Background Dengue has become a major public health threat in Bangladesh since 2000, when the first outbreak was reported. Each outbreak has distinct characteristics, and thus, the report of the outbreak helps to understand the disease process and subsequent clinical management of these patients. On that ground, the study was designed to sketch the clinico-epidemiological characteristics of the 2018 dengue outbreak in Bangladesh. Methods This hospital-based cross-sectional study was conducted in one of the largest public medical college hospitals and a single private hospital located in the southern and northern parts of the megacity of the country. A total of 297 confirmed dengue cases were assessed with a preformed pretested questionnaire. Clinico-epidemiological and laboratory parameters were reported along with sociodemographic details. Statistical analysis was performed with SPSS 20. Results Male patients were predominantly affected by dengue infection. The mean age of the patients was 31.24 ± 13.99 (SD) years, with a range from 2 to 85 years. Eighty-two percent of patients reported from the Dhaka metropolitan city. The highest percentage of cases (37.1%) was isolated from Bansree, Dhaka city, followed by Rampura (21.4%) and Khilgaon (6.2%). In addition to common symptoms, e.g., fever (90.6%), headache (90.6%), chills (81.8%), anorexia and vomiting (76.4%), backache, and redness of the eyes were two prominent symptoms that affected more than two-thirds of the study population. On the other hand, less common symptoms, such as cough, abdominal pain, and respiratory distress, were present in 39.7%, 33.7%, and 15.5% of patients, respectively. Overall, 17.6% of patients were hypotensive during admission, with a mean systolic blood pressure of 107.65 ± 18.17 (SD) mmHg. Other prominent signs were dehydration (80.5%) and rash (33%). Conclusion This outbreak was especially characterized by gastrointestinal symptoms, which were predominant along with other typical features.
Over 100,000 individuals in the United States lost their lives secondary to drug overdose in 2021, with opioid use disorder (OUD) being a leading cause. Pain is an important component of opioid withdrawal, which can complicate recovery from OUD. This study's objectives were to assess the effects of transcutaneous cervical vagus nerve stimulation (tcVNS), a technique shown to reduce sympathetic arousal in other populations, on pain during acute opioid withdrawal and to study pain's relationships with objective cardiorespiratory markers. Twenty patients with OUD underwent opioid withdrawal while participating in a two-hour protocol. The protocol involved opioid cues to induce opioid craving and neutral conditions for control purposes. Adhering to a double-blind design, patients were randomly assigned to receive active tcVNS (n = 9) or sham stimulation (n = 11) throughout the protocol. At the beginning and end of the protocol, patients' pain levels were assessed using the numerical rating scale (0–10 scale) for pain (NRS Pain). During the protocol, electrocardiogram and respiratory effort signals were measured, from which heart rate variability (HRV) and respiration pattern variability (RPV) were extracted. Pre- to post- changes (denoted with a Δ) were computed for all measures. Δ NRS Pain scores were lower (P = 0.045) for the active group (mean ± standard deviation: −0.8 ± 2.4) compared to the sham group (0.9 ± 1.0). A positive correlation existed between Δ NRS pain scores and Δ RPV (Spearman's ρ = 0.46; P = 0.04). Following adjustment for device group, a negative correlation existed between Δ HRV and Δ NRS Pain (Spearman's ρ = −0.43; P = 0.04). This randomized, double-blind, sham-controlled pilot study provides the first evidence of tcVNS-induced reductions in pain in patients with OUD experiencing opioid withdrawal. This study also provides the first quantitative evidence of an association between breathing irregularity and pain. The correlations between changes in pain and changes in objective physiological markers add validity to the data. Given the clinical importance of reducing pain non-pharmacologically, the findings support the need for further investigation of tcVNS and wearable cardiorespiratory sensing for pain monitoring and management in patients with OUD.
The main objectives of this investigation were to study the inheritance of earliness traits in wheat, (Triticum aestivum L.) also to evaluate and study some early and late mature parents and their resulted crosses. This investigation included eight bread wheat parental genotypes differed in their earliness components. Half diallel cross was made between these genotypes. The eight parents and their 28 F1 crosses were planted in two sowing dates, early and normal. The collected data were analyzed using Griffing 1956 procedure, Method 2, model 1.The collected data of this experiment were days to first node emergence, days to booting, days to heading, days to anthesis, days to maturity, grain filling period and grain filling rate. Mean performance of most earliness components was low at early sowing date comparing with those at normal one for most genotypes. The parental genotypes Line 1 and Line 2 and most of their crosses gave the most desirable values in most earliness traits. The crosses Line 1 × line 2, Line 1× Sonalica, Giza 163 × Gemmeiza 9 and Sakha 61 × Giza 163 gave the lowest mean values of earliness traits in early sowing date. Meanwhile, the crosses Line 1 × Line 2, Line 2 × Sonalica and Line 1 × Line 3 gave the best values toward earliness at normal sowing date. The cross between Line 1 and Line 2 was the most superior one in its earliness traits at the two sowing dates. Genotypes mean squares for all earliness traits were highly significant at the two sowing dates. The highest and desirable values of heterosis percentage relative to the mid parent for days to first node, to booting and days to heading were obtained from cross Giza 163 × Sids 1 at the two sowing dates, for days to anthesis from cross Giza 163 × Sids 1 under early sowing date and from cross Line 1 × Giza 163 at normal sowing one and, for days to maturity from cross Line 1 × Giza 163 at the two sowing dates. The best crosses over better parent for grain filling period was cross Giza 163 × Sids 1 under the two sowing dates, for grain filling rate was crosses Sakha 61× Giza 163 and Line 2 × Line 3 at the two sowing dates, respectively. General and Specific combining ability mean squares were highly significant for all traits under study at early and normal sowing dates. The GCA/SCA ratios were more than unity for all earliness traits at both sowing dates except for grain filling rate under normal sowing date. Based on general combining ability estimates, the best combiners at early and normal sowing dates for days to first node, to booting, to heading, to anthesis and for days to maturity were Line 1 and Line 2; and for grain filling period and grain filling rate were Giza 163 and Gemmeiza 9. Based on the estimates of specific combining ability estimates, the best cross for days to first node, to booting, and days to heading was cross Giza 163 × Sids 1 at both sowing dates, for days to anthesis was Giza 163 × Sids 1 at early sowing date and Sonalika × Giza 163 at normal sowing date; for days to maturity was Line 1× Giza 163 at early sowing ...
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