Giant adrenal endothelial cyst associated with acute and chronic morbidity in a young female: a case report

Adrenal cysts are rare clinical entities that can present as acute abdomen through rupture and internal hemorrhage as well as chronic symptoms such as gastrointestinal disturbances. A 20-year-old girl presented to our hospital with a 4-years history of abdominal pain and diarrhea. Ultrasound of the abdomen revealed a cystic area measuring 10 × 10 cm between the spleen and left kidney. Computed tomography scan showed a large cystic, homogeneous mass measuring 12.8 × 9.5 × 9.4 cm in the left hypochondrium with most likely origin from the left adrenal gland. Limited work up for hormone hypersecretion was negative. The patient was then encountered in the emergency room with an acute abdomen secondary to intracystic hemorrhage. A laparotomy with left adrenalectomy was performed. Final pathology showed a benign adrenal endothelial cyst. Post-operatively, the patient's long standing complaints of diarrhea and abdominal pain completely resolved. Surgical resection appears a safe and reasonable management strategy in a patient with intracystic hemorrhage of adrenal cyst

Gaussian mixture model based probabilistic modeling of images for medical image segmentation

In this paper, we propose a novel image segmentation algorithm that is based on the probability distributions of the object and background. It uses the variational level sets formulation with a novel region based term in addition to the edge-based term giving a complementary functional, that can potentially result in a robust segmentation of the images. The main theme of the method is that in most of the medical imaging scenarios, the objects are characterized by some typical characteristics such a color, texture, etc. Consequently, an image can be modeled as a Gaussian mixture of distributions corresponding to the object and background. During the procedure of curve evolution, a novel term is incorporated in the segmentation framework which is based on the maximization of the distance between the GMM corresponding to the object and background. The maximization of this distance using differential calculus potentially leads to the desired segmentation results. The proposed method has been used for segmenting images from three distinct imaging modalities i.e. magnetic resonance imaging (MRI), dermoscopy and chromoendoscopy. Experiments show the effectiveness of the proposed method giving better qualitative and quantitative results when compared with the current state-of-the-art. INDEX TERMS Gaussian Mixture Model, Level Sets, Active Contours, Biomedical Engineerin

An Electro-Optical Technique For The Measurement Of Temperature Of High Potential Bodies.

In this paper we have presented a low cost, simple and robust mechatronic system for the measurement of temperature in extreme conditions. It is specially designed for the protection of high potential parts of power transformers and switch gears under faulty operating conditions

Analysis of channel uncertainty in ARQ relay networks

Several power allocation algorithms for cooperative relay networks are presented in the literature. These contributions assume perfect channel knowledge and capacity achieving codes. However in practice, obtaining the channel state information at a relay or at the destination is an estimation problem and can generally not be error free. The investigation of the power allocation mechanism in a wireless network due to channel imperfections is important because it can severely degrade its performance regarding throughput and bit error rate. In this paper, the impact of imperfect channel state information on the power allocation of an adaptive relay network is investigated. Moreover, a framework including Automatic Repeat reQuest (ARQ) mechanism is provided to make the power allocation mechanism robust against these channel imperfections. For this framework, the end-to end SNR is calculated considering imperfect channel knowledge using ARQ analytically. The goal is to emphasize the impact of imperfect channel knowledge on the power allocation mechanism. In this paper, the simulation results illustrate the impact of channel uncertainties on the average outage probability, throughput, and consumed sum power for different qualities of channel estimation. It is shown that the presented framework with ARQ is extremely robust against the channel imperfections

Phytochemical, Antioxidant, Cytotoxic, Antibacterial Activity, and Enzymatic Inhibition Study of Piper Betle Leaves

