16 research outputs found
Diversified Impact of COVID-19 Pandemic on the Overall Health and Well-Being of Children: A Survey Based Case Study
BACKGROUND: COVID-19 pandemic led to the closure of non-essential services including educational institutions and recreational facilities all around the world. The pandemic has affected children at different levels including their mental well- being. AIM: The objective of this study was to assess the overall impact of the pandemic on the well-being of children in terms of their demographic details, physical activity pattern, sanitary practices, mental health and nutritional practices. 300 children aged between 4-18 years were surveyed through an online survey developed as a Google form. MATERIAL AND METHODS: Parents or guardians were asked to fill the questionnaire. The questionnaire was approved by Medical doctors for the sake of accuracy and authenticity. RESULTS: The annual household income of majority of the respondents was between 1-5 lakhs, and they belonged to urban and nuclear households. Although modern amenities were available for the children at home, yet majority of them did not have a separate room and a personal smart phone. 89.4% (n=268) children used internet for 1-5 hours every day. 82.4% (=247) of them were also enrolled in other online courses as well. Lesser time was devoted on physical activity during the pandemic. Negative psychological symptoms like lack in concentration and anxiety, etc. were reported. CONCLUSION: The paper addresses the changes impacting children’s lives at different levels related to their health and well-being. The results must be corroborated with studies reported in literature and may be used for formulating strategies to make children adapt the situation without any negative impact on their personality
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
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Development of 18F-labelled Tris(2-pyridylmethyl)amine-based Chelator to Image Zinc Distribution in Prostate Cancer Models Using Positron Emission Tomography
While methods for early detection and risk stratification of prostate cancer (PCa) have greatly improved in recent years, there remains an unmet clinical need for improved methods to accurately detect and grade PCa non-invasively using imaging techniques. Zinc (Zn) has been studied as a target biomarker due to its unique physiology in the prostate. It accumulates in a healthy prostate to a remarkable high concentration, while it significantly decreases by 60-80% in de-differentiated PCa. Previous studies have examined this property as a potential biomarker for using imaging modalities such as MRI and fluorescence to characterize PCa, however, these techniques are not amenable to clinical translation. PET imaging has yet to be explored in detecting Zn for a tool of PCa diagnosis. This study focused on developing a novel probe, 18F-labelled Tris(2-pyridylmethyl)amine-based (18F-TPA), which exhibits excellent zinc specificity and targetability, cell membrane permeability, and low cytotoxicity. Once the cells uptake the radionuclides, they bind with intracellular free zinc ion and will not flux out of the cells. Thus, the 18F-TPA PET imaging method could directly image zinc biodistribution and therefore be applied to detect alterations in zinc homeostasis in PCa and other diseases. Methods: This project started from the chemical synthesis of a precursor compound NO2-TPA and a non-radioactive reference compound, 19F-TPA for the subsequent synthesis and characterization of radioactive 18F-TPA. 18F-TPA was synthesized in a hot cell with NO2-TPA reacting 18F in the presence of kryptofix 222 and purified using semi-prep HPLC with the conditions determined by the co-injection of NO2-TPA and 19F-TPA. The quality of 18F-TPA was ensured by co-injection with 19F-TPA to an analytical HPLC showing the same retention time. Furthermore, 19F-TPA was used to characterize Zn binding by determining a Zn19F-TPA complex formation on an analytical HPLC. Subsequently the developed probe was used to test the hypothesis of its trapping behavior when bound to Zn+2 using an in vitro cell binding assay. One group had only the probe while two other groups had TPEN, a known strong Zn chelator, and TPA that were used as blocking agents followed by the introduction of the probe. The radioactivity was measured using a Hidex gamma counter with results recording in counts per minute. Results: The 18F-TPA probe was successfully developed and purified with high