Recent Articles

Objective: This study was conducted to investigate the effects of gabapentin enacarbil (GEn) on sleep EEG, heart rate (HR), blood presssure, anterior tibialis EMG activity (PLMs power) and subjective complaints in subjects with moderate to severe RLS and disturbed sleep. Methods: This was a single site, single-blind, placebo run-in, fixed dose single group polysomnography (PSG) study. Eligible subjects (age 24-66 years) were treated with placebo for one week and GEn (600 mg/day) for 4 weeks. Two in-laboratory PSGs were collected for adaptation and baseline at the end of the placebo run-in period and for re-adaptation and efficacy assessment at the end of the 4-week treatment period. The primary endpoint was the difference in PSG derived cortical arousal intensity (arousal scale, 0-9) associated with PLMs between 4 weeks of treatment with GEn and placebo. Secondary endpoints included changes in HR responses (ΔHR), nocturnal systolic blood pressure (SBP) changes (>10 mmHg) secondary to PLMs and PLMs power. Other PSG and subjective measures were assessed. Results: Of 20 subjects enrolled, 18 completed the study. Subjects treated with GEn did not show significant improvements in cortical arousal intensity and ΔHR. However, subjects showed reduced PLMs power (p= 0.013) and associated reductions in nocturnal SBP per hour of sleep (p= 0.041) GEn showed significant improvement in other PSG parameters and subjective endpoints. Conclusion: The data suggests that GEn reduces the frequency and power of PLMs and the corresponding SBP changes in subjects with RLS. Despite reducing the total number of PLM associated arousals and nocturnal HR, the study did not demonstrate consistent effects of GEn on cortical arousal intensity and corresponding HR changes associated with PLMs. Clinical Trial Registration: ClinicalTrials.gov identifier: NCT02424695

Several factors have been identified as contributing to medical errors such as labels, appearance, and location of ampules. In this paper, inadvertent intrathecal Injection of tranexamic acid has resulted from similarities in appearance between tranexamic acid and heavy bupivacaine 0.5% ampoules. The patient experienced severe itching in the gluteal region followed by generalized myoclonic seizures after accidental intrathecal administration of tranexamic acid.

One factor underlying medical errors in “confirmation bias,” the tendency to interpret new evidence as confirmation of one’s existing beliefs or theories. When a medical error occurs, the physician has a moral duty to examine the factors which lead to its occurrence, to discuss these factors with the patient who suffered the error, and to perform their due diligence to prevent the error from occurring again. Restorative Justice is a form of collaborative decisionmaking including all parties involved in a precipitating event, including the perpetrators, victims, and stakeholders. We report on a case in which confirmation bias played a major role in misdiagnosis followed by the application of Restorative Justice principles to address the consequent mistrust between the physician and patient.

Background: Gliomatosis cerebri is a rare primary brain tumor that can have extensive infiltration into the brain parenchyma. It can affect any age group and often has poor clinical outcomes. Given its unique pathology, presentation and treatment can be challenging to recognize and efficaciously treat

Purpose: The present bioequivalence study aimed at demonstrating the bioequivalence of a recently developed novel riluzole orodispersible film vs. a reference tablet. Methods: Healthy male and female volunteers received single oral doses of 50 mg of riluzole, as test and reference formulation, under fasting conditions, in each of 4 subsequent periods separated by wash-out intervals of at least 7 days, according to a 2-treatment, 4-period, replicate randomised cross-over design. Findings: Riluzole plasma concentrations were almost superimposable. Riluzole attained a similar peak concentration (315.62±124.95 ng/mL with the film and 278.81±123.32 ng/mL with the tablet) at a median tmax of 0.75 h after both treatments. Then, riluzole plasma concentrations showed a superimposable decline from the peak up to 36 h post-dose, with mean half-lives of 10.22±1.66 and 10.22±1.48 h with the film and the tablet. Mean AUC0-t was 1263.40±571.58 h*ng/mL with the film and 1135.98±514.98 h*ng/mL with the tablet. The 90% confidence intervals of Cmax, AUC0-t and AUC0-¥ of riluzole fell within the predefined range 80.00-125.00%. The treatments did not differ significantly either in tmax or t1/2. On average, the test orodispersible film dissolved on the tongue in a median time of about 2.5 min with a range of 0.7-5.7 min. Orodispersible film palatability was good or acceptable for most subjects.

