An alternative model for assessing mortality risk in Stevens Johnson syndrome/toxic epidermal necrolysis using a random forests classifier: A pilot study

IntroductionMortality risk prediction is an important part of the clinical assessment in the Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) patient. The SCORTEN and ABCD-10 scoring systems have been used as predictive clinical tools for assessing this risk. However, some of the metrics required in calculating these scores, such as the total body surface area (TBSA) involvement, are difficult to calculate. In addition, TBSA involvement is calculated in a variety of ways and is observer dependent and subjective. The goal of this study was to develop an alternative method to predict mortality in patients with SJS/TEN.MethodsData was split into training and test datasets and preprocessed. Models were trained using five-fold cross validation. Out of several possible candidates, a random forests model was evaluated as being the most robust in predictive power for this dataset. Upon feature selection, a final random forests model was developed which was used for comparison against SCORTEN.ResultsThe differences in both accuracy (p = 0.324) and area under the receiver operating characteristic curve (AUROC) (p = 0.318) between the final random forests model and the SCORTEN and ABCD-10 models were not statistically significant. As such, this alternative method performs similarly to SCORTEN while only requiring simple laboratory tests from the day of admission.DiscussionThis new alternative can make the mortality prediction process more efficient, along with providing a seamless implementation of the patient laboratory tests directly into the model from existing electronic health record (EHR) systems. Once the model was developed, a web application was built to deploy the model which integrates with the Epic EHR system on the Fast Healthcare Interoperability Resources (FHIR) Application Programming Interface (API); this only requires the patient medical record number and a date of the lab tests as parameters. This model ultimately allows clinicians to calculate patient mortality risk with only a few clicks. Further studies are needed for validation of this tool

Growth and Yield of Sesame (Sesamum indicum L.) under the Influence of Planting Geometry and Irrigation Regimes

Abstract A. Nadeem et al. 981 particularly seed yield (765.00 kg•ha −1 ), whereas minimum traits were noted in the interaction of planting geometry of 30 × 20 cm × two irrigations (20 and 40 DAS). Furthermore, the results of four and three irrigations had non-significant differences with each other means not sharing the same letter differ significantly at 0.05 probability level. Hence, it is concluded that interaction of 45 × 15 cm planting geometry and three irrigations (20, 40 and 60 DAS) is conducive to produce maximum seed yield (kg•ha −1 ) of sesame

Does malaria during pregnancy affect the newborn?

Objective: To investigate the effect of malarial infection during pregnancy on the newborn.Methods: A retrospective cohort study was conducted at The Aga Khan University Hospital (AKUH), Karachi, using in-patient hospital records over an 11-year period from 1988 to 1999. The incidence of preterm delivery, low birth weight (LBW) and intrauterine growth retardation (IUGR) in 29 pregnant women with malaria, was compared with that in 66 selected pregnant women without malaria, who delivered at the AKUH during the same time period.Results: Pregnant women with malaria had a 3.1 times greater risk of preterm labor (p=0.14). They were more likely to be anaemic compared to women without malaria (RR=2.9, 95% CI=1.6-5.4) and had a significantly lower mean haemoglobin level (p=0.0001). Maternal malaria was significantly associated with LBW babies (p=0.001). The mean birth weight of infants born to pregnant women with malaria was 461 g less (p=0.0005). No significant association was, however, found between malarial infection during pregnancy and IUGR (p=0.33).CONCLUSION: Malarial infection during pregnancy is associated with poor maternal and fetal outcome. It is significantly associated with maternal anaemia and LBW infants. Appropriate measures must, therefore, be taken to prevent malaria during pregnancy, especially in endemic areas

Polypyrrole-Fe[sub]2O[sub]3 nanocomposites with high dielectric constant : in situ chemical polymerisation

Novel nanocomposites of polypyrrole (PPy) dispersed with iron oxide (Fe2O3) particles have been synthesised by in-situ chemical oxidative polymerisation of pyrrole in the presence of ammonium persulfate (APS) as an oxidising agent. The concentration of Fe2O3 was varied between 10-50wt% of PPy. The simultaneous polymerisation of pyrrole and oxide addition led to the complete synthesis of nanocomposites. A maximum dielectric constant of ~28500 was observed at 20wt% of Fe2O3. The nanocomposites were characterised by X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and transmission electron microscopy (TEM). XRD analysis confirmed the structure and crystallinity of the nanocomposites, and a strong interaction between PPy and the Fe2O3 nanoparticles was observed by FTIR technique. SEM and TEM images showed that Fe2O3 particles had been coated with PPy by establishing a network during the polymerisation process. The values of dielectric constant were obtained from capacitance measurements. The value of dielectric constant for nanocomposites with 20wt% of Fe2O3 was observed to be almost 12 times that of the pure PPy matrix. The high value of dielectric constant indicated a high packing density of Fe2O3 particles in the PPy matrix. These nanocomposites have potential applications in electronic or biomedical devices

Hydroethanolic Allium sativum extract accelerates excision wound healing: evidence for roles of mast-cell infiltration and intracytoplasmic carbohydrate ratio

