Fulminant invasive aspergillosis of the mediastinum in an immunocompetent host: a case report

Introduction: Invasive aspergillosis is a serious complication in immunocompromised patients. It is an opportunistic disease, which predominantly occurs in the lungs, although dissemination to virtually any organ is possible. Invasive aspergillosis in an immunocompetent patient with extension to the mediastinum has rarely been reported. Here, we present the case of a patient with no apparent immunodeficiency state, who presented with Aspergillus endocarditis and fulminant invasive aspergillosis with extensive involvement of the mediastinal structures, which ultimately was responsible for her death. To the best of our knowledge, this is the first reported case in the literature on fulminant invasive mediastinal aspergillosis with extension to the pulmonary vasculature and concomitant Aspergillus endocarditis in an apparently immunocompetent patient without pre-existing lung disease. Case presentation: Our patient was a previously healthy 47-year-old Asian woman, who presented to our emergency room with severe progressive shortness of breath of one month’s duration, associated with orthopnea and unstable vital signs. Conclusion: Invasive aspergillosis has been described in the presence of pulmonary disease, such as chronic obstructive pulmonary disorder, and one case has been reported in a patient without preexistent disease, but none of these have been fatal. Our case is therefore the first reported case of its kind. Our case shows that fulminant aspergillosis can occur in an immunocompetent host and can be fatal. We conclude that invasive aspergillosis should not be excluded from the differential diagnosis on the basis of immunocompetency

A Case of Subhyaloid Haemorrhage Managed with ND:YAG Laser Hyaloidotomy

Subhyaloid hemorrhage is rarely seen in ophthalmological practice in young males. We managed one such case in our set-up. A youngmale presented with sudden decreased vision. Fundus showed large collection of darkish red colored blood in subhyaloid space of theposterior pole in front of the macula, typical of sub-hyaloid hemorrhage. Treatment includes, amongst others, Nd: YAG laserhyaloidotomy. Prognosis, if treated on appropriate lines, is usually good. This case was being reported for general awareness.Key-words: Nd: Yag laser hyaloidotomy, premacular sub-hyaloid haemorrhag

Fulminant invasive aspergillosis of the mediastinum in an immunocompetent host: a case report.

Introduction: Invasive aspergillosis is a serious complication in immunocompromised patients. It is an opportunistic disease, which predominantly occurs in the lungs, although dissemination to virtually any organ is possible. Invasive aspergillosis in an immunocompetent patient with extension to the mediastinum has rarely been reported. Here, we present the case of a patient with no apparent immunodeficiency state, who presented with Aspergillus endocarditis and fulminant invasive aspergillosis with extensive involvement of the mediastinal structures, which ultimately was responsible for her death. To the best of our knowledge, this is the first reported case in the literature on fulminant invasive mediastinal aspergillosis with extension to the pulmonary vasculature and concomitant Aspergillus endocarditis in an apparently immunocompetent patient without pre-existing lung disease. Case presentation: Our patient was a previously healthy 47-year-old Asian woman, who presented to our emergency room with severe progressive shortness of breath of one month’s duration, associated with orthopnea and unstable vital signs. Conclusion: Invasive aspergillosis has been described in the presence of pulmonary disease, such as chronic obstructive pulmonary disorder, and one case has been reported in a patient without preexistent disease, but none of these have been fatal. Our case is therefore the first reported case of its kind. Our case shows that fulminant aspergillosis can occur in an immunocompetent host and can be fatal. We conclude that invasive aspergillosis should not be excluded from the differential diagnosis on the basis of immunocompetency

The Alteration and Mineralization Characteristics of Miocene Porphyry Cu-Au Deposits of Chagai Magmatic Belt, District Chagai, Balochistan, Pakistan

Subduction related Miocene porphyry type deposits are found in the east-west trending Chagai magmatic belt (CMB) in Pakistan's western margin, Balochistan. This arc exists on the west segment of the Tethyan metallogenic belt in the south-west of Pakistan. Tethyan metallogenic belt is widely spread over 12,000 km from east to west direction from Indochina, Tibet, Pakistan, Iran, Turkey and Alpine mountain range in Europe. During the last thirty to forty years several porphyry deposits have been reported in the Chagai magmatic arc, including the very large Reko Diq H14-H15, large Saindak, Tanjeel, H35, H8 and medium Dasht-e-Kain porphyry deposits and many small porphyry copper deposits. These porphyry deposits were developed within the phase of calc-alkaline type magmatism in the Chagai arc. Tonalite, quartz diorite, and monzonite host the porphyry deposits within the adjacent sedimentary wall rock units of Sinjrani Volcanic Group, Juzzak, Saindak, and Amalaf Formations. The concentric zonal pattern of hydrothermal alteration in these porphyry deposits of the Chagai magmatic arc follows the world's major porphyry deposits' alteration pattern. Zones of hydrothermal alteration from distal to proximal part includesa potassic alteration, sericitic-clay-chlorite alteration, sericitic alteration, argillic alteration and propylitic alteration. Major ore mineralization in these deposits is of copper, gold, silver, molybdenum, and minor constituents of other base metals that have been reported to occur within hydrothermal alteration zones in the Miocene porphyry Chagai magmatic ar

