End stage renal disease: Seroprevalence of hepatitises B and C along with associated aetiology and risk factors in children

Background: End Stage Renal Disease (ESRD) normally requires dialysis or transplantation for survival. Since ESRD patients are on long term dialysis, infections such as Hepatitis B (HBV) and Hepatitis C (HCV) are commonly reported.Methods: This was a retrospective study carried out at a government hospital during a 12-month period from January 2013 to December 2013. The data was collected using a predesigned pro forma to note the etiology, gender, age, and HBsAg and anti-HCV test result of each patient.Results: 444 children suffering from ESRD were included in our analysis. The mean age of sample was 12.7 ± 4.1 years. Sixty percent (n = 262) of the children were boys. The most common etiology of ESRD was kidney stones (n = 44, 29.3%). HBV was positive in 11 children (2.5%) while HCV was positive in 13 (2.9%).Conclusion: This study asserts the need for carrying out further work to confirm these findings and expand our recommendations. It is imperative to reliably determine the burden of HBV and HCV disease and to determine the aetiology of their spread especially in children with ESRD

Outcome of perforator propeller flap for the coverage of soft tissue defects over middle and distal part of leg

Background: Plastic surgery is a constant battle between blood supply and beauty. The end result of a reconstructive procedure is primarily attributable to the stability of the vascular component, which is fundamental in that it ensures survival and proper functioning of tissues that have been transferred to the recipient site. The aim of the study was to evaluate the clinical outcome of perforator propeller flap for coverage of soft tissue defects in middle and distal legs. Methods: This was a prospective observational study and was conducted in the Department of Plastic Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh during the period from September 2018 to February 2020. The study population includes the total of 30 patients having soft tissue defects of the middle and distal thirds of leg necessary for flap coverage in the Department of Plastic Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh. Results: In total 30 patients maximum 11 (36.7%) were in 31-40 years age group. Majority 27 (90%) were male and 3 (10%) were female in our study. Out of 22 flaps in distal leg necrosis occurred in 4 (18.19%) and among 8 flaps in middle leg necrosis occurred in 1 (12.5%). Conclusions: This study observed that that perforator propeller flaps are ideal in reconstructing soft tissue defects of the middle and distal third of the leg, being safe, easy to perform, providing similar tissue in texture and thickness of damaged tissues, with low donor site morbidity

The prevalence of HBV infection in the cohort of IDPs of war against terrorism in Malakand Division of Northern Pakistan

<p>Abstract</p> <p>Background</p> <p>Hepatitis B is an important public health problem in the Pakistani population and is the major cause of chronic hepatitis, cirrhosis, fibrosis and hepatocellular carcinoma. High prevalence of HBV infections has been observed especially in areas of low economic status. In spite of effective immunization programs, no significant change has been observed in the epidemiology of HBV in the rural areas of Pakistan (~67.5% of the total population) mainly due to lack of interest from government authorities and poor hygienic measures. The current study was aimed at estimating the prevalence and risk factors associated with HBV infection within internally displaced persons (IDPs) due to war against terrorism in the Malakand Division of Northern Pakistan.</p> <p>Methods</p> <p>Blood samples from 950 IDPs suspected with HBV infection (including both males and females) were collected and processed with commercial ELISA kits for HBsAg, Anti HBs, HBeAg, Anti HBe antibodies. The samples positive by ELISA were confirmed for HBV DNA by real-time PCR analysis.</p> <p>Results</p> <p>The overall prevalence of HBV observed was 21.05% of which 78.5% were males and 21.5% were females. Most confirmed HBV patients belong to the Malakand and Dir (lower) district. High-risk of infection was found in the older subjects 29.13% (46-60 years), while a lower incidence (11.97%) was observed in children aged <15 years. Lack of awareness, socioecomic conditions, sexual activities and sharing of razor blades, syringes and tattooing needles were the most common risk factors of HBV infection observed during the cohort of patients.</p> <p>Conclusion</p> <p>The present study, revealed for the first time a high degree of prevalence of HBV infection in rural areas of Northern Pakistan. The noticed prevalence is gender- and age-dependent that might be due to their high exposures to the common risk factors. To avoid the transmission of HBV infection proper awareness about the possible risk factors and extension of immunization to the rural areas are recommended.</p

