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This article discusses the development and analysis of a broadband filter capable of suppressing specific frequencies of wireless applications at 4.7 GHz for WLAN, 8.3 GHz, and 11.5 GHz (for satellite communication) by combining a T-shaped stub loaded resonator with a central square ring to achieves high performance and compact size within the bandwidth of interest. The filter achieves low signal loss of 0.4 dB across the entire passband of 14.9 GHz bandwidth, good reflection suppression exceeding 10 dB, and independently adjustable multi stopbands. It utilizes a simple planar topology for a small footprint of 0.52 λg × 0.32 λg, where λg represents the wavelength at 4.7 GHz. The proposed filter evaluated using classical method an even-odd-mode analysis, and a 3D software tool HFSS-15 is used for simulations. The physical prototype is built on a Rogers RO-4350 substrate using LPKF S63 ProtoLaser machine. To confirm the accuracy and performance of the prototype, measurements were conducted using a ZNB20 vector network analyser. The simulations and measurement results confirm its effectiveness, paving the way for applications in various fields such as radar systems, medical imaging, and wireless communication.

The impact of heat generation and activation energy on the Darcy-Forchheimer flow of magnetized fluid with nanoparticles in the condition of blood flowing arteries is being investigated by researchers from all over the world in an effort to understand the heat transmission component for the treatment of numerous diseases. The assessment of heat transmission has been made with the enclosure of influence like the viscous dissipation, heat source, Joules heating, and thermal radiation. Utilized is a tetra hybrid nanofluid made up of silver (Ag), gold (Au), titanium oxide (TiO2), coper (Cu), and Blood as the base fluid. The main justification for the use of gold, copper, and silver nanoparticles as drug delivery nanomaterials is their potential for drug transport and imaging. The purpose of the presented model is to assess the performance of the well-known tetra hybrid nanofluid models developed by Yamada-Ota and Xue. The main PDE are transformed into ODE via similarity renovations, and these ODE are then numerically solved using the MATLAB built-in bvp4c scheme. The arteries' internal temperature rises as a result of thermal radiation and viscous dissipation. The velocity and thermal distributions show an increasing behavior with greater variations in the flow parameter. The Yamada-Ota model outperforms the Xue tetra hybrid nanofluid model in terms of heat transmission effectiveness.

Secondary biotransformation of 11β-hydroxy-dianabol (11β,17β-dihydroxy-17α-methylandrost-1,4-dien-3-one) (1), catalyzed by using two fungi Gibberella fujikuroi and Cunninghamella blakesleeana at ambient conditions, was carried out to synthesize its analogues. Transformation of compound 1 with G. fujikuroi yielded a new metabolite, 11β, 17β-dihydroxy-17α-methyl-5β-androst-1-ene-3-one (2), while four new derivatives, 6β, 17β-dihydroxy-17α-methylandrost-1,4-diene-3,11-dione (3), 15α,17β-dihydroxy-17α-methylandrost-1,4-diene-3,11-dione (4), 6β,11β,17β-trihydroxy-17α-methylandrost-1,4-dien-3-one (5), and 7β,11β,17β-trihydroxy-17α-methylandrost-1,4-dien-3-one (6) were obtained by transformation with C. blakesleeana. Compounds 1-6 showed a significant aromatase inhibition with IC 50 values in the range of 2.01-3.13 μM as compared to the standard drug, exemestane (IC 50  = 0.21 ± 0.16 μM). Aromatase is a valid target for drug discovery against ER+ breast cancers. Compounds 1-6 were subjected to molecular docking studies to predict the key interactions, and the MMGBSA studies to analyze the binding affinity and thermal stability of the protein-ligand complexes. Further, the relationship between the metabolites 1-6 and breast tumor androgen receptors was evaluated by in silico approach to analyze the binding interactions between androgen receptors and metabolites. Moreover, compounds 1-6 were found as non-cytotoxic to BJ (Human fibroblast) normal cell line. Hence, these molecules can be further studied for optimization as potential aromatase inhibitors against breast cancer., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Due to multitude of gaps in Pakistan's healthcare system, community pharmacies serve as