Evaluation of soluble TNF-like weak inducer of apoptosis (sTWEAK) levels to predict preeclampsia in early weeks of pregnancy

Introduction: Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) is linked to endothelial dysfunction; a key factor in pre-eclamptic pathogenesis. This study aimed to compare sTWEAK levels during pregnancy to assess for its prognostic ability.Materials and Methods: Sixty three high risk pregnant women were followed up from 12 weeks of gestation till term. Serum levels of sTWEAK and platelet derived growth factor (PlGF), blood pressure, serum glucose, uric acid, urea/creatinine and liver function tests were measured. Subjects were stratified according to the ACOG criteria as women who developed PE, or PIH or remained normotensive at term. A negative control group of normotensive healthy pregnant women (n = 17) was also recruited for comparison.Results: Baseline sTWEAK levels were lower (4.03 ± 0.37 ng/dl) in HR cohort that developed PE and further reduced at term (1.93 ± 0.23 ng/dl) as compared to HR subjects who remained normotensive and negative control group (30.53 ± 0.79 ng/dl; p \u3c 0.01). Likewise PlGF levels were significantly lower (74.22 ± 10.11 pg/ml) in HR cohort that developed PE (p = 0.013). At term 39.68% (n = 22) HR subjects with low sTWEAK developed PIH and 34.92% (n = 24) developed PE. In terms of high risk characteristics observed in the HR group; 73% of the subjects were multiparous, whereas 26.98% reported to have developed PE in previous pregnancies.Conclusion: sTWEAK levels at early pregnancy weeks were found to be low in high risk females who developed PE at follow up versus normotensive pregnant women. Baseline TWEAK might serve as an independent variable for prediction of pre-eclampsia; however longitudinal studies with larger sample size are required to ascertain the causal relation

A Case Report Of A Giant Plunging Ranula In A 25-Year-Old Patient: A case report

Abstract This case report aims to present an unusual case of a plunging ranula that extended to the superior vertebral body of the T4 vertebrae, we will be elaborating on the patient presentation, investigations, diagnosis, and treatment of the lesion, while also talking about the adversities faced while diagnosing and treating the patient. The rarity of this condition and an atypical presentation makes this a difficult case to diagnose and vigilant treatment is needed to prevent any complications associated with the condition and ensure a successful treatment and recovery

Serum anti mullerian hormone and renalase levels in predicting the risk of preeclampsia

Objective: The aim of the study was to explore the association of serum AMH and Renalase with the risk of preeclampsia thereby assessing them as screening tools, reducing the risk of gravid consequences of preeclampsia.Materials and Methods: This cross-sectional study recruited n = 95 pregnant women between 14 and 32 gestational weeks. They were categorized as a) women with gestational hypertension (n = 45); b) women with pre-eclampsia (n = 20) and c) normotensive pregnant women (n = 30) according to the ACOG criteria. Anthropometrics data and blood and urine samples were collected. AMH and Renalase levels were measured by ELISA assay.Results: The mean age of study cohort was 27.3 ± 6.2 year and weight was 65.1 ± 14.1 kg. Blood pressures were significantly higher in pre-eclamptic patients versus both the gestational hypertensive females and controls (p \u3c 0.05). AMH was found to be significantly higher in controls but no difference was observed between gestational hypertensive and pre-eclamptic patients. No difference was seen for serum Renalase among the three groups (p \u3e 0.05). AMH showed a negative weak correlation with diastolic blood pressure (r = -0.272; p = 0.008) that remained significant even after adjustment (r = -0.236; p = 0.023) whereas Renalase did not show any difference (r = -0.051; p \u3e 0.05). Females with low levels of AMH were 1.07 times at risk of developing hypertension even after adjustment for age and BMI (p \u3c 0.05).Conclusion: Low AMH levels may lead to hypertension in pregnancy suggesting a role in detecting vascular diseases as well as its effect on ovarian aging. However, further research is required to establish a causal relationship

Cerebral venous thrombosis: a descriptive multicenter study of patients in Pakistan and Middle East

