The effect of Bombyx mori larvae extract in reducing the toxicity of methotrexate in pregnant female albino rats

Methotrexate (MTX) is an anticancer agent which is used alone or in combination with other anticancer agents in the treatment of breast cancer, epidermoid cancers of the head and neck, cutaneous T cell lymphoma, and lung cancer. Bombyx mori larvae have a huge value as health food especially for cardiac and diabetic patients, bronchial asthma, primary trigeminal neuralgia, vocal nodules and polyps and in the treatment of facial palsy and pain. In the present study meeting occurred under the normal conditions and about 40 pregnant female rats were used. Herein the pregnant females will be divided into five groups;  group 1 will be used as negative control received distilled water, group 2 will used as positive control and recived buffer of Bombyx mori larvae extract,  group 3 was treated with MTX at the 12th day of gestation (at organogenesis phase), group 4 was treated with Bombyx mori larvae  extract at 7th , 9th , 11th ,13th  and 15th days of gestation (during the oraganogensis  period), & group 5 was injected by MTX the 12th day of  gestation as well as bombyx mori larvae extract at 7th ,9th ,11th ,13th  &15th days of gestation. Animals of all groups will be sacrificed at 20th day, the end of gestation periods. Then livers of all pregnant rats were removed for examination. The obtained results showed decrease in maternal body weight gain plus increase in the abortion rate and uterine weight in the MTX-treated group. In addition, MTX induced an elevation in the examined liver oxidative stress biomarkers plus myeloperoxidase activity and decrease in reduced glutathione content and catalase activity; in mothers. Histopathological studies of liver tissues showed congestion of central vein of mothers in MTX group showing ballooning degeneration of hepatocytes, perivascular inflammatory cells infiltration and strong deposition of collagen fibers. Noteworthy, Bombyx mori larvae induced marked improvement in injuries associated with MTX administration. Keywords: Methotrexate, Bombyx mori larvae, Pregnant female rats, Hepatotoxicity

Subcutaneous hydatid cysts occurring in the palm and the thigh: two case reports

<p>Abstract</p> <p>Introduction</p> <p>Hydatid cyst disease is common in some regions of the world and is usually located in the liver and lungs. This report presents two cases of primary hydatid cysts located subcutaneously: one in the medial thigh and one in the left palm between the index and middle fingers.</p> <p>Case presentations</p> <p>A 64-year-old male farmer visited our hospital because a swelling on the right medial thigh had grown during the last year. Superficial ultrasound and computed tomography revealed a lesion resembling a hydatid cyst. A germinative membrane was encountered during surgical excision. Pathological examination was compatible with a hydatid cyst. The second case involved a 67-year-old male farmer who complained of a swelling that had grown in his left palm in the last year. The preliminary diagnosis was a lipoma. However, a hydatid cyst was diagnosed during surgical excision and after the pathological examination. The patient did not have a history of hydatid cyst disease and hydatid cysts were not detected in other organs. There has been no disease recurrence after following both patients for 3 years.</p> <p>Conclusion</p> <p>A hydatid cyst should be considered in the differential diagnosis of subcutaneous cystic lesions in regions where hydatid cysts are endemic, and should be excised totally, with an intact wall, to avoid recurrence.</p

Analysis of residual acrylamide in field crops

Polyacrylamide (PAM) is a widely used product for a large number of applications. Many of the emerging applications are in the area of agriculture. PAM is blended with pesticides as a thickening agent, added to irrigation water to minimize soil erosion, and used as a medium for hydroponically grown crops. Although PAM is stable and considered to be safe, residual acrylamide (AMD) monomer is a neurotoxin and animal carcinogen. In this work, residual AMD is analyzed in a variety of crops that were grown under PAM treatment to stabilize soil erosion. Corn, potatoes, sugar beets, and beans are analyzed for AMD. A sample of the crop is homogenized with water, and the water layer is filtered and derivatized with bromine to form 2,3-dibromopropionamide. The derivative is then extracted with ethyl acetate and converted to the more stable 2-propenamide prior to gas chromatographic analysis using an electron capture detector. Capillary Carbowax columns were used. All tested crops show < 10 ppb AMD. Furthermore, it seems that AMD is not stable when it comes in contact with the crop tissues. In the presence of plant tissues, AMD will disappear as a function of time. Beans blended with 100 ppb AMD for 10 min yield a recovery of only 22%. For a bean sample that was soaked with 500 ppb AMD solution for 18 h, the recovery is 7%. Other crops show different AMD recoveries

