Coverage of hospital-based cataract surgery and barriers to the uptake of surgery among cataract blind persons in nigeria: the Nigeria National Blindness and Visual Impairment Survey.

PURPOSE: To determine cataract surgical coverage, and barriers to modern cataract surgery in Nigeria. METHODS: Multistage stratified cluster random sampling was used to identify a nationally representative sample of 15,027 persons aged 40+ years. All underwent visual acuity testing, frequency doubling technology visual field testing, autorefraction, and measurement of best corrected vision if <6/12 in one or both eyes. An ophthalmologist examined the anterior segment and fundus through an undilated pupil for all participants. Participants were examined by a second ophthalmologist using a slit lamp and dilated fundus examination using a 90 diopter condensing lens if vision was <6/12 in one or both eyes, there were optic disc changes suggestive of glaucoma, and 1 in 7 participants regardless of findings. All those who had undergone cataract surgery were asked where and when this had taken place. Individuals who were severely visually impaired or blind from unoperated cataract were asked to explain why they had not undergone surgery. RESULTS: A total of 13,591 participants were examined (response rate 89.9%). Prevalence of cataract surgery was 1.6% (95% confidence interval 1.4-1.8), significantly higher among those aged ≥70 years. Cataract surgical coverage (persons) in Nigeria was 38.3%. Coverage was 1.7 times higher among males than females. Coverage was only 9.1% among women in the South-South geopolitical zone. Over one third of those who were cataract blind said they could not afford surgery (36%). CONCLUSIONS: Cataract surgical coverage in Nigeria was among the lowest in the world. Urgent initiatives are necessary to improve surgical output and access to surgery

In-situ upgrading of Napier grass pyrolysis vapour over microporous and hierarchical mesoporous zeolites

This study presents in-situ upgrading of pyrolysis vapour derived from Napier grass over microporous and mesoporous ZSM-5 catalysts. It evaluates effect of process variables such catalyst–biomass ratio and catalyst type in a vertical fixed bed pyrolysis system at 600 °C, 50 °C/min under 5 L/min nitrogen flow. Increasing catalyst–biomass ratio during the catalytic process with microporous structure reduced production of organic phase bio-oil by approximately 7.0 wt%. Using mesoporous catalyst promoted nearly 4.0 wt% higher organic yield relative to microporous catalyst, which translate to only about 3.0 wt% reduction in organic phase compared to the yield of organic phase from non-catalytic process. GC–MS analysis of bio-oil organic phase revealed maximum degree of deoxygenation of about 36.9% with microporous catalyst compared to the mesoporous catalysts, which had between 39 and 43%. Mesoporous catalysts promoted production olefins and alkanes, normal phenol, monoaromatic hydrocarbons while microporous catalyst favoured the production of alkenes and polyaromatic hydrocarbons. There was no significant increase in the production of normal phenols over microporous catalyst due to its inability to transform the methoxyphenols and methoxy aromatics. This study demonstrated that upgrading of Napier grass pyrolysis vapour over mesoporous ZSM-5 produced bio-oil with improved physicochemical properties

Effects of ethyl acetate leaf extracts of Vitex simplicifolia on antioxidant vitamins, sod, liver glycogen content and lipid profile in alloxan induced - diabetic wistar rats

The effects of oral administration of ethyl acetate leaf extract of Vitex simplicifolia on vitamins A, E and C, Superoxide dismutase (SOD) and lipid profile levels in alloxan induced diabetic Wistar rats were investigated. The study was conducted with 30 Wistar rats, assigned into six groups of five rats each, and daily administration of ethyl acetate leaf extract of Vitex simplicifolia for 21 days was done. Diabetes mellitus was induced in overnight fasted rats by a single intraperitoneal injection (i.p) of 150 mg/kg body weight of alloxan monohydrate. Group 1 was the normal control group 2 was the diabetic control, group 3 was administered 10mg/kg of glibenclimide (positive control) and groups 4, 5, and 6 were administered 250,500 and 1000mg/kg body weight of aqueous leaf extracts of Vitex simplicifolia respectively. There were no significant changes (p&lt;0.01) in the levels of total cholesterol (TC), triglycerol (TAG), low density lipoprotein – cholesterol (LDL-C), high density lipoprotein –cholesterol (HDL –C), SOD, vitamins A, E and C for the animals administered with the extract compared with the control groups. The result of this study suggests that aqueous leaf extract of Vitex simplicifolia has no antioxidant and hypolipidemic effect.Keywords: Vitex simplicifolia, SOD, Lipid Profile, Antioxidant Vitamin

Effects of pretreatments of Napier Grass with deionized water, sulfuric acid and sodium hydroxide on pyrolysis oil characteristics