the" first port of call" for various illnesses. However, the present scarcity of pharmacists in these settings poses significant challenges to healthcare delivery in the country. This scarcity is primarily due to difficulties in retaining pharmacists for community practice. The aim of this study was to explore the factors that influence the retention of community pharmacists by using COM-B model., Methods: A qualitative methodology employing the COM-|B model was utilized to design this study. In-depth interviews were conducted with pharmacists experienced in community pharmacy practice, at time and place convenient to them. Data were transcribed, translated and analyzed by deductive thematic analysis in accordance with the constructs of COM-B model., Results: A diverse range of factors were identified that negatively influenced the retention of community pharmacists including working conditions and proprietor's demeanor, deficiency in training and intern experience, lack of career planning, low social acceptance, less salary and job satisfaction, less regulatory control and aptitude of renting out category. Conversely, the study also identified the factors that motivate community pharmacists to stay in their roles despite the challenges including strong educational background, abundant job opportunities, flexible schedules, direct patient engagement and positive impact on sales., Conclusion: There was an observed discrepancy between the challenges faced by community pharmacists and the motivators that encourage them to continue their job. Due to a disparity and abundance of challenges rather than motivators, retention rates for community pharmacists are low. This imbalance shed light on areas where improvements are needed to enhance pharmacist retention. Various areas for change were highlighted including strict implementation of regulations, integration of practical experience of community pharmacy practice and internships into academic programs, career guidance, and raising patient awareness about the roles of community pharmacists., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: To explore the determinants that innervate or avert the parents to use antibiotics responsibly for their children in Bahawalpur, Pakistan. Further, to assess the cognizance of Pakistani parents about antibiotic resistance., Methods: The Health Belief Model (HBM) was utilized to design this study. Parents who were using antibiotics for their children were taken as study participants. They were recruited purposively from various public and private healthcare settings and were asked to conveniently participate in the study. A total of 18 in-depth interviews were conducted at time and place convenient to the study participants. Data were transcribed, translated and analyzed by framework analysis in accordance with the constructs of Health Belief Model including perceived susceptibility, severity, benefit, barriers, self-efficacy and cues to action., Results: Within each HBM construct, responses of participants were analyzed, yielding 8 themes and 17 subthemes. Parents had a knowledge of antibiotics but considered their families to be at low risk of antibiotic resistance since their families were "low users" of antibiotics. Majority of the participants were not aware of the indications and risks of antibiotic use and perceived the antibiotics as a quick fix for every ailment. Communicating the risks of antibiotic resistance to parents and providing actionable solutions to tackle antibiotic resistance may address these perceptions., Conclusion: Though parents revealed awareness about antibiotics, they continue to overestimate the value of antibiotics. Refocus of the antibiotic stewardship interventions are required and these campaigns are needed to be tailored to target their intended audience in a format that is appropriate to them., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Due to the rapid race of industrialization natural assets like fresh water has been deteriorated causing lethal effects in living organisms. In the current study robust and sustainable composite of in-situ antimony nanoarchitectonics in chitosan/synthesized carboxymethyl chitosan matrix were synthesized. To improve solubility, metal adsorption and water decontamination, chitosan was modified into carboxymethyl chitosan and the modification was confirmed through various characterization