Bilateral renal angiomyolipomas with invasion of the renal vein: A case report

An angiomyolipoma (AML) is usually a benign, rare, and, more commonly, a unilateral renal tumour. Bilateral tumours are very rare, particularly in the absence of tuberous sclerosis complex. Only in a few isolated cases have features of malignancy been associated with an AML. We present a unique case of bilateral AMLs mimicking invasive tumours in the absence of any other features of tuberous sclerosis complex

EXAMINING THE EFFECT OF HIGH SEASONALITY ON FRONTLINE EMPLOYEES: A CASE STUDY OF FIVE STARS HOTELS IN AQABA

In recent times, the impact of seasonality on tourism industry has been recognized. There has been a distinct lack of studies that focus on the effects of high seasonality on front-line employees (the receptionist) in hotels. Therefore, this study attempted to address the importance of the receptionist job in high seasonality and the effect of high seasonality on them. To answer the questions of the study, an instrument was used for evaluation. Also, a questionnaire was addressed to both employees and managers. T-test, ANOVA, and multiple regressions were utilized to test the hypotheses. The findings of the study revealed that the high seasonality in hotels has effects on the receptionists regarding miscommunication and bad relation with others during work hours. Therefore, this study has several recommendations for both the managers and the enterprises

Prognostic scoring system and risk stratification in patients with emphysematous pyelonephritis: an 11‐year prospective study at a tertiary referral centre

Objectives: To define pre‐morbid, clinical, laboratory, and imaging features and identify prognostic factors associated with morbidity and mortality in patients with emphysematous pyelonephritis (EPN) and develop a prognostic scoring system for improving management outcomes. / Patients and Methods: From January 2009 to December 2019, we performed a prospective study of all patients with a suspected diagnosis of EPN referred to a specialist tertiary centre in South India. All patients who underwent non‐contrast computed tomography of the abdomen and those diagnosed with EPN were included in this study. Demographic parameters, imaging, haematological and microbiology results were recorded. Patients were divided into three groups: Group 1, patients who survived without any intervention; Group 2, those who survived with surgical intervention; and Group 3, those who died with or without intervention. A prognostic scoring system was developed from 18 different parameters and risk stratification was developed. The scores were correlated with overall prognosis. / Results: Data from 131 patients with EPN enrolled in the study were analysed: Group 1 (n = 22), Group 2 (n = 102) and Group 3 (n = 7). By using univariate analysis, 10 factors were identified to be significantly associated with prognosis. Diabetes mellitus was the most common comorbidity. Shock at initial admission indicated a poor prognosis and warranted immediate attention (P < 0.001). / Conclusions: A multi‐disciplinary approach, a high index of clinical suspicion, an early diagnosis and administration of culture‐specific antibiotics with identification of prognostic indicators and risk stratification, allows prompt and appropriate medical and surgical treatments that could improve EPN management outcomes

Establishing reference interval for thyroid-stimulating hormone in children below two-year ages in Pakistani population

Introduction: Reference intervals (RIs) of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) are age, assay and population specific. Currently, the age and assay-specific RIs for TSH are not available for children under two years of age. This study aimed to establish reference intervals for serum concentrations of TSH and FT4 in healthy children aged 1-24 months as per CLSI C28-A3 guidelines.Methods: This prospective cross-sectional study was conducted in children from 1 to 24 months visiting the clinical laboratory for serum vitamin D testing but without any recent illness, hospitalization, medication and history of maternal thyroid diseases from August 2018 to March 2019 were invited to participate in the study.Serum TSH and FT4 were measured on ADVIA Centaur (Siemens Diagnostics, US), using chemiluminescence immunoassay. Kolmogorov-Smirnov test assessed normality of the data and RIs based on central 95% of the population were established using the non-parametric approach.Results: After excluding one subject with confirmed congenital hypothyroidism, a total of 131 children were included in the study. The median (IQR) age of the study subjects was 12 months (11), and majority 78 (59.5%) were boys. The RIs were established using non-parametric approach as the data was not normally distributed. Reference interval for TSH was 0.73-4.94 μIU/mL and for FT4 was 0.81-1.51 ng/dl.Conclusion: We established assay-specific RIs for serum TSH and FT4 in children aged 1-24 months in our population. The RIs were slightly lower from RIs developed on other platforms in different population

Titanium Dioxide-Mediated Photcatalysed Degradation of Two Herbicide Derivatives Chloridazon and Metribuzin in Aqueous Suspensions

The aim of this paper is to find out the optimal degradation condition for two potential environmental pollutants, chloridazon and metribuzin (herbicide derivatives), employing advanced oxidation process using TiO2 photocatalyst in aqueous suspensions. The degradation/mineralization of the herbicide was monitored by measuring the change in pollutant concentration and depletion in TOC content as a function of time. A detailed degradation kinetics was studied under different conditions such as types of TiO2 (anatase/anatase-rutile mixture), catalyst concentration, herbicide concentration, initial reaction pH, and in the presence of electron acceptors (hydrogen peroxide, ammonium persulphate, potassium persulphate) in addition to atmospheric oxygen. The photocatalyst, Degussa P25, was found to be more efficient catalyst for the degradation of both herbicides as compared with two other commercially available TiO2 powders like Hombikat UV100 and PC500. Chloridazon (CHL) was found to degrade more efficiently under acidic condition, whereas metribuzin (MET) degraded faster under alkaline medium. All three electron acceptors tested in this study were found to enhance the degradation rate of both herbicides