Gastrointestinal Stromal Tumor: A Rare Abdominal Tumor

Gastrointestinal stromal tumors (GISTs) are rare abdominal tumors which arise from the interstitial cells of Cajal in the gastrointestinal tract. Gastric GISTs are the most commonly seen GIST tumors and may grow to a very large size. They are often associated with abdominal pain, anorexia and weight loss. Most of them can be detected by CT. These tumors have been found to harbor mutations in CD117 which causes constitutional activation of the tyrosine kinase signaling pathway and is considered to be pathognomic. Tyrosine kinase inhibitors such as imatinib have revolutionized the treatment of these tumors, which are otherwise resistant to conventional chemotherapy and radiotherapy. Although surgical resection is the mainstay of treatment, tyrosine kinase inhibitors have been useful in prolonging the recurrence-free survival of these patients. Resistance to imatinib has been reported in GISTs with specific mutations. We present a case of gastric GIST which grew to a very large size and was associated with abdominal pain and weight loss. It was successfully resected and the patient was commenced on imatinib therapy

Extracavitary Manifestation of Primary Effusion Lymphoma as a Right Atrial Mass

Primary effusion lymphoma (PEL) is a subset of large B cell lymphomas and has been mostly associated with human immunodeficiency virus infection. Rare cases have been reported in organ transplant recipients and chronic hepatitis C patients. It typically presents as an effusion in the pleural and pericardial spaces but rarely disseminates. However, involvement of the gastrointestinal tract, lymph nodes and bone marrow has been reported. Diagnosis is based on characteristic clinical, histopathological and immunohistochemical features. We present a case with a right atrial mass which tested positive for human herpes virus 8 (HHV-8), CD20, CD30 and lambda light chains and negative for CD138, kappa light chain, PAX5, Epstein-Barr virus, latent membrane protein 1, CD2, CD3, CD8 and CD56. Bilateral pleural effusions and pericardial effusions were noted which tested positive for HHV-8, CD30 and CD45. The patient responded well to the R-EPOCH regimen with complete resolution of the effusions and a significant decrease in the size of the right atrial mass. This case report illustrates the atypical manifestation of PEL as a right atrial mass

Uterine Leiomyosarcoma Manifesting as a Tricuspid Valve Mass

Uterine leiomyosarcoma is a rare malignancy and carries a poorer prognosis when compared to endometrial carcinoma. It has been observed to metastasize to all the major organs. It presents with symptoms of abdominal distension, vaginal bleeding and may pass unnoticed until an advanced stage in patients with leiomyomas. Surgery is a viable option in patients with disease limited to the uterus, but metastasis to the heart may require surgery to prevent acute and catastrophic complications. The case described here involves metastasis to the tricuspid valve, which caused severe tricuspid regurgitation in the setting of acute pulmonary embolism. Surgical resection restored cardiac function and stabilized the patient. This case illustrates a rare site of metastasis of leiomyosarcoma which required immediate intervention and resulted in a favorable outcome

Histomorphometric Effcets of Oral use of Tobacco in Testes of Offsprings of Swiss Albino Mice

Objective: To study the gross micro structural changes in the testis of the offspring of Swiss albino mice exposed to oral use of tobacco during pregnancy. Study Design: Experimental Duration and Setting of Study: This study was conducted from July 2017 to December 2017 at Isra University Hyderabad  Methodology: ­­20 female albino mice were mated. After confirmation of pregnancy by vaginal plug they were divided into two groups; experimental A and control B of 10 each. Experimental mice of group A were given 5% tobacco in their chow diet and0water ad libitum; however, control group B were given only normal chow0diet and0water0ad libitum. After 15 days of birth the 10 male offsprings each of control and experimental mice were randomly selected. Their initial and final body weight was recorded.  They were sacrificed0by cervical dislocations and0their testes were taken away for further gross & histological0analysis.  Results: Noticeable changes were observed in the body weight and weight of testes. The mean initial weight of experimental male offspring was found to be 1.76 ± 0.33 g, while in control group it was 2.60± 0.45 g. The final weight in experimental offspring was 9.38± 0.59 g and in control group it was 12.75±0.96 g.  Statistically the difference of body weight in offspring was found to be significant (p value <0.05). The testes weight was markedly decreased in experimental group as compared to control group.  The mean testes weight in experiment group was recorded as 0.03 ± 0.004 g however in control group it was recorded as   0.07 ± 0.004 g. Simultaneously, 5 micro structural variations were also observed in the testes of off-springs of mice. In0the0experimental group0of off-springs, very few0layers and decreased number of spermatocytes were noticed in seminiferous tubules of 9 testes.  Sperm degenerative changes, cellular inflammation and mild to massive hyalinization were noticed in 9, 6, and 9 testes of experimental group respectively. Loss of architecture of seminiferous tubules in 8 testes as well as destruction of the basement membrane in 7 testes were also observed in experiment group testes. However, the decreased number of spermatocytes in only 1 testes and mild hyalinization in 2 testes of control group were observed. Conclusion: The consumption of smokeless tobacco has vital effects on the body weight, micro structure  and weight of testes of offsprings of mice given with cellular injury of seminiferous tubules especially decreased sperm count, cellular inflammation, destruction of basement membrane as well as massive hyalinization. &nbsp