techniques. The characteristic bands in the FTIR spectrum confirm substitution of carboxymethyl group in the chitosan. This was further illustrated that the characteristic proton peaks of CMCh observed at δ = 4.097 to 4.192 ppm, suggesting O-carboxy methylation of chitosan by 1 H NMR. The second order derivative of potentiometric analysis confirmed 0.83 degree of substitution. The antimony (Sb) loaded modified chitosan were confirmed by FTIR and XRD analysis. The potential effectiveness of chitosan matrix was determined and compared toward reductive removal of the Rhodamine b dye. Rhodamine b mitigation is following first order kinetics with R 2 value of 0.9832 and 0.969 with a constant rate of 0.0977 and 0.2534 ml/min for Sb loaded chitosan and carboxymethyl chitosan respectively. The Sb/CMCh-CFP enables us to achieve 98.5 % mitigation efficiency within 10 min. The CMCh-CFP chelating substrate was found stable and efficient even after 4th batches of cycles with <4 % decrease in efficiency. The in-situ synthesized material was found tailored composite, in terms of dyes remediation, reusability and biocompatibility as compared to chitosan., Competing Interests: Declaration of competing interest The author(s) declare no conflicting interests., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Introduction: In December 2019, the city of Wuhan, located in the Hubei province of China became the epicentre of an outbreak of a pandemic called COVID-19 by the World Health Organisation. The detection of this virus by rRTPCR (Real-Time Reverse Transcription-Polymerase Chain Reaction) tests reported high false negative rate. The manifestations of CXR (Chest X-Ray) images contained salient features of the virus. The objective of this paper is to establish the application of an early automated screening model that uses low computational power coupled with raw radiology images to assist the physicians and radiologists in the early detection and isolation of potential positive COVID-19 patients, to stop the rapid spread of the virus in vulnerable countries with limited hospital capacities and low doctor to patient ratio in order to prevent the escalating death rates., Materials and Methods: Our database consists of 447 and 447 CXR images of COVID-19 and Nofindings respectively, a total of 894 CXR images. They were then divided into 4 parts namely training, validation, testing and local/Aligarh dataset. The 4th (local/Aligarh) folder of the dataset was created to retest the diagnostics efficacy of our model on a developing nation such as India (Images from J.N.M.C., Aligarh, Uttar Pradesh, India). We used an Artificial Intelligence technique called CNN (Convolutional Neural Network). The architecture based on CNN used was MobileNet. MobileNet makes it faster than the ordinary convolutional model, while substantially decreasing the computational cost., Results: The experimental results of our model show an accuracy of 96.33%. The F1-score is 93% and 96% for the 1st testing and 2nd testing (local/Aligarh) datasets (Tables 3.3 and 3.4). The false negative (FN) value, for the validation dataset is 6 (Fig. 3.6), for the testing dataset is 0 (Fig. 3.7) and that for the local/Aligarh dataset is 2 . The recall/sensitivity of the classifier is 93% and 96% for the 1st testing and 2nd testing (local/Aligarh) datasets (Tables 3.3 and 3.4). The recall/sensitivity for the detection of specifically COVID-19 (+) for the testing dataset is 88% and for the locally acquired dataset from India is 100%. The False Negative Rate (FNR) is 12% for the testing dataset and 0% for the locally acquired dataset (local/Aligarh). The execution time for the model to predict the input images and classify them is less than 0.1 s., Discussion and Conclusion: The false negative rate is much lower than the standard rRT-PCR tests and even 0% on the locally acquired dataset. This suggests that the established model with end-to-end structure and deep learning technique can be employed to assist radiologists in validating their initial screenings of Chest X-Ray images of COVID-19 in developed and developing nations. Further research is needed to test the model to make it more robust, employ it on multiclass classification and also try sensitise it to identify new strains of COVID-19. This model might help cultivate tele-radiology., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Author(s).)