First finding of patent urachus with omphalophlebitis and omphaloarteritis in Pakistani Neeli-Ravi buffalo calf and its successful surgical rectification: Case report

Patent urachus is rare condition in buffalo calves. Only one case has been reported in India (Pandu et al., 2000). The present case represents the first case report of a buffalo female calf of Nili-Ravi breed of Pakistan. Physically the animal was attentive and nourishing on milk usually. There was dribbling of urine from the umbilical region. The dribbled urine from umbilicus was confirmed as urine by the laboratory tests. On the basis of laboratory and clinical assessment, it was confirmed as patent urachus and was subjected to surgical treatment. Urachus was approached with inflamed umbilical artery and veins at their bases and were dissected after ligation. The animal got uneventful recovery after 10 days of post-operative management

Nitrous oxide emission from agricultural soils: Application of animal manure or biochar? A global meta-analysis

Organic amendments (animal manure and biochar) to agricultural soils may enhance soil organic carbon (SOC) contents, improve soil fertility and crop productivity but also contribute to global warming through nitrous oxide (N2O) emission. However, the effects of organic amendments on N2O emissions from agricultural soils seem variable among numerous research studies and remains uncertain. Here, eighty-five publications (peer-reviewed) were selected to perform a meta-analysis study. The results of this meta-analysis study show that the application of animal manure enhanced N2O emissions by 17.7%, whereas, biochar amendment significantly mitigated N2O emissions by 19.7%. Moreover, coarse textured soils increased [ = 182.6%, 95% confidence interval (CI) = 151.4%, 217.7%] N2O emission after animal manure, in contrast, N2O emission mitigated by 7.0% from coarse textured soils after biochar amendment. In addition, this study found that 121–320 kg N ha−1 and ⩽ 30 T ha−1 application rates of animal manure and biochar mitigated N2O emissions by 72.3% and 22.5%, respectively. Soil pH also played a vital role in regulating the N2O emissions after organic amendments. Furthermore, > 10 soil C: N ratios increased N2O emissions by 121.4% and 27.6% after animal and biochar amendments, respectively. Overall, animal manure C: N ratios significantly enhanced N2O emissions, while, biochar C: N ratio had not shown any effect on N2O emissions. Overall, average N2O emission factors (EFs) for animal manure and biochar amendments were 0.46% and −0.08%, respectively. Thus, the results of this meta-analysis study provide scientific evidence about how organic amendments such as animal manure and biochar regulating the N2O emission from agricultural soils.The part of work contributed by Muhammad Aammar Tufail, has received funding form the European Union’s Horizon 2020 Research and Innovation program under the Maria Skłodowska-Curie grant agreement no. 722642 (project INTER-FUTUR

The potential of plasma-derived hard carbon for sodium-ion batteries

Sodium-ion batteries (SIB) are receiving wider attention due to sodium abundance and lower cost. The application of hard carbon to SIB electrodes has shown their significant potential to increase rates, capacities, stability, and overall performance. This article describes the significance of hard carbon, its structural models, and mechanisms for SIB applications. Further, this work unveils the potential of plasma methods as a scalable and sustainable manufacturing source of hard carbon to meet its increasing industrial demands for energy storage applications. The working mechanisms of major plasma technologies, the influence of their parameters on carbon structure, and their suitability for SIB applications are described. This work summarises the performance of emerging plasma-driven hard carbon solutions for SIB, including extreme environments, and revolves around the flexibilities offered by plasma methods in a wider spectrum such as multi-materials doping, in-situ multilayer fabrication, and a broad range of formulations and environments to deposit hard carbon-based electrodes for superior SIB performance. It is conceived the challenges around the stable interface, capacity fading, and uplifting SIB capacities and rates at higher voltage are currently being researched, Whereas, the development of real-time monitoring and robust diagnostic tools for SIB are new horizons. This work proposes a data-driven framework for plasma-driven hard carbon to make high-performance energy storage batteries

Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050

Background Antimicrobial resistance (AMR) poses an important global health challenge in the 21st century. A previous study has quantified the global and regional burden of AMR for 2019, followed with additional publications that provided more detailed estimates for several WHO regions by country. To date, there have been no studies that produce comprehensive estimates of AMR burden across locations that encompass historical trends and future forecasts. Methods We estimated all-age and age-specific deaths and disability-adjusted life-years (DALYs) attributable to and associated with bacterial AMR for 22 pathogens, 84 pathogen–drug combinations, and 11 infectious syndromes in 204 countries and territories from 1990 to 2021. We collected and used multiple cause of death data, hospital discharge data, microbiology data, literature studies, single drug resistance profiles, pharmaceutical sales, antibiotic use surveys, mortality surveillance, linkage data, outpatient and inpatient insurance claims data, and previously published data, covering 520 million individual records or isolates and 19 513 study-location-years. We used statistical modelling to produce estimates of AMR burden for all locations, including those with no data. Our approach leverages the estimation of five broad component quantities: the number of deaths involving sepsis; the proportion of infectious deaths attributable to a given infectious syndrome; the proportion of infectious syndrome deaths attributable to a given pathogen; the percentage of a given pathogen resistant to an antibiotic of interest; and the excess risk of death or duration of an infection associated with this resistance. Using these components, we estimated disease burden attributable to and associated with AMR, which we define based on two counterfactuals; respectively, an alternative scenario in which all drug-resistant infections are replaced by drug-susceptible infections, and an alternative scenario in which all drug-resistant infections were replaced by no infection. Additionally, we produced global and regional forecasts of AMR burden until 2050 for three scenarios: a reference scenario that is a probabilistic forecast of the most likely future; a Gram-negative drug scenario that assumes future drug development that targets Gram-negative pathogens; and a better care scenario that assumes future improvements in health-care quality and access to appropriate antimicrobials. We present final estimates aggregated to the global, super-regional, and regional level. Findings In 2021, we estimated 4·71 million (95% UI 4·23–5·19) deaths were associated with bacterial AMR, including 1·14 million (1·00–1·28) deaths attributable to bacterial AMR. Trends in AMR mortality over the past 31 years varied substantially by age and location. From 1990 to 2021, deaths from AMR decreased by more than 50% among children younger than 5 years yet increased by over 80% for adults 70 years and older. AMR mortality decreased for children younger than 5 years in all super-regions, whereas AMR mortality in people 5 years and older increased in all super-regions. For both deaths associated with and deaths attributable to AMR, meticillin-resistant Staphylococcus aureus increased the most globally (from 261 000 associated deaths [95% UI 150 000–372 000] and 57 200 attributable deaths [34 100–80 300] in 1990, to 550 000 associated deaths [500 000–600 000] and 130 000 attributable deaths [113 000–146 000] in 2021). Among Gram-negative bacteria, resistance to carbapenems increased more than any other antibiotic class, rising from 619 000 associated deaths (405 000–834 000) in 1990, to 1·03 million associated deaths (909 000–1·16 million) in 2021, and from 127 000 attributable deaths (82 100–171 000) in 1990, to 216 000 (168 000–264 000) attributable deaths in 2021. There was a notable decrease in non-COVID-related infectious disease in 2020 and 2021. Our forecasts show that an estimated 1·91 million (1·56–2·26) deaths attributable to AMR and 8·22 million (6·85–9·65) deaths associated with AMR could occur globally in 2050. Super-regions with the highest all-age AMR mortality rate in 2050 are forecasted to be south Asia and Latin America and the Caribbean. Increases in deaths attributable to AMR will be largest among those 70 years and older (65·9% [61·2–69·8] of all-age deaths attributable to AMR in 2050). In stark contrast to the strong increase in number of deaths due to AMR of 69·6% (51·5–89·2) from 2022 to 2050, the number of DALYs showed a much smaller increase of 9·4% (–6·9 to 29·0) to 46·5 million (37·7 to 57·3) in 2050. Under the better care scenario, across all age groups, 92·0 million deaths (82·8–102·0) could be cumulatively averted between 2025 and 2050, through better care of severe infections and improved access to antibiotics, and under the Gram-negative drug scenario, 11·1 million AMR deaths (9·08–13·2) could be averted through the development of a Gram-negative drug pipeline to prevent AMR deaths. Interpretation This study presents the first comprehensive assessment of the global burden of AMR from 1990 to 2021, with results forecasted until 2050. Evaluating changing trends in AMR mortality across time and location is necessary to understand how this important global health threat is developing and prepares us to make informed decisions regarding interventions. Our findings show the importance of infection prevention, as shown by the reduction of AMR deaths in those younger than 5 years. Simultaneously, our results underscore the concerning trend of AMR burden among those older than 70 years, alongside a rapidly ageing global community. The opposing trends in the burden of AMR deaths between younger and older individuals explains the moderate future increase in global number of DALYs versus number of deaths. Given the high variability of AMR burden by location and age, it is important that interventions combine infection prevention, vaccination, minimisation of inappropriate antibiotic use in farming and humans, and research into new antibiotics to mitigate the number of AMR deaths that are forecasted for 2050