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Neuralgia Posherpética , Humanos , Neuralgia Posherpética/terapia , Estudios Retrospectivos , Ganglios Espinales , Tratamiento de Radiofrecuencia Pulsada/métodos , Interferón alfa-2/uso terapéutico , Interferón alfa-2/administración & dosificación , Terapia Combinada , Interferón-alfa/administración & dosificación , Resultado del TratamientoRESUMEN
BACKGROUND & AIMS: Chronic migraine poses a global health burden, particularly affecting young women, and has substantial societal implications. This study aimed to assess the efficacy of Greater Occipital Nerve Block (GONB) in individuals with chronic migraine, focusing on the impact of local anesthetics compared with placebo. METHODS: A meta-analysis and systematic review were conducted following the PRISMA principles and Cochrane Collaboration methods. Eligible studies included case-control, cohort, and randomized control trials in adults with chronic migraine, adhering to the International Classification of Headache Disorders, third edition (ICHD3). Primary efficacy outcomes included headache frequency, duration, and intensity along with safety assessments. RESULTS: Literature searches across multiple databases yielded eight studies for qualitative analysis, with five included in the final quantitative analysis. A remarkable reduction in headache intensity and frequency during the first and second months of treatment with GONB using local anesthetics compared to placebo has been reported. The incidence of adverse events did not differ significantly between the intervention and placebo groups. CONCLUSION: The analysis emphasized the safety and efficacy of GONB, albeit with a cautious interpretation due to the limited number of studies and relatively small sample size. This study advocates for further research exploring various drugs, frequencies, and treatment plans to enhance the robustness and applicability of GONB for chronic migraine management.
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Trastornos Migrañosos , Bloqueo Nervioso , Humanos , Bloqueo Nervioso/métodos , Enfermedad Crónica , Anestésicos Locales/administración & dosificación , Anestésicos Locales/uso terapéutico , Resultado del TratamientoRESUMEN
Treatment-resistant schizophrenia (TRS) presents considerable challenges in contemporary psychiatric practice due to inadequate response to conventional antipsychotic treatments. Paliperidone, the primary active metabolite of risperidone, particularly in its long-acting injectable (LAI) form, has emerged as a promising option for TRS due to its consistent medication delivery, reducing symptom exacerbation and relapse associated with oral dosing fluctuations. This case report presents the clinical journey of a 42-year-old female diagnosed with schizophrenia at age 15. Despite numerous hospital admissions and trials of various oral and injectable antipsychotics, including clozapine and electroconvulsive therapy (ECT), her symptoms persisted. During her last admission, her condition showed minimal improvement despite extensive pharmacological interventions. Introducing paliperidone LAI while tapering off other antipsychotics led to significant improvements within four weeks. The patient exhibited reduced hallucinatory behaviour, delusions, and disorganized behaviour. Follow-up assessments confirmed sustained progress, with the patient showing increased engagement in daily activities and reduced irritability and suspiciousness. This case underscores the potential efficacy of paliperidone LAI in managing TRS. The patient's notable improvement highlights the importance of personalized treatment plans and continuous monitoring in complex psychiatric conditions. Its favourable safety and tolerability profile further supports its use as a long-term treatment option for TRS, potentially leading to enhanced patient compliance and overall quality of life. The significant symptomatic relief and functional improvement observed advocate for the consideration of paliperidone LAI as a promising therapeutic option for TRS, with the potential to be considered in the future among the first-line treatments for TRS.
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BACKGROUND: Linezolid-resistant Enterococcus faecium (LRE) is a global priority pathogen. Thirteen LRE were reported from clinical specimens between November 2021 and April 2023 at two laboratories in Karachi, Pakistan. We aimed to investigate the strain types and genes associated with linezolid resistance among these isolates. Whole genome sequencing (WGS) was performed and analyzed by multilocus sequence typing (MLST). The presence of linezolid resistance genes was identified using ResFinder v4.1.11 and the LRE-finder tool. RESULTS: Twelve isolates belonged to clonal complex 17 (CC17); ST80 (n = 10), ST612 (n = 1) and ST1380 (n = 1). Six isolates showed the presence of optrA gene and G2576T mutations in the 23S rRNA gene, while six showed poxtA and cfr(D) genes. One isolate showed the combination of optrA, cfr(D) and poxtA genes. CONCLUSION: Our findings show the circulation of CC17 sequence types with a known outbreak potential and we identified molecular mechanisms of resistance that were not previously reported from Pakistan.
