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1.
J Surg Educ ; 81(11): 1491-1497, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39217679

RESUMEN

OBJECTIVE: Concerns exist about clinical and operative skill decay in surgery residents when they dedicate time away from clinical training to pursue research. However, it remains undetermined how to best prevent these negative impacts. Our study evaluated the perspectives of surgical research residents on interventions to improve their reentry into clinical training. DESIGN, SETTING, AND PARTICIPANTS: An anonymous web-based survey was distributed between 5/01/2023 and 6/01/2023 to 102 current and former (within the previous 3 years) general surgery research residents from 4 academic medical centers in Boston, MA. RESULTS: Survey response rate was 35.3% (36/102 residents). About 22 of 36 residents (61.1%) felt that their clinical aptitude decreased during the research years, whereas 33 of 36 (91.7%) reported reduced surgical skills. When reflecting on their re-entry to residency, former research residents reported feeling anxious and less confident (3.84/5 on a 1-5 Likert scale) as well as being below the expected level of clinical performance (3.42/5). Most of them (12 of 17; 70.6%) reported that it took up to 6 months, whereas 5 of them (29.4%) up to 12 months to feel at the expected level. When compared to nonmoonlighting residents, those who moonlighted often and operated during moonlighting, denied a decrease in clinical and surgical skills, and reported less anxiety, higher confidence, and a quicker return to the expected level of performance. Interventions proposed for improving their clinical re-entry included individualized development plans for 3 months before returning to clinical training, established curriculum for clinical work throughout the research years, clinical preceptorships throughout the research years, and simulation curriculum throughout the research years. CONCLUSIONS: General surgery residents feel that their clinical and surgical skills decreased during the research years, leading to anxiety and lack of confidence when returning to residency. Therefore, comprehensive interventions are needed to improve the reentry of the research residents into clinical training.

3.
J Am Coll Surg ; 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-39087692

RESUMEN

Immigrants in the United States face unique challenges in accessing healthcare. There have been several studies highlighting some of the barriers that this population faces; however, there is still a lack of robust research on this patient population in the context of surgical access and outcomes. Immigration status is a protected variable that is not documented in patient charts for a myriad of reasons. This makes it incredibly difficult to identify this population in the first place, resulting in a decreased ability to study this group retrospectively and, therefore, restricting the quantity and quality of research into these vulnerable patients. This article aims to provide a call to action for medical professionals to develop ways to accurately document immigration status in medical records while simultaneously assuaging the concerns related to this documentation and its implications on patient care and confidentiality.

5.
Vasc Endovascular Surg ; 58(7): 752-756, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38747057

RESUMEN

This case report documents the management of a 66-year old man with atrial fibrillation with recent placement of a WATCHMAN® Flex atrial appendage occlusion device. The patient presented with renal failure, abdominal pain, and difficulty walking 2 months after placement. The WATCHMAN® Flex device was found to have embolized to his abdominal aorta at the level of the renal arteries with associated thrombus. Extensive workup revealed reduced left ventricular cardiac function and decreased renal function, both of which were felt to be potentially reversible with device removal. The patient then underwent retrieval of the device and all associated thrombus via an open retroperitoneal approach. This case demonstrates a potential consequence of implanting devices such as an atrial appendage occlusion device and describes a technique for removal.


Asunto(s)
Apéndice Atrial , Fibrilación Atrial , Remoción de Dispositivos , Migración de Cuerpo Extraño , Humanos , Anciano , Masculino , Apéndice Atrial/fisiopatología , Apéndice Atrial/diagnóstico por imagen , Fibrilación Atrial/fisiopatología , Fibrilación Atrial/terapia , Fibrilación Atrial/diagnóstico , Resultado del Tratamiento , Migración de Cuerpo Extraño/etiología , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/terapia , Aorta Abdominal/diagnóstico por imagen , Aorta Abdominal/cirugía , Diseño de Prótesis , Cateterismo Cardíaco/instrumentación , Cateterismo Cardíaco/efectos adversos , Trombosis/etiología , Trombosis/diagnóstico por imagen , Trombosis/terapia , Trombosis/fisiopatología , Aortografía , Angiografía por Tomografía Computarizada , Embolia/etiología , Embolia/diagnóstico por imagen , Embolia/terapia
7.
J Surg Res ; 299: 51-55, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38701704