Background and Purpose: The natural history, causative factors, and outcomes of patients with cerebral venous thrombosis from Asia and Middle East have not been well described. This descriptive multicenter study describes the results for cerebral venous thrombosis patients in South Asia and the Middle East. Methods: The retrospective and prospective data of patients with radiologically confirmed cerebral venous thrombosis were collected from 4 centers located in Pakistan and United Arab Emirates. The demographic, clinical, radiological, and outcome data were recorded and analyzed. Primary outcome was death or dependency (modified Rankin score \u3e2) at the time of hospital discharge. Results: This study included 109 patients with cerebral venous thrombosis; the presenting features most commonly being observed were headache (81%), focal motor deficits (45%), seizures (39%), and mental status changes (37%). Important predisposing factors included systemic and central nervous system infection (18%), postpartum state (17%), hyperhomocystinemia (9%), genetic thrombophilia (5%), and oral contraceptive pill use (3%). Ninety-six (67%) patients received therapeutic anticoagulation. Seven patients died and 43 had poor outcome at discharge. Focal motor deficits (OR, 2.93; 95% CI, 1.2–7.5; P=0.018) and hemorrhagic infarctions (OR, 2.81; 95% CI, 1.04–7.85; P=0.041) were independent predictors of unfavorable outcome at discharge. Hemorrhagic infarction was the most significant factor of long-term unfavorable outcome (OR, 5.87; 95% CI, 1.49–23.02; P=0.011). Conclusions: Infections and postpartum state were the most common predisposing factors for cerebral venous thrombosis in this cohort. Most patients (67%) were treated with anticoagulation therapy. Almost 50% of patients were dead or disabled at discharge

Iron, copper and silver nanoparticles: green synthesis using green and black tea leaves extracts and evaluation of antibacterial, antifungal and aflatoxin B1 adsorption activity

peer-reviewedThe present study was aimed to account an eco-friendly synthesis of iron (Fe), copper (Cu) and silver (Ag) nanoparticles (NPs) using green tea and black tea leaves extracts. Synthesized NPs were characterized using SEM, FTIR, EDX and UV/Vis spectroscopy techniques. Antibacterial activity of NPs was assessed against methicillin- and vancomycin-resistance Staphylococcus aureus strains. Antifungal activity was investigated against Aspergillus flavus and A. parasiticus fungal species. Adsorbent capability with aflatoxin B1 (AFB1) was also assessed in solution. Ag-NPs showed superior antibacterial/antifungal activities and reduced the aflatoxins production in comparison to Fe-NPs and Cu-NPs. Adsorption capability of all NPs with AFB1 contamination was found in the order of Fe-NPs > Cu-NPs > Ag-NPs. The equilibrium data showed the favorability of Langmuir isotherm with the adsorption capacity (131–139 ng/mg), Cu-NPs (114–118 ng/mg) and Ag-NPs (110–115 ng/mg). Thermodynamic parameters and kinetic studies revealed that adsorption process is spontaneous, endothermic and followed the pseudo-second order. These results suggest that the synthesized NPs could be effectively utilize as an alternative antibacterial/antifungal agent against diseases caused by multiple drug resistant pathogens. In addition, these metal NPs may be utilize as a possible aflatoxins adsorbent in human food and animal feed such as rice, wheat, maize, red chillies and poultry feed

Soil-plant relationship of Pteropyrum olivieri, a serpentine flora of Wadh, Balochistan, Pakistan and its use in mineral prospecting

Biogeochemical investigation of Pteropyrum olivieri, a flora of Wadh area in perspective of plant-soil-rock relationship has been made. It is a native of Irano-Turanian region which extended into Saharo-Sindian region of Pakistan. The distribution of P. olivieri and some other co-ecological flora in relation to lithology was also discussed. Field observations showed its controlled population on the serpentine soil. The average abundance of Mg and Ca in soil was estimated as 2.43% and 5.46 respectively. The Mg/Ca ratio of the soils of the study area was below unity (0.445), indicating pedogenesis from serpentinite. Quantitative estimation of Cr, Ni, Co and Cu in soils and plant ash was made. Distribution of these elements has been discussed in context with soil chemistry, average abundance in plant ash and the exclusion mechanism of the flora. The concentration of Cr, Ni and Co in the twigs of P. olivieri is more than the average abundance in the plant ash, while Cu concentration was less. Relationship among Cr, Ni, Co and Cu has been established using scatter-grams to evaluate biogeochemistry of the P. olivieri. Bio-concentration factor (BCF) of the specie attributed Co>Cu>Ni>Cr trend. Present study signifies a number of anomalous zones which can be utilized for the exploration of new hidden mineral deposits in and around Wadh area. The rocks in the anomalous zone served as good host for podiform chromite and associated mineralization

