Giant adrenal endothelial cyst associated with acute and chronic morbidity in a young female: a case report

Adrenal cysts are rare clinical entities that can present as acute abdomen through rupture and internal hemorrhage as well as chronic symptoms such as gastrointestinal disturbances. A 20-year-old girl presented to our hospital with a 4-years history of abdominal pain and diarrhea. Ultrasound of the abdomen revealed a cystic area measuring 10 × 10 cm between the spleen and left kidney. Computed tomography scan showed a large cystic, homogeneous mass measuring 12.8 × 9.5 × 9.4 cm in the left hypochondrium with most likely origin from the left adrenal gland. Limited work up for hormone hypersecretion was negative. The patient was then encountered in the emergency room with an acute abdomen secondary to intracystic hemorrhage. A laparotomy with left adrenalectomy was performed. Final pathology showed a benign adrenal endothelial cyst. Post-operatively, the patient's long standing complaints of diarrhea and abdominal pain completely resolved. Surgical resection appears a safe and reasonable management strategy in a patient with intracystic hemorrhage of adrenal cyst

Model free operational space control of mechanical manipulators

Doctor of Philosoph

Factors Influencing Choice of Energy Sources in Rural Pakistan

Modernisation of the agricultural and industrial sectors in Pakistan over the last thirty years, increased village electrification, increasing use of energy appliances by domestic users, and the usage of modern technology in all sectors, caused energy demand to increase more rapidly than energy supply. Sources of energy vary between urban and rural populations, across income groups, and by type of households. Pakistanis consume energy from both modern and traditional sources for different purposes, such as lighting, cooking, heating, and transportation. Modern sources of energy include electricity, oil, gas and coal, while traditional sources consist of animal/plant residue (firewood, crop residue and animal waste). Using a multinomial logit regression model, this study analyses how rural households make choices among different energy alternatives. The results suggest that because of the limited access to modern energy sources, households rely on traditional sources excessively, which may have a negative impact not only on human and animal health but also on the environment. These results suggest that the conversion of traditional energy sources into modern ones, such as, biogas, use of energy efficient appliances, etc. can have a positive impact on the environment and sustainable economic growth. JEL Classification: R20, D11, Q43, Q42, Q5 Keywords: Rural, Households, Energy Consumption, Energy Sources, Environmen

Host defence peptides in diabetes mellitus type 2 patients with periodontal disease. A systematic review

The aim of the study was to critically assess and review the latest evidence relating the associations between host defence peptides (HDPs), periodontal diseases (PD) and diabetes mellitus type 2 (DM2). To explore studies on HDPs, periodontal disease, and DM2, researchers utilised specific key phrases to search the electronic databases PubMed (National Library of Medicine), Embase (Ovid), Medline (EBSCO), and Dentistry and Oral Sciences (EBSCO). Quality assessment was conducted by means of the Newcastle Ottawa scale and the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool. Following a thorough screening process, a total of 12 papers (4 case‐control, 6 cross‐sectional, 1 animal, and 1 in vitro) fulfilled the selection criteria and were included. The majority of research found that HDPs were upregulated in DM2 patients with PD. Three investigations, however, found that HDPs were downregulated in DM2 patients with PD. HDPs play a part in the pathophysiology of PD and DM2. Nonetheless, more human, animal and laboratory investigations are needed to fully understand validation of the link, as the evidence is limited. Understanding HDPs as common moderators is critical, aimed at unlocking their potential as therapeutic and diagnostic agents

Cardiopulmonary Resuscitation–attitudes and awareness among physical therapists of Karachi–A Cross-sectional Survey

Background: The prime objective of CPR is to maintain enough circulation to preserve existence till specialized treatment is provided. As mentioned, early CPR is an essential aspect in the chain of survival in Emergency Cardiovascular Care (ECC). Objective: To compare and study the attitude and awareness level related to Cardiopulmonary Resuscitation (CPR) among physical therapists in Karachi. Methods: The total sample was 126 physical therapists in this study. This was an observational study based on a cross-sectional design conducted for the assessment of CPR attitude and awareness of physical therapists through simple convenient sampling technique during the period of December 2020 to June 2021 from various public and private sector hospitals and rehabilitation centers of Karachi. Data collection was done through a questionnaire consisting 31 questions categorized into three sections including demographics, CPR attitudes and CPR awareness. Results: Results revealed more female physical therapists (76%). Most of them (70%) were aged less than 35 years and had less than 15 years of working experience. Most of them were engaged in musculoskeletal practice (40.5%). Almost 31% participants had CPR certifications. Less than half of the physical therapists (38.9%) reported ≤ 25% success rate of CPR. Majority of the participants stated that their ability to perform CPR was satisfactory (44.4%). Conclusion: The overall awareness of physical therapists regarding CPR was evident, but the attitude regarding CPR need improvement. It was also evident from the results that mandatory professional training programs should be conducted.   Keywords: Attitude, Awareness, Cardiac Arrest, Cardiopulmonary Resuscitation (CPR), Physical Therapist

