Estrogen hormone acts as a potential key player in providing immunity against certain viral infection. It is found to be associated in providing immunity against acute lungs inflammation and influenza virus by modulating cytokines storm and mediating adaptive immune alterations respectively. Women are less affected by SARS-CoV-2 infection because of the possible influence of estrogen hormone as compared to men. We hypothesized that SARS-CoV-2 causes stress in endoplasmic reticulum (ER) which in turn aggravates the infection, estrogen hormone might play key role in decreasing ER stress by activating estrogen mediated signaling pathways, results in unfolded protein response (UPR). Estrogen governs degradation of phosphotidylinositol 4,5-bisphosphate (PIP 2 ) into diacylglycerol (DAG) and inositol triphosphate (IP 3 ) with the help of phospholipase C. IP 3 start in-fluxing Ca +2 ions that helps in UPR activation. To support our hypothesis, we analyzed the data of 162,392 COVID-19 patients to determine the relation of this disease with gender. We observed that 26% of women and 74% of men were affected by SARS-CoV-2. It indicated that women are less affected because of the possible influence of estrogen hormone in women.

No abstract

Some fundamental conditions and hypotheses are established to ensure the existence, uniqueness, and stability to a class of implicit boundary value problems (BVPs) with Atangana–Baleanu–Caputo type derivative and integral. The required results are established by utilizing the Banach contraction mapping principle and fixed point theorem of Krasnoselskii. In addition, various types of stability results including Hyers–Ulam, generalized Hyers–Ulam, Hyers–Ulam–Rassias, and generalized Hyers–Ulam–Rassias stability are formulated for the problem under consideration. Pertinent examples are given to justify the results we obtain.

BackgroundMultiple organ damage has been observed in patients with COVID-19, but the exact pathway is not known. Vital organs of the human body may get affected after replication of SARS-CoV-2, including the lungs, heart, kidneys, liver and brain. It triggers severe inflammation and impairs the function of two or more organ systems. Ischaemia–reperfusion (IR) injury is a phenomenon that can have disastrous effects on the human body.MethodsIn this study, we analysed the laboratory data of 7052 hospitalised patients with COVID-19 including lactate dehydrogenase (LDH). A total of 66.4% patients were men and 33.6% were women, which indicated gender difference as a prominent factor to be considered.ResultsOur data showed high levels of inflammation and elevated markers of tissue injury from multiple organs C reactive protein, white blood cell count, alanine transaminase, aspartate aminotransferase and LDH. The number of red blood cells, haemoglobin concentration and haematocrit were lower than normal which indicated a reduction in oxygen supply and anaemia.ConclusionOn the basis of these results, we proposed a model linking IR injury to multiple organ damage by SARS-CoV-2. COVID-19 may cause a reduction in oxygen towards an organ, which leads to IR injury.

Antimicrobial prophylaxis is effective in reducing the rate of surgical site infections (SSIs) post-operatively. However, there are concerns with the extent of prophylaxis post-operatively, especially in low- and middle-income countries (LMICs). This increases antimicrobial resistance (AMR), which is a key issue in Pakistan. Consequently, we conducted an observational cross-sectional study on 583 patients undergoing surgery at a leading teaching hospital in Pakistan with respect to the choice, time and duration of antimicrobials to prevent SSIs. The identified variables included post-operative prophylactic antimicrobials given to all patients for all surgical procedures. In addition, cephalosporins were frequently used for all surgical procedures, and among these, the use of third-generation cephalosporins was common. The duration of post-operative prophylaxis was 3–4 days, appreciably longer than the suggestions of the guidelines, with most patients prescribed antimicrobials until discharge. The inappropriate choice of antimicrobials combined with prolonged post-operative antibiotic administration need to be addressed. This includes appropriate interventions, such as antimicrobial stewardship programs, which have been successful in other LMICs to improve antibiotic utilization associated with SSIs and to reduce AMR.