yield. The cell binding assay provided evidence of the possibility the probe can be internalized when it binds to intracellular Zn+2. This was evidenced by high counts per minute (CPM) levels in cells with only probe uptake. In comparison, the cells with TPEN and TPA as blocking agents demonstrated low CPM levels. This provides preliminary evidence that the probe is Zn+2 specific. However, further in vitro assays need to be conducted with consideration of separating the membrane from the internal components of the cell. Without this consideration, it can be concluded that the probe is membrane-bound and not essentially trapped in the intracellular space of the cell. Conclusion: A new Zn+2 binding PET imaging radionuclide was developed and utilized for subsequent in vitro and in vivo assays. The in vitro cell binding assays have provided promising results that may support the hypothesis of cell internalization of the probe as it binds to Zn. The work on the in vitro assays and animal studies are still in progress. Future work will focus on additional in vitro assays and performing in vivo assays. The results from this study thus far have been encouraging on the potential of this probe as a diagnostic tool to examine zinc distribution
Antioxidant, Anti-inflammatory, and Antiulcer Potential of Manuka Honey against Gastric Ulcer in Rats
Gastric ulcers are among the most common diseases affecting humans. This study aimed at investigating the gastroprotective effects of manuka honey against ethanol-induced gastric ulcers in rats. The mechanism by which honey exerts its antiulcer potential was elucidated. Four groups of rats were used: control, ethanol (ulcer), omeprazole, and manuka honey. Stomachs were examined macroscopically for hemorrhagic lesions in the glandular mucosa, histopathological changes, and glycoprotein detection. The effects of oxidative stress were investigated using the following indicators: gastric mucosal nitric oxide (NO), reduced glutathione (GSH), lipid peroxide (MDA, measured as malondialdehyde) glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase. Plasma tumour necrosis factor-α, interleukin-1β, and IL-6 were also measured. Manuka honey significantly decreased the ulcer index, completely protected the mucosa from lesions, and preserved gastric mucosal glycoprotein. It significantly increased gastric mucosal levels of NO, GSH, GPx, and SOD. Manuka honey also decreased gastric mucosal MDA and plasma TNF-α, IL-1β, and IL-6 concentrations. In conclusion, manuka honey likely exerted its antiulcer, effect by keeping enzymatic (GPx and SOD) and nonenzymatic (GSH and NO) antioxidants as well as inflammatory cytokines (TNF-α, IL-1β, and IL-6) in a reduced form, inhibited lipid peroxidation (MDA), and preserved mucous glycoproteins levels
Red Sea Suberea mollis Sponge Extract Protects against CCl4-Induced Acute Liver Injury in Rats via an Antioxidant Mechanism
Recent studies have demonstrated that marine sponges and their active constituents exhibited several potential medical applications. This study aimed to evaluate the possible hepatoprotective role as well as the antioxidant effect of the Red Sea Suberea mollis sponge extract (SMSE) on carbon tetrachloride- (CCl4-) induced acute liver injury in rats. In vitro antioxidant activity of SMSE was evaluated by 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) assay. Rats were orally administered three different concentrations (100, 200, and 400 mg/kg) of SMSE and silymarin (100 mg/kg) along with CCl4 (1 mL/kg, i.p., every 72 hr) for 14 days. Plasma aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin were measured. Hepatic malondialdehyde (MDA), reduced glutathione (GSH), nitric oxide (NO), superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) were also measured. Liver specimens were histopathologically examined. SMSE showed strong scavenging activity against free radicals in DPPH assay. SMSE significantly reduced liver enzyme activities. Moreover, SMSE significantly reduced hepatic MDA formation. In addition, SMSE restored GSH, NO, SOD, GPx, and CAT. The histopathological results confirmed these findings. The results of this study suggested a potent protective effect of the SMSE against CCl4-induced hepatic injury. This may be due to its antioxidant and radical scavenging activity
Evaluation of the Anti-Inflammatory, Antioxidant and Immunomodulatory Effects of the Organic Extract of the Red Sea Marine Sponge Xestospongia testudinaria against Carrageenan Induced Rat Paw Inflammation.
