This is an interim analysis of the Beta-blocker (Propranolol) use in traumatic brain injury (TBI) based on the high-sensitive troponin status (BBTBBT) study. The BBTBBT is an ongoing double-blind placebo-controlled randomized clinical trial with a target sample size of 771 patients with TBI. We sought, after attaining 50% of the sample size, to explore the impact of early administration of beta-blockers (BBs) on the adrenergic surge, pro-inflammatory cytokines, and the TBI biomarkers linked to the status of high-sensitivity troponin T (HsTnT).
View Article and Find Full Text PDFTreatment regimens for post-kala-azar dermal leishmaniasis (PKDL) are usually extrapolated from those for visceral leishmaniasis (VL), but drug pharmacokinetics (PK) can differ due to disease-specific variations in absorption, distribution, and elimination. This study characterized PK differences in paromomycin and miltefosine between 109 PKDL and 264 VL patients from Eastern Africa. VL patients showed 0.
View Article and Find Full Text PDFBackground: The host cellular immune response associated with two treatments for post-kala-azar dermal leishmaniasis (PKDL) - paromomycin plus miltefosine (Arm 1), and liposomal amphotericin B plus miltefosine (Arm 2) - was examined in Sudanese patients before treatment (D0), at the end of treatment (D42), and during the post-treatment period (D180).
Methods: Whole blood samples were stimulated with soluble Leishmania antigen for 24 h (whole blood assay [WBA]) and the concentrations of Th1/Th2/Th17-associated cytokines, IP-10, PDL-1 and granzyme B were determined.
Results: The Arm 1 treatment (98.
J Emerg Trauma Shock
February 2024
Background: Grade (III-V) blunt splenic injuries (BSI) in hemodynamically stable patients represent clinical challenges for successful non-operative management (NOM). In 2014, Our institution proposed a treatment protocol requiring splenic angiography and embolization for stable, intermediate, and high-grade BSI. It also included a follow-up CT scan for grade III BSI.
View Article and Find Full Text PDFIn this work, a higher order-to-fundamental mode converter is reported and analyzed based on an asymmetric dual channel waveguide (ADC-WG) on silicon. In the reported structure, one of the two waveguides is infiltrated with nematic liquid crystal (NLC) material to add temperature tunability while the other one is a solid BK7 waveguide. The modal characteristics are obtained using the full vectorial finite difference method (FVFDM).
View Article and Find Full Text PDFUtilizing nonlinear evolution equations (NEEs) is common practice to establish the fundamental assumptions underlying natural phenomena. This paper examines the weakly dispersed non-linear waves in mathematical physics represented by the Konopelchenko-Dubrovsky (KD) equations. The [Formula: see text]-expansion method is used to analyze the model under consideration.
View Article and Find Full Text PDFPLoS Negl Trop Dis
November 2023
Background: Treatment for post-kala-azar dermal leishmaniasis (PKDL) in Sudan is currently recommended only for patients with persistent or severe disease, mainly because of the limitations of current therapies, namely toxicity and long hospitalization. We assessed the safety and efficacy of miltefosine combined with paromomycin and liposomal amphotericin B (LAmB) for the treatment of PKDL in Sudan.
Methodology/principal Findings: An open-label, phase II, randomized, parallel-arm, non-comparative trial was conducted in patients with persistent (stable or progressive disease for ≥ 6 months) or grade 3 PKDL, aged 6 to ≤ 60 years in Sudan.
J Intensive Care Med
October 2023
Cervical spine clearance in intubated patients due to blunt trauma remains contentious. Accumulating evidence suggests that a normal computed tomography (CT) cervical spine can be used to clear the cervical spine and remove the collar in unconscious patients presenting to the emergency department. However, whether this strategy can safely be employed by critical care physicians with intubated patients admitted to the trauma intensive care unit (TICU) with cervical collars in situ, has not been definitively studied.
View Article and Find Full Text PDFThe leishmaniases are neglected tropical diseases caused by various parasite species transmitted by sand flies. They comprise a number of systemic and cutaneous syndromes including kala-azar (visceral leishmaniasis, VL), cutaneous leishmaniasis (CL), and post-kala-azar dermal leishmaniasis (PKDL). The leishmaniases cause significant mortality (estimated 20 - 50,000 deaths annually), morbidity, psychological sequelae, and healthcare and societal costs.
View Article and Find Full Text PDFReduction of the crosstalk (CT) between contiguous photonic components is still a big challenge in fabricating high packing density photonic integrated circuits (PICs). Few techniques to accomplish that goal have been offered in recent years but all in the near-IR region. In this paper, we report a design for realizing a highly efficient CT reduction in the MIR regime, for the first time to the best of our knowledge.