Coronavirus (COVID-19) outbreak from Wuhan, Hubei province in China and spread out all over the World. In this work, a new mathematical model is proposed. The model consists the system of ODEs. The developed model describes the transmission pathways by employing non constant transmission rates with respect to the conditions of environment and epidemiology. There are many mathematical models purposed by many scientists. In this model, " α E " and " α I ", transmission coefficients of the exposed cases to susceptible and infectious cases to susceptible respectively, are included. " δ " as a governmental action and restriction against the spread of coronavirus is also introduced. The RK method of order four (RK4) is employed to solve the model equations. The results are presented for four countries i.e., Pakistan, Italy, Japan, and Spain etc. The parametric study is also performed to validate the proposed model., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)

The targeted drug release at tumor cells while sparing normal cells is a huge challenge. Core-shell magnetoelectric (ME) nanoparticles have addressed this problem using shape-dependent magneto-electric attributes. The colloidally stable, core-shell cobalt ferrite@barium titanate (CFO@BTO) ME nanoparticles (NPs) used for in vitro study were synthesized using sonochemical method. The structural characteristics and core-shell morphology were analyzed by X-ray Diffraction (XRD) and Transmission Electron Microscopy (TEM) respectively. Further magnetic and exchange coupling between two phases of ME nanostructures were studied at room temperature. Colloidal stability was studied in different suspension solutions (Water, SBB, PBS, and DMEM) using dynamic light scattering. Subsequently, the synthesized nanoparticles were functionalized with anticancer drugs including doxorubicin and methotrexate up to 80% via (EDC) chemistry. In vitro cytotoxicity studies carried out on human hepatocellular carcinoma (HepG2) and human malignant melanoma (HT144), cells validated the magneto-electric property of CFO@BTO nano-carriers in the presence of external magnetic field (5 mT), with significantly enhanced cytotoxicity when compared to free drugs and without field replicates. The resulted IC 50 values ranging from 5.3-7.3 μg/ml compared to 30.1-43.1 μg/ml in the absence of a magnetic field also confirmed the involved physical attributes of magnetoelectric nanostructures. The fluorescent microscopy results also indicated the increased apoptosis in magnetic field-assisted samples. Finally, hemolysis assay indicated the suitability of CFO@BTO nano-carriers for intravenous applications at IC 50 concentration., (Copyright © 2020 Elsevier B.V. All rights reserved.)

In the present study, the spectral diagnosis of blood plasma samples of breast cancer patients and an equal number of normal controls was investigated. A set of ratio parameters was acquired by employing SXS and FES. The samples were also analyzed statistically by employing Welch two-sample t-tests, and the effects of three ratio parameters, R 1 , R 2 , and R 3 , were also studied by plotting them against the subject numbers. A linear discriminant was also applied to verify the exact classification of normal control and breast cancer patients. It was observed that the levels of biofluorophores such as porphyrin, NADH, tryptophan and flavins were elevated 2- to 3-fold for breast cancer patients compared to normal controls, with an accuracy of approximately 100 %. We have also confirmed the validity of the obtained experimental results by using an advanced robust diagnostic algorithm. The experimental results of the current study may have a vital and substantial impact on the detection and screening protocols used for future breast cancer patients. The spectral analysis of body fluid could be of great value to add to and enhance the current procedures with an accuracy of approximately 100 % with limited number of samples. The results and objectives of this preliminary study were encouraging and useful for the discrimination of the features of breast cancer patients compared to those of normal controls., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Pharmacies are a primary source of healthcare services in low and middle income countries, especially where patient to physician ratio is low. Due to the wide variability in the training of pharmacy workers, inappropriate antibiotic dispensing is common, which increases the risk of poor therapeutic outcomes and antibiotic resistance., Objectives: This study aims to understand the factors that drive the inappropriate dispensing of antibiotics among pharmacy workers in Bahawalpur, Pakistan., Methods: In this qualitative study, the data were collected from the pharmacy workers through semi-structured interviews. A two-step sampling procedure, including purposive and convenient sampling techniques, was adopted to recruit the study participants. The sample