Nanoparticles (NPs) that are ∼100 nm in diameter can potentially cause toxicity in the central nervous system (CNS). Although NPs exhibit positive aspects, these molecules primarily exert negative or harmful effects. Thus, the beneficial and harmful effects should be compared. The prevalence of neurodegenerative diseases, such as Alzheimer disease, Parkinson disease, and some brain tumors, has increased. However, the major cause of these diseases remains unknown. NPs have been considered as one of the major potential causes of these diseases, penetrating the human body via different pathways. This review summarizes various pathways for NP-induced neurotoxicity, suggesting the development of strategies for nanoneuroprotection using in silico and biological methods. Studies of oxidative stress associated with gene expression analyses provide efficient information for understanding neuroinflammation and neurodegeneration associated with NPs. The brain is a sensitive and fragile organ, and evolution has developed mechanisms to protect it from injury; however, this protection also hinders the methods used for therapeutic purposes. Thus, brain and CNS-related diseases that are the cause of disability and disorder are the most difficult to treat. There are many obstacles to drug delivery in the CNS, such as the blood brain barrier and blood tumor barrier. Considering these barriers, we have reviewed the strategies available to map NPs using biological techniques. The surface adsorption energy of NPs is the basic force driving NP gathering, protein corona formation, and many other interactions of NPs within biological systems. These interactions can be described using an approach named the biological surface adsorption index. A quantitative structural activity relationship study helps to understand different protein-protein or protein-ligand interactions. Moreover, equilibrium between cerebrovascular permeability is required when a drug is transferred via the circulatory system for the therapy of neurodegenerative diseases. Various drug delivery approaches, such as chemical drug delivery and carrier-mediated drug delivery, have been established to avoid different barriers inhibiting CNS penetration by therapeutic substances. Developing an improved understanding of drug receptors and the sites of drug action, together with advances in medicinal chemistry, will make it possible to design drugs with greatly enhanced activity and selectivity; this may result in a significant increase in the therapeutic index.
The authors have highlighted the ever-spreading menace of fake research and predatory journalism in the medicine. The lack of incentives and facilities for genuine research, coupled with compulsion to publish a minimum number of papers for promotions, have forced the authors to adopt the short-cut and choose the journals, which are willing to publish for money, without rigorous peer-review. This tendency can only be curtailed by strict adherence to the rules already set by international agencies. Key words: Access to Information; Authorship; Editorial Policies; Fraud; Open Access Publishing / standards; Peer Review; Scientific Misconduct Citation: Saleem H, Iqbal A. The scam of the research world: the predatory practices. Anaesth. pain intensive care 2022;26(4):430-432; DOI: 10.35975/apic.v26i4.1943 Received: June 14, 2022; Reviewed: June 22, 2022; Accepted: July 06, 2022
Background & Objectives: Radiation therapy is one of the modalities used in cancer treatment to destroy rapidly growing tumor mass. The fractionated radiation session targets up to four fields of 90 sec each, over 10-15 min. Young children require deep sedation or general anesthesia to make them immobile, for the safe delivery of radiation fractions. Common drugs used for sedation are propofol, ketamine and midazolam. Repeated exposure to anesthetic drugs over a short period of time may lead to development of tolerance and increased dose requirements. We aimed to determine if drug tolerance phenomenon develops in children receiving frequent doses of anesthetic drugs over a short time period. Methodology: This is a retrospective observational study of the pediatric population who underwent frequent radiotherapy sessions with deep sedation from January to May 2019. The data of the first and last day of drugs administered was analyzed to determine if the dose requirement for any of the three drugs increased over time. Results: We collected data of twenty-one patients and applied two tailed student’s t-test on the mean dose of drugs on the first day and the last day of the treatment. It remained unchanged with insignificant p value (propofol p = 0.15; midazolam p = 0.5; ketamine p = 0.32). To minimize the drug augmenting each other’s effect, multilinear regression analysis of the drugs over the time period showed that there was neither an increase nor a decrease in the doses used (αi- propofol coefficient 0.019 ± 0.053; βi- midazolam coefficient -0.002 ± 0.007; γi- ketamine coefficient 0.049 ± 0.218)). The overall duration of the recovery time was not different from the first to the last day of radiotherapy. Conclusion: Frequent and repeated doses of sedative drugs over a short period of time in children undergoing repeated deep sedation for radiation therapy, do not result in the development of tolerance. Key words: Sedation; Tolerance; Radiotherapy Citation: Iqbal A, Saleem H, Durrani RS. Tolerance development in children undergoing repeated exposure to anesthesia drugs for radiation therapy. Anaesth. pain intensive care 2020;24(5): Received: 7 July 2020, Reviewed: 26 August 2020, Accepted: 3 September 2020
Background: The outbreak of COVID-19 in Pakistan started from February 2020 and over the next few months it affected around a million people, leaving thousands dead in an already burdened healthcare infrastructure. Rising to the challenge of COVID 19 airway management, we adopted components of ‘Consensus guidelines for managing airways in patients with COVID 19 to improve success of first pass intubation alongwith minimising risk of infection to self and others. Aim: To analyse the techniques of airway management and complications of suspected or confirmed COVID status at time of their airway management. Methodology: After ethical approval by the institutional review board, data is collected from the Hospital Information System (HIS) for cases fulfilling inclusion criteria, from April to September 2020 in a tertiary care cancer hospital, Pakistan. Results: In our centre, forty-five intubations were performed, 71% of these intubations were out of hours and 43% performed by consultants. It had a high 1st attempt success rate of 84.4%, using Videolaryngoscope (64.4%) and 55.6% confirmed use of capnography. In all cases (100%) PPE was available and used. Minimum number of personnel in room during intubation was kept to four to five in 55.6% of cases. Conclusion: Dedicated airway team used Personal Protective Equipment in all cases (100%) and restricted the number of personnel during the procedure. A high success rate of 1st attempt intubation, widely used videolaryngoscope, single agent induction and consultant intubators were salient features of our practice. Keywords: Keywords: Airway, Covid 19, Intubation, Pakistan
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