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  • Article
    Ullah W, Ali H, Muhammad Y, Ullah N, Khalil I, Ahmad S, Ullah O, Ali A, Ali MY, Manan A, Safdar S, Hanfi H.
    Cureus. 2024 Oct;16(10):e72595.
    BACKGROUND: Guillain-Barre Syndrome (GBS) is a severe autoimmune neuropathy that has to be treated quickly and efficiently in emergency situations, when both cost and effectiveness are vital.
    OBJECTIVE: To compare the clinical outcomes and cost-effectiveness of plasmapheresis and intravenous immunoglobulin (IVIG) in managing acute GBS in emergency departments.
    METHODOLOGY: A prospective observational study conducted from January to December 2023 evaluated the treatment of adults with acute GBS using IVIG or plasmapheresis. Cost analysis was done in conjunction with clinical outcomes assessment, such as improvement in motor function, length of recovery, and length of hospital stay. Each therapy group consisted of 39 individuals, and data were gathered via patient evaluations and medical records. Through statistical analysis, the two regimens' costs and results were compared.
    RESULTS: Plasmapheresis proved significantly more cost-effective than IVIG, with an average treatment cost of 295,000 Pakistani rupees (PKR) per patient versus 587,000 PKR for IVIG. Plasmapheresis showed a greater mean improvement in motor function (Glasgow Coma Scale (GCS) score change of 5.93 ± 2.17) compared to IVIG (4.98 ± 2.34), though the difference was not statistically significant (p=0.091). Recovery time was slightly shorter with plasmapheresis, averaging 8.26 ± 1.53 weeks versus 8.74 ± 1.87 weeks for IVIG (p=0.282). Hospital length of stay was marginally reduced with plasmapheresis (12.16 ± 3.28 days) compared to IVIG (12.95 ± 3.64 days, p=0.302). The time to reach maximum improvement was also shorter with plasmapheresis (6.51 ± 1.24 weeks) compared to IVIG (7.08 ± 1.32 weeks, p=0.260). Additionally, plasmapheresis had a lower complication rate, with 4 out of 39 patients (10.25%) experiencing complications, compared to 8 out of 39 patients (20.51%) with IVIG.
    CONCLUSION: Plasmapheresis is more cost-effective than IVIG for acute GBS management in emergency departments, offering similar or potentially superior clinical outcomes at a lower cost.
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  • Article
    Liu C, Zwiebel LJ.
    PLoS One. 2013;8(8):e72595.
    Thermosensation provides vital inputs for the malaria vector mosquito, Anopheles gambiae which utilizes heat-sensitivity within a broad spectrum of behaviors, most notably, the localization of human hosts for blood feeding. In this study, we examine thermosensory behaviors in larval-stage An. gambiae, which as a result of their obligate aquatic habitats and importance for vectorial capacity, represents an opportunistic target for vector control as part of the global campaign to eliminate malaria. As is the case for adults, immature mosquitoes respond differentially to a diverse array of external heat stimuli. In addition, larvae exhibit a striking phenotypic plasticity in thermal-driven behaviors that are established by temperature at which embryonic development occurs. Within this spectrum, RNAi-directed gene-silencing studies provide evidence for the essential role of the Transient Receptor Potential sub-family A1 (TRPA1) channel in mediating larval thermal-induced locomotion and thermal preference within a discrete upper range of ambient temperatures.
    Digital Access Access Options
  • Book
    Contents:
    Introduction : certification examination and tips for preparation
    Part I. Practice questions and answers with rationales. Cardiovascular questions ; Respiratory questions ; Endocrine, hematologic, gastrointestinal, renal, and integumentary questions ; Musculoskeletal, neurological, and psychosocial questions ; Multisystem questions ; Professional caring and ethical practice questions
    Part II. Practice test and answers with rationales. Practice test ; Answers with rationales.
    Digital Access R2Library [2022]