size was determined by applying the saturation point criteria. All interviews were audio recorded and transcribed verbatim. The data were analysed to draw conclusions using the inductive thematic analysis approach., Results: A total of 16 in-depth interviews were conducted. Data analysis yielded four themes and 18 subthemes. Under-dispensing and dispensing of antibiotics without need were reported. Lack of knowledge of dispensers, false feeling of being qualified, social acceptance, customer demands, public beliefs, high consultation fees of doctors, expensive diagnostic tests, economic influences and profit maximization were the main factors associated with the inappropriate dispensing of antibiotics., Conclusions: Multiple pharmacy worker (non-pharmacist) level factors that may lead to the inappropriate dispensing of antibiotics were identified in this study. There is a dire need for the training of pharmacy workers and supervision of their dispensing practices. Strict enforcement of legislation is required to restrict the irrational use of antibiotics in Pakistan., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Hemophilia (HP), the deficiency of clotting factors such as VIII (FVIII) and IX, is an inherited blood disorder which is due to the lack of clotting protein. Conventional techniques for detecting hemophilia are based on clotting factor tests such as hemostasis assays to determine various types of hemophilia and its severity. In the current study, we propose a new approach involving a spectral technique to discriminate normal controls from hemophilia patients with an accuracy above 80 %. This accuracy is calculated on the normalized relative intensity based on the light measurement of blood components by analyzing a certain set of fluorescent bio molecules. Our results indicated that Red Blood Cells (RBCs) show lower porphyrin content and enzyme deficiencies in hemophilia patients than in normal controls. Therefore, the spectral features in hemophilia patients are different from those of normal controls. Thus, the proposed technique is a good alternative for the detection of hemophilia patients when compared with conventional detection techniques., Competing Interests: Declaration of Competing Interest The Authors declare no conflicts of interest., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: The World Health Organization released a Global Action Plan to overcome the threatening concerns of antibacterial resistance. One of the cornerstones of this plan is the Antibiotic Stewardship Program (ASP). The study aimed to assess the community pharmacists' knowledge, perceptions and current practices regarding ASP., Methods: A qualitative study was conducted in Bahawalpur, Pakistan, in which data were collected from the community pharmacists through in-depth, semi-structured interviews. The convenience sampling technique was used to recruit the study participants. Interview protocol was pilot tested and the sample size was limited by applying the saturation point criteria. All interviews were audio recorded and transcribed verbatim. The thematic analysis approach was used to analyze the data and draw conclusions based on study objectives., Results: A total of fifteen community pharmacists were interviewed. Analysis of the data yielded five themes and 16 subthemes. All of the respondents had sound knowledge about the irrational use of antibiotics; however, they were oblivious about the ASP. After explaining the term, the respondents were of the opinion that these strategies could not be implemented in the current healthcare system of the country. According to the findings of the study, prescribing and dispensing practices were not followed. Only a few patients were educated about the antibiotics they were purchasing., Conclusion: Most of the study participants were unaware of any ASP being offered in the community pharmacy settings. The study participants agreed to be the antibiotic stewards, but a number of obstacles were reported. The training of pharmacists, medication reconciliation, the implementation of the good pharmacy practice guidelines and assurance of pharmacist availability at drug retail outlets were few suggestions given by the study participants to incorporate the ASP in the community settings., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Evaluating treatment outcomes of a cohort of patients is an effective way for analyzing the effectiveness of a program. Information regarding drug resistance pattern, detailed management, treatment outcomes and factors associated with unsuccessful outcomes in multidrug resistant (MDR-TB) patients is missing from Baluchistan province of Pakistan., Methods: This study was carried out at Programmatic Management of Drug Resistant TB unit at Fatimah Jinnah General and Chest Hospital Quetta. All eligible 186 MDR-TB patients enrolled at the study site from January 1, 2012 to April 30, 2016 were retrospectively followed until