Intravenous Vitamin C Administered as Adjunctive Therapy for Recurrent Acute Respiratory Distress Syndrome

This case report summarizes the first use of intravenous vitamin C employed as an adjunctive interventional agent in the therapy of recurrent acute respiratory distress syndrome (ARDS). The two episodes of ARDS occurred in a young female patient with Cronkhite-Canada syndrome, a rare, sporadically occurring, noninherited disorder that is characterized by extensive gastrointestinal polyposis and malabsorption. Prior to the episodes of sepsis, the patient was receiving nutrition via chronic hyperalimentation administered through a long-standing central venous catheter. The patient became recurrently septic with Gram positive cocci which led to two instances of ARDS. This report describes the broad-based general critical care of a septic patient with acute respiratory failure that includes fluid resuscitation, broad-spectrum antibiotics, and vasopressor support. Intravenous vitamin C infused at 50 mg per kilogram body weight every 6 hours for 96 hours was incorporated as an adjunctive agent in the care of this patient. Vitamin C when used as a parenteral agent in high doses acts “pleiotropically” to attenuate proinflammatory mediator expression, to improve alveolar fluid clearance, and to act as an antioxidant

Efficacy of memantine in treating patients with migraine and tension-type headache

Objective: To assess the efficacy of Memantine as a preventive and therapeutic intervention for migraine and tension-type headache. Methods: This clinical trial was conducted over a period of 3 months. A total of 44 subjects, with diagnosed migraine and/or tension-type headache, presenting to a private neurology clinic in Karachi, Pakistan were selected through purposive sampling technique. Patients were treated with incremental doses of Memantine. Adult patients belonging to both genders were included in the study. Data was analyzed using SPSS version 16.0 and associations were made using Chi square test with p-value of less than 0.05 taken as significant. Results: Out of 44 patients, 35 (79.5%) were females and 9 (20.5%) were males which shows a very high occurrence of migraine and tension-type headache in females. Average age was found to be 32.6 ≈ 33 years. Efficacy of the drug was observed to be 81.8% which is significantly high. The baseline MIDAS score when compared with the score at 3-month follow-up by applying Wilcoxon signed rank test showed mean ± S.D (39.52±21.27 vs. 6.72±6.41) where p=0.000 (\u3c0.05) which shows a highly significant result. All 44 patients were known cases of migraine while 25% (11) of them also suffered from tension-type headache. Patients were treated with incremental doses of Memantine and were observed for the efficacy of the drug. Patients maintained their diaries of intensity of pain, distressing influence of the pain and how it hindered their daily routine. Results showed that intensity of pain decreased significantly by the end of the 3rd month of treatment and majority of the patients felt less distressed on their final follow-up visit. By the end of the 3rd month, the level of hindrance in the daily routines of the patients caused by the headache also fell significantly. Conclusion: Memantine has significant beneficial effects in reducing intensity of pain and disability in patients with migraine and tension type headache

Preventive zinc supplementation for children, and the effect of additional iron: a systematic review and meta-analysis

Objective: Zinc deficiency is widespread, and preventive supplementation may have benefits in young children. Effects for children over 5 years of age, and effects when coadministered with other micronutrients are uncertain. These are obstacles to scale-up. This review seeks to determine if preventive supplementation reduces mortality and morbidity for children aged 6 months to 12 years. Design: Systematic review conducted with the Cochrane Developmental, Psychosocial and Learning Problems Group. Two reviewers independently assessed studies. Meta-analyses were performed for mortality, illness and side effects. Data sources We searched multiple databases, including CENTRAL and MEDLINE in January 2013. Authors were contacted for missing information. Eligibility criteria for selecting studies Randomised trials of preventive zinc supplementation. Hospitalised children and children with chronic diseases were excluded. Results: 80 randomised trials with 205 401 participants were included. There was a small but non-significant effect on all-cause mortality (risk ratio (RR) 0.95 (95% CI 0.86 to 1.05)). Supplementation may reduce incidence of all-cause diarrhoea (RR 0.87 (0.85 to 0.89)), but there was evidence of reporting bias. There was no evidence of an effect of incidence or prevalence of respiratory infections or malaria. There was moderate quality evidence of a very small effect on linear growth (standardised mean difference 0.09 (0.06 to 0.13)) and an increase in vomiting (RR 1.29 (1.14 to 1.46)). There was no evidence of an effect on iron status. Comparing zinc with and without iron cosupplementation and direct comparisons of zinc plus iron versus zinc administered alone favoured cointervention for some outcomes and zinc alone for other outcomes. Effects may be larger for children over 1 year of age, but most differences were not significant. Conclusions: Benefits of preventive zinc supplementation may outweigh any potentially adverse effects in areas where risk of zinc deficiency is high. Further research should determine optimal intervention characteristics and delivery strategies

Silicon slow-light-based photonic mixer for microwave-frequencyconversion applications