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Antibacterianos , Farmacorresistencia Bacteriana , Enterococcus faecium , Infecciones por Bacterias Grampositivas , Linezolid , Pruebas de Sensibilidad Microbiana , Tipificación de Secuencias Multilocus , Secuenciación Completa del Genoma , Enterococcus faecium/genética , Enterococcus faecium/efectos de los fármacos , Enterococcus faecium/aislamiento & purificación , Enterococcus faecium/clasificación , Pakistán , Linezolid/farmacología , Humanos , Antibacterianos/farmacología , Farmacorresistencia Bacteriana/genética , Infecciones por Bacterias Grampositivas/microbiología , Infecciones por Bacterias Grampositivas/epidemiología , ARN Ribosómico 23S/genética , Femenino , Masculino , Genoma Bacteriano/genética , Genómica , Adulto , Proteínas Bacterianas/genética , Persona de Mediana Edad , MutaciónRESUMEN
The performance of photovoltaic (PV) modules is greatly impacted by dust accumulation and defects appearing in photovoltaic (PV) modules. Existing studies primarily focus on the effect of dust on general photovoltaic performance, neglecting the interactions with pre-existing defects such as snail trails. These defects are known to degrade the efficiency of PV modules. However, their interaction with environmental factors like dust accumulation has not been extensively analyzed. This research comprehensively analyzes the impact of dust accumulation on the performance of PV modules affected by snail trails. Using an experimental setup under outdoor conditions, the study incorporates thermal imaging, current-voltage characteristic curve tracing (IV curve tracing), electroluminescence (EL) imaging, and chemical analysis of the accumulated dust, to evaluate the electrical and thermal parameters affecting PV module performance. The study focuses on three types of modules, clean serves as a reference module (PV-R), normal unclean (PV-N), and snail trail-affected unclean PV module (PV-S). Compared to the PV-R module, the study meticulously quantifies the effect of accumulated dust on key performance indicators such as output power, V, and I. The PV-N module exhibits reductions of 17.7 % in current, 3.91 % in voltage, and 18.15 % in power output. The PV-S module experienced a decrease of 7.4 % in current, 7.55 % in voltage, and 14.87 % in power output under the dust deposition density of 6.984 g/m^2 having a mean particle size of 2.2279 µm. The dust deposition reduced the transmittance of glass, which indicates a potentially adverse impact on the PV module's efficiency. The findings highlighted in the current work provide a significant understanding of the detrimental impacts of dust accumulation on defected photo voltaic modules, highlighting the need for regular maintenance and cleaning to ensure optimal performance.
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Pakistan is faces significant challenges in meeting its energy demand and consumption needs for consumers. This country's energy production from primary sources such as petroleum and natural gasses is incompetent in fuel-use and hence unable to meet feasibility cost. With an increasing population, Pakistan's energy consumption per capita has been steadily rising. This behaviour is leading to critical energy issues, especially in remote rural areas. This trend in rising energy costs and demand factors are similar to those in the energy markets in the South and South-East Asia. The primary energy sources in Asia continent, including fossil fuels, are insufficient supply to meet this growing demand in production and thus resulting in frequent electricity blackouts. Consequently, renewable energy sources such as solar photovoltaic (PV) and wind power have substantially started to produce energy and to provide a huge portion of Pakistan's daily energy needs apart in conventional energy currently. However, these sources are not yet as reliable, conventional energy bases have a challenge for sustainable energy production. As a result, renewable energy factors nonetheless initial started have effectively stabilized energy consumption, particularly for green electricity with net-zero carbon emissions. The aim of this study is to evaluate the feasibility and cost-effectiveness of integrating a microgrid hybrid system with combined (solar PV/wind power) renewable energy as well as conventional fossil fuel generators. This evaluation focuses on predicting energy production and its costs using Hybrid Optimization of Multiple Energy Resources (HOMER) software, and to enhance the electricity standards at NUST (National University for Sciences and Technology), Pakistan. The proposed methodology of microgrid hybrid system, when evaluated using HOMER software, shows a significant improvement in energy stability and cost efficiency. Moreover, this proposed system can reduce reliance on fossil fuels by a substantial percentage, enhances the predictability of energy production, and optimizes its energy consumption. These can achieve better performance metrics in terms of reliability, cost, and environmental impact; feasible solution for Pakistan and the developing countries. This proposed methodology offers a novel approach by integrating renewable energy sources with conventional generators to create a balanced and efficiency factor by microgrid system. This hybrid system goals as an investigation is to optimize this energy production, reduce carbon emissions, and provide a more stable and cost-effective energy supply.