the treatment outcomes were reported. Data was abstracted through a standardized data collection form and analysed by SPSS 20. Multivariate binary logistic regression (MVBLR) analysis was used to evaluate factors associated with i) death and treatment failure and ii) lost to follow up. A p-value of <0.05 was considered statistically significant., Results: The study participants were resistant to a median of four drugs (range 2-8) with majority being resistant to any second-line anti-TB drug (SLD) (55.5%). Among SLD, resistance was highest for ofloxacin (52.2%). The study site had an overall treatment success rate of 71.6%. A total of 129 (69.4%) patients were cured, four (2.2%) completed treatment, 37 died (19.9%), 14 (7.5%) were lost to follow up and two (1.1%) were declared treatment failures. In MVBLR analysis, patients' age of >40 years (OR = 4.249, p-value = 0.001) had statistically significant positive and baseline body weight of >40 kg (OR = 0.256, p-value = 0.002) had statistically significant negative association with death and treatment failure. No factor had statistical significant association with lost to follow up., Conclusion: Overall treatment success rate was promising but did not achieve the target success rate (>75%) set by World Health Organization. It can be further improved by paying special attention and providing enhanced management to the patients with risk factors for unsuccessful outcomes., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

In this study, we compared different types of biomolecular markers in kidney cancer patients and in normal healthy controls, using fluorescence emission spectra and synchronous fluorescence excitation spectra. We were able to provide an accurate classification of the spectral features of kidney cancer patients relative to that of normal controls, in terms of the concentration ratios of biomolecules (viz., tryptophan, NADH, FAD, basic porphyrin, and acidic porphyrin) based on the intensity of their spectral peaks. The specificity and sensitivity of the method were 90%. The rationale of our current approach is to evolve an innovative protocol for the spectral characterization of in vitro optical analyses suitable for both small clinics and hospitals., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Despite evidence of an association between tuberculosis (TB) treatment outcomes and the performance of national tuberculosis programmes (NTP), no study to date has rigorously documented the duration of treatment among TB patients. As such, this study was conducted to report the durations of the intensive and continuation phases of TB treatment and their predictors among new smear-positive pulmonary tuberculosis (PTB) patients in Malaysia., Study Design: Descriptive, non-experimental, follow-up cohort study., Methods: This study was conducted at the Chest Clinic of Penang General Hospital between March 2010 and February 2011. The medical records and TB notification forms of all new smear-positive PTB patients, diagnosed during the study period, were reviewed to obtain sociodemographic and clinical data. Based on standard guidelines, the normal benchmarks for the durations of the intensive and continuation phases of PTB treatment were taken as two and four months, respectively. A patient in whom the clinicians decided to extend the intensive phase of treatment by ≥2 weeks was categorized as a case with a prolonged intensive phase. The same criterion applied for the continuation phase. Multiple logistic regression analysis was performed to find independent factors associated with the duration of TB treatment. Data were analyzed using Predictive Analysis Software Version 19.0., Results: Of the 336 patients included in this study, 261 completed the intensive phase of treatment, and 226 completed the continuation phase of treatment. The mean duration of TB treatment (n = 226) was 8.19 (standard deviation 1.65) months. Half (49.4%, 129/261) of the patients completed the intensive phase of treatment in two months, whereas only 37.6% (85/226) of the patients completed the continuation phase of treatment in four months. On multiple logistic regression analysis, being a smoker, being underweight and having a history of cough for ≥4 weeks at TB diagnosis were found to be predictive of a prolonged intensive phase of treatment. Diabetes mellitus and the presence of lung cavities at the start of treatment were the only predictors found for a prolonged continuation phase of treatment., Conclusions: The average durations of the intensive and continuation phases of treatment among PTB patients were longer than the targets recommended by the World Health Organization. As there are no internationally agreed criteria, it was not possible to judge how well the Malaysian NTP performed in terms of managing treatment duration among PTB patients., (Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Introduction: The metabolic syndrome is a risk factor for