A clinical study of arrhythmias associated with acute coronary syndrome: a hospital based study of a high risk and previously undocumented population

Background: ACS represents a global epidemic. Arrhythmia in ACS is common. Careful investigation may lead to further improvement of prognosis. Retrospectively analyzed the year- round data of our center. Study was undertaken to analyze the incidence, frequency and type of arrhythmias in ACS. This is to aid timely intervention and to modify the outcome. Identification of the type of arrhythmia is of therapeutic and prognostic importance.Methods: This cross sectional analytical study was conducted in the Department of Cardiology, Apollo Hospitals Dhaka, from January 2019 to January 2020 with ACS patients. Enrolled consecutively and data analyzed.Results: There were 500 patients enrolled considering inclusion and exclusion criteria. Sample was subdivided into 3 groups on the type of ACS. Group-I with UA, Group-II with NSTE - ACS and Group-III with STE - ACS. Different types of arrhythmia noted. Types of arrhythmia were correlated with type of ACS. 500 patients included. Mean age 55.53±12.70, 71.6% male and 28.4% female. 60.4% hypertensive, 46.2% diabetic, 20.2% positive family history of CAD, 32.2% current smoker, 56.4% dyslipidaemic and 9.6% asthmatic. 31.2% UA, 39.2% NSTE-ACS and 29.6% STE-ACS. Type of arrhythmias noted. 22% sinus tachycardia, 20.2% sinus bradycardia, 9% atrial fibrillation, 5.2% ventricular ectopic, 4.8% supra ventricular ectopic, 2.8% bundle branch block, 2.2% atrio-ventricular block, 1% broad complex tachycardia, 0.4% narrow complex tachycardia, 0.2% sinus node dysfunction and 32.2% without any arrhythmia. Significant incidences of arrhythmia detected - respectively 29.8%, 39.2% and 31%, p<0.001.Conclusions: In conclusion, arrhythmias in ACS are common. More attention should be paid to improve their treatment and prognosis

Review of intelligence for additive and subtractive manufacturing: current status and future prospects

Additive manufacturing (AM), an enabler of Industry 4.0, recently opened limitless possibilities in various sectors covering personal, industrial, medical, aviation and even extra-terrestrial applications. Although significant research thrust is prevalent on this topic, a detailed review covering the impact, status, and prospects of artificial intelligence (AI) in the manufacturing sector has been ignored in the literature. Therefore, this review provides comprehensive information on smart mechanisms and systems emphasizing additive, subtractive and/or hybrid manufacturing processes in a collaborative, predictive, decisive, and intelligent environment. Relevant electronic databases were searched, and 248 articles were selected for qualitative synthesis. Our review suggests that significant improvements are required in connectivity, data sensing, and collection to enhance both subtractive and additive technologies, though the pervasive use of AI by machines and software helps to automate processes. An intelligent system is highly recommended in both conventional and non-conventional subtractive manufacturing (SM) methods to monitor and inspect the workpiece conditions for defect detection and to control the machining strategies in response to instantaneous output. Similarly, AM product quality can be improved through the online monitoring of melt pool and defect formation using suitable sensing devices followed by process control using machine learning (ML) algorithms. Challenges in implementing intelligent additive and subtractive manufacturing systems are also discussed in the article. The challenges comprise difficulty in self-optimizing CNC systems considering real-time material property and tool condition, defect detections by in-situ AM process monitoring, issues of overfitting and underfitting data in ML models and expensive and complicated set-ups in hybrid manufacturing processes

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Chemical composition and in vitro biological evaluation of essential oil of euphorbia larica boiss from Northern Oman

