Clinical Study Prognostic Factors in Tuberculosis Related Mortalities in Hospitalized Patients

Setting. The study was undertaken at the Department of Pulmonology at a public, tertiary care centre in Karachi, Pakistan. Objectives. To evaluate factors concerned with in-hospital deaths in patients admitted with pulmonary tuberculosis (TB). Design. A retrospective case-control audit was performed for 120 patients hospitalised with pulmonary TB. Sixty of those discharged after treatment were compared to sixty who did not survive. Radiological findings, clinical indicators, and laboratory values were compared between the two groups to identify factors related to poor prognosis. Results. Factors concerned with in-hospital mortality listed late presentation of disease ( < 0.01), noncompliance to antituberculosis therapy ( < 0.01), smoking ( < 0.01), longer duration of illness prior to treatment ( < 0.01), and low body weight ( < 0.01). Most deaths occurred during the first week of admission ( < 0.01) indicating late referrals as significant. Immunocompromised status and multi-drug resistance were not implicated in higher mortality. Conclusions. Poor prognosis was associated with noncompliance to therapy resulting in longer duration of illness, late patient referrals to care centres, and development of complications. Early diagnosis, timely referrals, and monitored compliance may help reduce mortality. Adherence to a more radically effective treatment regimen is required to eliminate TB early during disease onset

Chat GPT and its potential role in medicine

Dear Editor, Since the dawn of the technological revolution, natural language processing (NLP) has been an interesting prospect for different professions. Chat GPT, a system developed by open artificial intelligence (AI), is the latest innovation that generates text in a human-like language format. It is considered to have learned the entire internet, enabling it to create responses containing almost accurate information in answer to the prompt provided by the user1. In this letter, we would like to discuss some key areas where chat GPT can play its role in medicine. Cancer is a global healthcare crisis where a vast amount of money is annually spent, search of cure and drug development. Improvements in cancer therapeutics have increased life expectancy, which has resulted in patients requiring extended support and monitoring thereby increasing the load of healthcare professionals. In this scenario, chat GPT based chatbots which are automated artificial intelligence tools that can serve as an intermediate element between doctors and patients. They can facilitate history taking, especially of sensitive and intimate details that patients might be shy of talking about. On the other hand, these chatbots could help in decreasing costs and burdens related to healthcare resources. It can also reduce the workload of doctors by reducing the number of minor consultations which can be done by the artificially intelligent chatbot and allow the resources to be directed towards more sicker patients who might need more attention and care2. The pandemic has made the world realize the importance of remote diagnostic systems, which are not only fast, reliable, and pocket friendly but have also increased access of healthcare to disadvantaged populations. NLP systems make use of linguistics analysis and deep learning to obtain vital information from a patient prompt detailing symptom, their onset, and demographic details (3). Chat GPT works via language processing can be linked to a text messaging system where the patient can provide their details and it would suggest possible diagnoses and recommend if the patient should visit a doctor or the symptoms would go away with home remedy/over-the-counter medications. This would be possible by training the algorithm on a larger set of medical data and human surveillance to improve efficacy over a period of time. This potentially would decrease the burden of primary care providers and benefit a larger population. ---Continu

Prognostic Factors in Tuberculosis Related Mortalities in Hospitalized Patients

Setting. The study was undertaken at the Department of Pulmonology at a public, tertiary care centre in Karachi, Pakistan. Objectives. To evaluate factors concerned with in-hospital deaths in patients admitted with pulmonary tuberculosis (TB). Design. A retrospective case-control audit was performed for 120 patients hospitalised with pulmonary TB. Sixty of those discharged after treatment were compared to sixty who did not survive. Radiological findings, clinical indicators, and laboratory values were compared between the two groups to identify factors related to poor prognosis. Results. Factors concerned with in-hospital mortality listed late presentation of disease (P<0.01), noncompliance to antituberculosis therapy (P<0.01), smoking (P<0.01), longer duration of illness prior to treatment (P<0.01), and low body weight (P<0.01). Most deaths occurred during the first week of admission (P<0.01) indicating late referrals as significant. Immunocompromised status and multi-drug resistance were not implicated in higher mortality. Conclusions. Poor prognosis was associated with noncompliance to therapy resulting in longer duration of illness, late patient referrals to care centres, and development of complications. Early diagnosis, timely referrals, and monitored compliance may help reduce mortality. Adherence to a more radically effective treatment regimen is required to eliminate TB early during disease onset

A Comparative Assessment of Nanotoxicity Induced by Metal (Silver, Nickel) and Metal Oxide (Cobalt, Chromium) Nanoparticles in <i>Labeo rohita</i>

