea of the RFD algorithm which is based on one kind of agent called drop that moves from source to destination only. This will eliminate the need of feedback packets to update the network and offers a suitable solution to change data packet into smart packets. Simulation results shows improvement in the throughput and reduction in end to end delay and jitter compared to AODV and AntHocNet protocols. © 2013 Elsevier B.V. All rights reserved

Extended α - η - µ Fading Distribution: Statistical Properties and Applications

© Copyright 2022 The Author(s). In this paper, the impact of the non-linearity of the propagation medium on the extended η - μ fading distribution is studied. In particular, the extended α - η - μ fading model in which the parameter α represents the non-linearity of the propagation environment is presented via providing the exact and asymptotic of the statistical properties, namely, the probability density function (PDF), cumulative distribution function (CDF), and generalized-moment generating function (G-MGF). To this effect, exact closed-form mathematically tractable expressions of the outage probability (OP), average symbol error probability (ASEP), amount of fading (AoF), channel quality estimation index (CQEI) and effective rate (ER) are obtained. The asymptotic behaviour at high average signal-to-noise (SNR) values is also analysed to gain further insights into the influence of the index α on the performance metrics of the wireless communication systems. Moreover, the average channel capacity (ACC) under different adaptive transmission techniques, such as, optimum rate and adaptation (ORA), capacity of the channel with inversion and fixed rate (CIFR), and truncated inversion and fixed rate (TIFR) are derived. The validation of the derived expressions is verified via comparing the numerical results with the Monte-Carlo simulations as well as some previous works for different scenarios

Hepatic artery aneurysm repair: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hepatic artery aneurysms remain a clinically significant entity. Their incidence continues to rise slowly and mortality from spontaneous rupture is high. Repair is recommended in those aneurysms greater than 2 cm in diameter. It is not surprising that vascular comorbidities, such as ischaemic heart disease, are common in surgical patients, particularly those with arterial aneurysms such as these. The decision of when to operate on patients who require urgent surgery despite having recently suffered an acute coronary syndrome remains somewhat of a grey and controversial area. We discuss the role of delayed surgery and postoperative followup of this vascular problem.</p> <p>Case presentation</p> <p>A 58-year-old man was admitted with a 5.5 cm hepatic artery aneurysm. The aneurysm was asymptomatic and was an incidental finding as a result of an abdominal computed tomography scan to investigate an episode of haemoptysis (Figure <figr fid="F1">1</figr>). Three weeks prior to admission, the patient had suffered a large inferior myocardial infarction and was treated by thrombolysis and primary coronary angioplasty. Angiographic assessment revealed a large aneurysm of the common hepatic artery involving the origins of the hepatic, gastroduodenal, left and right gastric arteries and the splenic artery (Figures <figr fid="F2">2</figr> and <figr fid="F3">3</figr>). Endovascular treatment was not considered feasible and immediate surgery was too high-risk in the early post-infarction period. Therefore, surgery was delayed for 3 months when aneurysm repair with reconstruction of the hepatic artery was successfully performed. Graft patency was confirmed with the aid of an abdominal arterial duplex. Plasma levels of conventional liver function enzymes and of alpha-glutathione-<it>S</it>-transferase were within normal limits. This was used to assess the extent of any hepatocellular damage perioperatively. The patient made a good recovery and was well at his routine outpatient check-ups.</p> <p>Conclusion</p> <p>There is no significant difference in cardiac risk in patients who have undergone vascular surgery within 6 months of a myocardial infarction compared with those who have had the operation in the 6 to12 month time frame. Use of alpha-glutathione-<it>S</it>-transferase gives an indication of the immediate state of hepatic function and should be used in addition to traditional liver function tests to monitor hepatic function postoperatively.</p

Ruptured renal artery aneurysm during pregnancy, a clinical dilemma

BACKGROUND: Rupture of a renal artery aneurysm (RAA) during pregnancy is a rare event, with a high mortality rate for both mother and fetus. Increased blood flow and intra-abdominal pressure, and vascular changes secondary to increased steroid production are postulated as contributory to the increased risk of rupture during pregnancy. CASE PRESENTATION: We present here a case report of total avulsion of solitary kidney secondary to rupture of RAA in a pregnant patient with congenital absence of the contralateral kidney. The main indication for nephrectomy was severely damaged kidney. Diagnosis was made during operation and both mother and fetus were saved. There are no previous reports of an intact renal artery aneurysm diagnosed either antepartum or postpartum. CONCLUSION: The possibility of a ruptured RAA should be considered in pregnant women with evidence of retroperitoneal hemorrhage. This case was unusual because it occurred in a solitary kidney, during the third trimester of pregnancy

Down-regulation of estrogen receptor-alpha and rearranged during transfection tyrosine kinase is associated with withaferin a-induced apoptosis in MCF-7 breast cancer cells