Among the common hemostatic issues of the patients of liver cirrhosis, deep venous thrombosis, pulmonary embolism, and intrahepatic thrombus development are more often ignored. With an estimated frequency ranging from 0.6 to 26 percent, portal venous thrombosis is another potentially dangerous consequence of liver cirrhosis. Objectives: To determine the frequency of various acquired thrombophilic / hypercoagulable states seen in patients with liver cirrhosis. Study design: Descriptive, cross sectional. Settings: Department of Medicine, Allied Hospital, Faisalabad Study duration: 30th June 2019 to 29th December 2019 Materials & Methods: Cirrhosis cases ranging in age from 25 to 75 years old and of both genders were included in the study. Patients with HCC, heritable thrombophilias such as the Factor V leiden mutation, congenital budd chiari, and cholestatic liver disorders such as primary biliary cirrhosis (PBC) and primary sclerosing cholangitis were also eliminated. To assess for hepatic decompensation, ultrasonography, LFTs, and other baseline procedures were performed. Doppler USG was performed in each case with the assistance of the Radiology Department of Allied Hospital Faisalabad to assess for DVT, Budd-Chiari syndrome, and Portal venous thrombosis. Results: Mean age of the patients enrolled was 52.08 ± 10.47 years. Among these 840 patients, 461 (54.88%) were male and 379 (45.12%) were females (ratio 1.2 : 1). Mean AST levels were 77.49 ± 8.93 units/liter. Mean ALT levels were 88.51 ± 9.17 units/liter. Mean total bilirubin levels were 8.33 ± 1.65 mg/dl. Frequency of various acquired thrombophilic / hypercoagulable states seen in patients with liver cirrhosis were as follows; portal vein thrombosis in 136 (16.19%) patients, budd chiari syndrome in 102 (12.14%), deep vein thrombosis in 96 (11.43%) and pulmonary embolism in 108 (12.86%) patients. Conclusion: This study concluded that frequency of various acquired thrombophilic / hypercoagulable states seen in patients with liver cirrhosis is quite high. Keywords: liver cirrhosis, hypercoagulable states, portal vein thrombosis.

Chemokine receptor type 4 (CXCR4) is a G protein-coupled receptor that plays an essential role in immune system function and disease processes. Our study aims to conduct a comparative structural and phylogenetic analysis of the CXCR4 protein to gain insights into its role in emerging and re-emerging diseases that impact the health of mammals. In this study, we analyzed the evolution of CXCR4 genes across a wide range of mammalian species. The phylogenetic study showed species-specific evolutionary patterns. Our analysis revealed novel insights into the evolutionary history of CXCR4, including genetic changes that may have led to functional differences in the protein. This study revealed that the structural homologous human proteins and mammalian CXCR4 shared many characteristics. We also examined the three-dimensional structure of CXCR4 and its interactions with other molecules in the cell. Our findings provide new insights into the genomic landscape of CXCR4 in the context of emerging and re-emerging diseases, which could inform the development of more effective treatments or prevention strategies. Overall, our study sheds light on the vital role of CXCR4 in mammalian health and disease, highlighting its potential as a therapeutic target for various diseases impacting human and animal health. These findings provided insight into the study of human immunological disorders by indicating that Chemokines may have activities identical to or similar to those in humans and several mammalian species.

Objective: To evaluate the Effects of Pre-operative education and physical therapy training for dyspnea prevention in patients undergoing valvular cardiac surgery. Methods: A Prospective RCT was performed on sample size of 40 patients of cardiac valvular disease that were obtain from Faisalabad Institute of cardiology. At the time of admission, all patients were tested by baseline dyspnea index then the subjects were randomly assigned into two groups by computerized random generator. Both groups were having education but treatment group were having additional breathing exercises and functional tasks for 10 minutes in 1st week regularly and 1 hour in 2nd week regularly. Each group were tested again by BDI after the treatment on second post-op day. Tracheal extubation and eye-opening time were also noted as outcome measures of study. Results were compiled on SPSS.20 for finding post-operative dyspnea. Results: Pre-operative and post-operative findings showed that the patients of treatment group performed better than control group as the effects of pre-operative treatment on dyspnea by total baseline dyspnea index is significant (p<0.05) as well as the treatment group had significant reduction in eye-opening and tracheal extubation time in comparison of control group having (p<0.05). Conclusion: The results shows that in patients of valvular cardiac surgery, pre-surgical education and physical therapy training showed significant reduction in post-surgical dyspnea, tracheal extubation and eye-opening time. Keywords: Valvular cardiac surgery, physical therapy training, presurgical education, cardiopulmonary physiotherapy, baseline dyspnea index, rehabilitation.