RESUMEN

INTRODUCTION: Diversity in medicine has a positive effect on outcomes, especially for Asian patients. We sought to evaluate representation of Asians across entry and leadership levels in surgical training. METHODS: Publicly accessible population data from 2018 to 2023 were collected from the US Census Bureau, the Association of American Medical Colleges, and the American Board of Surgery (ABS). Frequencies based on self-identified Asian status were identified, and proportions were calculated. RESULTS: The US census showed Asians constituted 4.9% of the US population in 2018 versus 6% in 2023. The proportion of Asian medical students rose from 21.6% to 24.8%; however, Asian surgical residency applicants remained constant at 20%. ABS certifications of Asians have increased from 13.7% to 18.5%. ABS examiners increased from 15.7% to 17.1%. CONCLUSIONS: In 5 years, Asians have made numeric gains in medical school and surgical training. However, Asian representation lags at Board examiner levels compared to the medical student population. The ABS has made recent efforts at transparency around examiner and examinee characteristics. A pillar of ensuring a well-trained surgical workforce to serve the public is to mandate that all surgical trainees and graduates undergo fair examinations, and are fairly assessed on their qualifications. Observed progress should further invigorate all surgical applicants, residents and leadership to take an even more active role in making surgery more diverse and welcoming to all, by including careful analyses of diversity at all levels.


Asunto(s)
Cirugía General , Liderazgo , Humanos , Certificación/estadística & datos numéricos , Diversidad Cultural , Cirugía General/educación , Internado y Residencia/estadística & datos numéricos , Estudiantes de Medicina/estadística & datos numéricos , Estados Unidos , Asiático
8.
Int J Clin Pediatr Dent ; 17(1): 109-113, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38559852

RESUMEN

Aim and Background: The respective review articles aim is to provide an overview as well as describes and enlists different orofacial myofunctional therapy exercises as a modality for tongue tie secondary to surgery.Tongue tie is the basically a connection that joints base of tongue to the floor of mouth. This leads to difficulties various difficulties such as altered speech, oral habits, maligned teeth and many more. During formative years, most children successfully treated of tongue tie by releasing it, but problems start after its correction. That it may can reappear or may lead to same difficulties as prior. Parents and clinicians are only concerned about speech and aesthetics after release of tongue tie. But OMT plays important role ore and post-surgical procedure. OMT help in proper tongue posture along with reducing the probability of tissue reattachment after surgery by exercises. This therapy positively influenced functions by reducing deleterious habits. Methods: A review of relevant literature is predicated on articles found using free text terms, mesh terms, and some basic tongue tie as well as tongue tie release pamphlets that were published in English up until the year 2023 in the electronic databases PubMed, EBSCO, Scopus, Google Scholar, and Web of Science. With the aid of mesh keywords, the initial search yielded 38-40 articles; 20-35 were chosen depending on the requirements. Also we searched for orofacial myofunctional exercises or exercises recommended after tongue tie release. Results: Various exercises enlisted in our article that will guide a individual before and after tongue tie release which will give positive outcomes such as proper tongue posture, speech, swallow, regained aesthetics and self-esteem. Conclusion: Tongue plays an important role in development of perioral structures as well as in the swallow to good speech articulation and dental occlusion. So, as pediatric dentist its important know that after release of tongue tie what to do and how to maintain. This review article is focused on the various orofacial myofunctional therapy techniques employed for tongue tie but not a single one to describe them. Clinical significance: Our pertaining review act as a guide for clinicians as well as individuals to manage tongue tie after its release. How to cite this article: Shah SS, Agarwal PV, Rathi N, et al. Tongues Tied by Orofacial Myofunctional Therapy about Tongue Tie: A Narrative Review. Int J Clin Pediatr Dent 2024;17(1):109-113.

9.
J Pediatr Surg ; 59(9): 1759-1764, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38561308

RESUMEN

BACKGROUND: Necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) affect 6-8% of extremely low birth weight (ELBW) infants. SIP has lower mortality than NEC, but with similar short-term morbidity in length of stay, growth failure, and supplemental oxygen requirements. Comparative long-term neurodevelopmental outcomes have not been clarified. METHODS: Data were prospectively collected from 59 North American neonatal units, regarding ELBW infants (401-1000 g or 22-27 weeks gestational age) born between 2011 and 2018 and evaluated again at 16-26 months corrected age. Outcomes were collected from infants with laparotomy-confirmed NEC, laparotomy-confirmed SIP, and those without NEC or SIP. The primary outcome was severe neurodevelopmental disability. Secondary outcomes were weight <10th percentile, medical readmission, post-discharge surgery and medical support at home. Adjusted risk ratios (ARR) were calculated. RESULTS: Of 13,673 ELBW infants, 6391 (47%) were followed including 93 of 232 (40%) with NEC and 100 of 235 (42%) with SIP. There were no statistically significant differences in adjusted risk of any outcomes when directly comparing NEC to SIP (ARR 2.35; 95% CI 0.89, 6.26). However, infants with NEC had greater risk of severe neurodevelopmental disability (ARR 1.43; 1.09-1.86), rehospitalization (ARR 1.46; 1.17-1.82), and post-discharge surgery (ARR 1.82; 1.48-2.23) compared to infants without NEC or SIP. Infants with SIP only had greater risk of post-discharge surgery (ARR 1.64; 1.34-2.00) compared to infants without NEC or SIP. CONCLUSIONS: ELBW infants with NEC had significantly increased risk of severe neurodevelopmental disability and post-discharge healthcare needs, consistent with prior literature. We now know infants with SIP also have increased healthcare needs. LEVELS OF EVIDENCE: Level II.


Asunto(s)
Enterocolitis Necrotizante , Recien Nacido con Peso al Nacer Extremadamente Bajo , Perforación Intestinal , Humanos , Perforación Intestinal/cirugía , Perforación Intestinal/etiología , Perforación Intestinal/epidemiología , Enterocolitis Necrotizante/cirugía , Enterocolitis Necrotizante/epidemiología , Recién Nacido , Masculino , Femenino , Enfermedades del Prematuro/cirugía , Enfermedades del Prematuro/epidemiología , Estudios Prospectivos , Perforación Espontánea/cirugía , Perforación Espontánea/etiología , Perforación Espontánea/epidemiología , Trastornos del Neurodesarrollo/epidemiología , Trastornos del Neurodesarrollo/etiología , Readmisión del Paciente/estadística & datos numéricos
10.
J Pediatr Surg ; 59(5): 818-824, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38368194

RESUMEN

BACKGROUND: Limited data exists regarding the mortality of very low birth weight (VLBW) neonates with congenital diaphragmatic hernia (CDH). This study aims to quantify and determine predictors of mortality in VLBW neonates with CDH. METHODS: This analysis of 829 U.S. NICUs included VLBW [birth weight ≤1500g] neonates, born 2011-2021 with and without CDH. The primary outcome was in-hospital mortality. A generalized estimating equation regression model determined the adjusted risk ratio (ARR) of mortality. RESULTS: Of 426,140 VLBW neonates, 535 had CDH. In neonates with CDH, 48.4% had an additional congenital anomaly vs 5.5% without. In-hospital mortality for neonates with CDH was 70.4% vs 12.6% without. Of those with CDH, 73.3% died by day of life 3. Of VLBW neonates with CDH, 38% were repaired. A subgroup analysis was performed on 60% of VLBW neonates who underwent delivery room intubation or mechanical ventilation, as an indicator of active treatment. Mortality in this group was 62.7% for neonates with CDH vs 16.4% without. Higher Apgars at 1 min and repair of CDH were associated with lower mortality (ARR 0.91; 95%CI 0.87,0.96 and ARR 0.28; 0.21,0.39). The presence of additional congenital anomalies was associated with higher mortality (ARR 1.14; 1.01,1.30). CONCLUSION: These benchmark data reveal that VLBW neonates with CDH have an extremely high mortality. Almost half of the cohort have an additional congenital anomaly which significantly increases the risk of death. This study may be utilized by providers and families to better understand the guarded prognosis of VLBW neonates with CDH. TYPE OF STUDY: Level II. LEVEL OF EVIDENCE: Level II.


