Surgical and oncological outcomes of hepatic resection for hepatocellular carcinoma: Report from a low volume centre in a developing country

Objective: To review the surgical and oncological outcomes of patients who underwent hepatic resection for hepatocellular carcinoma (HCC).Study design: Cohort study.Place and duration of study: Department of Surgery of the Aga Khan University Hospital Karachi, from 2008 to 2019.Methodology: Consecutive patients who underwent hepatic resection for HCC at the Hospital were included. The data were collected and analysed on aspects including demographics, liver function status, tumour characteristics, perioperative management, and surgical and oncological outcomes. Survival analyses were performed using the Kaplan-Meier method, and log-rank test was applied to determine the influence of variables on overall and disease-free survival.ZResults: A total of 59 patients underwent hepatic resection for HCC during the study period including 38(64%) males. The majority of the patients had a single lesion (88%), unilobar disease (95%), underlying cirrhosis (75%) and BCLC stage B (73%). Major hepatic resection was performed in 27(46%) patients. The mean duration of surgery was 288+101 minutes and the mean estimated blood loss was 986+637 mls. Postoperative complications developed in 22(37%) patients including surgical complications in 11(19%), liver decompensation in 4(7%) and systemic complications in 9(15%) patients. The overall 30-day mortality was 7%. With a mean follow-up of 2.8 years, disease recurrence was documented in 25(42%) patients and the median overall survival was 45 months.Conclusion: Hepatic resection for HCC is an effective treatment option in this setup. Despite low volumes, surgical and oncological outcomes of hepatic resection for HCC were comparable to the international standards

Role of Oxidative Stress in various stages of Psoriasis

Background: Psoriasis is a chronic inflammatory, immune mediated, provocative and challenging skin condition. It is a non-contagious but debilitating disease and a leading cause of socioeconomic burden on the health system. Objective: To evaluate the role of antioxidant levels, lipid peroxidation status and lipid profile in the etiology and degree of severity of psoriatic illness among psoriasis patients presenting in Dermatology department. Study Design: This study was carried out as a retrospective case control study. Place and duration of Study: It was carried out by the Department of Biochemistry, Basic Medical Sciences Institute (BMSI) in collaboration with Departmnt of Biochemistry, Khyber Medical College, Peshawar and Department of Skin and Venereal disease, Jinnah Post Graduate Medical Centre (JPMC) Karachi. Material and Methods: One hundred and twenty cases (n=130) of already diagnosed psoriasis patients were randommely and fifty healthy matched controls (n=50) of the same age and gender were included from the general population for comparison. Lipid profile including serum total cholesterol, TG, HDL-c and LDL-c levels were measured by enzyme colorimetric analysis on Micro Lab 300 (Merck & Germany). Antioxidant status SOD and lipid peroxidation status MDA were measured by ELISA technique. Statistical analysis was performed using SPSS software Version 16. In this analysis, a “p” value of less than 0.05 was considered to be significant. Results: The study showed significantly elevated levels of MDA, serum TG, total cholesterol and LDL-c levels in psoriatic patients in comparison with controls, whereas SOD levels and HDL-c levels were found to be significantly lower in psoriatic patients as compared to normal healthy matched controls. Conclusion: The findings of this study support the hypothesis that an imbalance in oxidant-antioxidant system may play a role in the etiology of psoriasis and the degree of severity of its presentation. The study also concluded that dyslipidemia was an observed risk factor for the development of cardiovascular diseases in psoriatic patients.

Application of Nanofluids for Thermal Management of Photovoltaic Modules: A Review

Mounting temperature impedes the conversion efficiency of photovoltaic systems. Studies have shown drastic efficiency escalation of PV modules, if cooled by nanofluids. Ability of nanofluids to supplement the efficiency improvement of PV cells has sought attention of researchers. This chapter presents the magnitude of improved efficiency found by different researchers due to the cooling via nanofluids. The effect of factors (such as, nanoparticle size, nanofluid concentration, flowrate of nanofluid and geometry of channel containing nanofluid) influencing the efficiency of PV systems has been discussed. Collective results of different researchers indicate that the efficiency of the PV/T systems (using nanofluids as coolant) increases with increasing flowrate. Efficiency of these systems increases with increasing concentration of nanofluid up to a certain amount, but as the concentration gets above this certain value, the efficiency tends to decline due to agglomeration/clustering of nanoparticles. Pertaining to the most recent studies, stability of nanoparticles is still the major unresolved issue, hindering the commercial scale application of nanofluids for the cooling of PV panels. Eventually, the environmental and economic advantages of these systems are presented

Yeast sludge and its components ameliorate ochratoxin Ainduced toxicity in broiler chicks