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BACKGROUND: Endemic fluorosis refers to the condition when individuals are exposed to excessive amounts of fluoride ion due to living in a region characterized by elevated levels of fluorine in the drinking water, food, and/or air. In Pakistan, a substantial proportion of the population is thereby affected, posing a public health concern. OBJECTIVES: Assessing how the gut microbiota and its metabolic profiles are impacted by chronic exposure to fluoride in drinking water (that caused Dental Fluorosis) as well as to perceive how this microbiota is connected to adverse health outcomes prevailing with fluoride exposure. METHODS: Drinking water (n=27) and biological samples (n=100) of blood, urine and feces were collected from 70 high fluoride exposed (with Dental Fluorosis) and 30 healthy control (without Dental Fluorosis) subjects. Water and urinary fluoride concentrations were determined. Serum/plasma biochemical testing was performed. Fecal DNA extraction, 16S rRNA analysis of microbial taxa, their predicted metabolic function and fecal short chain fatty acids (SCFAs) quantification were carried out. RESULTS: The study revealed that microbiota taxonomic shifts and their metabolic characterization had been linked to certain host clinical parameters under the chronic fluoride exposure. Some sets of genera showed strong specificity to water and urine fluoride concentrations, Relative Fat Mass index and SCFAs. The SCFAs response in fluoride-exposed samples was observed to be correlated with bacterial taxa that could contribute to adverse health effects. CONCLUSIONS: Microbial dysbiosis as a result of endemic fluorosis exhibits a structure that is associated with risk of metabolic deregulation and is implicated in various diseases. Our results may form the development of novel interventions and may have utility in diagnosis and monitoring.
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Achieving circularity in the plastic economy predominantly depends on sourcing higher quality recyclates. Packaging plastic poses a significant challenge as it is often not prioritised for collection or recycling initiatives. The presence of additives, such as printing ink, impedes the quality of recyclates. Considering the volume of packaging plastics and the importance of branding (aesthetics and consumer information), ink removal is a critical pre-treatment step. However, the literature is limited, with only 14 studies exploring de-inking processes. Drawing parallels with the detergent laundering process, surfactants have been widely investigated in plastic de-inking, with cationic surfactants proving the most effective with a de-inking efficiency of up to 100%. However, concerns exist regarding the toxic and hazardous nature of the surfactants and chemicals. The average hazard quotient (AHQ) was developed, which compares de-inking chemicals as one of the key findings. AHQ provides a quantitative proxy for the hazards and toxicities, which are qualitatively presented as part of the globally harmonised system (GHS) classification of chemicals. To drive emerging packaging plastic de-inking, including the development of green surfactants (e.g. gamma-valerolactone), this work enables an informed chemical selection minimising potential hazards (rather than creating more adverse effects in plastic recycling processes) and toxicities from plastic waste, fulfilling the objectives of cleaner plastic waste recycling.
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Here, we report for the first time, green-synthesized selenium nanoparticles (SeNPs) using pharmacologically potent herb of Polygonum bistorta Linn. for multiple biomedical applications. In the study, a facile and an eco-friendly approach is utilized for synthesis of SeNPs using an aqueous roots extract of P. bistorta Linn. followed by extensive characterization via Fourier transform infrared spectroscopy, X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and Energy Dispersive X-Ray (EDX) analysis. The XRD and FTIR data determine the phase composition and successful capping of plant extract onto the surface of NPs while SEM and TEM micrographic examination reveals the elliptical and spherical morphology of the particles with a mean size of 69 ± 23 nm. After comprehensive characterization, the NPs are investigated for antifungal, antibacterial, antileishmanial, antioxidant, and biocompatibility properties. The study reveals that Polygonum bistorta Linn. synthesized SeNPs exhibit significant antibacterial and antifungal activities with Staphylococcus aureus and Fusarium oxysporum inducing the highest zone of inhibition of 14 ± 1.0 mm and 20 ± 1.2 mm, respectively at the concentration of 40 mg/mL. The NPs are also found to have antiparasitic potential against promastigote and amastigote forms of Leishmania tropica. Furthermore, the NPs are discovered to have excellent potential in neutralizing harmful free radicals thus exhibiting considerable antioxidant potential. Most importantly, Polygonum bistorta Linn. synthesized SeNPs showed substantial compatibility against blood cells in vitro studies, which signifies the nontoxic nature of the NPs. The study thus concludes that medicinally important Polygonum bistorta Linn. roots can be utilized as an eco-friendly, sustainable, and green source for the synthesis of pharmacologically potent selenium nanoparticles.