Marine sponges are found to be a rich source of bioactive compounds which show a wide range of biological activities including antiviral, antibacterial, and anti-inflammatory activities. This study aimed to investigate the possible anti-inflammatory, antioxidant and immunomodulator effects of the methanolic extract of the Red Sea marine sponge Xestospongia testudinaria. The chemical composition of the Xestospongia testudinaria methanolic extract was determined using Gas chromatography-mass spectroscopy (GC-MS) analysis. DPPH (2, 2-diphenyl-1-picryl-hydrazyl) was measured to assess the antioxidant activity of the sponge extract. Carrageenan-induced rat hind paw edema was adopted in this study. Six groups of rats were used: group1: Control, group 2: Carrageenan, group 3: indomethacin (10 mg/kg), group 4-6: Xestospongia testudinaria methanolic extract (25, 50, and 100 mg/kg). Evaluation of the anti-inflammatory activity was performed by both calculating the percentage increase in paw weight and hisopathologically. Assessment of the antioxidant and immunomodulatory activity was performed. GC-MS analysis revealed that there were 41 different compounds present in the methanolic extract. Sponge extract exhibited antioxidant activity against DPPH free radicals. Xestospongia testudinaria methanolic extract (100 mg/kg) significantly decreased % increase in paw weight measured at 1, 2, 3 and 4 h after carrageenan injection. Histopathologically, the extract caused a marked decrease in the capillary congestion and inflammatory cells infiltrate. The extract decreased paw malondialdehyde (MDA) and nitric oxide (NO) and increased the reduced glutathione (GSH), glutathione peroxidase (GPx), and catalase (CAT) activity. It also decreased the inflammatory cytokines, tumor necrosis factor-α (TNF-α), interleukin-1 β(IL-1β) and IL-6. The results of this study demonstrated the anti-inflammatory, antioxidant, and immunomodulatory effects of the methanolic extract of the Red Sea sponge Xestospongia testudinaria (100 mg/kg)
Manuka Honey Exerts Antioxidant and Anti-Inflammatory Activities That Promote Healing of Acetic Acid-Induced Gastric Ulcer in Rats
Gastric ulcers are a major problem worldwide with no effective treatment. The objective of this study was to evaluate the use of manuka honey in the treatment of acetic acid-induced chronic gastric ulcers in rats. Different groups of rats were treated with three different concentrations of honey. Stomachs were checked macroscopically for ulcerative lesions in the glandular mucosa and microscopically for histopathological alterations. Treatment with manuka honey significantly reduced the ulcer index and maintained the glycoprotein content. It also reduced the mucosal myeloperoxidase activity, lipid peroxidation (MDA), and the inflammatory cytokines (TNF-α, IL-1β, and IL-6) as compared to untreated control group. In addition, honey-treated groups showed significant increase in enzymatic (GPx and SOD) and nonenzymatic (GSH) antioxidants besides levels of the anti-inflammatory cytokine IL-10. Flow cytometry studies showed that treatment of animals with manuka honey has normalized cell cycle distribution and significantly lowered apoptosis in gastric mucosa. In conclusion, the results indicated that manuka honey is effective in the treatment of chronic ulcer and preservation of mucosal glycoproteins. Its effects are due to its antioxidant and anti-inflammatory properties that resulted in a significant reduction of the gastric mucosal MDA, TNF-α, IL-1β, and IL-6 and caused an elevation in IL-10 levels
Low and magnified power of rat paw sections stained by H&E, (a) Control group, E: epidermis, D: dermis with no signs of vascular congestion or inflammatory cells (dotted square) with normal capillaries (black arrows) and connective tissue dermis (stars). (b) Carrageenan group, showing marked inflammatory infiltration in the deep dermis (D), capillary dilation and congestion with neutrophils margination prior to escape into the surrounding tissue (arrows;) (c) <i>Xestospongia testudinaria</i> methanolic extract group, showing significant decrease of the inflammatory cells in the dermis and within blood vessels. (d) Indomethacin group, showing a decrease in both inflammatory cells infiltration and vascular congestion.
<p>Low and magnified power of rat paw sections stained by H&E, (a) Control group, E: epidermis, D: dermis with no signs of vascular congestion or inflammatory cells (dotted square) with normal capillaries (black arrows) and connective tissue dermis (stars). (b) Carrageenan group, showing marked inflammatory infiltration in the deep dermis (D), capillary dilation and congestion with neutrophils margination prior to escape into the surrounding tissue (arrows;) (c) <i>Xestospongia testudinaria</i> methanolic extract group, showing significant decrease of the inflammatory cells in the dermis and within blood vessels. (d) Indomethacin group, showing a decrease in both inflammatory cells infiltration and vascular congestion.</p
Effect of <i>Xestospongia testudinaria</i> methanolic extract (100 mg/kg) and indomethacin (10 mg/kg) on paw GPX, SOD and CAT enzymes activity measured in carrageenan-induced rat hind paw edema.
<p>Data are mean ± SD (n = 6).</p><p><sup>a</sup> Significant versus control (P ≤ 0.05).</p><p><sup>b</sup> Significant versus carrageenan (P ≤ 0.05).</p><p>Effect of <i>Xestospongia testudinaria</i> methanolic extract (100 mg/kg) and indomethacin (10 mg/kg) on paw GPX, SOD and CAT enzymes activity measured in carrageenan-induced rat hind paw edema.</p
Chromatogram obtained from GC-MS with the methanolic extracts of the <i>Xestospongia testudinaria</i>.
<p>Chromatogram obtained from GC-MS with the methanolic extracts of the <i>Xestospongia testudinaria</i>.</p