Asunto(s)
Hernias Diafragmáticas Congénitas , Recién Nacido , Humanos , Peso al Nacer , Recién Nacido de muy Bajo Peso , Oportunidad Relativa , Mortalidad Hospitalaria , Estudios Retrospectivos
11.
Artículo en Inglés | MEDLINE | ID: mdl-37947426

RESUMEN

INTRODUCTION: Previous research involving diabetes mellitus (DM), glycemic control, and complications in orthopaedic patients has primarily focused on elective procedures. The purpose of this study was to evaluate hemoglobin A1c (A1c) as a predictor of postoperative surgical site infection (SSI) in patients with orthopaedic trauma. METHODS: Patients aged 18 years or older treated surgically for an acute fracture by a fellowship-trained orthopaedic trauma surgeon at a single academic tertiary referral center with a laboratory value for A1c available within 3 months of their surgery were identified retrospectively. Postoperative SSI was defined according to 'Fracture related infection: A consensus on definition from an international expert group,' by Metsemakers et al. RESULTS: A total of 925 patients met criteria for analysis. A receiver operating characteristic curve was calculated using A1c as a predictor for signs suggestive and confirmatory of SSI and demonstrated an area under the curve of 0.535 and 0.539, respectively. No significant difference was found in the rate of signs suggestive or confirmatory of SSI in patients with normal A1c levels (<6.5) compared with patients with A1c levels consistent with a diagnosis of DM (>6.5), P-value = 0.199 and P-value = 0.297, respectively. No significant difference was found in the rate of signs suggestive or confirmatory of SSI in patients with completely uncontrolled DM (A1c > 10) compared with patients with A1c levels <10, P-value 0.528 and P-value = 0.552, respectively. CONCLUSION: Existing literature has demonstrated an association with postoperative infection in orthopaedic patients who have elevated A1c values. In this cohort of patients with orthopaedic trauma, hemoglobin A1c was not a valuable tool to predict postoperative SSI. Given these findings, routine A1c monitoring is not a reliable predictor of SSI criteria in patients with orthopaedic trauma based on the current consensus definition of SSI in fracture surgery.


Asunto(s)
Diabetes Mellitus , Fracturas Óseas , Ortopedia , Humanos , Infección de la Herida Quirúrgica/diagnóstico , Infección de la Herida Quirúrgica/etiología , Hemoglobina Glucada , Estudios Retrospectivos , Fracturas Óseas/complicaciones , Fracturas Óseas/cirugía
12.
Ann Neurosci ; 30(4): 256-261, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38020407

RESUMEN

Background: Headache is an extremely common symptom of the general outpatient department and also the headache clinic, with prevalence of 48.9% in the general population. None has ever experienced headache in life time. Headache is seen in 1 patient out of 10 general practitioner (GP) consultations, 1 referral out of 3 is headache in neurology OPD, and 1 in 5 of all emergency medical admissions. Of all headaches, around 98% constitute primary headache: migraine without aura, tension headache, and cluster headache. With advancement in various drug modalities, certain headache forms respond less well to the regular approved medications, and some headaches are complicated by the analgesic itself. Steroids have been tried in many subtypes of headache, especially in primary forms of headache with dysautonomia, headache with trigeminal pathway activation and disinhibition, and in certain medication-culprit headaches. This subgroup of headaches is almost a challenge in an emergency for the headache expert as well. So, we need to assess the role of steroids in less well-responsive headaches. Summary: Current reviewed evidence on the role of steroids in primary headache suggests that steroids have a role in status migrainosus and medication overuse headache when used in the mentioned and monitored manner. Consideration and further exploration of its role in other primary headaches may reveal insight into steroid efficacy as a treatment modality in various subtypes of headache. Key message: Steroids, when used cautiously in specifically selected primary headaches under supervision, proved miraculous where other modalities failed.