Removal of Congo Red from Aqueous Solution by Anion Exchange Membrane (EBTAC): Adsorption Kinetics and Themodynamics

The adsorption behavior of anionic dye congo red (CR) from aqueous solutions using an anion exchange membrane (EBTAC) has been investigated at room temperature. The effect of several factors including contact time, membrane dosage, ionic strength and temperature were studied. Kinetic models, namely pseudo-first-order and pseudo-second-order, liquid film diffusion and Elovich models as well as Bangham and modified freundlich Equations, were employed to evaluate the experimental results. Parameters such as adsorption capacities, rate constant and related correlation coefficients for every model were calculated and discussed. The adsorption of CR on anion exchange membranes followed pseudo-second-order Kinetics. Thermodynamic parameters, namely changes in Gibbs free energy (ΔG°), enthalpy (ΔH°) and entropy (ΔS°) were calculated for the adsorption of congo red, indicating an exothermic proces

BPPO-Based Anion Exchange Membranes for Acid Recovery via Diffusion Dialysis

To reduce the environmental impact of acids present in various industrial wastes, improved and robust anion exchange membranes (AEMs) are highly desired. Moreover, they should exhibit high retention of salts, fast acid permeation and they should be able to operate with low energy input. In this work, AEMs are prepared using a facile solution-casting from brominated poly-(2,6-dimethyl-1,4-phenylene oxide) (BPPO) and increasing amounts of 2-phenylimidazole (PI). Neither quaternary ammonium salts, nor ionic liquids and silica-containing compounds are involved in the synthesis. The prepared membranes showed an ion exchange capacity of 1.1–1.8 mmol/g, a water uptake of 22%–47%, a linear expansion ratio of 1%–6% and a tensile strength of 0.83–10.20 MPa. These membranes have potential for recovering waste acid via diffusion dialysis, as the acid dialysis coefficient (UH) at room temperature for HCl is in the range of 0.006–0.018 m/h while the separation factor (S) is in the range of 16–28, which are higher than commercial DF-120B membranes (UH = 0.004 m/h, S = 24)

خود انعکاسیت اور فرانز کافکا

Franz Kafka’s voice is one of the most powerful and unique voices in twentieth-century literature because of his works of philosophical ambiguity and self-reflexivity. “The Judgment”, “The Metamorphosis” and “Amerika” are Kafka’s stories in which his personal life is reflected, and they reveal his body and soul. These stories deal with the complex relationship between father and son. The father’s role represents traditional patriarchal authority, while son’s role represents acceptance and sacrifice. Sons are fighting against the fear and hatred of their fathers for the survival of their existence, and they pay for their knowing and unknowing sins by giving their lives. Kafka wanted to be like his father since his childhood and wanted to fulfill all his father’s expectations, but his father’s behavior made him a victim of fear, hatred. Despite his strong desire, he could not build his life on natural lines. Contempt, the pain of rejection, mistrust, impotence, feelings of inadequacy and the resulting anxiety and uncertainty influenced Kafka’s major life decisions. His personality could not attain the strength, needed to fight the external battle of life, instead he had to struggle with “childish strength” throughout his life. In addition to his works, his diaries and letters also reveals the complex relationships between father and son

