Diagnostic Accuracy and Imaging Appearance Glioblastoma Multiforme on MRI and MRS

Objective: To determine the diagnostic accuracy of contrast-enhanced MRI with conventional sequences and MR Spectroscopy in the diagnosis of Glioblastoma Multiforme, taking histopathology as the gold standard. We also determined the MR imaging appearance of GBM on conventional sequences. Methodology: This descriptive cross-sectional study was conducted at a tertiary care hospital from 19th August 2019 to 18th August 2020 on 165 adult patients suspected of having an intracranial space-occupying lesion. Informed consent was sought and a questionnaire was filled out for patient data, MRI imaging findings, and MRS results. Histopathology results were subsequently followed and recorded. The diagnostic accuracy of contrast enhanced MRI brain as well as MRS was determined in terms of sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy, taking histopathology as gold standard. Results: In a total of 165 patients selected for the study, the mean age was 56.34±10.04 years with a male to female ratio of 1:1 and the frontal lobe being the most common location (34.5%). In histopathological positive GBM cases, margins of the mass were ill-defined in 55.1%, intralesional low ADC values were observed in 63.3%, signal drop out on susceptibility imaging in 42.8%, and MRS with raised choline and reduced NAA in 75.5%. MRI had a sensitivity of 81.6% and  specificity of 94.8%, and MRS has a sensitivity of 75.5% and a specificity of 100%. Conclusion: Ill-defined margins, necrosis, and hemorrhage are important MRI features suggesting GBM. MRS combined with conventional MR sequences has high sensitivity and specificity in its diagnosis

Total Sialic Acid (TSA) Level as a Tumor Marker in the Diagnosis of Oral Cancer

Objective: To estimate serum Total Sialic Acid (TSA) levels in different grades of oral squamous cell carcinoma and to accessit`s utility as a tumor marker in this cancer.Materials and Methods: This study was conducted in 68 adult subjects equally divided into two groups, healthy individualsand patients with oral squamous cell cancer. Under aseptic precautions venous blood was drawn and serum was separated.Estimationof serum total sialic acid level was done according to Spectrophotometeric method of Plucinsky. Statistical analysis was carriedout by using SPSS 19.Results: Total subjects in the study included were 58.82% males and 41.17% females. Mean age of oral cancer patients was48.05 ± 8.82 years. There was significant male predominance with P<0.05. Oral cancer was most common in Tobacco+ Chaliya+ Areca nut and Gutka+pan groups. Mean serum total sialic acid (TSA) level in control group was 60.2 ± 4.27 mg/dl, whereasit was 99.1 ± 18.30 mg/dl in oral cancer group. It was significantly increased in oral cancer group when compared to controlgroup with P value < 0.01. There was progressive elevation in mean serum TSA level in oral squamous cell carcinoma,Conclusion:Estimation of serum total sialic acid level (TSA) in different grades of oral squamous cell carcinoma showedpositive relation with stage of malignancy, specifically with the tumor burden. It can be used as a diagnostic biomarker in oralsquamous cell cancers

A Method For Early Detection Of Cardiac Arrhythmias

According to the WHO (World Health Organization), the beginning of specific cardiovascular illnesses is the leading cause of death worldwide. Cardiac arrhythmias, in particular, can develop into cardiovascular diseases like heart disease, so it's essential to figure out how to make an early diagnosis to stop the arrhythmia from developing into a condition that, in more advanced stages, wouldn't respond well to treatments. It was possible to extract typical heart electrophysiology patterns like the QRS complex, the P.R. segment, the Q.R. segment, the R.S. segment, and the S.T. segment by characterizing the signals picked up by external ambulatory monitors and using the T.W. (Wavelet Transform) for this type of signal analysis. Digital filters were used in the filtering process, and the signal was then described, facilitating easier differentiation through a support vector machine-based classification method established by comparing the outcomes from the various methodologies. The research showed that it is possible to create an automatic tool for detecting cardiac issues as a decision support tool for sending patients for examination by a specialist doctor using the proposed model

Transvaginal Ultrasonographic Findings of Infertile Females in Population of Lahore