13.
Ann Neurosci ; 30(3): 197-204, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37779553

RESUMEN

Rates of cerebral venous sinus thrombosis (CVT) misdiagnosis or at times delayed diagnosis and related outcomes have remained underexplore, and also there is less knowledge about the long-term outcome of patients with untreated cerebral venous sinus thrombosis (CVT). Long-term presentations of untreated CVT are rare. We hereby presenting series of four interesting patients of chronic CVT whose diagnosis was missed and how varied chronic presentations of untreated CVT appeared to neurology and how subtle radiologic features helped with correct diagnosis.

14.
Cureus ; 15(6): e40510, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37461792

RESUMEN

INTRODUCTION: Prostate adenocarcinoma is the second-most common cause of cancer. Globally, many cancer-related deaths among men were noted due to prostate adenocarcinoma. CD44 plays a key role in mediating cell-to-cell and cell-to-matrix interaction, which further helps to maintain the integrity of tissue and also inhibits tumor metastasis. MATERIALS AND METHODS: Cross-sectional study was done on chips from transurethral resections of the prostate (TURP) and prostatic core biopsy specimens. All specimens with clinically diagnosed and histopathologically confirmed prostatic adenocarcinoma were included in the study. Prostatic intraepithelial neoplasia (PIN), recurrent cases, and patients who had undergone radiotherapy/ chemotherapy prior to biopsy were excluded from the study. The sample size for the current study was 57 with an 8% prevalence value, 95% confidence interval, and 8% absolute error. Immunoreaction to CD44 antibody is membranous and was evaluated by calculating positively stained cell percentage and staining intensity. These two parameters were added to obtain a final score; a score of 0-3 was considered as negative, and a score of 4-6 was regarded as positive. RESULTS: A statistically significant difference was only found between Gleason grade (p<0.001), clinical staging (p<0.002), nodal metastasis (p<0.015), and distant metastasis (p<0.020) with CD44 positive expression. The rest of the parameters like PSA (p=0.642) and age (p=0.051) did not correlate with CD44-positive expression. Out of 29 cases with positive CD44 expression, 100% positivity was seen in Gleason's grades 1, 2, and 3. This indicates that CD44 expression showed lesser positivity in poorly differentiated carcinoma. CD44 positivity was seen in 83.3% in the T2 stage. An inverse relationship between tumor staging and CD44 expression was observed with positive CD44 expression in lower tumor staging which implies loss of CD44 expression was associated with greater tumor aggressiveness. Lymph node metastasis cases showed more negative CD44 expression (59.5%) and the same was noted in patients without distant metastasis, that is in 61% of the subjects.  Conclusion: Cells tend to lose the ability of CD44 expression as they progress from well-differentiated adenocarcinoma to poorly differentiated adenocarcinoma. CD44 expression suggests that the tumor is in a well-differentiated and gland-forming state as compared to Gleason's grade. Loss of CD44 expression suggests tumor aggressiveness. Thus, the upregulation of CD44 expression can be considered as a potential target for targeted therapy. As many targeted and gene therapies are in clinical trials, large-scale multicentered studies are needed for a better understanding of the clinical course of the disease.

15.
J Surg Educ ; 80(11): 1614-1617, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37455192

RESUMEN

OBJECTIVE: To provide a more welcoming environment for LGBTQ residents. DESIGN: This paper is based upon the authors experience creating a training program welcoming to LGBTQ residents. SETTING: University General Surgery Training Program. PARTICIPANTS: Surgical Residents and Surgical Faculty. RESULTS: Over a 9 year period, our residency has made intentional efforts to welcome LGBTQ applicants and support LGBTQ residents. We now have a residency in which over 25% of our residents identify as LGBTQ. CONCLUSIONS: We see opportunities for other residencies to signal to applicants and trainees that they are welcome and celebrated for who they are.


