Experience of managing acute pancreatitis in a surgical unit of a tertiary care hospital

Objective: To study the etiology, diagnosis, treatment and complications of acute pancreatitis in a tertiary care hospital.  Methodology: Study Design: It was a descriptive study. The study was conducted at Surgical Unit of Benazir Bhutto Hospital (BBH) Rawalpindi from 1st January 2014 to 31 July 2017.  All the patients who presented in emergency with abdominal symptoms and diagnosed as a case of acute pancreatitis were included in the study. All the data of gender, age, serum amylase & lipase, etiology, CT severity index, Ranson’s criteria, complications, mortality and management were noted on a predesigned proforma. Percentages and frequencies were calculated for all the data by SPSS 21 version. Results: Total 161 patients were included in the study, with 60.9% females and 39.1% males. Maximum patients 31% were from age group of 26 to 40  years of age and minimum 1.2% from 71 to 85 years. Gall stones were the major cause of the disease contributing 67% of cases.  At admission Ranson’s score of the maximum patients 32.2% had total score of 1, While only 1.2% had moderate pancreatitis.  After 48 hours of admission 24.2% had 2 score while only 1.2%had severe pancreatitis.  The radiological CT severity index 82.6% patients had mild pancreatitis while1.2% patients had severe disease. 93.1% patients were managed conservatively, 1.9%  patients went Cystogastrostomy, 1.2% patients needed Exploratory laparotomy and  1.2% patients went for Pancreatic Necrosectomy.  On calculating the morbidity 67.7% patients had no significant morbidity. 32.3% had complications including pleural effusion, ascites, pancreatic necrosis, pseudo cyst formation, shock, acute renal failure and multi organ failure.  Overall mortality rate was  3.7%. Conclusion: Acute pancreatitis in our set up is mainly due to gall stones. A multidisciplinary approach, measurement of severity of disease with computerized tomography scan and Ranson’s scoring system is always helpful in disease management and its complications. Key Words : Acute pancreatitis, Gall stones, Ranson’s scoring, Pancreatic necrosis, Pseudocyst

Improvement of Abiotic Stress Tolerance in Plants with the Application of Nanoparticles

Plants are under the threat of climatic changes and there is a reduction in productivity and deterioration in quality. The application of nanoparticles is one of the recent approaches to improve plant yield and quality traits. A number of nanoparticles, such as zinc nanoparticles (ZnO NPs), iron nanoparticles (Fe2O3 NPs), silicon nanoparticles (SiO2 NPs), cerium nanoparticles (CeO2 NPs), silver nanoparticles (Ag NPs), titanium dioxide nanoparticles (TiO2 NPs), and carbon nanoparticles (C NPs), have been reported in different plant species to play a role to improve the plant physiology and metabolic pathways under environmental stresses. Crop plants readily absorb the nanoparticles through the cellular machinery of different tissues and organs to take part in metabolic and growth processes. Nanoparticles promote the activity of a range of antioxidant enzymes, including catalase (CAT), peroxidase (POD), and superoxide dismutase (SOD), in plant species, which in turn improve the growth and development under stressful conditions. The present review focuses on the mode of action and signaling of nanoparticles to the plant systems and their positive impact on growth, development, and ROS scavenging potential. The appropriate elucidation on mechanisms of nanoparticles in plants leads to better growth and yields under stress conditions, which will ultimately lead to increased agricultural production

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Benchmarking entrepreneurial intentions of women in the United Arab Emirates

Purpose: Based on the extensive literature review and the research published in the context of Western countries, this study proposes that the entrepreneurship education, participation in entrepreneurial seminars at the universities and their involvement in the activities of innovation and incubation center of the universities may foster entrepreneurial intentions (EIs) among Emirati female graduating students. Design/methodology/approach: To test the study’s hypothesized model, survey data are collected from 283 female graduating students of 19 public and private universities in the United Arab Emirates (UAE). The analysis of the data relies upon multiple hierarchical regression and moderation analysis in SPSS. Findings: The results suggest that all three types of educational activities positively influence the women\u27s EIs in the UAE. However, formal entrepreneurship courses are more effective than the participation in seminars and involvement in the activities of innovation/incubation center. The authors also found that perceived social support does not moderate the impact of education on EIs, which means that entrepreneurship education is equally effective in fostering EIs, no matter female students perceive low or high social support. On the other hand, results demonstrate that the level of gender stereotypes negatively moderates the impact of education on it. This implies that if a female student believes in a high gender stereotype, the impact of education on her EIs will be low and vice versa. Research limitations/implications: This study specifically focuses on women entrepreneurship and for the UAE only. However, the results can be generalized for female entrepreneurship, specifically for countries where governments are taking initiatives to foster female entrepreneurship. The study provides specific implications for the UAE public policy government. Practical implications: As the Government of the UAE is keenly interested to boost up the women entrepreneurial behavior, the findings of the study support that in addition to entrepreneurship education, the government should also encourage the universities to arrange entrepreneurship seminars as these seminars also increase the EIs of women. In addition, the government and the universities should also focus on the involvement of women in the incubation centers/innovation park because the incubation centers can provide the practical exposure to the women in the new business start-ups. Originality/value: This research is among the first, which benchmarks women EIs in the UAE