Soil-plant relationship of \u3ci\u3ePteropyrum olivieri\u3c/i\u3e, a serpentine flora of Wadh, Balochistan, Pakistan and its use in mineral prospecting

Biogeochemical investigation of Pteropyrum olivieri, a flora of Wadh area in perspective of plant-soil-rock relationship has been made. It is a native of Irano-Turanian region which extended into Saharo-Sindian region of Pakistan. The distribution of P. olivieri and some other co-ecological flora in relation to lithology was also discussed. Field observations showed its controlled population on the serpentine soil. The average abundance of Mg and Ca in soil was estimated as 2.43% and 5.46 respectively. The Mg/Ca ratio of the soils of the study area was below unity (0.445), indicating pedogenesis from serpentinite. Quantitative estimation of Cr, Ni, Co and Cu in soils and plant ash was made. Distribution of these elements has been discussed in context with soil chemistry, average abundance in plant ash and the exclusion mechanism of the flora. The concentration of Cr, Ni and Co in the twigs of P. olivieri is more than the average abundance in the plant ash, while Cu concentration was less. Relationship among Cr, Ni, Co and Cu has been established using scatter-grams to evaluate biogeochemistry of the P. olivieri. Bio-concentration factor (BCF) of the specie attributed Co\u3eCu\u3eNi\u3eCr trend. Present study signifies a number of anomalous zones which can be utilized for the exploration of new hidden mineral deposits in and around Wadh area. The rocks in the anomalous zone served as good host for podiform chromite and associated mineralization

Phantosmia: A neglected symptom after Dacryocystorhinostomy with intubation (A case report)

A 62-year-old female presented with complaints of persistent phantosmia (foul smell) for the last 4 months. She has a past history of right-sided dacryocystorhinostomy (DCR) 18 months back and left-sided DCR 12 months back. In the initial follow-up period, the patient had frequent visits to her otolaryngologist and ophthalmologist. She experienced phantosmia often but was reassured. The patient presented to us and was examined in an operation theater. It was discovered that the foul-smelling foreign body was present in her right nasal cavity above the middle turbinate. It was removed. A retained gauze piece was revealed to be a cause of phantosmia. The purpose of reporting is to create awareness among ophthalmologists and otolaryngologists. Retained gauze piece following DCR surgery presenting as phantosmia is a new symptom after DCR surgery previously not reported in the literature. Repeated complaints of a postoperative patient, should be dealt with vigilantly and timely

Musculoskeletal problems in frequent computer and internet users

Aim: This study was carried out to see the frequency of musculoskeletal problems in frequent Computer and Internet Users. Methods: This was a Cross Sectional Study performed in the community and we chose Office workers and students aged 18 to 50 years using Computers and Internet for not less than 3 hours per day. After a verbal consent, they were given a questionnaire in English. People having prior diagnosed musculoskeletal problems were excluded. Results: Total number of participants were 150, out of which 80% were males, and 67 (44.7%) suffered from musculoskeletal problems, affecting at least one of the four anatomical sites (low back, neck, shoulder, wrist/hand). Common symptoms were Headache, which was seen in 46% and neck pain in 41.3% of subjects. Whereas wrist pain was least commonly seen in 16% of subjects. Independent t test was used to compare the musculoskeletal problems with duration of computer use which has a significant value i.e. less than 0.05. Conclusion: Musculoskeletal symptoms are quite common, headache and back pain being most common symptoms. These symptoms are associated with prolonged use of computer and internet and often left unreported and unrelated