Asunto(s)
Cirugía General , Internado y Residencia , Minorías Sexuales y de Género , Humanos , Cirugía General/educación
16.
Hand (N Y) ; : 15589447231167883, 2023 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-37128854

RESUMEN

BACKGROUND: Scapho-lunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) of the wrist are the most common types of wrist arthritis. We compared the union rate and complication profile of patients with SLAC and SNAC wrist undergoing 4 corner arthrodesis with partially threaded or fully threaded headless compression screws. METHODS: A single-center retrospective review was conducted to identify all patients treated for SLAC and SNAC with 4 corner fusion using headless compression screws from 2016 to 2021. A total of 33 patients undergoing surgery on 35 wrists were identified and included in the study. Demographics, comorbidities, complication profile, and radiographs were collected and compared between groups. RESULTS: One hundred percent (16/16) of partially threaded and 84.2% (16/19) of fully threaded screws demonstrated union by minimum 10-week follow-up. The total complication rate (avascular necrosis of lunate, screw loosening, etc.) was 31.4%; 52.6% of wrists implanted with fully threaded screws experienced complications compared with a 6.3% complication rate with partially threaded screws. The difference was statistically significant between the 2 groups (P = .004). CONCLUSIONS: Four corner arthrodesis using antegrade compression screws is an effective, reproducible method to achieve fusion in the wrist. The use of fully threaded screws was associated with more complications than with partially threaded screws, although union rate was not significantly different. Future studies with larger sample sizes would be useful to fully elucidate differences between these 2 constructs.

17.
J Wound Care ; 32(Sup5a): lxiii-lxxiv, 2023 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-37094978

RESUMEN

OBJECTIVE: Treatment of contaminated wounds represents a significant challenge in healthcare and there is a need to develop approaches maximising skin retention to maintain therapeutic concentrations of anti-infectives at the wound site. The objective of the present study was to develop and evaluate mupirocin calcium nanolipid emulgels to enhance wound healing performance and patient acceptability. METHODS: Nanostructured lipid carriers (NLCs) of mupirocin calcium were prepared by the phase inversion temperature method using Precirol ATO 5 (Gattefosse, India) and oleic acid as lipids and Kolliphor RH 40 (BASF, India) as surfactant and further incorporated into a gel base for topical delivery. RESULTS: The particle size, polydispersity index and zeta potential of mupirocin NLCs were found to be 128.8±1.25nm, 0.283±0.003 and -24.2±0.56mV, respectively. In vitro release studies from developed emulgel showed sustained drug release over 24 hours. Ex vivo drug permeation studies through excised rat abdominal skin showed better skin permeation (1712.38±15. 57µg/cm2) from developed emulgel compared to marketed ointment (827.92±21.42µg/cm2) after 8 hours, which was in agreement with in vitro antibacterial activity. Studies on Wistar rats indicated the nonirritant potential of developed emulgels. Further, mupirocin emulgels showed improved efficacy in percent wound contraction of acute contaminated open wounds in Wistar rats using a full-thickness excision wound healing model. CONCLUSION: The emulgels of mupirocin calcium NLCs appear to be effective in the treatment of contaminated wounds due to increased skin deposition and sustained release, thereby enhancing the wound healing potential of existing molecules.


Asunto(s)
Sistemas de Liberación de Medicamentos , Mupirocina , Ratas , Animales , Mupirocina/farmacología , Sistemas de Liberación de Medicamentos/métodos , Ratas Wistar , Piel , Cicatrización de Heridas
18.
Ann Indian Acad Neurol ; 26(1): 59-66, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37034037