Tracing the causality between Livestock and poverty alleviation in the rural economy of Gilgit Baltistan-Pakistan

Livestock rearing and its production are deemed as a lucrative economic activity which provides livelihood and sustainable growth to rural population of Gilgit Baltistan . This sector not only delivers variety of food and non-food products but also contributes in income generation and subsequently diminishes the rural poverty. The fundamental aim of this research endeavor was to assess the poverty status and its determinants for livestock growers of the study area. The primary data was gleaned from 100 respondents through interview schedule following systematic sampling procedure. Uni-dimensional poverty estimates for sampled respondents employing Foster, Greer, and Thorbecke (FGT) poverty index are incorporated as dependent variable to model the binary probability expressions through Logit. Out of Explanatory variables used in model, benefit from the livestock, age, form size and gender of household head, showed a significant but negative relationship with poverty status whereas, household size and education of household head had a insignificant influence on poverty. This study recommends, that increase in farm size and youth’s participation in livestock farming can elevate the household income. The capacity building of the livestock farmers through trainings and more women contribution in livestock sector should be encouraged to reduce poverty in the area which can play a remarkable role in sustainable economic growth

Tracing the causality between Livestock and poverty alleviation in the rural economy of Gilgit Baltistan-Pakistan

Livestock rearing and its production are deemed as a lucrative economic activity which provides livelihood and sustainable growth to rural population of Gilgit Baltistan . This sector not only delivers variety of food and non-food products but also contributes in income generation and subsequently diminishes the rural poverty. The fundamental aim of this research endeavor was to assess the poverty status and its determinants for livestock growers of the study area. The primary data was gleaned from 100 respondents through interview schedule following systematic sampling procedure. Uni-dimensional poverty estimates for sampled respondents employing Foster, Greer, and Thorbecke (FGT) poverty index are incorporated as dependent variable to model the binary probability expressions through Logit. Out of Explanatory variables used in model, benefit from the livestock, age, form size and gender of household head, showed a significant but negative relationship with poverty status whereas, household size and education of household head had a insignificant influence on poverty. This study recommends, that increase in farm size and youth’s participation in livestock farming can elevate the household income. The capacity building of the livestock farmers through trainings and more women contribution in livestock sector should be encouraged to reduce poverty in the area which can play a remarkable role in sustainable economic growth

Conservative management of nivolumab-induced pericardial effusion: a case report and review of literature

Abstract Background Nivolumab is an immune checkpoint inhibitor targeting programmed death-1 protein and has been approved for the treatment of multiple advanced malignancies. Adverse effects of immune checkpoint inhibitors are distinct from conventional cytotoxic chemotherapy and can be life-threatening if left unrecognized. Here, we present a case of nivolumab-induced pericardial effusion successfully managed with high-dose corticosteroids. Case presentation A 70-year-old Caucasian female with a history of 50-pack-year cigarette smoking was diagnosed of recurrent adenocarcinoma of lung after initial surgery. She progressed through multiple lines of chemotherapy and was eventually started on nivolumab. She developed a large pericardial effusion, grade 3 by Common Terminology Criteria for Adverse Events v4.0, about 4 days after receiving first nivolumab treatment. She was treated with oral prednisone at 1 mg/kg daily with gradual resolution of pericardial effusion over 5 weeks while she still received nivolumab every 2 weeks. Prednisone treatment was eventually tapered off about 10 weeks from initial nivolumab treatment. However 1 week after stopping prednisone, she again presented with shortness of breath and bilateral ankle edema, imaging confirmed recurrent pericardial effusion measuring 2.8 cm. Nivolumab was stopped and patient was again started back on prednisone 1 mg/kg daily which resulted in complete resolution of pericardial effusion in 3 weeks. Nivolumab was resumed 1 week afterwards while patient was on tapering dose of prednisone. There was no recurrent pericardial effusion when she continued low-dose prednisone during the remaining course of nivolumab treatment. Conclusions With increasing use of immune checkpoint inhibitors, clinicians need to be aware of the unusual immune-related adverse events in order to provide timely management and effective patient care. To our knowledge, this is the first reported case of immune-related pericardial effusion from nivolumab successfully managed with high-dose corticosteroids. Furthermore, recurrent pericardial effusion was prevented by using low-dose corticosteroids as maintenance in order for patient to continue nivolumab treatment