Failure of conception in women after frequent unprotected intercourse for one year is known as infertility. Ultrasound examination can detect certain pathologies that may result in primary or secondary infertility. Objective: To describe the various transvaginal ultrasonographic findings of infertile females in population of Lahore. Methods: The study was started after the consent of ethical committee of the University of Lahore. All the patients were registered in this study after signing the informed consent form. Toshiba Xario with transvaginal transducer frequency ranging from 9-12 MHz was used. Pathologies were evaluated through transvaginal scanning and sonographic data was kept in the ultrasound machine. A consecutive sampling technique was used and data was further evaluated with the help of Statistical Package for the Social Sciences version 24. Results: Among 138 females, PCOS was seen in 40.6% of the subjects. The second most common pathology was ovarian cyst which was seen in 10.9% of subjects. And the incidence of multiple fibroids was 5.1% as third most common pathology in both primary and secondary infertility cases. Most ovarian pathologies were found to be bilateral. 12.3% subjects had no findings on ultrasound. Conclusion: PCOS was the utmost common pathology connected with primary and secondary infertility. The second and third most common pathologies were ovarian cyst and multiple fibroids respectively. Keywords: female infertility, PCOS, PID DOI: 10.7176/JBAH/10-12-05 Publication date:June 30th 202

Imidazole and its derivatives as potential candidates for drug development

Imidazole and its derivatives are the pharmacological significant scaffolds with the broad spectrum of activities can be synthesized in the laboratory in the single step by the action of the catalyst. The current review summarizes the role of the imidazole and its derivatives during the last decade (2005-2014) for the treatment of many diseases. Review highlights their significant contribution towards the drug development for the treatment of some fatal diseases like HIV, cancer, tuberculosis and hepatitis C. As imidazole and its derivatives continue to play an important role for the treatment of many diseases so there is a need to trigger research in this field

Epidemiology of Extended Spectrum Beta Lactamase Producing Gram Negative Rods

OBJECTIVE: To estimate the distribution of ESBL producing capacity among different Gram negative isolates along with specimen and department wise prevalence in a tertiary care hospital. METHODOLGY: This cross-sectional study was conducted at the Microbiology section of Pathology Department, Allama Iqbal Medical College, Lahore, Pakistan, from August 2016 to January 2017. Total of 437 clinical samples were collected from different wards of Jinnah Hospital, Lahore. Sample was cultured on Blood agar, MacConkey’s agar, chocolate agar, CLED agar. After the identification every Gram negative isolate was further processed for the antibiotic susceptibility testing following Modified Kirby Bauer disc diffusion method. ESBL detection was performed by the combination drugs disc method using ceftriaxone + clavulanic acid (30/10 µg) in case of Enterobacteriacae, ceftazidime + clavulanic acid (30/10µg) in case of Pseudomonas species. RESULTS: Among total 437 patients male and female were 61% and 39% respectively, overall 21.5% (94/437) were ESBl producers. Distribution of ESBL producers was as followed Acinetobacter spp 22.3% (31/139), Escherichia coli 37.5% (27/72), Klebsiella spp 31.9% (15/47), Pseudomonas aeruginosa 8.4% (13/154) and Proteus spp 32.0% (8/25). Department wise ESBL positivity was as followed Surgical units 25.6% (32/125) Medical unit 31.9% (30/94), Burn centre 10% (8/80), ICU 20% (8/40) Surgical Allied 11.7% (4/34), Medical Allied 6.2% (2/32), Neurology 36.3% (8/22), Gynaecology 28.5% (2/7) and Dermatology 33.3% (1/3). CONCLUSION: High percentage of ESBL positivity seen in Escherichia coli and Proteus spp, among departments neurology and medical unit is holding maximum positivity. High frequency of ESBL producing Gram negative isolates strongly recommend its detection and management accordingly. It can lead to treatment failures in Gram negative rods associated infections

All-optical OFDM and distributed Raman amplification:challenges to enable high capacities and extend reach

We review recent advances in all-optical OFDM technologies and discuss the performance of a field trial of a 2 Tbit/s Coherent WDM over 124 km with distributed Raman amplification. The results indicate that careful optimisation of the Raman pumps is essential. We also consider how all-optical OFDM systems perform favourably against energy consumption when compared with alternative coherent detection schemes. We argue that, in an energy constrained high-capacity transmission system, direct detected all-optical OFDM with `ideal' Raman amplification is an attractive candidate for metro area datacentre interconnects with ~100 km fibre spans, with an overall energy requirement at least three times lower than coherent detection techniques

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic