Malignant Melanoma metastacizing to the Thyroid Gland: A Case Report and Review of the Literature

Oral presentation 2006 AAO-H&NS Annual Meeting Toronto, Canada September 17-20, 2006. Objectives: The thyroid gland is a relatively uncommon site for secondary malignancy. Even lesscommon is metastasis of malignant melanoma to the thyroid gland. We present a case of malignantmelanoma metastatic to the thyroid gland presenting as thyroid enlargement. Study Design: This is a case report which utilizes chart review, intraoperative photographs,radiographic images, and pathology slides. Methods: A 68 year old patient with no prior evidence of primary skin melanoma presented witha neck mass which tested positive for melanoma. A year and a half following modified radical neckdissection, the patient presented with a diffusely enlarged thyroid gland from which fine needleaspiration revealed metastatic malignant melanoma. Results: A few months following this, the patient began having seizures and was found on MRIto have metastatic disease to the brain. He developed ventilator dependent respiratory failure andrequired a subtotal thyroidectomy for the placement of a tracheostomy tube. Conclusions: Patients with a history of malignancy and a thyroid nodule present a diagnosticdilemma—is it benign, a new primary, or distant metastasis? Review of this case and the literaturestrengthens the argument that any patient with a history of malignancy and a thyroid mass shouldbe considered as having metastasis until proven otherwise

Sex hormones alter the effect of aspirin on bleeding

Background: Interaction of aspirin and sex hormones was investigated through bleeding time.Methods: Bleeding time in 32 males and 105 unmarried females with previous 6 normal menstrual cycles and all aged between 18 to 21 years was found by Duke’s method before and after 2 hours of aspirin administration. Phase of menstrual cycle of each female was determined by present menstrual history.Results: Bleeding time in 32 male was 69.33± 4.94 seconds and in 105 female was 73.03±1.89 seconds which were not statistically different (P>0.05).This time was increased to 107.66±4.76 seconds in males and 113.65±3.73 seconds in females after aspirin administration which were statistically different (P0.05) difference after aspirin administration with a greater effect in Follicular phase probably due to estradiol.Conclusion: Males respond to aspirin more as compared to females which is likely the effect of the drug and testosterone interaction. Similarly females in the follicular phase respond to aspirin more as compared to females in the luteal phase which may be a result of interaction of estrogen and aspirin

Malignant melanoma metastatic to the thyroid gland: a case report and review of the literature.

The thyroid gland is a relatively uncommon site for a secondary malignancy; even less common is a case of malignant melanoma metastatic to the thyroid. We describe the case of a 68-year-old man who presented with a neck mass in the posterior triangle. Fine-needle aspiration biopsy (FNAB) identified the mass as a malignant melanoma. The patient had had no known primary skin melanoma. He underwent a left modified radical neck dissection, and the mass was discovered to be a positive lymph node. Postoperatively, he declined to undergo radio- and chemotherapy. Eighteen months later, he returned with a diffusely enlarged thyroid. FNAB again attributed the enlargement to malignant melanoma. Soon thereafter, the patient began experiencing seizures, and on magnetic resonance imaging, he was found to have metastatic disease to the brain. He developed ventilator-dependent respiratory failure and required a subtotal thyroidectomy for the placement of a tracheostomy tube. Patients who present with a thyroid nodule and who have a history of malignancy present a diagnostic dilemma: Is the nodule benign, a new primary, or a distant metastasis? The findings of this case and a review of the literature strengthen the argument that any patient with a thyroid mass and a history of malignancy should be considered to have a metastasis until proven otherwise

Fuzzy Logic Speed Regulator for D.C. Motor Tuning

A D.C. motor's rotational speed is regulated in this study using a PID controller and a fuzzy logic controller. In contrast to the fuzzy logic controller, which uses rules based on knowledge and experience, the proportional-integral-derivative (PID) controller requires a mathematical system model.   This study investigates the regulation of a DC motor's velocity using PID and fuzzy logic controllers. The PID controller utilizes a mathematical model and parameter tuning by trial and error. Still, the fuzzy logic controller (FLC) operates on rule-based knowledge, enabling it to handle the nonlinear features of the DC motor effectively. The FLC design entails intricate determinations, including the establishment of a rule base and the process of fuzzification. A total of 49 fuzzy rules have been devised to achieve precise control. Based on MATLAB/SIMULINK simulations, the study concludes that the Fuzzy Logic Controller (FLC) beats the Proportional-Integral-Derivative (PID) controller. The FLC exhibits superior transient and steady-state responses, shorter response times, reduced steady-state errors, and higher precision. This study emphasizes the efficacy of the FLC (Fuzzy Logic Controller) in dealing with the difficulties associated with DC motor control. It presents a strong argument for the suitability and efficiency of FLCs in industrial environments compared to conventional PID (Proportional-Integral-Derivative) controllers. There are a wide variety of ways to construct a fuzzy logic controller. The speed error and the rate of change in the speed error are two inputs to the FLC. Defuzzification is done by focusing on the core of the problem. The results show that FLC is superior to PID controllers in efficiency and effectiveness due to its reduced transient and steady-state factors