cardiovascular diseases. It exposes to two main complications: cardiovascular diseases and type II diabetes. This risk is higher among women. It causes a high cardiovascular mortality., Objectives: Assess the prevalence of the metabolic syndrome (MS) among our black hypertensive population. Study of the distribution of the different criteria in the cluster. Search cardiovascular complications., Materials and Methods: This longitudinal study that was carried out included one thousand five hundred and fifty subjects of both sexes from black and white populations aged 40 and older, living in the Algerian Sahara and reviewed after six years of decline. The control consisted of filling a questionnaire oriented on civil status, in addition to a clinical examination, including morphometry, measurement of blood pressure performed with validated electronic device (OMRON 705 CP). Also, a biological check-up was done (glycemy, HDL, cholesterol). A univariate and multivariate analysis have been carried out. All calculations and statistical analyzes are processed by the SPSS 17.0 and Epi Info6 software., Results: The MS frequency is 20.8%, more frequent among women than among men, with a significant difference (28.4% versus 15.1%, P<0.001). We found out a difference between black and white populations in terms of obesity (37.6% versus 31.1%), hypertension (60.6% versus 55.0%), diabetes (25.2% versus 19.2%) or other metabolic syndrome criteria. The most frequent complications according to decreasing frequency are: hospitalization for cardiovascular diseases 8.9%, stroke 6.3%, heart failure 5.8%, myocardial infarction 3.6%. The mortality rate is 14.7% among the blacks and 11.3% among the whites without difference. The survival rate of the population is influenced by the MS and by a non-checked blood pressure by an antihypertensive treatment., Conclusion: The MS is highly prevailing among hypertensive black population, and significantly higher among women. The ranking of the cluster elements frequency shows clearly the specifities of our population. It is necessary to elaborate an adequate strategy to prevent such cardiovascular morbidity and mortality., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Renal allograft tolerance has been achieved in MHC-mismatched primates via nonmyeloablative conditioning beginning 6 days prior to planned kidney and donor bone marrow transplantation (DBMT). To extend the applicability of this approach to deceased donor transplantation, we recently developed a novel-conditioning regimen, the "delayed protocol" in which donor bone marrow (DBM) is transplanted several months after kidney transplantation. However, activation/expansion of donor-reactive CD8(+) memory T cells (TMEM) occurring during the interval between kidney and DBM transplantation impaired tolerance induction using this strategy. In the current study, we tested whether, Alefacept, a fusion protein which targets LFA-3/CD2 interactions and selectively depletes CD2(high) CD8(+) effector memory T cells (TEM) could similarly induce long-term immunosuppression-free renal allograft survival but avoid the deleterious effects of anti-CD8 mAb treatment. We found that Alefacept significantly delayed the expansion of CD2(high) cells including CD8(+) TEM while sparing naïve CD8(+) T and NK cells and achieved mixed chimerism and long-term immunosuppression-free renal allograft survival. In conclusion, elimination of CD2(high) T cells represents a promising approach to prevent electively the expansion/activation of donor-reactive TEM and promotes tolerance induction via the delayed protocol mixed chimerism approach., (© Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.)

Container closure integrity is a critical factor for maintaining product sterility and stability. Therefore, closure systems (found in vials, syringes, and cartridges) are designed to provide a seal between rubber stoppers and glass containers. To ensure that the contained product has maintained its sterility and stability at the time of deployment, the seal must remain intact within acceptable limits. To this end, a mathematical model has been developed to describe vacuum loss in evacuated drug vials. The model computes equivalent leak diameter corresponding to initial air leak rate as well as vacuum loss as a function of time and vial size. The theory accounts for three flow regimes that may be encountered. Initial leak rates from 10(-8) to 10(3) sccm (standard cubic centimeters per minute) were investigated for vials ranging from 1 to 100 mL. Corresponding leak diameters of 0.25-173 μm were predicted. The time for a vial to lose half of its vacuum, the T50 value, ranged from many years at the lowest leak rates and largest vials, to fractions of a second at the highest leak rates and smallest vials. These results may be used to determine what level of initial vacuum leak is acceptable for a given product., (Copyright © 2013 Wiley Periodicals, Inc.)

