•Prophylactic vasopressors are advised in caesarean delivery under spinal anaesthesia.•Norepinephrine and phenylephrine effectively controlled maternal blood pressure.•Lower number of physician ...interventions was noticed in norepinephrine group.•Reactive hypertension incidence was potentially lower in norepinephrine group.•Also, the incidence of bradycardia was potentially lower in norepinephrine group.
Prophylactic vasopressors are fundamental during caesarean delivery under spinal anaesthesia. The aim of this work is to compare the efficacy and safety of phenylephrine and norepinephrine when used in variable infusion rate during caesarean delivery.
A randomised, double-blinded, controlled trial was conducted including mothers scheduled for elective caesarean delivery under spinal anaesthesia. Participants were allocated to two groups norepinephrine group (n = 60), and phenylephrine group (n = 63). Participants received prophylactic vasopressors after spinal block at rate started at 0.05 mcg/kg/min and 0.75 mcg/kg/min respectively. The rate of vasopressor infusion was manually adjusted according to maternal systolic blood pressure. Both groups were compared according to incidence of post-spinal hypotension (the primary outcome), incidence of bradycardia, incidence of reactive hypertension, systolic blood pressure, heart rate, rescue vasopressor consumption, number of physician interventions, and neonatal outcomes.
One hundred and twenty-three mothers were available for final analysis. Both groups were comparable in the incidence of post-spinal hypotension (32% versus 30%, P = 0.8). The number of physician intervention was lower in norepinephrine group. The incidence of bradycardia and the incidence of reactive hypertension were potentially lower in norepinephrine group without reaching statistical significance, (13% vs. 21%, P = 0.3) and (12% vs. 24%, P = 0.1). Rescue vasopressor consumption, and neonatal outcomes were comparable between both groups.
When given in a manually adjusted infusion, norepinephrine effectively maintained maternal SBP during caesarean delivery under spinal anaesthesia with lower number of physician interventions, and likely less incidence of reactive hypertension and bradycardia compared to phenylephrine.
Background Early stages of amyotrophic lateral sclerosis (ALS)-like syndrome when only one limb is affected can be missed by physicians suggesting other unrelated disorders especially with evidenced ...concomitant pathology of the same limb, leading to diagnostic pitfalls and unnecessary procedures. Objective The aim of this study was to support the diagnosis of early stages of ALS-like disorders in clinically suspected patients by electrophysiological studies (EDX) including segments that may be clinically unaffected, and searching for the possible etiology. Patients and methods This study was conducted on 120 adult patients with unilateral limb symptoms associated with irrelevant imaging abnormalities. Diagnostic workup included history taking, general and neurological examination, and EDX using the El Escorial diagnostic criteria. Further investigations included laboratory studies and paraneoplastic and hormonal assays. Results Motor nerve conduction studies revealed reduced amplitude of compound muscle action potential in 62.5% of patients, borderline conduction velocities, normal distal latencies, conduction block in one case, and normal sensory nerve conduction studies. Electromyography of the cranial, cervical, lumbosacral, and dorsal segments showed acute denervation in 80% of patients and chronic denervation in all segments in 35% and in three body segments in 65% of patients. Laboratory investigations revealed 50.83% of patients with chronic hepatitis C, with significant statistical association between EDX and laboratory results, 30.83% with hyperthyroidism, 8.33% with paraneoplastic syndrome, one case with multifocal motor neuropathy with conduction block, one case with myasthenia gravis, and 8.3% with negative results. Conclusion ALS-like disorder should be investigated whenever ALS is suspected, and further laboratory workup might unveil a coexisting 'possibly causative' pathological condition.
β-Enaminonitriles bearing 9-hydroxy-1H-benzofchromene moiety was synthesized. The targeted compounds were evaluated for their anti-proliferative activity against three human tumor cell lines, PC-3, ...SKOV-3 and HeLa, and the active cytotoxic compounds were further evaluated against cancer cells, MCF-7/ADR, and two normal cell lines, HFL-1 and WI-38. Few compounds were assigned to be the most potent derivatives against PC-3, SKOV-3 and HeLa cell lines in comparison with Vinblastine and Doxorubicin. Several compounds possessed a relatively good potency against MCF-7/ADR cells as compared with Doxorubicin and were tested as a P-gp inhibitor. Moreover, the halogenated substituents, 2,4-F2, 2,3-Cl2, 2,5-Cl2 and 3,4-Cl2; have good potency against P-gp-mediated MDR in MCF-7/ADR as compared with Doxorubicin. Meanwhile, Rho123 accumulation assays revealed that few compounds effectively inhibited P-pg and efflux function. In addition, certain derivatives induced apoptosis and an accumulation of the treated MCF-7/ADR cells in the G1, S and G1/S phases.
