Hydrogen sulfide is gaining acceptance as an endogenously produced modulator of tissue function. The present paradigm of H(2)S (diprotonated, gaseous form of hydrogen sulfide) as a tissue messenger consists of H(2)S being released from the desulfhydration of l-cysteine at a rate sufficient to maintain whole tissue hydrogen sulfide concentrations of 30 microM to >100 microM, and these tissue concentrations serve a messenger function. Utilizing physiological concentrations of l-cysteine and aerobic conditions, we found that catabolism of hydrogen sulfide by mouse liver and brain homogenates exceeded the rate of enzymatic release of this compound such that measureable hydrogen sulfide release was less with tissue-containing vs. tissue-free buffers. Analyses of the gas space over rapidly homogenized mouse brain and liver indicated that in situ tissue hydrogen sulfide concentrations were only about 15 nM. Human alveolar air measurements indicated negligible free H(2)S concentrations in blood. We conclude rapid tissue catabolism of hydrogen sulfide maintains whole tissue brain and liver concentrations of free hydrogen sulfide that are three orders of magnitude less than conventionally accepted values and only 1/5,000 of the hydrogen sulfide concentration (100 microM) required to alter cellular function in vitro. For hydrogen sulfide to serve as an endogenously produced messenger, tissue production and catabolism must result in intracellular microenvironments with a sufficiently high hydrogen sulfide concentration to activate a local signaling mechanism, while whole tissue concentrations remain very low.
Aim: To find out the perspective of knowledge, attitude and practice regarding dental hygiene in patients visiting teaching hospitals of Sialkot and Multan, Pakistan. Methods: This was a comparative cross-sectional study conducted at Islam Dental College, Sialkot and Nishter institute of dentistry, Multan during the year 2021. By using random sampling technique, about 400 patients were included in the study. A questionnaire was asked based on the aim of the study and the data was collected and analyzed. Result: Male patients were more in numbers as compared to the female patients with an age range between 25-55 years in both cities. More than 65% patients had insufficient knowledge about various dental hygiene aids available and their proper usage along with their impact on dental hygiene. Very low practice and attitude has been found regarding dental hygiene. More than 60% of the patients in both cities don’t know importance of maintaining good dental hygiene on their overall health status. Conclusion: Very low level of KAP has been found in patients of both the cities and counseling sessions along with community work and seminars should be carried out to emphasize the importance of maintaining good dental hygiene. Keywords: Knowledge, attitude and practice (KAP), patients, hygiene
Results: Overall morbidity and mortality for RH was 23.2% and 3.0%, for ERH 26.3% and 2.3% respectively. After 2010, use of PVE became more frequent (2.6% to 31.3%, p = 0.001), being used in 27.1% of RH and 37.5% of ERH. Incidence of hepatic insufficiency reduced in both groups (RH 5.2% to 3.3%, p = 0.734; ERH 5.4% to 2.5% p = 0.667). There was a significant decrease in morbidity after RH (27.0% to 11.9%, p = 0.020) but not ERH (22.6% to 35.0%, p = 0.260). Mortality also decreased for RH (3.4% to 1.7%, p = 0.682) but not ERH (2.2% to 2.5%, p = 1.000). Reasons underlying a lack of improved outcomes following ERH are likely multifactorial and may involve the increasing use of neoadjuvant chemotherapy with Irinotecan in this group (4.3% to 15.0%, p = 0.065). Conclusions: Increased use of PVE resulted in lower incidence of hepatic insufficiency, although improved early outcomes were only seen in the RH group. Our recent and overall outcomes, in particular mortality, compare very favourably with the NSQUIP data.
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