This paper was published in OPTICS LETTERS and is made available as an electronic reprint with the permission of OSA. The paper can be found at the following URL on the OSA website: http://dx.doi.org/10.1364/OL.37.001721. Systematic or multiple reproduction or distribution to multiple locations via electronic or other means is prohibited and is subject to penalties under law[EN] We describe and demonstrate experimentally a method for photonic mixing of microwave signals by using a silicon electro-optical Mach¿Zehnder modulator enhanced via slow-light propagation. Slow light with a group index of ~11, achieved in a one-dimensional periodic structure, is exploited to improve the upconversion performance of an input frequency signal from 1 to 10.25 GHz. A minimum transmission point is used to successfully demonstrate the upconversion with very low conversion losses of ~7¿¿dB and excellent quality of the received I/Q modulated QPSK signal with an optimum EVM of ~8%.Financial support from FP7-224312 HELIOS project and Generalitat Valenciana under PROMETEO-2010-087 R&D Excellency Program (NANOMET) are acknowledged. F. Y.Gardes, D. J. Thomson, and G. T. Reed are supported by funding received from the UK EPSRC funding body under the grant “UK Silicon Photonics.” The author A. M. Gutiérrez thanks D. Marpaung for his useful help.Gutiérrez Campo, AM.; Brimont, ACJ.; Herrera Llorente, J.; Aamer, M.; Martí Sendra, J.; Thomson, DJ.; Gardes, FY.... (2012). Silicon slow-light-based photonic mixer for microwave-frequencyconversion applications. Optics Letters. 37(10):1721-1723. https://doi.org/10.1364/OL.37.001721S17211723371

Resistance to simian immunodeficiency virus low dose rectal challenge is associated with higher constitutive TRIM5α expression in PBMC

Background: At least six host-encoded restriction factors (RFs), APOBEC3G, TRIM5α, tetherin, SAMHD1, schlafen 11, and Mx2 have now been shown to inhibit HIV and/or SIV replication in vitro. To determine their role in vivo in the resistance of macaques to mucosally-acquired SIV, we quantified both pre-exposure (basal) and post-exposure mRNA levels of these RFs, Mx1, and IFNγ in PBMC, lymph nodes, and duodenum of rhesus macaques undergoing weekly low dose rectal exposures to the primary isolate, SIV/DeltaB670. Results: Repetitive challenge divided the monkeys into two groups with respect to their susceptibility to infection: highly susceptible (2–3 challenges, 5 monkeys) and poorly susceptible (≥6 challenges, 3 monkeys). Basal RF and Mx1 expression varied among the three tissues examined, with the lowest expression generally detected in duodenal tissues, and the highest observed in PBMC. The one exception was A3G whose basal expression was greatest in lymph nodes. Importantly, significantly higher basal expression of TRIM5α and Mx1 was observed in PBMC of animals more resistant to mucosal infection. Moreover, individual TRIM5α levels were stable throughout a year prior to infection. Post-exposure induction of these genes was also observed after virus appearance in plasma, with elevated levels in PBMC and duodenum transiently occurring 7–10 days post infection. They did not appear to have an effect on control of viremia. Interestingly, minimal to no induction was observed in the resistant animal that became an elite controller. Conclusions: These results suggest that constitutively expressed TRIM5α appears to play a greater role in restricting mucosal transmission of SIV than that associated with type I interferon induction following virus entry. Surprisingly, this association was not observed with the other RFs. The higher basal expression of TRIM5α observed in PBMC than in duodenal tissues emphasizes the understated role of the second barrier to systemic infection involving the transport of virus from the mucosal compartment to the blood. Together, these observations provide a strong incentive for a more comprehensive examination of the intrinsic, variable control of constitutive expression of these genes in the sexual transmission of HIV

Phase I safety trial of intravenous ascorbic acid in patients with severe sepsis

Background Parenterally administered ascorbic acid modulates sepsis-induced inflammation and coagulation in experimental animal models. The objective of this randomized, double-blind, placebo-controlled, phase I trial was to determine the safety of intravenously infused ascorbic acid in patients with severe sepsis. Methods Twenty-four patients with severe sepsis in the medical intensive care unit were randomized 1:1:1 to receive intravenous infusions every six hours for four days of ascorbic acid: Lo-AscA (50 mg/kg/24 h, n = 8), or Hi-AscA (200 mg/kg/24 h, n = 8), or Placebo (5% dextrose/water, n = 8). The primary end points were ascorbic acid safety and tolerability, assessed as treatment-related adverse-event frequency and severity. Patients were monitored for worsened arterial hypotension, tachycardia, hypernatremia, and nausea or vomiting. In addition Sequential Organ Failure Assessment (SOFA) scores and plasma levels of ascorbic acid, C-reactive protein, procalcitonin, and thrombomodulin were monitored. Results Mean plasma ascorbic acid levels at entry for the entire cohort were 17.9 ± 2.4 μM (normal range 50-70 μM). Ascorbic acid infusion rapidly and significantly increased plasma ascorbic acid levels. No adverse safety events were observed in ascorbic acid-infused patients. Patients receiving ascorbic acid exhibited prompt reductions in SOFA scores while placebo patients exhibited no such reduction. Ascorbic acid significantly reduced the proinflammatory biomarkers C-reactive protein and procalcitonin. Unlike placebo patients, thrombomodulin in ascorbic acid infused patients exhibited no significant rise, suggesting attenuation of vascular endothelial injury. Conclusions Intravenous ascorbic acid infusion was safe and well tolerated in this study and may positively impact the extent of multiple organ failure and biomarkers of inflammation and endothelial injury