Purpose: To investigate the protective effect of yeast sludge (YS) and its components against ochratoxin A (OTA) in broiler chicks. Methods: Ochratoxin A (OTA) was produced through solid state fermentation, and quantified using high performance liquid chromatography (HPLC). A total of 1250 one-day old broiler chicks of Arbreaker breed were randomly assigned to five diet groups (A - E) replicated five times in such a way that each replicate had 50 chicks. The five diet groups were: A (normal poultry feed), B (200 µg/kg OTA), C (200 µg/kg OTA plus 2 g/kg YS), D (200 µg/kg OTA plus 2 g/kg yeast sludge cell mass, YSCM), and E (200 µg/kg OTA plus 2 g/kg yeast sludge cell wall (YSCW). The study lasted 35 days. Indices of liver and kidney functions were determined, as well as histopathological examination of samples of kidney, liver and bursa of Fabricius. Results: Supplementation of chicks diet with OTA at a dose of 200 ppb significantly reduced serum levels of total protein (TP), albumin, and creatinine, but significantly raised the activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (p < 0.05). However, inclusion of YS, YSCM, and YSCW in OTA-contaminated diet significantly reversed the effect of OTA on the indices of liver and kidney functions (p < 0.05). Yeast sludge and its components also significantly ameliorated OTA-induced histological changes in the liver, kidney and bursa of Fabricius. Conclusion: These results indicate that YS and it components improve hepatorenal function and histological changes induced by OTA

Prognostically Significant Fusion Oncogenes and Gene Mutations in Pakistani AML Patients

Background: The onset and progression of leukemia is associated with many genetic abnormalities including gene mutations and production of fusion oncogenes. Molecular studies on fusion oncogenes and mutations in different populations have been done. However, not much research on correlation of the fusion oncogenes with acute myeloid leukemia have been done in Pakistan.Methods: Genetic analysis of 105 AML patients was done to investigate AML1-ETOand CBFB-MYH11 fusion oncogenes and mutations in NPM1 and NRAS genes. The genomic DNA and cDNA were subjected to amplification, electrophoresis, and Sanger sequencing.Results: The frequency of AML1-ETO was 26% in AML patients and 34.2% in AML-M2 patients. CBFB-MYH11 was present in 11.4% AML patients. A total of six mutations in 4 regions of NPM1 gene and 2 regions of NRAS gene were detected. 3’UTR of NPMI gene had three variants; g.1128C>T (57.1%), g.1185-/T insertion (80.95%), and g.1163A>T (57.14%) while c.867_871subGTGGA >CAAGTTTGC (2.86%) was present in exon 12. NRAS gene had two mutations c.12C>T (51.4%) and c.33A>T (11.43%) in exon 2. c.867_871subGTGGA >CAAGTTTGC , and g.1163A>T in NPM1 gene and c.33A>T in NRAS gene were the novel findings in this ethnic population.Conclusion: This genetic analysis may help to modulate the treatment strategies and improve survival of patients.Keywords: Acute Myeloid Leukemia; Fusion Oncogenes; AML; AML1-ETO; CBFB-MYH11; AML-M2; Nucleophosmin, NPM1; NRAS

Current status and overview of farm mechanization in Pakistan – A review

Economic growth in Pakistani agricultural sector lags behind growth in industry and services, creating an ever widening rural-urban income fissure.  Agricultural mechanization plays a strategic role in improving agricultural production and productivity in developing countries. The average farm size in Pakistan is small (2.5 acres) and small and marginal land holdings (less than 2.0 ha) account for 85% of land holdings.  Mechanizing small and non-contiguous group of small farms is against ‘economies of scale’ for individual ownership of farm machinery. It was observed that there was a direct correlation between farm power availability and productivity during the past six decades. Being an agrarian country, mechanization can be called as back bone of Pakistan’s economy as it optimizes the use of biological, chemical and hydrological inputs.  So far, Pakistan has only experienced selective farm mechanization as this concept has remained limited to use of tractors only and at the country level, the temporal analysis shows that an increase in tractor population from 1975 -1984 was about 341% while it was 61% from 1984-1994.  At present there are about 0.94 million tractors in Pakistan, which alone provides 0.84 hp/acre.  Land preparation is the only operation that is nearly 100% mechanized in the country for almost all crops with 901 thousand chisel plough and 108 thousand Mould board ploughs.  The market of planting and spraying machinery has grown from 70 and 21 thousands in 2004 to 295 and 1438 thousands in 2014 respectively due to the inclination of the farming community towards mechanized sowing and spraying.  The thrasher’s market in Pakistan is estimated at 20,000-30,000 units annually by sales resulting in nearly 100% mechanized threshing operation for cereal crops. By increasing the available horse power per hectare and by the proper management of agricultural machinery the average crop yield can be enhanced