Introduction: El-Menia is an oasis located in the middle of Algerian Sahara. The drinking water in this oasis has low sodium content. The objectives of this study were to estimate the prevalence of hypertension, to describe the metabolic characteristics of population study and to assess the factors associated with blood pressure levels., Methods: A cross sectional study was conducted in 2010. Subjects (n=722) were selected from individuals aged 40 years or older by random cluster sampling. Blood pressure measurements, combined with a clinical questionnaire, and standard blood samples for the detection of dyslipidemia and diabetes mellitus, were collected., Results: Sixty-seven percent of subjects were females and 18% were black. The mean age was 58.5 ± 13.2 years. The prevalence of hypertension was 50.2%: 49.7% in females and 51.3% in males. The factors associated with presence of hypertension following a logistic multivariate regression were age, skin colour, waist circumference, and plasma glucose. The treatment and control of hypertension were 41% and 20% respectively., Conclusions: The prevalence oh hypertension was high in this oasis and the rate of treatment control was low. Our findings suggest that appropriate healthcare should be given to hypertensive subjects, including a better information on hypertension., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Gleason score is the most common method of grading the virulence of prostate malignancy and is based on the pathological assessment of morphology of cellular matrix. Since this involves the excision of the tissue, we are working on a new, minimally invasive, non-contact, procedure of spectral diagnosis of prostate malignancy. In this preliminary in vitro study reported here, we have analyzed 27 tissue samples (normal control=7: benign=8: malignant=12) by Stokes' shift spectra (SSS) to establish a one-to-one correspondence between spectral grading and Gleason grading., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Objective: The study objective was to assess the awareness of standard precautions (SP) among healthcare professionals, 1 year after the latest national guidelines were issued., Methods: A multicenter cross-sectional survey was conducted in 34 volunteer institutions in 2010. Data was collected using an anonymous and self-administered questionnaire. The data was analyzed with a program developed from Epi-Info software., Results: Four thousand four hundred and thirty-nine questionnaires were analyzed. Most respondents were nurses (44.1%) or nurses' aides (26.7%) followed by physicians (3.5%). 25% of respondents had participated in specific PS training in the previous 5 years. The percentage of correct answers for each question ranged from 37.1 to 91%. There was 72.6% of correct answers on hand hygiene but only 7.3% of correct answers on use of appropriate barriers and disposal of needles. 39.3% of respondents gave correct answers to eight or more of the 10 SP questions. The level of knowledge of nurses was higher compared to other professionals. The lowest level of knowledge was observed in long-term care and psychiatric institutions., Conclusions: The knowledge of healthcare professionals on use of appropriate protective barriers and disposal of needles is still too limited. The survey results should be used to develop adequate and targeted educational interventions., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

The study aims to evaluate general public perceptions regarding the use of Traditional and Complementary Medicines (TCM) for aphrodisiac purposes. A questionnaire based, cross-sectional study was undertaken. Respondents were selected in the state of Penang, Malaysia. A total of 392 respondents were included in the study. Descriptive statistics were used for data analysis. Chi Square/Fischer Exact tests were used where appropriate. Out of 392 respondents, 150 (38.26%) reported using specific Traditional medicines for aphrodisiac purposes. Most respondents (46.94%) agreed that aphrodisiac medicines were easily available t. Moreover, 40.31% of the respondents reported that traditional aphrodisiac medicines were cheaper than modern (prescription) medicines. This study highlights limited public knowledge regarding the use of traditional aphrodisiac medicine. Healthcare professionals should be aware of informal TCM usage when prescribing allopathic medicines., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Microbial transformation of (20S)-20-hydroxymethylpregna-1,4-dien-3-one (1) by four filamentous fungi, Cunninghamella elegans, Macrophomina phaseolina, Rhizopus stolonifer, and Gibberella fujikuroi, afforded nine new, and two known metabolites 2-12. The structures of these metabolites were characterized through detailed spectroscopic analysis. These metabolites were obtained as a result of biohydroxylation of 1 at C-6β, -7β, -11α, -14α, -15β, -16β, and -17α positions, except metabolite 2 which contain an O-acetyl group at C-22. These fungal strains demonstrated to be efficient biocatalysts for 11α-hydroxylation. Compound 1, and its metabolites were evaluated for the first time for their cytotoxicity against the HeLa cancer cell lines, and some interesting results were obtained., (Copyright © 2011 Elsevier Inc. All rights reserved.)