Stenting of Anomalous Left Main Coronary Artery Stenosis in an Adult with a Retroaortic Course

Coronary bypass graft has been the conventional treatment of choice in anomalous left man coronary artery stenosis. We are reporting an interesting case with anomalous left main coronary artery originating from right aortic sinus having retroaortic course complicated by significant atherosclerotic narrowing of the vessel and its percutaneous management

From Text to MITRE Techniques: Exploring the Malicious Use of Large Language Models for Generating Cyber Attack Payloads

This research article critically examines the potential risks and implications arising from the malicious utilization of large language models(LLM), focusing specifically on ChatGPT and Google's Bard. Although these large language models have numerous beneficial applications, the misuse of this technology by cybercriminals for creating offensive payloads and tools is a significant concern. In this study, we systematically generated implementable code for the top-10 MITRE Techniques prevalent in 2022, utilizing ChatGPT, and conduct a comparative analysis of its performance with Google's Bard. Our experimentation reveals that ChatGPT has the potential to enable attackers to accelerate the operation of more targeted and sophisticated attacks. Additionally, the technology provides amateur attackers with more capabilities to perform a wide range of attacks and empowers script kiddies to develop customized tools that contribute to the acceleration of cybercrime. Furthermore, LLMs significantly benefits malware authors, particularly ransomware gangs, in generating sophisticated variants of wiper and ransomware attacks with ease. On a positive note, our study also highlights how offensive security researchers and pentesters can make use of LLMs to simulate realistic attack scenarios, identify potential vulnerabilities, and better protect organizations. Overall, we conclude by emphasizing the need for increased vigilance in mitigating the risks associated with LLMs. This includes implementing robust security measures, increasing awareness and education around the potential risks of this technology, and collaborating with security experts to stay ahead of emerging threats

STUDY ON RISK FACTORS, CLINICAL AND THERAPEUTIC PROFILE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS IN GOVERNMENT GENERAL HOSPITAL

Objective: This study mainly aims to assess and evaluate risk factors, clinical and therapeutical profile in chronic obstructive pulmonary disease (COPD) patients and promote rational drug therapy; to identify the prevalence of COPD symptoms and to assess the drugs prescribed in treating COPD patients; and to evaluate patterns of diagnosing COPD in patients and determine the severity of COPD in patients using COPD assessment test (CAT). Methods: A prospective observational study conducted in government general hospital among 220 patients for 6 months. Data were collected from patients by CAT questionnaire through interviewing each subject. Results: The majority of the patients (36%) were in the age group of 71–80 years. Males are more prone to the COPD (91%). Most common initiation interdependence of these habits are 31–40 years and 61.8% are suffering with comorbidities. A total of 145 (65%) have social habits. About 68% of the patients are suffering from occupational exposure, 78% of the patients are suffering from old pulmonary problems. Conclusion: Clinical pharmacist main provision is providing care to individual patients by patient counseling, regarding the rational usage of drug and also providing proper education regarding the usage of nebulizers and creating awareness to the patients

3D Printing: The Dawn of a New Era in Manufacturing

Printing is a process for reproducing text and images, typically with ink on paper using a print press.3D printing is method of converting a virtual 3D model into a physical object from a digital file. It is achieved using Additive Process, where an object is created by laying down successive layers of material until the entire object is created.3D printing could revolutionize and reshape the world. Advances in 3D printing technology can significantly change and improve the manufacturing world with effects on energy use, waste reduction, customization, product availability, medicine, art, construction and science. By using this technology it becomes easier to transmit designs for new objects around the world

Pathological study of elective nephrectomies for a two year period

Background: Nephrectomies whether partial, total or radical are common surgical procedures these days with trauma being the most common cause of an emergency nephrectomy. The indications of elective nephrectomies vary with different age groups- malignancies being common in the elderly age group and non-neoplastic indications of nephrectomy may present in any age group. The present study was undertaken in view of the increasing elective nephrectomies in our area thus analyzing the common causes requiring nephrectomy as a treatment. The present study also aimed at determining the age and sex distribution of various renal lesions requiring a nephrectomy.Methods: It was a prospective study for a period of 2 years - January 2013 to December 2014. A total of 45 nephrectomies were included in the study. Detailed clinical, biochemical and imaging findings were taken into consideration before analyzing each case. Results: There was a male predominance(64.4%) and 26.6% of the cases were in the age group of 40-50 years. 95.5% of the nephrectomies were performed for a non-neoplastic indication. Involvement of the right and left kidney was almost equal in the study. Chronic pyelonephritis was the most common histopathological diagnosis(68.8%).Conclusion: Inflammatory causes more commonly required a nephrectomy in the study population.  Chronic calculous pyelonephritis was the most common underlying pathophysiology leading to a nonfunctioning kidney thus highlighting the early treatment of renal calculi.

