SINONASAL VERRUCOUS CARCINOMA Case series and review of literature

Verrucous carcinoma is a low grade malignancy and is a variant of squamous cell carcinoma. It is a rare tumour of the Sino nasal tract. The neoplasm occurs in older people usually in the seventh or eighth decade of life. Our cases were sinonasal in origin and patients affected were young.

Diagnostic accuracy of ultrasound in detecting retained products of conception: A study from a tertiary care hospital in Karachi, Pakistan

Introduction Retained products of conception (RPOC) are a known complication after abortion or childbirth. To improve clinical evaluation and avoid unnecessary surgery, transvaginal scan is performed in suspected cases. However, both RPOC and blood clots appear isoechoic on ultrasound, and false positives can lead to unnecessary intervention. In this study, the ultrasound findings have been correlated with the histopathology (as a gold standard) to determine the diagnostic value of sonography in the detection of RPOC in postpartum or post-abortion patients. Methods This cross-sectional study was carried out to determine the diagnostic accuracy of ultrasound in the detection of the retained products of conception in relation with the histopathological findings at the Department of Radiology, Aga Khan University Hospital (AKUH), Karachi. A total of 193 patients with suspicion of RPOC undergoing a transvaginal scan in the Department of Radiology, AKUH, were enrolled. The study was conducted for a period of 12 months from October 2014 to October 2015. Results Our results yielded that out of 193 cases, 113 cases (87.05%) had histopathology positive for RPOC, while 107 (55.44%) RPOC cases were identified by ultrasound as having RPOC. The mean endometrial thickness of the patients included in the study was 13.5 mm. According to our results, ultrasound has a sensitivity of 75.22%, specificity of 72.50%, a positive predictive value (PPV) of 79.44%, a negative predictive value (NPV) of 67.44%, and a diagnostic accuracy of 74.09%. Conclusion Transvaginal ultrasound is a modality that can be used for early diagnosis of the retained products of conception including fetal parts and could prove to be lifesaving. However, the operator and equipment variables need to be looked at, and a uniform criterion needs to be agreed on

DINAMIKA ALIANSI AMERIKA SERIKAT– FILIPINA: PENURUNAN KERJASAMA MILITER AMERIKA SERIKAT SEBAGAI TINDAKAN RASIONAL (2016-2018)

Tulisan ini membahas tentang sejarah dinamika aliansi antara Amerika Serikat-Filipina khususunya untuk menganalisis tindakan Amerika Serikat dalam menurunkan kerjasama militer dengan Filipina tahun 2016- 2018. Kajian terdahulu sudah banyak yang membahas tentang dinamika aliansi antara kedua negara ini. Na- mun belum ada yang membahas tentang fenomena dinamika aliansi yang terjadi antara keduanya merupa- kan tindakan yang rasional. Dengan menggunakan teori aksi/pilihan rasional penulis akan menganalisis tinda- kan dari Amerika Serikat dalam menurunan kerjasama militer terhadap Filipina merupakan tidakan rasional atau irasional ditengah kompetisi antara Amerika Serikat dan PRC di regional tersebut. Temuan dari tulisan ini adalah tindakan yang dilakukan oleh Amerika Serikat dengan menurunkan kerjasama militer merupakan aksi/pilihan yang rasional.  Kata Kunci : Dinamika Aliansi Amerika Serikat-Filipina, Penurunan Kerjasama Militer, Pilihan Rasional

A comprehensive review of 53 gynae surgeries on the versius robotic system in a tertiary care hospital

Background: Robotic-assisted surgery has attained widespread acceptance within clinical practice, emerging as the definitive standard for various medical indications. Within the realm of Gynae surgery, there has been a notable upsurge in the utilization of robotic and laparoscopic techniques. The Versius robotic system, developed by CMR Surgical, has demonstrated its efficacy on a global scale since its introduction in 2018, marking a significant stride in the landscape of robotic-assisted surgery. This review article was dedicated to providing an impartial assessment of robotic technology, elucidating our insights gleaned from 53 gynaecological surgeries conducted with the Versius robotic system. Methods: A meticulous examination of 53 cases was undertaken, wherein average operative time, estimated blood loss, postoperative hospital stay, Intraoperative and postoperative complications, and conversion rates were subjected to retrospective scrutiny. Results: The study conducted at a Tertiary care hospital involved the analysis of 53 gynecological cases using the Versius system. Results indicate the feasibility, efficiency, and patient-friendly nature of the Versius system, with notable advantages such as reduced hospital stay and smoother manipulation of tissues. Conclusions: We acknowledge the ongoing evolutionary trajectory of robotic surgery and it is evident that its merit has already been substantiated by the endorsement of numerous medical practitioners and patients worldwide. The Versius robotic system stands as a revolutionary force within the healthcare paradigm, distinguished not only by its favorability among medical professionals but also by its patient-friendly attributes. In the realm of minimally invasive gynecologic surgery, robot-assisted surgery emerges as a compelling alternative

Potential of Cellulosic Ethanol to Overcome Energy Crisis in Pakistan

Liquid biofuel industry in Pakistan may become a promising source for saving our foreign exchange and environment. Currently, bioethanol production is dependent on cane molasses, a product of sugar industry. Harnessing of more bioethanol from lignocellulosic waste crop residue has potential to respond to the fuel scarcity. Lignocellulose exists in nature as a polymer and serves as the largest sink for fixed global carbon and could be used both as a carbon source for microbial growth-assisted bioethanol production and for fabricating enzymes for more energetic simultaneous production to represent an important segment of the renewable energy sector. An exciting aspect of this research is the development of new biorefining techniques that facilitate the extraction of sugar-derived biofuel by processing of waste crop residues by employing novel nature inspired lignolytic enzyme. Further research will explore more avenues for stabilization of system in terms of process parameters for optimum bioethanol yield from enzymatically hydrolyzed lignin waste streams. The chapter can be considered as an anticipatory work and exploration of new dimensions for promotion of nature-inspired enzyme-assisted lignocellulose-based bioethanol production industry, which maximizes sustainable development opportunities especially in energy sector

KNOWLEDGE, ATTITUDES, AND PRACTICES TOWARD CORONAVIRUS DISEASE-19 INFECTION AMONG RESIDENTS OF DELHI NCR, INDIA: A CROSS-SECTIONAL SURVEY BASED STUDY

Objective: In the given study, we have carried out a survey among general population of Delhi NCR (India) for the knowledge, perceptions, and attitude toward coronavirus disease (COVID-19) and also attempted to reach to a few conclusions in the form of recommendations. Methods: A cross-sectional questionnaire based online survey (using Google Forms) was conducted between April 2020 and May 2020 to investigative knowledge, perceptions, and attitude toward COVID-19. Chi-square test was used for the computation of p-value. Results: There were total 823 respondents, with 43.01% females and 56.98% males. Around 73.74% respondents believe that it has become a social stigma. About 75.09% were of the opinion that sneezing etiquettes can help in curbing the infection. About 93.43% of study population follows the personal hygiene, 24.78% wished to get insurance coverage. Similarly, interesting data were collected over different aspects of COVID-19. Conclusions: The current pandemic is the first exposure at such a large scale to the existing population but with the progression of time, authorities and general population are collating knowledge about the same. It is to be fought at all the fronts such as medical, social, economic, and psychological. Hence, this type of survey becomes an important tool in decision making