Prospect of the use of checkpoint inhibitors in hepatocellular cancer treatments

Hepatocellular cancer (HCC) is a very fatal disease due to limited therapeutic options as well as due to its association with underlying chronic liver disease in the majority of cases. The immune evasion in HCC signifies a major barrier to the delivery of effective immunotherapy. Sorafenib is the only Food and Drug Administration-approved drug available with an overall response rate of 2%–3% and overall survival of 2.8 months. Chemotherapy has not been used routinely because of the relative refractoriness of advanced HCC. The introduction of immune checkpoint inhibitors (cytotoxic T-lymphocyte antigen 4, programmed death 1, and programmed death-ligand 1) has opened a new horizon for cancer immunotherapy. Future direction in immunotherapy for HCC is to rationally combine it with other treatment modalities, including surgery, radiofrequency ablation, and cytotoxic agents, to maximize its therapeutic efficacy

Assessment of Asphalt Binders and Hot Mix Asphalt Modified with Nanomaterials

In the recent times, asphalt binder modification has emerged an inevitable alternative in the paving industry to ensure better performing pavements against the distresses caused by common factors such as; moisture susceptibility and high-temperature sensitivity of asphalt binders. Nanomaterials, as asphalt-modifiers, have proved to be the most promising materials in the industry owing to their higher active surface area and small particle size. This study was devoted to assessing the modification influence of three different types of nanomaterials, including nano-Bentonite, nano-CaCO3, and ZycoTherm, on the properties of asphalt binder and HMA. Conventional and rheological tests on asphalt binders, as well as, Marshall mix design and modified Lottman test on laboratory-prepared HMA specimens were conducted in order to signify the influence of nanomodification. The research findings suggested that nanomaterials can potentially enhance the high-temperature susceptibility resistance, storage stability, and rheological properties of asphalt binder samples. Mix design results revealed that the optimum binder contents decreased and Marshall stabilities were slightly improved with nanomodification. Moreover, the modified Lottman test results indicated that 0.1 % of ZycoTherm increased the TSR by 22 % as compared to the control mixture that infers its efficiency in terms of improving the HMA resistance against the moisture-induced damages

PO5.53 critical illness polyneuropathy and myopathy: experience at a tertiary care center in Pakistan

Background: Polyneuropathy and Myopathy are frequently encountere in the setting of Critical illness patients. Up to 50% of intensive care unit (ICU) patients show electrophysiological features of either or both conditions. These conditions interfere with functional recovery and delay weaning from mechanical ventilation, resulting in excess morbidity,mortality and cost of care. This study was to define the clinical spectrum of critical illness Polyneuropathy (CIP) and Myopathy (CIM) in a setting of developing country. Methods: Hospital records spanning the period 2000 through 2005 weresearched with ICD-9 codes to identify patients with CIP and CIM. Functional improvement was judged by (i) increment of at least 1grade on the Medical Research Council scale of motor strength: and (ii)reappearance of deep-tendon reflexes. Results: CIP or CIM was established in 47 patients of these, mean age was 54: mean length of stay in hospital 34 (range 8100) electrophysiological studiesrevealed CIP in 31 patients (66%) CIM in 12 (26%) and a mixedpicture in 4 (8%). Major co-morbid conditions included sepsis (39%) anddiabetes mellitus (17%), with an additional 28% having both and 17% having either. Neuromuscular blocking drugs were administered to 14 (30%) and steroids to 10 (21%) patients: an additional 11 (23%) patients received both agents while 12 (26%) patients received neither. In hospital mortality was 51%. At discharge and follow-up, motor improvement was seen in 11 (23%) while 12 (26%) remained neurologically unchanged. Conclusions: We conclude that CIP and CIM are frequent identifiable complications of critical illness in our setting. These observations need further prospective studies to delineate risk factors and out come predictors, to improve critical care patients

Primary Retroperitoneal Melanoma Presented in a Rare Extracutaneous Site for Malignant Melanoma

Malignant melanoma, as the name implies, is a malignant tumor of melanocytes, found in the skin, eyes, meningeal lining and the mucosal epithelium of the aero-digestive and genitourinary tracts. Malignant melanoma is typically skin malignancy, which rarely presents at extracutaneous site. Here we present a rare case of primary retroperitoneal melanoma and review the findings in comparison with other cases described in literature