Isolated single coronary artery (RII-B type) presenting as an inferior wall myocardial infarction: A rare clinical entity

AbstractIsolated single coronary artery without other congenital cardiac anomalies is very rare among the different variations of anomalous coronary patterns. The prognosis in patients with single coronary varies according to the anatomic distribution and associated coronary atherosclerosis. If the left main coronary artery travels between the aorta and pulmonary arteries, it may be a cause of sudden cardiac death. We present multimodality images of a single coronary artery, in which the whole coronary system originated by a single trunk from the right sinus of Valsalva with inter-arterial course of left main coronary artery. This rare type of single coronary artery was classified as RII-B type according to Lipton's scheme of classification. A significant flow-limiting lesions were found in the right coronary artery that was successfully treated with percutaneous coronary intervention

Role of Meda (Adipocyte) in Yakrit Vikara (liver diseases) - Ayurveda prospective

Meda Dhatu (Adipose tissue) was considered as inert tissue that stores fat only but now it is an endocrine gland which controls coagulation, appetite regulation, immunity, glucose and lipid metabolism, reproduction, angiogenesis, fibrinolysis, body weight homeostasis and vascular tone control. Meda is the fourth Dhatu (stable constituent of body) as per Ayurveda doctrine and resemble with the adipose tissue. Meda can create not only Sthyaulya (Obesity) in general but also organ specific disorders like - Medaja Granthi , Medaja Masurika, Medaja Galaganda, Medaja Vridhi etc. Yakritmeda is found in Sanskrit literature. But Medaja Yakritdalludara or Yakrit Vikar is not enumerated in classical Ayurveda literature. Strong evidences suggested that accumulation of lipids in non-adipose tissues can contribute to cellular dysfunction and cell death, a phenomenon that is called lipotoxicity. Various components of Meda and its function found in Ayurveda literature are discussed. Multiple factors hit hypothesis for Samprapti (pathogenesis) of Medaja Yakrut Vikara (Fatty liver disorders) and its progression with preventive and curative strategies are described with scientific evidences

A prospective observational study to evaluate the role of restaging transurethral resection of bladder tumour in patients with non-muscle invasive bladder cancer

Background: Transurethral resection of bladder tumour (TURBT) is the primary treatment modality for Non-muscle invasive bladder cancer (NMIBC). Restaging transurethral resection of bladder tumour (RETURBT) is indicated to reduce risk of residual disease and correct staging errors after primary TURBT. The aim of the study is to evaluate the risk of residual tumour and upstaging in NMIBC after TURBT and to investigate the risk factors for the same.Methods: A prospective observational study was carried out over 4 years and 87 patients were included in the study. Patients with NMIBC underwent RETURBT after 2-6 weeks of primary TURBT. The incidence of residual tumour and upstaging in RETUBRT was correlated with various histopathological and morphological parameters in primary TURBT.Results: Out of 87 patients, who underwent RETURBT, residual disease was present in 51 patients (58.6%) and upstaging occurred in 22 patients (25.2%).On univariate analysis, T1 stage (p=0.01), high grade (p=0.01), Carcinoma in situ(CIS) (p=0.01) and multifocality (p=0.05) were predictive for residual disease in RETURBT. High grade (p=0.01), CIS (p=0.01) and absence of detrusor muscle in specimen (p=0.03) were risk factors for upstaging in RETURBT.Conclusions: NMIBC have high incidence of residual disease and upstaging after primary TURBT. T1 stage, high tumour grade, CIS, and multifocality are risk factors for residual disease after primary TURBT. High tumour grade, CIS and absence of detrusor muscle are strongly associated with upstaging during RETURBT

Theta phase synchronization between the human hippocampus and prefrontal cortex increases during encoding of unexpected information: A case study

Events that violate predictions are thought to not only modulate activity within the hippocampus and PFC but also enhance communication between the two regions. Scalp and intracranial EEG studies have shown that oscillations in the theta frequency band are enhanced during processing of contextually unexpected information. Some theories suggest that the hippocampus and PFC interact during processing of unexpected events, and it is possible that theta oscillations may mediate these interactions. Here, we had the rare opportunity to conduct simultaneous electrophysiological recordings from the human hippocampus and PFC from two patients undergoing presurgical evaluation for pharmacoresistant epilepsy. Recordings were conducted during a task that involved encoding of contextually expected and unexpected visual stimuli. Across both patients, hippocampal–prefrontal theta phase synchronization was significantly higher during encoding of contextually unexpected study items, relative to contextually expected study items. Furthermore, the hippocampal–prefrontal theta phase synchronization was larger for contextually unexpected items that were later remembered compared with later forgotten items. Moreover, we did not find increased theta synchronization between the PFC and rhinal cortex, suggesting that the observed effects were specific to prefrontal–hippocampal interactions. Our findings are consistent with the idea that theta oscillations orchestrate communication between the hippocampus and PFC in support of enhanced encoding of contextually deviant information