There are several energy drinks available in the market such as Red Bull, Sting, Rebound, Power Up! Triple X Energy Drink, and so on. After the Red Bull drink was introduced in the market in1990s, Energy drinks started to gain popularity and afterwards it became a common name especially among teenagers and young adults [1]. Most energy drinks are caffeinated nonindulgent beverages that are professed to give an additional increase in energy for day-by-day work, increase alertness, and improve athletic performance and mood. There are even certain shreds of evidence present to substantiate these claims, but the effects of these drinks on mental and physical health cannot be neglected. There are reports of adverse events such as insomnia, anxiety, cardiovascular events, seizures, tachycardia, type-2 diabetes, and even death are associated with the consumption of these drinks [2]. This review will focus on energy drinks, their ingredients, health risks associated with these drinks, and will also suggest some recommendations such as changes in marketing, providing education to children regarding adverse effects of these drinks, and further research should be carried out in this domain.

Chronic wounds substantially reduce the quality of life for millions of people worldwide. As a result, researchers have developed various treatments and therapies to reduce the time for a wound to heal. Mathematical models that help better understand and predict the wound healing process have also been developed. This paper presents and validates a mathematical model known as the vibration enhanced wound healing model (VEWH) that includes the effects of vibration treatment in the wound healing process. The model is based on existing models of cutaneous wound healing but includes the effects of vibration on blood flow, macrophages, chemoattractant, and fibroblasts. These parameters were derived from published data on vibration accelerated wound healing of healthy mice. The VEWH model is confirmed with published experimental animal data that show vibration can reduce the wound healing time by 8%. The model reveals that vibration primarily affects healing through the mechanotransduction of vibration by fibroblasts into greater production of extracellular matrix. Model simulations agree with the validation data, with optimal healing predicted to occur with frequencies between 5 Hz and 25 Hz.

The emergency committee said the spread of COVID-19 can be halted through early detection, isolation, prompt treatment and implementation of a robust contact traceability system.

There are no guidelines for pharmacological treatment of COVID-19 disease, but several drugs are being tested every day in search of an optimal therapeutic strategy. The drugs that have been tested, so far, include some antiviral drugs such as danoprevir, favipiravir, darunavir, nelfinavir, remdesivir, umifenovir and the combination lopinavir/ritonavir. Others are drugs targeting inflammatory mediators such as meplazumab, siltuximab, tocilizumab, azithromycin and corticosteroids. Also included in this array of tested drugs are those with pleiotropic actions against SARS-CoV-2 infection like chloroquine/hydroxychloroquine, ivermectin and nitazoxanide, postulated as inhibitors of several phases of virus life cycle. Upon diagnosis of SARS-CoV-2 infection, it is pertinent to embark on a treatment approach based on potential antiviral options, adequately managed under proper medical situation. We suggest that, in addition to the antiviral option efforts, drugs targeting inflammatory mediators should be considered.

Background: exposure to Pesticides may lead to high risk of toxicity, in which these chemical compounds can affect blood component causing chronic diseases and inflammations. Design: This descriptive case control study was conducted in Khartoum state from November to December 2021. Objectives: The goal is to measure the effect of pesticides on blood parameters among exposures compared to healthy individuals using the analysis of complete blood count. And to correlate between duration of work according to age and gender. Materials and Methods: 3 ml of intravenous blood samples were collected from 500 participants, 400 samples from men and 100 samples from women aged between 20-65 years, majority were dealers and the rest of them were working at farms and the structural questionnaire was used. Results: The results of these study show marked increase in red blood cells and absolute lymphocytes count accompanied by decreased in platelets count, platelets distribution width, mean platelets volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration and red cells distribution width upon exposures to pesticides for long time. Conclusion: this study concluded that there is decrease in PLTs count, PDW, MPV, MCH, MCHC, RDW, and an increase in RBCs count and absolute lymphocytes count among pesticides exposures.

Introduction: Diabetic retinopathy maybe defined as the presence and characteristic evolution of typical retinal micro-vascular lesions to an patient with diabetes. DR usually manifests as a gradual, painless progression of vision loss; however, visual loss may occur with vitreous hemorrhage or macular edema. Aims: To ascertain the prevalence of diabetic retinopathy (DR) based on the duration of the diabetes mellitus (DM) and to compare it with data from relevant literature and other referent clinics. This exploratory research was conducted to evaluate the clinical experience of DR, its impact of the other disease and health related quality of life. Material and methods: In this study are included the patients with diabetes mellitus type I insulin dependent (DMID) and diabetes mellitus type II non-insulin dependent (DMNID). The duration of diabetes in the examined patients varied from 5 till 30 years. We have applied examination by ophthalmoscope, slit lamp bio-microscopy with Volk and Goldman lens, optical coherence tomography - OCT as well as fluorescent angiography - FAG. Have been included for focus groups (n = 450) the treated patients with DR, from December 2016 - 2020. Results: Participants described a range of evaluate symptoms and clinical impact. In suffering for a period of 5 years, the prevalence of DR is 12.5%. In diabetic patients suffering over 30 years, the prevalence of DR is over 90.5 %. After the test of PDR impact the comlications results by the X2 -test, the difference was found to be statistically significant for p

The choice of induction immunosuppression can affect several outcomes after kidney transplant (KTx). We aimed to evaluate infectious and malignant complications between alemtuzumab and basiliximab in elderly KTx recipients. Patients ≥ 65 years old who received alemtuzumab or basiliximab induction for their primary KTx from 2006 – 2018 were included.

