Shearwave Elastography in Differentiating Benign and Malignant Breast Lesions

Shearwave elastography is a new advance technique of the ultrasound with ultrafast shearwave mode which displays evaluation of the elasticity in real time. As the disease process tend to affect stiffness of the tissue thereby distorting its architecture. This architectural change makes the basic principal of the palpation part of the clinical examination. The shearwave elastography uses the principal of palpation. The output of shearwave is displayed in qualitative mode in the form of color change (ranging from blue to red) and quantitative mode as measure of elasticity in kilopascals (ranging from 0 to 300). The soft tissues are penetrated easily giving a homogenous pattern with blue to green color while cancers show color from red to dark red portraying high elasticity. The scoring system for interpretation of the shearwave results suggest that benign lesions show less (i.e., <200 kPa) elasticity while cancers reach high levels (upto 300 kPa). Shearwave elastography has shown superiority as compared to B-mode ultrasound and mammogram in determining the nature of the breast lesions. It has shown high sensitivity in BIRAD 3 and 4 lesions to downgrade and helps in making accurate diagnosis. It has also shown potential in predicting response of neoadjuvant chemotherapy

SPONTANEOUS BACTERIAL PERITONITIS: A COMMON AND LETHAL COMPLICATION OF CHRONIC LIVER DISEASE

Objective: To determine the frequency and pattern of spontaneous bacterial peritonitis in patients with chronic liver disease. Patients and Methods: Total fifty patients of age ≥12 years and either gender had liver cirrhosis (known / diagnosed cases) with ascites were included in this six months cross sectional study. The ascitic fluid analysis was done by taking 10 ml of ascitic fluid in a 10 CC sterilize syringe and ascitic fluid neutrophil count greater than 250 cells/µL was considered to be the case of SBP. The frequency and percentages was calculated for categorical variables whereas the numerical statistics were used to compute mean ±SD in SPSS 16. Results: During six months study period total fifty patients with chronic liver disease were evaluate for spontaneous bacterial peritonitis. The mean ± for age (years) & duration of chronic liver disease (years) for whole population was 45.62±5.98 & 7.93 ±2.41 respectively. The SBP observed in 37 (74%) while the common pathogen detected were E. Coli 10 (27%), S. aureus (18.9%) and Klebsiella 6 (16.2%) whereas regarding outcome 26 (70.2%) patients were recovered, recurrence observed in 5 (13.5%) and mortality in 6 (16.2%) respectively. Conclusion: SBP is a common and recurrent complication of cirrhosis and the ascitic fluid examination including culture and sensitivity is more sensitive and best tool as far as diagnose and management is concerned Keywords: Spontaneous bacterial peritonitis, Chronic liver disease, Hepatitis B and Hepatitis C

Effect of Renal Function Impairment on the Mortality of Cirrhotic Patients With Hepatic Encephalopathy: A Population-Based 3-Year Follow-Up Study

[[abstract]]Kidney is an important organ to clear neurotoxic substance in circulation. However, it is still unknown about the effect of renal function impairment (RFI) on the mortality of cirrhotic patients with hepatic encephalopathy (HE). We used the Taiwan National Health Insurance Database to identify 4932 cirrhotic patients with HE, hospitalized between January 1, 2007 and December 31, 2007. The enrolled patients were followed up individually for 3 years to identify their 3-year mortalities. There were 411 (8.3%) patients with RFI and 4521 (91.7%) patients without RFI. The adjusted hazard ratio (HR) of RFI for 3-year mortality was 2.03 (95% CI, 1.82–2.27). In RFI group, there were 157 (38.2%) patients with acute renal failure (ARF), 61 (14.8%) with hepatorenal syndrome (HRS), 93 (22.6%) with chronic kidney disease (CKD), and 100 (24.3%) with end-stage renal disease (ESRD). Compared with the non-RFI group, the adjusted HR of ARF for 3-year mortality was 2.57 (95% CI, 2.17–3.06), CKD 1.93 (95% CI, 1.55–2.40), ESRD 1.26 (95% CI, 1.01–1.57), and HRS 3.58 (95% CI, 2.78–4.63). Among ESRD patients, there were 99 patients receiving hemodialysis regularly. Compared with the CKD group, the adjusted HR of ESRD with hemodialysis for 3-year mortality was 0.664 (95% CI, 0.466–0.945). RFI increased the 3-year mortality of cirrhotic patients with HE, especially ARF and HRS. HE patients with ESRD receiving hemodialysis had better 3-year survival rate than those with CKD.[[notice]]補正完畢[[journaltype]]國外[[incitationindex]]SCI[[ispeerreviewed]]Y[[booktype]]電子版[[countrycodes]]IN