In the present in vivo study, we provide a comparison of toxicological consequences induced by four different types of spherical nanoparticles (NPs)&#8212;silver nanoparticles (AgNPs, 40 &#177; 6 nm), nickel (NiNPs, 43 &#177; 6 nm), cobalt oxide (Co3O4NPs, 60 &#177; 6 nm), and chromium oxide (Cr3O4NPs, 50 &#177; 5 nm)&#8212;on freshwater fish Labeo rohita. Fish were exposed to NPs (25 mg/L) for 21 days. We observed a NPs type-dependent toxicity in fish. An altered behavior showing signs of stress and a substantial reduction in total leukocyte count was noticed in all NP-treated groups. A low total erythrocyte count in all NP-treated fish except for Co3O4NPs was discerned while a low survival rate in the case of Cr3O4NP-treated fish was observed. A significant decrease in growth and hemoglobin were noticed in NiNP- and Cr3O4NP-treated fish. A considerable total protein elevation was detected in NiNP-, Co3O4NP-, and Cr3O4NP-treated groups. An upgrading in albumin level was witnessed in Co3O4NP- and Cr3O4NP-treated groups while a high level of globulin was noted in NiNP- and Co3O4NP-exposed groups. In all NP-treated groups, a depleted activity of antioxidative enzymes and pathological lesions in liver and kidney were noticed

Structural, optical and thermoelectric properties of (Al and Zn) doped Co9S8-NPs synthesized via co-precipitation method

In the previous decade nanostructure materials have emerged as the necessary ingredient in electronic application and enhancement of device performance. Cobalt sulfide is one such transition metal sulfide which has provoked a lot of interest in the field of research. The present study was related to pure, (Al and Zn) doped cobalt sulfide NPs have been fabricated using facile co-precipitation method. The cubic structure has conformed to XRD analysis and crystallite size of pure and doped Co9S8 NPs in the range of 11 to 29 nm and with W-H method varies from 29 to 51 nm. The SEM micrograph shows that the agglomeration of the particles in the form of clusters. To conform the vibrational modes of (Al and Zn) doped Co9S8-NPs was done with Raman spectroscopy analysis. The absorbance of prepared materials was investigated with UV–VIS and it was also observed that the band gap decreased from 3.6 to 1.94 eV with doping agents. In case of IV analysis shows that the resistivity decreased and conductivity increased of Al and Zn doped Co9S8 NPs. Furthermore, the sharp increase in potential difference at lower temperature indicates that the doped material is an excellent thermoelectric material for energy storage devices

Clinico-Etiological and Clinico-Haematological Study of Patients with Pancytopenia in Rural Area

Pancytopenia is a manifestation of other underlying conditions, commonly associated with multiple benign and malignant conditions. Any patient presenting with pancytopenia requires a thorough evaluation to identify the underlying aetiology

Structural communication fingerprinting and dynamic investigation of RBD-hACE2 complex from BA.1 × AY.4 recombinant variant (Deltacron) of SARS-CoV-2 to decipher the structural basis for enhanced transmission

The BA.1 × AY.4 recombinant variant (Deltacron) continues to inflict chaos globally due to its rapid transmission and infectivity. To decipher the mechanism of pathogenesis by the BA.1 × AY.4 recombinant variant (Deltacron), a protein coupling, protein structural graphs (PSG), residue communication and all atoms simulation protocols were used. We observed that the bonding network is altered by this variant; engaging new residues that helps to robustly bind. HADDOCK docking score for the wild type has been previously reported to be -111.8 ± 1.5 kcal/mol while the docking score for the Deltacron variant was calculated to be -128.3 ± 2.5 kcal/mol. The protein structural graphs revealed variations in the hub residues, number of nodes, inter and intra residues communities, and path communication perturbation caused by the acquired mutations in the Deltacron-RBD thus alter the binding approach and infectivity. Moreover, the dynamic behaviour reported a highly flexible structure with enhanced residues flexibility particularly by the loops required for interaction with ACE2. It was observed that these mutations have altered the secondary structure of the RBD mostly transited to the loops thus acquired higher flexible dynamics than the native structure during the simulation. The total binding free energy for each of these complexes, that is, WT-RBD and Deltacron-RBD were reported to be -61.38 kcal/mol and -70.47 kcal/mol. Protein's motion revealed a high trace value in the Deltacron variant that clearly depict more structural flexibility. The broad range of phase space covered by the Deltacron variant along PC1 and PC2 suggests that these mutations are important in contributing conformational heterogeneity or flexibility that consequently help the variant to bind more efficiently than the wild type. The current study provides a basis for structure-based drug designing against SARS-CoV-2.Communicated by Ramaswamy H. Sarma