Euphorbia larica Boiss is a wild plant of Oman that grows in gravel plains, mountain areas, desert and forest edges. Traditionally, Omani herbalists use the Euphorbia larica plant extract, resins, latex and juice to treat a wide range of ailments such as wounds, burns, insect bites, intestinal parasites, gonorrhea, eye infections, migraines and warts. In an attempt to scientifically validate the traditional uses and to unlock its hidden therapeutic potential, in this work, the chemical composition of E. larica essential oil (ELEO) along with its potential antioxidant, antimicrobial and hemolytic activities is studied. In a GC-MS analysis of the extracted ELEO, 29 chemicals were found, with α- pinene (27.36%) and limonene (11.5%) being the two most abundant volatile components. ELEO exhibited moderate inhibition of DPPH radicals (17.74-40.96%; IC50 = 48.97 μg/mL). It showed antimicrobial activity against S. aureus, B. subtilis, S. pyogenes, E. coli, P. aeruginosa and P. vulgaris but was ineffective against K. pneumoniae bacterial strain however, exhibited the maximum antibacterial activity against S. aureus (11 ± 1.3 and 15 ± 2.3 mm at 5 and 10 μL concentrations, respectively) comparable to positive antibiotic ampicillin (15 mm at 5 μg). Moreover, ELEO exhibited a very low hemolytic activity (0.12 to 1.1% at doses of 50-500 μg) suggesting it to be non-toxic to human or animal cells. Thus, it can be concluded that E. larica plant holds significant potential as a source of bioactive agents for the development of novel therapeutics

Performance of hot-mix asphalt using polymer-modified bitumen and marble dust as a filler

Marble dust waste powder generated by the marble cutting industry has a high alkalinity. In this research, the use of marble dust (MD) as a mineral filler substitute in hot mixed asphalt (HMA) was evaluated. The Marshall mix design was used to determine the optimum bitumen content (OBC) for all of the mixtures. For each of the four MD contents, i.e., 0, 2%, 4%, and 6% by weight of the total aggregates, four different bitumen percentages were used. The results of the Marshall stability test showed that the optimum filler content was 4% MD. Samples were prepared with 0 MD in the control mix and varying percentages of MD as an alternate filler. In addition, MD aided in increasing the Marshall stability, rutting resistance, and permanent deformation and reduced the fatigue life of asphalt mixtures. As the percentage of MD increases, the rutting resistance and stiffness at high temperatures both increase. As the percentage of MD increases, the fatigue life reduces. Rut resistance in high-temperature conditions can be improved by using MD in HMA as a partial substitute for stone dust (SD). In areas where extensive MD waste is present, MD can be incorporated into HMA mixtures instead of conventional fillers

Impact of Exogenous Melatonin Application on Photosynthetic Machinery under Abiotic Stress Conditions

Inhospitable conditions that hinder plant growth and development encompass a range of abiotic stresses, such as drought, extreme temperatures (both low and high), salinity, exposure to heavy metals, and irradiation. The cumulative impact of these stresses leads to a considerable reduction in agricultural productivity worldwide. The generation of reactive oxygen species (ROS) is a shared mechanism of toxicity induced by all these abiotic stimuli in plants, resulting in oxidative damage and membrane instability. Extensive research has shed light on the dual role of melatonin in plants, where it serves as both a growth regulator, fostering growth and development, and a potent protector against abiotic stresses. The inherent potential of melatonin to function as a natural antioxidant positions it as a promising biostimulant for agricultural use, bolstering plants’ abilities to withstand a wide array of environmental challenges. Beyond its antioxidant properties, melatonin has demonstrated its capacity to regulate the expression of genes associated with the photosynthetic process. This additional characteristic enhances its appeal as a versatile chemical agent that can be exogenously applied to plants, particularly in adverse conditions, to improve their resilience and optimize photosynthetic efficiency in every phase of the plant life cycle. An examination of the molecular mechanisms underlying the stress-protective effects of exogenous melatonin on the photosynthetic machinery of plants under various abiotic stresses is presented in this paper. In addition, future prospects are discussed for developing stress-tolerant crops for sustainable agriculture in challenging environments