Management of irrigation and drainage systems for salt balance: a solute transport study for saline and waterlogged soils

A study was conducted to evaluate the effects of sodium chloride (NaCl) and calcium chloride (CaCl[subscript]2) at different concentrations in the soil profile on saturated hydraulic conductivity, salt movement, and transport of nitrate-nitrogen (NO[subscript]3-N) and atrazine to the groundwater. Also, the effects of various water table depths were evaluated on salt movement and the fate of NO[subscript]3-N under simultaneous irrigation and drainage practices;Two sets of experiments were conducted in the laboratory under simulated saline and waterlogged conditions. Three sets of soil columns (45, 75, and 115-cm long) were fabricated using PVC pipes of 20.0 cm diameter for this study. Large columns (115-cm long) were filled with a sandy loam soil brought from the bank of Squaw Creek river near Ames, Iowa. For one experiment, these long columns were filled with soil in seven layers of different bulk densities. For other four experiments, the soil was filled in the columns uniformly by mixing the entire soil profile to give a single bulk density for the entire column;For the short columns, two types of soils were used (sandy loam soil from Squaw Creek and nicollet loam soil from Iowa State University Farm at Ankeny, Iowa) to pack the columns. These soils were packed in the columns at uniform densities of 1.40 and 1.25 g/cm[superscript]3 for sandy loam and nicollet loam soils, respectively;The salt equilibria were obtained by mixing weighed amounts of salts in weighed amounts of soil, and by subsequent saturating the soil in the columns with desired salt concentrations. Four levels of salt concentrations (3200, 6400, 19,200, and 38,400 ppm) were used for different experiments;The results of this study showed that hydraulic conductivity of the soil decreased with the increase in salt concentrations. But reverse effect of salt concentrations was observed when salt concentrations were increased six-fold. The NO[subscript]3-N and atrazine leaching increased with increase in salt concentrations. The overall results of this study indicate that the simultaneous irrigation and drainage practices could be managed for soil reclamation by applying about 25 percent more water for irrigations. Also, nitrogen fertilizers can be managed better if proper irrigation and drainage systems can be designed for the benefits of the farmers by using some of the results of this study.</p

This is not the Last Wave of Covid-19, it Seems to be

Presently, several countries are facing third wave of COVID-19 pandemic while others second; most of the countries are passing through the different stages of second or third wave with varying degree of intensity. Pakistan faces the third wave of SARS CoV-2 infection. Number of the new reported cases and deaths are rapidly rising. Though the vaccination drive has started but the pace is very slow. The Third wave may further hamper the drive. At this point in time less than 1% of population is immunized against COVID-19. There is long-way to get 60-70% population immunized and reach the level of herd immunity through vaccination/infection. Situation indicates that this is not the last wave and raises the alarm that there may be waves to occur in future

Relationship between aging and control of metabolic syndrome with telomere shortening: a cross-sectional study

Abstract Aging is considered one of the major risk factors for several human disorders. The telomere plays a crucial role in regulating cellular responsiveness to stress and growth stimuli as well as maintaining the integrity of the Deoxyribonucleic Acid (DNA), and aging leads to the progressive decline in the telomere length (TL) due to continuous cell division. The aim of this study was to determine the relationship between TL and advancing age and the impact of metabolic syndrome (MetS) on TL. Firstly, we determined the association of advancing age and TL, by measuring telomere length (T/S ratio) in healthy volunteers (n = 90). The TL was compared between normal population and patients with metabolic syndrome (n = 298). The age matched controlled and uncontrolled MetS patients (n = 149) were also compared for their TL T/S ratio. The TL showed negative correlation with advancing age, whereas the significant change was observed at the cut-offs of 40 and 70 years defining 40 with longer TL and 70 as shorter TL. The longest T/S ratio at 2.46 was measured at the age range of 1 year in healthy volunteers, while elderly population showed considerably shorter TL. The patients older than 60 years with poor or uncontrolled MetS had shorter TL, as compared to the controlled MetS. In conclusion our findings suggest that TL was negatively correlated with advancing age. Uncontrolled metabolic syndrome appeared to have worsening effects on TL. Telomere length appears to have potential to be used a parameter to determine age. However, further large scale studies are recommended to make firm guidelines