The depletion of fossil fuel reserves has led to increasing interest in liquid bio-fuel from renewable biomass. Biomass is a complex organic material consisting of different degrees of cellulose, hemicellulose, lignin, extractives and minerals. Some of the mineral elements tend to retard conversions, yield and selectivity during pyrolysis processing. This study is focused on the extraction of mineral retardants from Napier grass using deionized water, dilute sodium hydroxide and sulfuric acid and subsequent pyrolysis in a fixed bed reactor. The raw biomass was characterized before and after each pretreatment following standard procedure. Pyrolysis study was conducted in a fixed bed reactor at 600 o�C, 30 �C/min and 30 mL/min N2 flow. Pyrolysis oil (bio-oil) collected was analyzed using standard analytic techniques. The bio-oil yield and characteristics from each pretreated sample were compared with oil from the non-pretreated sample. Bio-oil yield from the raw sample was 32.06 wt% compared to 38.71, 33.28 and 29.27 wt% oil yield recorded from the sample pretreated with sulfuric acid, deionized water and sodium hydroxide respectively. GC–MS analysis of the oil samples revealed that the oil from all the pretreated biomass had more value added chemicals and less ketones and aldehydes. Pretreatment with neutral solvent generated valuable leachate, showed significant impact on the ash extraction, pyrolysis oil yield, and its composition and therefore can be regarded as more appropriate for thermochemical conversion of Napier grass

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Nanotechnology-mediated delivery of resveratrol as promising strategy to improve therapeutic efficacy in triple negative breast cancer (TNBC): progress and promises

Introduction Triple-negative breast cancer (TNBC) presents unique challenges in diagnosis and treatment. Resveratrol exhibits potential as a therapeutic intervention against TNBC by regulating various pathways such as the PI3K/AKT, RAS/RAF/ERK, PKCδ, and AMPK, leading to apoptosis through ROS-mediated CHOP activationand the expression of DR4 and DR5. However, the clinical efficacy of resveratrol is limited due to its poor biopharmaceutical characteristics and low bioavailability at the tumor site. Nanotechnology offers a promising approach to improving the biopharmaceutical characteristics of resveratrol to achieve clinical efficacy in different cancers. The small dimension (<200 nm) of nanotechnology-mediated drug delivery system is helpful to improve the bioavailability, internalization into the TNBC cell, ligand-specific targeted delivery of loaded resveratrol to tumor site including reversal of MDR (multi-drug resistance) condition. Areas covered This manuscript provides a comprehensive discussion on the structure-activity relationship (SAR), underlying anticancer mechanism, evidence of anticancer activity in in-vitro/in-vivo investigations, and the significance of nanotechnology-mediated delivery of resveratrol in TNBC. Expert opinion Advanced nano-formulations of resveratrol such as oxidized mesoporous carbon nanoparticles, macrophage-derived vesicular system, functionalized gold nanoparticles, etc. have increased the accumulation of loaded therapeutics at the tumor-site, and avoid off-target drug release. In conclusion, nano-resveratrol as a strategy may provide improved tumor-specific image-guided treatment options for TNBC utilizing theranostic approach

Non-communicable diseases in Saudi adolescents: prevalence, risk factors, and implications for public health

ObjectivesThis study aimed to assess the prevalence of non-communicable diseases (NCDs) among Saudi adolescents, focusing on obesity, conduct disorder, asthma, and anxiety, and to identify potential risk factors associated with these conditions.MethodsA retrospective cross-sectional analysis was conducted using data from 2,160 adolescents sourced from official government databases and peer-reviewed literature. Statistical methods included one-way ANOVA, chi-square tests, logistic regression, and Pearson’s correlation coefficient, with significance set at p &lt; 0.05 and a 95% confidence interval.ResultsThe prevalence of NCDs among Saudi adolescents was 11.8%. Obesity was the most common condition (odds ratio [OR] = 1.24, p = 0.006), followed by conduct disorder (OR = 1.12, p = 0.041), asthma (OR = 1.09, p = 0.036), and anxiety (OR = 1.06, p = 0.042). Pearson’s correlation revealed significant associations between these disorders and adolescence stages.ConclusionObesity, conduct disorder, asthma, and anxiety are significant health challenges for Saudi adolescents. These findings highlight the role of lifestyle factors such as diet and physical inactivity. Targeted interventions are needed to promote healthy behaviors and mitigate the long-term risks of these conditions

The impact of enteric coating of aspirin on aspirin responsiveness in patients with suspected or newly diagnosed ischemic stroke: prospective cohort study: results from the (ECASIS) study