<p>Abstract</p> <p>Background</p> <p>Withaferin A (WA), a naturally occurring withanolide, induces apoptosis in both estrogen-responsive MCF-7 and estrogen-independent MDA-MB-231 breast cancer cell lines with higher sensitivity in MCF-7 cells, but the underlying mechanisms are not well defined. The purpose of this study was to determine the anti-cancer effects of WA in MCF-7 breast cancer cells and explore alterations in estrogen receptor alpha (ERα) and its associated molecules <it>in vitro </it>as novel mechanisms of WA action.</p> <p>Methods</p> <p>The effects of WA on MCF-7 viability and proliferation were evaluated by 3-(4, 5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay and trypan blue exclusion assays. Apoptosis was evaluated by Annexin V-fluorescein isothiocyanate (FITC)/propidium iodide (PI) flow cytometry and Western blot analysis of poly (ADP-ribose) polymerase (PARP) cleavage. Cell cycle effects were analyzed by PI flow cytometry. Western blotting was also conducted to examine alterations in the expression of ERα and pathways that are associated with ERα function.</p> <p>Results</p> <p>WA resulted in growth inhibition and decreased viability in MCF-7 cells with an IC50 of 576 nM for 72 h. It also caused a dose- and time-dependent apoptosis and G2/M cell cycle arrest. WA-induced apoptosis was associated with down-regulation of ERα, REarranged during Transfection (RET) tyrosine kinase, and heat shock factor-1 (HSF1), as well as up-regulation of phosphorylated p38 mitogen-activated protein kinase (phospho-p38 MAPK), p53 and p21 protein expression. Co-treatment with protein synthesis inhibitor cycloheximide or proteasome inhibitor MG132 revealed that depletion of ERα by WA is post-translational, due to proteasome-dependent ERα degradation.</p> <p>Conclusions</p> <p>Taken together, down-regulation of ERα, RET, HSF1 and up-regulation of phospho-p38 MAPK, p53, p21 are involved in the pro-apoptotic and growth-inhibitory effects of WA in MCF-7 breast cancer cells <it>in vitro</it>. Down-regulation of ERα protein levels by WA is caused by proteasome-dependent ERα degradation.</p

When healthcare providers are supportive, 'I'd rather not test alone': Exploring uptake and acceptability of HIV self-testing for youth in Zimbabwe - A mixed method study

Introduction: In sub-Saharan Africa, less than half of young people know their HIV status. HIV self-testing (HIVST) is a testing strategy with the potential to offer privacy and autonomy. We aimed to understand the uptake and acceptability of different HIV testing options for youth in Harare, Zimbabwe. Methods: This study was nested within a cluster randomized trial of a youth-friendly community-based integrated HIV and sexual and reproductive health intervention for youth aged 16–24 years. Three HIV testing options were offered: (1) provider-delivered testing; (2) HIVST on site in a private booth without a provider present; and (3) provision of a test kit to test off site. Descriptive statistics and proportions were used to investigate the uptake of HIV testing in a client sample. A focus group discussion (FGD) with intervention providers alongside in-depth interviews, paired interviews and FGDs with a selected sample of youth clients explored uptake and acceptability of the different HIV testing strategies. Thematic analysis was used to analyse the qualitative data. Results: Between April and June 2019, 951 eligible clients were tested for HIV: 898 (94.4%) chose option 1, 30 (3.25%) chose option 2 and 23 (2.4%) chose option 3. Option 1 clients cited their trust in the service and a desire for immediate counselling, support and guidance from trusted providers as the reasons for their choice. Young people were not confident in their expertise to conduct HIVST. Concerns about limited privacy, confidentiality and lack of support in the event of an HIV-positive result were barriers for off-site HIVST. Conclusions: In the context of supportive, trusted and youth-friendly providers, youth clients overwhelmingly preferred provider-delivered HIV testing over client-initiated HIVST or HIVST off site. This highlights the importance of listening to youth to improve engagement in testing. While young people want autonomy in choosing when, where and how to test, they do not want to necessarily test on their own. They desire quality in-person counselling, guidance and support, alongside privacy and confidentiality. To increase the appeal of HIVST for youth, greater provision of access to private spaces is required, and accessible pre- and post-test counselling and support may improve uptake

Modeling dynamic interactions between pre-exposure prophylaxis interventions & treatment programs: predicting HIV transmission & resistance

Clinical trials have recently demonstrated the effectiveness of Pre-Exposure Prophylaxis (PrEP) in preventing HIV infection. Consequently, PrEP may soon be used for epidemic control. We model the dynamic interactions that will occur between treatment programs and potential PrEP interventions in resource-constrained countries. We determine the consequences for HIV transmission and drug resistance. We use response hypersurface modeling to predict the effect of PrEP on decreasing transmission as a function of effectiveness, adherence and coverage. We predict PrEP will increase need for second-line therapies (SLT) for treatment-naïve individuals, but could significantly decrease need for SLT for treatment-experienced individuals. If the rollout of PrEP is carefully planned it could increase the sustainability of treatment programs. If not, need for SLT could increase and the sustainability of treatment programs could be compromised. Our results show the optimal strategy for rolling out PrEP in resource-constrained countries is to begin around the “worst” treatment programs