The Piper betle plant, known for its pharmacological properties, has been traditionally used in Asian cultures. The objective of the current study is to assess the antioxidant, cytotoxic, antibacterial, and enzymatic inhibitions of leaf extracts of the P. betle. DPPH radicals were used to assess the antioxidant potential. The Lethality Assay for Brine Shrimp was used to assess the cytotoxic potential of plant extracts. The disc diffusion method was used to measure the leaves' antibacterial activity against various Gram stains. The inhibitory potential of four enzymes linked to different diseases was screened spectrophotometrically. Chromatographic procedures were used to isolate active substances, and their structures were determined using spectroscopic approaches. The results indicated that the P. betle leaves extracts to possess potent antioxidant activity, highest with the EAPB (ethylacetate, P. betle) followed by DCPB (dichloromethane, P. betle), HPB (n-hexane, P. betle), BPB (n-butanol, P. betle) and AQPB (aqueous P. betle). For cytotoxic activity, the EAPB has the most potent cytotoxic activity among the tested extracts. AQBP and HPB showed activity against all bacteria used, while (EAPB and DCPB displayed good activities against all organisms except Streptococcus aglaciate. For anti-diabetic activity, DCPB, and EAPB both showed high percent inhibition and low IC50. The identified compound, allylpyrocatechol, isolated from the EAPB fraction of betel leaf attributed higher inhibitory activity than the standard against α-glucosidase with an IC50 of 42.61 ± 1.27. For anti-ulcer activity, the DCPB had the highest urease % inhibition and the lowest IC50 value, while (BPB) and AQBP fractions had lower levels of inhibition and higher IC50 values. DCPB and EAPB exhibited neurodegenerative therapeutic potential by targeting prolyl endopeptidase with good activity having IC50 values of 26.82 ± 0.36 and 52.92 ± 21.30 µg/mL). Furthermore, these extracts were tested for their therapeutic potential for skin diseases by targeting the tyrosinase enzyme. Interestingly, HPB and DCPB displayed good inhibitory capability with IC50 values of 36.14 ± 0.72, and 44.72 ± 1.28 µg/mL, respectively, compared to the standard kojic acid (IC50 = 7.49 ± 0.21 µg/mL). In conclusion, crude extracts of Piper betle leaves exhibit potent antioxidant, antibacterial, and moderately cytotoxic effects. It also has strong anti-ulcer and anti-diabetic properties. Additionally, it exhibits strong anti-pigentation properties and good neurodegenerative potential

Acute free perforation of gall bladder encountered at initial presentation in a 51 years old man: a case report

Introduction: Gallbladder perforation is a rare but life threatening event. We describe a case of gallbladder perforation encountered at initial presentation. Case Presentation: A 51 years old male, without any known medical co-morbidity, presented with a 1-day history of sudden-onset abdominal pain and abdominal distension. On examination, his abdomen was distended with generalized tenderness on palpation. Abdominal x-ray showed no signs of intestinal obstruction or pneumoperitoneum. Computed tomography scan of the abdomen showed appearance suggestive of gallbladder perforation. The Patient was taken to the operating room and a diagnostic laparoscopy was performed revealing yellowish green fluid in the peritoneum. Difficulty in visualization of the anatomy led to conversion of the procedure to an open laparotomy. Intra-operative findings included a perforation near the neck of the gall bladder in association with a 2 x 1 cm gall stone. Near-total cholecystectomy was performed and a single large gall stone was retrieved. The peritoneal cavity was washed with normal saline and a drain was placed. The rectus sheath was closed but the wound was kept open for healing by delayed primary closure. The Patient\u27s hospital course was uneventful and he was discharged from the hospital on the 3rd post-operative day. He returned to the clinic after one week whereby his drain was removed and his wound closed. Conclusion: Gallbladder perforation is an unusual initial presentation of gallbladder disease. Early diagnosis of gallbladder perforation and immediate surgical intervention are of prime importance in decreasing morbidity and mortality associated with this condition

Impact of Bacille Calmette-Guerin Vaccination on Neuroradiological Manifestations of Pediatric Tuberculous Meningitis

The authors conducted this study to identify whether bacille Calmette-Guerin (BCG) vaccination leads to an altered spectrum of neuroimaging findings outcome in pediatric Patients with tuberculous meningitis. This retrospective study was conducted through chart review and review of computed tomography (CT) scans and magnetic resonance imaging (MRI) of Patients with confirmed central nervous system tuberculosis from the year 1992 to 2005, at a large tertiary care hospital in Karachi, Pakistan. A total of 108 pediatric Patients with tuberculous meningitis were included in the analysis. Of the 108 Patients, 63 (58.3%) were male and 45 (41.7%) had received bacille Calmette-Guerin vaccination. There was no difference in terms of severity of clinical presentation and outcome between vaccinated and unvaccinated group. There were no significant differences in CT or MRI findings between the 2 groups except for tuberculomas on MRI, which were significantly higher in the non-bacille Calmette-Guerin vaccinated group (52.2% vs 22.7%, P = .042). Bacille Calmette-Guerin vaccination appears to translate into less tuberculoma formation on MRI