A Subjective Study on the Effects of Dynamic Virtual Chemistry Laboratory in a Secondary School Education

Virtual chemistry laboratories (VCLs) are the alternative solutions of the physical laboratories, where students can virtually conduct their experiments with a lower cost, and in an efficient and safer way. Considering the importance of technology-enhanced learning and that of the experimental study, several VCLs have been proposed. However, the existing VCLs are static and only provide the simulation of pre-defined experiments, procedures, or safety procedures and cannot be adapted according to the students’ level or new experimental tasks. In this paper, we proposed a dynamic virtual chemistry lab (DVCL) where instructors or experts are allowed to add a new chemical experiment by adding its apparatus, chemicals, glassware, and mechanism or add something new to its properties. We conducted a subjective study with field experts to investigate the effect of proposed DVCL in secondary school chemistry education. During evaluation, twenty-seven field experts were participated and evaluated the proposed DVCL with system usability scale (SUS)-questionnaire and by a simple questionnaire. The results showed that the proposed DVCL is very helpful for students’ performance and mental modeling and also for effortlessly uplifting their knowledge for hands-on experiments

Substantial and sustained reduction in under-5 mortality, diarrhea, and pneumonia in Oshikhandass, Pakistan : Evidence from two longitudinal cohort studies 15 years apart

Funding Information: Study 1 was funded through the Applied Diarrheal Disease Research Program at Harvard Institute for International Development with a grant from USAID (Project 936–5952, Cooperative Agreement # DPE-5952-A-00-5073-00), and the Aga Khan Health Service, Northern Areas and Chitral, Pakistan. Study 2 was funded by the Pakistan US S&T Cooperative Agreement between the Pakistan Higher Education Commission (HEC) (No.4–421/PAK-US/HEC/2010/955, grant to the Karakoram International University) and US National Academies of Science (Grant Number PGA-P211012 from NAS to the Fogarty International Center). The funding bodies had no role in the design of the study, data collection, analysis, interpretation, or writing of the manuscript. Publisher Copyright: © 2020 The Author(s).Peer reviewedPublisher PD

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Myoepithelial Carcinoma arising in a background of pleomorphic adenoma

Carcinoma ex pleomorphic adenoma is a neoplasm of the salivary gland that causes 3.6% of salivary gland tumours and 12% of salivary gland malignancies. It is a myoepithelial or epithelial neoplasm that arises from pleomorphic adenoma, whether primary or recurrent. Historically carcinoma ex pleomorphic adenoma is considered a high-grade malignancy. Salivary duct carcinoma and high-grade adenocarcinoma are the histologic types that most commonly arise in the background of Pleomorphic adenoma. However, 15% of tumours arising in Pleomorphic adenoma are considered low grade and have sluggish growth. Low-grade carcinoma ex pleomorphic adenoma can be difficult to differentiate from cellular pleomorphic adenoma. The case of a 56-year-old female patient who had neck swelling is being presented. The biopsy showed spindle cell component with mild atypia, invasion into surrounding tissue, and increased mitotic activity on the basis ---Continu

Activity and Anti-Aflatoxigenic Effect of Indigenously Characterized Probiotic Lactobacilli against <i>Aspergillus flavus</i>—A Common Poultry Feed Contaminant

Aflatoxin contamination in human food and animal feed is a threat to public safety. Aflatoxin B1 (AFB1) can be especially damaging to poultry production and consequently economic development of Pakistan. The present study assessed the in vitro binding of AFB1 by indigenously characterized probiotic lactobacilli. Six isolates (Lactobacillus gallinarum PDP 10, Lactobacillus reuetri FYP 38, Lactobacillus fermentum PDP 24, Lactobacillus gallinarum PL 53, Lactobacillus paracasei PL 120, and Lactobacillus gallinarum PL 149) were tested for activity against toxigenic Aspergillus flavus W-7.1 (AFB1 producer) by well diffusion assay. Only three isolates (PL 53, PL 120, and PL 149) had activity against A. flavus W-7.1. The ameliorative effect of these probiotic isolates on AFB1 production was determined by co-culturing fungus with lactobacilli for 12 days, followed by aflatoxin quantification by high-performance liquid chromatography. In vitro AFB1 binding capacities of lactobacilli were determined by their incubation with a standard amount of AFB1 in phosphate buffer saline at 37 &#176;C for 2 h. AFB1 binding capacities of isolates ranged from 28&#8211;65%. Four isolates (PDP 10, PDP 24, PL 120, and PL 149) also ceased aflatoxin production completely, whereas PL 53 showed 55% reduction in AFB1 production as compared to control. The present study demonstrated Lactobacillus gallinarum PL 149 to be an effective candidate AFB1 binding agent against Aspergillus flavus. These findings further support the binding ability of lactic acid bacteria for dietary contaminants