ABSTRACT The present study was designed to evaluate the in vivo effect of Allium sativum (garlic) hydroalcoholic extract on wound healing in rats. For this purpose, 72 mature Wistar rats were divided into four groups (n=18/each) to receive no treatment, placebo, Cicalfate(r), or 2% Allium sativum (AS) extract, administered topically to the wound area, for 21 days. Following the experimental period, tissue samples were dissected out and underwent to histopathological analyses. Fibroblasts, fibrocytes, mast cells, intra-cytoplasmic carbohydrate ratio, neovascularization, collagen deposition, and re-epithelialization were analyzed in all groups. Animals in the treated groups showed significant enhancement in fibroblast, fibrocyte, and mast-cell distribution. Significantly higher neovascularization was observed on day 3 after wound induction in AS-treated animals versus those in the placebo, Cicalfate, and untreated groups (P<0.05). A dose-dependent, significantly higher intra-cytoplasmic carbohydrate storage was observed in treated animals. Our data show that AS promotes wound healing due to its preliminary impact on mast-cell distribution, which enhanced collagen synthesis and upregulated angiogenesis, and shortened the healing process by enhancing the intra-cytoplasmic carbohydrate ratio

Metronome: adaptive and precise intermittent packet retrieval in DPDK

DPDK (Data Plane Development Kit) is arguably today's most employed framework for software packet processing. Its impressive performance however comes at the cost of precious CPU resources, dedicated to continuously poll the NICs. To face this issue, this paper presents Metronome, an approach devised to replace the continuous DPDK polling with a sleep&wake intermittent mode. Metronome revolves around two main innovations. First, we design a microseconds time-scale sleep function, named hr_sleep(), which outperforms Linux' nanosleep() of more than one order of magnitude in terms of precision when running threads with common time-sharing priorities. Then, we design, model, and assess an efficient multi-thread operation which guarantees service continuity and improved robustness against preemptive thread executions, like in common CPU-sharing scenarios, meanwhile providing controlled latency and high polling efficiency by dynamically adapting to the measured traffic load

HIV-1 subtype A infection in a community of intravenous drug users in Pakistan

BACKGROUND: Data on the subtypes of HIV in a population help in predicting the potential foci of epidemic, tracking the routes of infection and following the patterns of the virus' genetic divergence. Globally, the most prevalent HIV infection is the HIV-1 subtype C. In Asia, predominant subtypes of HIV-1 are B, C, and CRF-01AE. During the last few years, HIV prevalence in Pakistan has taken the form of a concentrated epidemic in at least two high risk groups, namely, Intravenous Drug Users (IDUs) and Male Sex Workers (MSWs). Factors that have facilitated the proliferation of HIV infection include transmission through a large number of repatriates and needle-sharing intravenous drug users, unscreened blood transfusions, and sexual illiteracy. The HIV subtypes infecting Pakistani populations have not been explored to date. In this study, we analyzed HIV-1 subtypes from in a high-risk community of IDUs in Karachi, the largest city of Pakistan. METHODS: Samples were collected from 34 IDUs after their informed consent. In addition, the study subjects were administered a questionnaire regarding their sexual behavior and travel history. For HIV analysis, DNA was extracted from the samples and analyzed for HIV types and subtypes using subtype-specific primers in a nested polymerase chain reaction (PCR). The results from this PCR were further confirmed using the Heteroduplex Mobility Assay (HMA). RESULTS: We found HIV-1 subtype A in all the 34 samples analyzed. A few of the study subjects were found to have a history of travel and stay in the United Arab Emirates. The same subjects also admitted to having contact with commercial sex workers during their stay abroad. CONCLUSION: Our study therefore shows clade A HIV-1 to be prevalent among the IDUs in Karachi. As the prevalence of HIV in Pakistan continues to rise, more work needs to be done to track the infection, and to analyze the strains of HIV spreading through the country

Obsessive-Compulsive Disorder in Primary Care: Overview on Diagnosis and Management

Background: Obsessive-Compulsive Disorder (OCD) is a debilitating condition marked by the presence of intrusive obsessions and repetitive compulsions. The primary care setting often serves as the first line of contact for individuals grappling with mental health issues, making it a crucial frontier in the early detection and management of OCD. Therefore, the accurate diagnosis of OCD in such settings is essential for effective management. Objective: This review article aims to provide a comprehensive overview of the diagnostic process for OCD, emphasizing the clinical presentation, differential diagnosis, and various diagnostic tools available. Additionally, it explores current strategies for managing OCD, including pharmacological and psychotherapeutic interventions. Methodology: For this review, a comprehensive literature search was conducted using Google Scholar and PubMed databases. Keywords such as "Diagnosis," "obsessive compulsive disorder," and "management" were employed to narrow down relevant studies. Both qualitative and quantitative research papers were included, while non-English publications and those lacking peer-review were excluded. Results: Core symptoms of OCD include obsessions and compulsions, with the Y-BOCS being a standard measure for diagnosis. Differential diagnosis is essential to distinguish OCD from other conditions. SSRIs have been recognized as first-line pharmacological treatments. CBT, particularly Exposure and Response Prevention, remains a potent psychotherapeutic intervention. Emerging treatments like DBS and TMS offer hope for those unresponsive to conventional treatments. Combination therapies have shown enhanced efficacy in certain cases. Conclusion: The meticulous diagnosis of OCD requires recognizing its core symptoms, ruling out other conditions, and leveraging validated clinical tools. A multi-faceted management approach combining pharmacological and psychological treatments ensures optimal patient outcomes, with ongoing research introducing promising new interventions