A mechanistic insight into chemical cues and interactions involved in herbivory induced jasmonate mediated plant defense mechanism

The first step in plant defense mechanism is to sense the insect attack stimulus. Plant sensitivity of an insect attack is the first step of defense. Molecules generated by the oral secretion of the insect interact with the plant receptors to trigger plant defense mechanisms. We selected some highly cited insect elicitors molecules, volicitin, caeliferin, bruchin which interact with plant defense by interacting with plant elicitors (systemin, inceptin and peps) located on the plant cell surface. This interaction activates plant receptors SYR1, LRR, PEPR and triggers downstream defense signaling. The octadecanoid pathways, involving enzymes allene oxide synthase (AOS) and Hydroxyperoxide lyase (HPL) are activated. These enzymes mediate production of green leafy volatiles and Jasmonic acid by interacting with hydroxperoxide molecules. We docked the elicitors with receptors and enzymes with substrates in the pathway of JA production. Phe was found to be an important amino acid that interacts with 13-hydroxyperoxides in the case of AOS to produce JA but not in the case of HPL. JA is converted to JA-Ile which shows strong binding with COI1 and COI1-JA-Ile complex docked with JAZ which showed strong interaction with ve hydrogens and one salt bridge bond. AOS and HPL showed less than 40% identity for sequence and structure alignment. AOS and HPL had shown an interaction between each other and showed a common interaction partner of the Lipoxygenase family. HPL shows interaction with ADH2 (Alcohol dehydrogenase) involved in GLVs production. AOS also showed interaction partner AOC, COI1 and OPR1 which are involved in JA-induced plant defense mechanism.peer-reviewe

Concept, Design and Implementation of a Cardiovascular Gene-Centric 50 K SNP Array for Large-Scale Genomic Association Studies

A wealth of genetic associations for cardiovascular and metabolic phenotypes in humans has been accumulating over the last decade, in particular a large number of loci derived from recent genome wide association studies (GWAS). True complex disease-associated loci often exert modest effects, so their delineation currently requires integration of diverse phenotypic data from large studies to ensure robust meta-analyses. We have designed a gene-centric 50 K single nucleotide polymorphism (SNP) array to assess potentially relevant loci across a range of cardiovascular, metabolic and inflammatory syndromes. The array utilizes a “cosmopolitan” tagging approach to capture the genetic diversity across ∼2,000 loci in populations represented in the HapMap and SeattleSNPs projects. The array content is informed by GWAS of vascular and inflammatory disease, expression quantitative trait loci implicated in atherosclerosis, pathway based approaches and comprehensive literature searching. The custom flexibility of the array platform facilitated interrogation of loci at differing stringencies, according to a gene prioritization strategy that allows saturation of high priority loci with a greater density of markers than the existing GWAS tools, particularly in African HapMap samples. We also demonstrate that the IBC array can be used to complement GWAS, increasing coverage in high priority CVD-related loci across all major HapMap populations. DNA from over 200,000 extensively phenotyped individuals will be genotyped with this array with a significant portion of the generated data being released into the academic domain facilitating in silico replication attempts, analyses of rare variants and cross-cohort meta-analyses in diverse populations. These datasets will also facilitate more robust secondary analyses, such as explorations with alternative genetic models, epistasis and gene-environment interactions

Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021

This online publication has been corrected. The corrected version first appeared at thelancet.com on September 28, 2023BACKGROUND : Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. METHODS : Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. FINDINGS : In 2021, there were 529 million (95% uncertainty interval [UI] 500–564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7–9·9]) and, at the regional level, in Oceania (12·3% [11·5–13·0]). Nationally, Qatar had the world’s highest age-specific prevalence of diabetes, at 76·1% (73·1–79·5) in individuals aged 75–79 years. Total diabetes prevalence—especially among older adults—primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1–96·8) of diabetes cases and 95·4% (94·9–95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5–71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5–30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1–17·6) in north Africa and the Middle East and 11·3% (10·8–11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. INTERPRETATION : Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers.Bill & Melinda Gates Foundation.http://www.thelancet.comam2024School of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-bein