Background and purpose: Uncertainty remains regarding the impact of enteric-coated aspirin (EC-ASA) on secondary prevention of ischemic stroke compared to plain aspirin (P-ASA). Hence, this study was designed to investigate the effect of EC formulation on ASA response via evaluating thromboxane B2 (TXB2) levels in patients with suspected or newly diagnosed stroke. Methods: A prospective cohort study on suspected or newly diagnosed ischemic stroke patients who are aspirin-naive was conducted. Patients were received either EC aspirin or plain aspirin for at least 3 days. The primary outcome was the proportion of aspirin non-responsiveness between two groups (level of residual serum TXB2 associated with elevated thrombotic risk ( 3.1 ng/ml) within 72 h after three daily aspirin doses, while secondary outcomes were the incidence of early gastrointestinal tract (GIT) bleeding with the various aspirin preparations. (Trial registration: Clinicaltrials.gov NCT04330872 registered on 02 April 2020). Results: Of 42 patients, ischemic strokes were confirmed in both P-ASA (81%) and EC-ASA (67%) arms. ASA non-responsiveness showed no significant difference between the two formulations (P-ASA vs. EC-ASA; 28.6% vs 23.8%; P = 0.726). Univariate and multivariate logistic regression analysis showed that patients treated with EC-ASA were more likely to have a lower rate of non-responders compared to P-ASA (unadjusted OR 0.78; 95% CI 0.20, 3.11); with the risk highest in type 2 diabetic patients with HBA1c > 6.5% (adjusted OR 6; 95% CI 1.02, 35.27; P = 0.047). No incidence of GIT bleeding observed throughout the study. Conclusion: A significant proportion of ASA non-responsiveness was recorded regardless of ASA formulation administered. The increased risk of ASA non-responsiveness in diabetic patients needs further exploration by larger prospective studies.Open Access funding provided by the Qatar National Library. Besides the publication fund provided by Qatar National library (QNL), this study was supported by an internal research grant from the MRC of Hamad Medical Corporation (HMC)

Nephroprotective potential of Polyalthia longifolia roots against vancomycin-induced renal toxicity in experimental animals

This study was done to investigate the possible nephroprotective effect of an ethanolic root extract of Polyalthia Longifolia (PL) on vancomycin-induced nephrotoxicity using curative and protective models. Vancomycin (150 mg/kg, intravenous) was given to healthy Wistar albino rats in the curative model before the start of treatment, whereas the protective group received vancomycin at the conclusion of the 10-day treatment procedure. Animals were divided into six groups for both models; group I served as the normal control, while groups II, III, IV, V, and VI were kept as toxic control, standard (selenium, 6 mg/kg), LDPL (low dose of PL 200 mg/kg), HDPL (high dose of PL 400 mg/kg), and HDPL + selenium (interactive) groups, respectively. Renal biomarkers [(uric acid, creatinine, blood urea nitrogen (BUN), serum proteins], and blood electrolyte levels were measured for all tested groups. When compared to the vancomycin group, the HDPL significantly (p &lt; 0.01) showed greater effectiveness in lowering the BUN, potassium, and calcium levels. Additionally, in the curative model, there was a significant (p &lt; 0.05) decrease in the blood levels of uric acid, creatinine, BUN, potassium, and calcium in the animals who received the combination of selenium and HDPL. Both LDPL and HDPL did not provide any distinguishable effect in the protective model, but groups that received HDPL with selenium did provide detectable protection by significantly lowering their levels of uric acid, BUN, serum potassium, and total serum protein in comparison to the vancomycin control group. These findings indicate that, whether administered before or after renal damage is induced, the Polyalthia longifolia root extract provided only modest protection to nephrons, which require selenium support to prevent vancomycin-induced kidney damage

Barriers to implement generic medicine prescribing and dispensing policies in Pakistan : current challenges and future implication

Background: Prescriptions comprising of generic names have made place as the norm in many countries owing to established drug regulatory regimes. Nevertheless, generics have greatly reduced worldwide pharmaceutical and healthcare spending. Objective: The current review comprehensively explores research studies focused on generic medicine in Pakistan, utilizing a variety of research methodologies. The prime objective of this review is to assess the barriers toward the implementation of generic medicine prescribing and dispensing policies in Pakistan in order to reduce the prescription cost. Methodology: The articles were filtered using databases: Google Scholar and PubMed. The research questions were developed and focused exclusively on all literature available regarding generic medicine in Pakistan. Results: Google Scholar and Pub-Med were searched for the period 2000-2023. 45 studies were included as per our criteria. The selected papers were grouped into different themes. Seven (7) papers were included regarding knowledge, attitude, perception & practice of healthcare givers regarding generic medicine in Pakistan. Seven (7) studies were related to Availability, Affordability, Pricing of Generic Medicine in Pakistan while 31 studies were included regarding percentage of generic prescribing as per WHO Core indicators. Both quantitative and qualitative research studies were eligible for inclusion. the selected papers were grouped into different themes. Conclusion: With the help of the evidence available through screening, it has been revealed that situation of generic medicine is quite alarming in Pakistan. Bioequivalence regulations as well as proper generic policy are need of the day. Educational interventions and uncompromising compliance to the drug policies of WHO may play a part in generic medication prescribing. Implementation of pricing policies is compulsory to promote rational use of drugs and to enhance availability. Presence of qualified pharmacists and electronic health system at every level of healthcare setups is need of an hour