Effect of Temperature and Alcohol on the Determination of Critical Micelle Concentration of Non- Ionic Surfactants in Magnetic Water

تم تقدير التركيز الماسيلي الحرج (CMC) لبعض المواد الفعالة سطحيا غير الايونية المنتخبة وهي ( Tween 20,40 80 ) لقد تم متابعة التقدير باستخدام تقنية التوصيلية الكهربائية في الوسط المائي الممغنط. كما تم دراسة تأثير إضافة الكحولات بتغير درجة الحرارة في المدى (293.15 -303.15K ). ومن خلال الثوابت الثرموداينمكية (∆Gᵒm ، ∆Hᵒm) تبين ان عملية التجمع المايسيلي تلقائية وماصة للحرارة كما تم دراسة وتعيين قيم الانتروبي(∆Som)، وتم كذلك دراسة النظام الغير ايوني بوجود وغياب الكحولات. كما تم تفسير النتائج على ضوء التداخلات الهيدروفوبية والهيدروفيلية بين الجزيئات إضافة الى طول السلاسل الكحولية ،وقد بينت الدراسة فشل الدرجات الحرارية في اثبات أي تغير ملموس على تقدير التجمع المايسيلي.The determination of critical micelle concentration of selected non-ionic surfactants (Tween 20,40 and 80) have been investigated using magnetic water(MW)as an aqueous medium.Conductometry technique is used to determine critical micelle concentration.The effect of alcohol addition and temperature variation at the range(293.15 -303.15K) are also pursued. It is concluded that the process of micellization is spontaneous and endothermic because of the observed free energy of micellization (ΔGom) , enthalpy change of micellization  (ΔHom), and entropy change of micellization (ΔSom) for the system was also studied.The properties of the non-ionic surfactants were studied, both in absence and presence of alcohol. The results obtained were explained in light of hydrophobic-hydrophilic interactions and chain length of alcohol.The temperature change has slight effect on the micellization process.

Effect of preventive zinc supplementation on linear growth in children under 5 years of age in developing countries: a meta-analysis of studies for input to the lives saved tool

<p>Abstract</p> <p>Introduction</p> <p>Zinc plays an important role in cellular growth, cellular differentiation and metabolism. The results of previous meta-analyses evaluating effect of zinc supplementation on linear growth are inconsistent. We have updated and evaluated the available evidence according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria and tried to explain the difference in results of the previous reviews.</p> <p>Methods</p> <p>A literature search was done on PubMed, Cochrane Library, IZiNCG database and WHO regional data bases using different terms for zinc and linear growth (height). Data were abstracted in a standardized form. Data were analyzed in two ways i.e. weighted mean difference (effect size) and pooled mean difference for absolute increment in length in centimeters. Random effect models were used for these pooled estimates. We have given our recommendations for effectiveness of zinc supplementation in the form of absolute increment in length (cm) in zinc supplemented group compared to control for input to Live Saves Tool (LiST).</p> <p>Results</p> <p>There were thirty six studies assessing the effect of zinc supplementation on linear growth in children < 5 years from developing countries. In eleven of these studies, zinc was given in combination with other micronutrients (iron, vitamin A, etc). The final effect size after pooling all the data sets (zinc ± iron etc) showed a significant positive effect of zinc supplementation on linear growth [Effect size: 0.13 (95% CI 0.04, 0.21), random model] in the developing countries. A subgroup analysis by excluding those data sets where zinc was supplemented in combination with iron showed a more pronounced effect of zinc supplementation on linear growth [Weighed mean difference 0.19 (95 % CI 0.08, 0.30), random model]. A subgroup analysis from studies that reported actual increase in length (cm) showed that a dose of 10 mg zinc/day for duration of 24 weeks led to a net a gain of 0.37 (±0.25) cm in zinc supplemented group compared to placebo. This estimate is recommended for inclusion in Lives Saved Tool (LiST) model.</p> <p>Conclusions</p> <p>Zinc supplementation has a significant positive effect on linear growth, especially when administered alone, and should be included in national strategies to reduce stunting in children < 5 years of age in developing countries.</p