Diseminasi Long Range (LoRa)Sebagai Perangkat Nirkabel Pada Jaringan Lokal Internet Of Things di SMK 2 Praya Lombok Tengah

Internet of Things atau dikenal juga dengan singkatan IoT, merupakan wujud perkembangan teknologi internet yang memungkinkan setiap barang (things) yang dimiliki dapat terhubung ke internet sehingga dapat dikendalikan dari jarak jauh menggunakan smartphone atau bahkan dengan perintah suara. Saat ini pemerintah sedang giat mengembangkan teknologi IoT untuk mendukung penerapan konsep Smart City. Salah satu himbauan pemerintah adalah meminta peran generasi muda khususnya yang berada pada jenjang Sekolah Menengah Kejuruan (SMK) untuk mengenal, mempelajari dan mengimplementasikan produk IoT yang mampu bersaing pada era globalisasi. Berdasarkan hasil observasi dan wawancara yang dilakukan, para guru dan siswa SMKN 2 Praya Tengah, belum mengerti mengenai IoT. Pengetahuan dan kompetensi IoT juga masih dirasa sangat rendah dikarenakan kurikulum belum secara langsung mengakomodir pada pembelajaran IoT. Untuk meningkatkan pengetahuan dan kompetensi di kalangan siswa terutama tentang IoT, diperlukan pelatihan bagi guru dan siswa SMKN 2 Praya Tengah terutama yang memiliki kompetensi Elektronika. Pelatihan dilakukan dengan memberikan ceramah mengenai IoT dan komunikasi LoRa, dilanjutkan dengan pengenalan dan perakitan modul penggunaan LoRa berbasis IoT. Dengan Pelatihan tersebut, para guru dan siswa khususnya kompetensi elektronika, mengerti dan memahami pemanfaatan IoT serta mampu mengimplementasikan IoT menggunakan jaringan komunikasi LoRa.

Primary subcutaneous cyst hydatic disease in proximal thigh: an unusual localisation: a case report

BACKGROUND: Musculoskeletal hydatidosis is very rare and represents 1% – 5.4% of all cases of echinococcosis. On clinical basis, infection mimics a soft-tissue tumor, and the preoperative radiological diagnosis is very important to avoid biopsy. CASE PRESENTATION: We report an unusual case of primary subcutaneous hydatidosis in proximity to vastus lateralis muscle. It was diagnosed according to the computed tomography appearance, clinical and pathological findings. A 43 year old female patient was admitted with a history of pain at proximal thigh for the last 30 days. On physical examination, a mass which was 4 × 5 cm in diameter, painful and erythamatous, was palpated over greater trochanter. Sedimentation rate was 40 mm in the first hour. CT (Computed Tomography) scan demonstrated, a soft tissue mass with central cystic component in the subcutaneous tissue near vastus lateralis muscle. Histopathological examination of the specimen revealed a pericystic structure, which consisted of connective tissue and scattered hyaline cells showing a necrotic basophilic structure that resembled a cuticular membrane. Treatment with high dose albendazole was conducted for 4 weeks. CONCLUSIONS: This case illustrates that echinococcal disease should be considered in the differential diagnosis of every cystic mass in every anatomic location, especially when they occur in areas where the disease is endemic

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

Background: The EMPA KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. Methods: EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. Findings: Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5–2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62–0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16–1·59), representing a 50% (42–58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all &gt;0·1). Interpretation: In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. Funding: Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362