RESUMEN

Background: Post-stroke cognitive impairment (PSCI) is a clinical entity that encompasses all types of cognitive impairment following an index stroke. Yoga has been proven to have a beneficial effect not only on cardiovascular risk factors but also on cognition. Hence, this study explored the PSCI spectrum and assessed the effect of yoga on PSCI. Methods: Forty stroke patients were enrolled in each yoga and control arm in this study. After the baseline assessment, control arm was administered standard care (including physiotherapy) while yoga arm received additional yoga intervention. Change in MoCA scores by 2 points in either direction, or FAB scale by 2 points at 6 months was taken as primary outcome, whereas improvement in MRS, CDPSS, CBS, and P300 values were considered as secondary outcomes. Results: Significant improvements were observed in MoCA, FAB, MRS, CPDSS, and CBS scores in both groups after 6 months. However, intergroup comparisons revealed better MoCA (25.5, IQR 22-27) and FAB scores (15.5, IQR 14-17) in yoga group compared to controls (24, IQR20-25.75) and (14, IQR12-15.75). Equivalent improvement was observed in MRS and CBS scores in both groups at 6 months; however, CDPSS score was better in yoga group (p = 0.0008). Both P300 amplitudes and latencies improved in all patients and median P300 amplitudes were significantly better in control group; however, no difference could be appreciated in P300 latencies improvement on intergroup comparisons at follow-up. Conclusion: Study reveals that early yoga intervention in stroke survivors leads to better improvement in cognitive abilities which would further facilitate in early reduction of caregiver burden.

19.
Dalton Trans ; 51(38): 14686-14699, 2022 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-36098266

RESUMEN

We report the controlled growth of biologically active compounds: gold nanoparticles (AuNPs) in various shapes, including their green synthesis, characterization, and studies of their applications towards biological, degradation and recycling. Using spectroscopic methods, studies on responsive binding mechanisms of AuNPs with biopolymers herring sperm deoxyribonucleic acid (hsDNA), bovine serum albumin (BSA), dyes degradation study, and exquisitely gold separation studies/recovery from nanowaste, COVID-19 testing kits, and pregnancy testing kits are discussed. The sensing ability of the AuNPs with biopolymers was investigated via various analytical techniques. The rate of degradation of various dyes in the presence and absence of AuNPs was studied by deploying stirring, IR, solar, and UV-Vis methods. AuNPs were found to be the most active cytotoxic agent against human breast cancer cell lines such as MCF-7 and MDAMB-468. Furthermore, an economical process for the recovery of gold traces from nanowaste, COVID-19 detection kits, and pregnancy testing kits was developed using inexpensive and eco-friendly α-cyclodextrin sugar. This method was found to be easy and safest in comparison with the universally accepted cyanidation process. In the future, small gold jewelry makers and related industries would benefit from the proposed gold-recycling process and it might contribute to their socio-economic growth. The methodologies proposed are also beneficial for trace-level forensic investigation.


Asunto(s)
COVID-19 , Nanopartículas del Metal , alfa-Ciclodextrinas , COVID-19/diagnóstico , Prueba de COVID-19 , Colorantes , Citotoxinas , ADN , Oro/química , Humanos , Masculino , Nanopartículas del Metal/química , Semen , Albúmina Sérica Bovina/química , Azúcares
20.
RSC Adv ; 12(29): 18425-18430, 2022 Jun 22.
Artículo en Inglés | MEDLINE | ID: mdl-35799927

RESUMEN

We developed a cost-effective and eco-friendly click biosynthesis of small molecule quercetin-gold quantum dots (QRT-AuQDs) involving quick conjugation using an ultrasonication method at ambient temperature by utilizing QRT and gold ions in the proportion of 0.1 : 1 (molar ratio). A comparatively very short amount of time (60 seconds) was required as compared to conventional procedures. The present biomimetics research relates to the isolation of bioactive QRT by the circularly spread silica gel layer technique (CSSGLT) and characterization (UV-Vis, FTIR, NMR and DSC analysis). Characterization of the synthesized QRT-AuQDs conjugated complex was carried out by UV-Vis, HR-TEM, DLS, zeta potential and X-ray diffraction. The main objective of the present work was to study the comparative anticancer activity of QRT and QRT-AuQDs on human lung cancer HOP-62 and leukemia K-562 cell lines. The results suggested that QRT-AuQDs showed potential for applications in anticancer treatment and were found to be a more cytotoxic agent in comparison to QRT, causing > 50% inhibition of cancer cells at the concentration < 10-7 M. Hence, small molecule conjugated QRT-AuQDs can be used as a promising material for biomedical, bioengineering and anti-infectives applications.

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