Thermo-economic and environmental analysis of integrating renewable energy sources in a district heating and cooling network

This paper presents the technical, environmental, and economic evaluation of integrating various combinations of renewable energy sources-based systems in the expansion of a district heating and cooling network of a Technology Park near Barcelona in Spain. At present, a combined heat and power plant running on fossil fuels serves the heating, cooling, and electricity demand of the Park. However, this energy demand is expected to increase substantially in the coming years. EnergyPRO software was used to model the energy demand growth till 2030. Validation of the software application was done by making a base model using real plant data from the year 2014. The software was then used to project the energy supply based on three 15-year scenarios, having different combinations of renewable energy technologies, from 2016 until 2030. Primary energy consumption, CO2 emissions, and the net present value obtained in each scenario were used to decide the best combinations of renewable energy sources. The results of the study showed that presently, biomass boilers combined with absorption chillers and supported with solar thermal cooling are the most competitive technologies in comparison to ground source heat pumps for large DHC networks. This is mainly because of the lower primary energy consumption (624,380 MWh/year in 2030 vs. 665,367 MWh/year), higher net present value (NPV) (222 million € vs. 178 million €), and lower CO2 emissions (107,753 tons/year in 2030 vs. 111,166 tons/year) obtained as a result of the simulations

Safety and Indications for Endoscopic Retrograde Cholangiopancreatography in Liver Transplant Patients: An Analysis of the United States’ National Inpatient Sample Database

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is performed to treat biliary complications after a liver transplantation; however, the previously available literature on the safety of ERCP in liver transplant patients is limited. We aimed to study the safety of ERCP in liver transplant patients. METHODS: We used a National Inpatient Sample database from 2016-2019 to identify patients who underwent ERCP and had a history of a liver transplantation, using the international classification of diseases, 10 RESULTS: Liver transplant patients who underwent ERCP had a higher rate of post-ERCP pancreatitis and bleeding compared to the general adult population (11.39% vs. 9.19%, 0.83% vs. 0.53%, respectively). However, the adjusted odds of post-ERCP pancreatitis (adjusted odds ratio [aOR] 1.13, 95% confidence interval [CI] 0.86-1.49; P=0.36) and bleeding (aOR 1.41, 95%CI 0.58-3.46; P=0.45) were similar in both the liver transplant and no-transplant groups. There was no difference in the odds of post-ERCP cholangitis (aOR 1.26, 95%CI 0.80-2.01; P=0.32), and sepsis (aOR 0.94, 95%CI 0.66-1.34; P=0.76) between liver transplant and no transplant groups. Biliary stricture was the most common indication for ERCP in the liver transplant group, whereas choledocholithiasis was the main reason for ERCP in the general adult population. CONCLUSIONS: ERCP is a safe procedure for treating biliary complications in liver transplant patients. The odds of post-ERCP complications (pancreatitis, bleeding, sepsis, cholangitis) in liver transplant patients are comparable to those in patients with no transplantation

Validated RP-HPLC method for the simultaneous determination of glucosamine sulphate and curcumin in cream formulation: A novel stability-indicating study

Purpose: To develop and validate a stability-indicating reverse phase-high performance liquid chromatography (RP-HPLC) method for the simultaneous determination of glucosamine sulphate (GS) and curcumin (Cur) in drug solution and formulation.Methods: The optimized chromatographic conditions were achieved by passing various compositions of mobile phases over  different reverse phase chromatographic columns. Various validation parameters, including linearity, range, limit of detection (LOD), limit of quantification (LOQ), accuracy, precision, specificity and system suitability were performed and evaluated. Stability studies under stressed conditions were done to evaluate the effects of acid, alkali, oxidation, heat and degradation by UV light.Results: The validated method was linear over the concentration range of 0.094 to 1.5 mg/mL for GS and 0.125 to 1.5 mg/mL for Cur, with a correlation coefficient > 0.999. The Intra and inter-day precision were 1.9 % for GS and 0.5 % for Cur, while accuracy was 96 and 102 % for GS and Cur, respectively. Stability studies showed that GS was highly sensitive to acid, alkali and oxidation and less sensitive to heat and UV. Cur was stable against acid, heat and oxidation but sensitive to alkali and UV.Conclusion: The developed and validated method was precise and accurate for both GS and Cur and can potentially be utilized for their identification and quantification at industrial, research and quality control laboratories