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Background: C3 glomerulopathy (C3G), which encompasses C3GN and dense deposit disease (DDD), results from dysregulation of the alternative complement pathway. Data on disease recurrence after kidney transplantation are limited, and details on histologic features of recurrent C3G are scarce. We aimed to evaluate C3G recurrence in the allograft, with a focus on histologic presentation and progression. Methods: We retrospectively analyzed 18 patients with native kidney failure attributed to C3G (12 C3GN and six DDD), who received a kidney transplant from January 2016 to January 2023. Demographic, genetic, clinical, and histologic data were studied. The NanoString 770 genes PanCancer Immune Profiling Panel was used for transcriptomic analysis. Disease recurrence was the primary outcome. Results: During a median (interquartile range) follow-up period of 37 (1856) months, C3G recurrence occurred in 16 (89%) patients (11 with C3GN and five with DDD) at a median (interquartile range) of 33 (13141) days after transplantation. Over a third (38%) of recurrent cases were detected in protocol biopsies, and only 31% of patients presented with >300 mg/g of proteinuria. Recurrence in index biopsies was mainly established through a combination of immunofluorescence and electron microscopy findings, while it showed only subtle histologic alterations and no characteristic transcriptomic signals. Over time, histologic chronicity indices increased, but all the allografts were functioning at the end of follow-up. Patients with recurrence of C3GN and DDD showed overlapping immunofluorescence and electron microscopy findings and had similar recurrence rate and time to recurrence. Conclusions: Most of the patients with native kidney failure attributed to C3G developed disease recurrence very early after kidney transplantation, usually with minimal proteinuria, mild histologic alterations, and favorable short-term allograft survival. Immunofluorescence and electron microscopy played a crucial role in detecting early, subclinical recurrence of C3GN and DDD, which showed significant overlapping features.
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Trasplante de Riñón , Recurrencia , Humanos , Trasplante de Riñón/efectos adversos , Biopsia , Masculino , Complemento C3/análisis , Factores de Tiempo , Persona de Mediana Edad , Femenino , Adulto , Glomerulonefritis/patologíaRESUMEN
[This corrects the article DOI: 10.1371/journal.pone.0297413.].
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The study draws attention to the associations between monetary and economic elements and their potential environmental impacts. The study uses time series data from 1960 to 2022 to examine the connection between CO2 emissions, industrial growth, GNE, and inflation in China. The researchers utilized the well-known econometric technique of nonlinear autoregressive distributed lag (NARDL) to examine nonlinear correlations between these variables. The results reveal that GDP, inflation, and economic development influence long-term CO2 emissions. The strong positive correlation between gross national expenditures and economic activity increases CO2 emissions. In the short run, CO2 emissions are positively and statistically significantly affected by inflation. While inflation temporarily affects CO2 emissions, this effect dissipates with time. Industrial activity increases CO2 emissions, and China's fast industrialization has damaged the environment. The energy-intensive fertiliser manufacturing process and fossil fuels increase CO2 emissions. The research shows how government officials and academics may collaborate to create tailored measures to alleviate the environmental impacts of economic activity.
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Dióxido de Carbono , Ambiente , Desarrollo Industrial , Dióxido de Carbono/análisis , China , Inflación Económica , Desarrollo Económico , Producto Interno BrutoRESUMEN
Malignant peripheral nerve sheath tumor of the orbit is an exceedingly rare entity. These tumors exhibit locally aggressive behavior, recurrences, distant metastasis, and poor response to existing treatment protocols. Orbital nerve sheath tumors are often associated with neurofibromatosis 1, and malignant transformation of neurofibroma into malignant nerve sheath tumor has also been seen. The recommended treatment for localized disease is radical or wide surgical excision to achieve negative margins followed by chemoradiation. For extensive disease, chemotherapy and radiotherapy can be utilized to stabilize the disease. Due to poor response and outcomes with current regimens, the focus has been shifted to approaches utilizing molecular targets and immunological agents. Despite all the advancements, the outcomes still remain discouraging for moderate- to high-grade lesions and thus necessitate studies to design promising treatment modalities.
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Cupronickel-based alloys are widely known for their excellent resistance against aqueous corrosion, however, they can be susceptible to corrosion at accelerated rates and premature failure when exposed to a polluted or brackish seawater medium, even for short-term exposure durations. This unfamiliar corrosion behavior may be a result of the formation of an unprotected corrosion film during the early exposure durations. The paper investigates the corrosion phenomenon in cupronickel 90/10 alloy, by exposing the coupons in two different seawater compositions in the Arabian Sea region. Corrosion losses were investigated on the experimental coupons in a submerged position, for a maximum exposure duration of 150 days, using the conventional weight loss method and a new dimensional metrology-based measurement technique. Additionally, in this research the tubes of a marine heat exchanger having similar material that failed prematurely during operation in the Arabian Sea were also investigated for corrosion losses, followed by the characterization of the corrosion deposits using following analytical techniques: SEM, EDS, XRD and Raman Scattering. The experimental results showed significantly higher corrosion losses on coupons exposed to seawater site rich in pollutants and nutrients including dissolved inorganic nitrogenous compounds, compared to those subjected to a natural seawater solution in corrosion tanks maintained in a controlled environment.