Obesity is a pandemic, chronic and relapsing disease with several treatment options. The aim of this work was to investigate the level of awareness that people with obesity (PwO) have of their own condition and the level of knowledge regarding possible treatments available. To compare and contrast collected data on PwO with data obtained from general practitioners (GPs)

Lower urinary tract injury in hysterectomy is rare, but once it occurs, the consequence can be deteriorating. We experienced late onset urinary tract injury that developed as late as 15 days after laparoscopic hysterectomy. The objective of this case report is to alert all gynecological laparoscopists that such late onset complication may happen to any of patients.

The coronavirus pandemic (COVID-19) has affected the whole world causing the lives of many victims. Africa has recorded more than a million cases and Cameroon around 18,600 cases (August 2020) since the first case was notified. The rapid spread of this disease, (among other factors), could have contributed to create a situation of fear and stigma among affected populations. It is, therefore, necessary to identify the characteristics of this stigma and its effect on the case management of this disease.

A Caucasian male with prostate cancer under androgen deprivation therapy after radiotherapy for a locally advanced lesion. Positron emission tomography/Computed Tomography revealed an adrenal lesion. The mass was removed, and histopathological examination showed adenocarcinoma of prostatic origin. Prostate-specific antigen decreased dramatically after adrenalectomy

Dasatinib is an orally bioavailable second generation TKI, more potent than imatinib. Bone marrow aplasia or hypoplasia secondary to TKI therapy is an uncommon adverse event. We report here the first case of chronic myeloid leukemia in chronic phase shortly treated with dasatinib that developed a prolonged bone marrow hypoplasia with concomitant response on the hematological disease with gradual improvement of the cytogenetic and molecular response after dasatinib discontinuation, without use of any other TKI therapy.

Driving pattern of the given vehicle in a city is represented by the driving cycle which is used by modal models for estimation of vehicular emissions. In this study, a driving cycle was developed for passenger cars in the city of Islamabad. A representative route for city was identified which included parts of highway, arteries, and streets. Speed-time data was collected along the selected route in both peak and off-peak hours. The on-board measurement method was adopted for data collection on highways, whereas on arteritis and streets, chase car method has opted for data collection. The developed cycle showed comparable values of average speed and acceleration with New European Driving Cycle (NEDC), but acceleration and deceleration were observed to be lower. The emission estimation and fuel consumption were calculated by the Comprehensive Modal Emission Model (CMEM) for 4 selected vehicle types. The average emissions for the selected vehicles were 204.4 g CO2/km, 2.3 g CO /km, 0.09 g HCs /km, 0.31 g NOx /km emitted, and 65.7 g of fuel consumed /km. The developed cycle showed higher fuel consumption and CO2 emissions /km traveled than NEDC for all 4 passenger car types. However, HCs, CO, and NOx emissions were lower. The developed driving cycle can be used for estimation of the emissions from passenger cars in the city and this information can be useful for future emission projections and policy making.

The emissions trading system is an important tool to combat climate change, which uses the “cap and trade” principle to reduce carbon dioxide emissions. This paper first adopts production technology considering carbon emission permit trading and proposes a data envelopment analysis (DEA) model to evaluate carbon emission efficiency of Chinese fire power industry from 2013 to 2017. Further, a new zero sum gains DEA（ZSG-DEA）considering carbon emission permit trading model is proposed based on efficiency principle to adjust the initial allocation of carbon emission permits (considering fairness principle) among regional fire power industries in 2030. The new approach enables us to investigate the carbon emission efficiency and emission permit allocation problem from an emission permit trading perspective. Theoretical analysis show that organizations have higher potential in reducing carbon emissions and greater potential in improving inputs and outputs after introducing emitting permit trading. Empirical results show that the southeastern fire power industries have higher carbon emission efficiencies and permitted emission levels. Under the background of carbon emission permit trading, the allocation level of carbon emissions permit in inefficient areas is limited and given greater responsibility for reducing emissions considering fairness and efficiency principles. This could promote active carbon emissions reduction in various regions so as to realize China’s carbon emissions [1] reduction targets in a faster pace.