The charge transfer interactions between the seproxetine (SRX) donor and
-electron acceptors picric acid (PA), dinitrobenzene (DNB), p-nitrobenzoic acid (p-NBA), 2,6-dichloroquinone-4-chloroimide ...(DCQ), 2,6-dibromoquinone-4-chloroimide (DBQ), and 7,7',8,8'-tetracyanoquinodi methane (TCNQ) were studied in a liquid medium, and the solid form was isolated and characterized. The spectrophotometric analysis confirmed that the charge-transfer interactions between the electrons of the donor and acceptors were 1:1 (SRX:
-acceptor). To study the comparative interactions between SRX and the other
-electron acceptors, molecular docking calculations were performed between SRX and the charge transfer (CT) complexes against three receptors (serotonin, dopamine, and TrkB kinase receptor). According to molecular docking, the CT complex (SRX)(TCNQ) binds with all three receptors more efficiently than SRX alone, and (SRX)(TCNQ)-dopamine (CTcD) has the highest binding energy value. The results of AutoDock Vina revealed that the molecular dynamics simulation of the 100 ns run revealed that both the SRX-dopamine and CTcD complexes had a stable conformation; however, the CTcD complex was more stable. The optimized structure of the CT complexes was obtained using density functional theory (B-3LYP/6-311G++) and was compared.
Assessing water quality in arid regions is vital due to scarce resources, impacting health and sustainable management.This study examines groundwater quality in Assuit Governorate, Egypt, using ...Principal Component Analysis, GIS, and Machine Learning Techniques. Data from 217 wells across 12 parameters were analyzed, including TDS, EC, Cl−, Fe++, Ca++, Mg++, Na+, SO4−−, Mn++, HCO3−, K+, and pH. The Water Quality Index (WQI) was calculated, and ArcGIS mapped its spatial distribution. Machine learning algorithms, including Ridge Regression, XGBoost, Decision Tree, Random Forest, and K-Nearest Neighbors, were used for predictive analysis. Higher concentrations of Na, K, Ca, Mg, Mn, and Fe were correlated with industrial and densely populated areas. Most samples exhibited excellent or good quality, with a small percentage unsuitable for consumption. Ridge Regression showed the lowest MAPE rates (0.22 % training, 0.26 % in testing). This research highlights the importance of advanced machine learning for sustainable groundwater management in arid regions. Thus, our results could provide valuable assistance to both national and local authorities involved in water management decisions, particularly for water resource managers and decision-makers. This information can aid in the development of regulations aimed at safeguarding and sustainably managing groundwater resources, which are essential for the overall prosperity of the country.
Display omitted
•Utilized PCA, GIS, and ML to assess groundwater quality across 217 wells, considering 12 parameters•Five ML algorithms (Ridge Regression, XGBoost, Decision Tree, Random Forest, KNN) used for WQI prediction.•Ridge regression outperformed other ML algorithms, offering a robust WQI estimation formula.•Subset regression identified nine high R2 input combinations, optimizing WQI prediction.•Diverse ML approaches offer comprehensive insights, enhancing prediction accuracy.
The aim of this study was to assess the utility of inexpensive techniques in evaluating the interactions of risperidone (Ris) with different traditional π-acceptors, with subsequent application of ...the findings into a Ris pharmaceutical formulation with improved therapeutic properties. Molecular docking calculations were performed using Ris and its different charge-transfer complexes (CT) with picric acid (PA), 2,3-dichloro-5,6-dicyanop-benzoquinon (DDQ), tetracyanoquinodimethane (TCNQ), tetracyano ethylene (TCNE), tetrabromo-pquinon (BL), and tetrachloro-p-quinon (CL), as donors, and three receptors (serotonin, dopamine, and adrenergic) as acceptors to study the comparative interactions among them. To refine the docking results and further investigate the molecular processes of receptor-ligand interactions, a molecular dynamics simulation was run with output obtained from AutoDock Vina. Among all investigated complexes, the (Ris) (PA)-serotonin (CTcS) complex showed the highest binding energy. Molecular dynamics simulation of the 100 ns run revealed that both the Ris-serotonin (RisS) and CTcS complexes had a stable conformation; however, the CTcS complex was more stable.
PDF