View Article and Find Full Text PDFType 2-diabetes, particularly poorly controlled diabetes, is a risk factor for several infections such as lower respiratory tract and skin infections. Hyperglycemia, a characteristic downstream effect of poorly controlled diabetes, has been shown to impair the function of immune cells, in particular neutrophils. Several studies have demonstrated that hyperglycemia-mediated priming of NADPH oxidase results in subsequent elevated levels of reactive oxygen species (ROS).
View Article and Find Full Text PDFIn this paper, we explore local dynamics with topological classifications, bifurcation analysis, and chaos control in a discrete-time COVID-19 epidemic model in the interior of . It is explored that for all involved parametric values, discrete-time COVID-19 epidemic model has boundary equilibrium solution and also it has an interior equilibrium solution under definite parametric condition. We have explored the local dynamics with topological classifications about boundary and interior equilibrium solutions of the discrete-time COVID-19 epidemic model by linear stability theory.
View Article and Find Full Text PDFPain is a major problem that burdens the health and economy of societies worldwide. Nonsteroidal anti-inflammatory drugs (NSAIDs) are over-the-counter medications that are widely indicated for mild to moderate pain conditions. Clinically, the selection of a medication among this class is mainly based according to both patient's and doctor's previous experiences.
View Article and Find Full Text PDFJ Chromatogr B Analyt Technol Biomed Life Sci
November 2022
Bioanalytical assay development and validation procedures were performed to quantify antiprotozoal drug paromomycin in human skin tissue by ultra-high performance liquid chromatography coupled to tandem mass spectrometry. Paromomycin, an aminoglycoside drug, is administered intra-muscularly and used in the treatment of multiple clinical presentations of the neglected tropical disease leishmaniasis. It is currently studied in the treatment of post-kala-azar dermal leishmaniasis, a disease where the Leishmania parasites divide and reside in the skin.
View Article and Find Full Text PDFEnd-of-life (EOL) care for newborns is challenging and requires well-prepared nurses to provide the best care for the dying baby and to prepare and support parents during such a difficult experience. This study aimed to explore Jordanian neonatal intensive care unit nurses' perceptions and needs regarding the provision of EOL care. This study used an exploratory descriptive qualitative approach and was conducted among a sample of 12 Jordanian neonatal intensive care unit nurses.
View Article and Find Full Text PDFBackground: Prehospital administration of tranexamic acid (TXA) to injured patients is increasing worldwide. However, optimal TXA dose and need of a second infusion on hospital arrival remain undetermined. We investigated the efficacy and safety of the second in-hospital dose of TXA in injured patients receiving 1 g of TXA in the prehospital setting.
View Article and Find Full Text PDFRecently, photonic crystal fibers (PCFs) have become of significant interest due to their various applications, especially in the mid-infrared (mid-IR) regime. In this work, an optical mid-IR modulator based on silicon D-shaped PCF (Si-D-PCF) with vanadium dioxide () as a phase changing material (PCM) is presented and analyzed. Thanks to the phase transition of the material between insulating (ON) and conducting (OFF) states, the modulation process can be attained.
View Article and Find Full Text PDFIn this study, a compact mode converter based on an asymmetric dual-core photonic crystal fiber (ADC-PCF) infiltrated with nematic liquid crystal (NLC) is reported. The full vectorial finite difference method is used to compute the modal characteristics of the studied transverse magnetic (TM) mode. In this investigation, the geometrical and material parameters of the proposed mode converter are studied to achieve high wavelength selectivity with a compact device length.
View Article and Find Full Text PDFBackground: The constellation of the initial hyperglycemia, proinflammatory cytokines and severity of injury among trauma patients is understudied. We aimed to evaluate the patterns and effects of on-admission hyperglycemia and inflammatory response in a level 1 trauma center. We hypothesized that higher initial readings of blood glucose and cytokines are associated with severe injuries and worse in-hospital outcomes in trauma patients.
View Article and Find Full Text PDFIntroduction: Intramuscular paromomycin monotherapy to treat visceral leishmaniasis (VL) has been shown to be effective for Indian patients, while a similar regimen resulted in lower efficacy in Eastern Africa, which could be related to differences in paromomycin pharmacokinetics.
Methods: Pharmacokinetic data were available from two randomized controlled trials in VL patients from Eastern Africa and India. African patients received intramuscular paromomycin monotherapy (20 mg/kg for 21 days) or combination therapy (15 mg/kg for 17 days) with sodium stibogluconate.