Post-traumatic stress disorder following childbirth: a neglected cause

Post-traumatic stress disorder (PTSD) following childbirth is a significant mental health risk for women globally. However, it remains a neglected cause, particularly in low-income countries like Pakistan. This paper explores the unique challenges faced by women in such settings, including limited access to healthcare and social support, cultural norms, and stigma surrounding mental health. The diagnosis and causes of postpartum PTSD are discussed, along with its effects on both mothers and their infants. The lack of awareness and training among healthcare professionals in recognizing and treating postpartum PTSD is highlighted as a major barrier to adequate care. To address these challenges, the paper proposes a comprehensive approach, including raising public awareness, providing mental health support and resources, and integrating postpartum mental health into medical education. Trauma-focused therapies are recommended for effective treatment. The paper concludes with the need for more research in low-income countries and emphasizes the importance of understanding and supporting women with postpartum PTSD to improve their well-being and maternal and child health

Acute Respiratory Distress Syndrome after Treatment of Metastatic Prostate Cancer with Taxotere: A Case Report and Literature Review

Prostate cancer is the most common cancer in men. Docetaxel is a common chemotherapeutic agent that has proven its efficacy in the treatment of patients with both castration sensitive and resistant metastatic prostate cancer. We report a case of acute respiratory distress syndrome (ARDS) in a patient with metastatic prostate cancer treated with docetaxel (Taxotere). ARDS is very rare but life threatening complication of docetaxel which requires aggressive supportive care and close monitoring. Better awareness and prompt diagnosis of this treatment related ARDS will improve the effectiveness and outcome of its management

Leukemia cutis in a patient with chronic lymphocytic leukemia presenting as bilateral helical nodules

Chronic lymphocytic leukemia, the most common adult leukemia worldwide, is considered an indolent but incurable non-Hodgkin lymphoma. Leukemia cutis is an uncommon manifestation of chronic lymphocytic leukemia. We present a case of an adult patient who presented with skin lesion of bilateral ears, which led to the diagnosis of chronic lymphocytic leukemia. We also reviewed the cases of auricular involvement in chronic lymphocytic leukemia patients reported in the literature. Local treatment is indicated in case of leukemia cutis; however, systemic treatment is recommended when there are systemic signs and symptoms. Better awareness of disease evolution and prompt diagnosis of this leukemia cutis of chronic lymphocytic leukemia will improve the effectiveness and outcome of its management

Apocrine carcinoma of the face in a 62-year-old Asian man

Apocrine carcinoma (AC) is a rare tumor with heterogeneous presentation. The disease has a highly morbid course and little is known about it. We present an otherwise healthy, 62- year-old Asian male who originally presented with chronic swelling of his left eyelid associated with excessive tears and diminished vision was diagnosed with AC. AC is often challenging to diagnose, yet it is critical to do so as early diagnosis and treatment can maximize patient survival

Assessment of Asphalt Binders and Hot Mix Asphalt Modified with Nanomaterials

In the recent times, asphalt binder modification has emerged an inevitable alternative in the paving industry to ensure better performing pavements against the distresses caused by common factors such as; moisture susceptibility and high-temperature sensitivity of asphalt binders. Nanomaterials, as asphalt-modifiers, have proved to be the most promising materials in the industry owing to their higher active surface area and small particle size. This study was devoted to assessing the modification influence of three different types of nanomaterials, including nano-Bentonite, nano-CaCO3, and ZycoTherm, on the properties of asphalt binder and HMA. Conventional and rheological tests on asphalt binders, as well as, Marshall mix design and modified Lottman test on laboratory-prepared HMA specimens were conducted in order to signify the influence of nanomodification. The research findings suggested that nanomaterials can potentially enhance the high-temperature susceptibility resistance, storage stability, and rheological properties of asphalt binder samples. Mix design results revealed that the optimum binder contents decreased and Marshall stabilities were slightly improved with nanomodification. Moreover, the modified Lottman test results indicated that 0.1 % of ZycoTherm increased the TSR by 22 % as compared to the control mixture that infers its efficiency in terms of improving the HMA resistance against the moisture-induced damages