Major, Minor and Trace Elements Existence in Surface Sediments from Gwadar to Jiwani Coastal Areas of Pakistan

This study was carried out along the western coastal parts of Balochistan from Gwadar east Bay to Jiwani. The local anomaly of major, minor and trace elements were studied in this area. Zone-I (Gwadar east and west Bay) indicates that calcium oxide, potassium oxide and titanium dioxide have higher or average concentrations, while ZoneII indicates higher or average concentrations of calcium oxide, titanium dioxide and ferric oxide. Trace elements zirconium, chromium, europium, strontium, and copper are in higher or average concentrations in both zones. Gwadar west Bay and Jiwani are intermediate in carbonate, which show a high degree of maturity, suggesting the high rate of weathering in the source area. Sediment samples from Ganz, Jiwani, and Gwadar east Bay represent the quartz-rich fields in this region. Gwadar east Bay has a positive correlation between aluminium oxide and potassium oxide which suggests that abundance of potassium oxide is controlled by variation in K-feldspar contents. A positive correlation between strontium and calcium oxide suggests that strontium is associated with calcium oxide in biogenic carbonate material in Gwadar west Bay. The positive correlation between aluminium oxide, copper, and zinc in Pishukan indicates that the abundance of these elements is due to limited silt and clay fractions present in sediments. Enrichment factor shows that chromium and strontium are probably of anthropogenic origin in this region. Keyword

Magnetic resonance spectroscopy in focal brain lesions

OBJECTIVE: To describe the spectrum of Magnetic Resonance spectroscopy in focal brain lesions and determine its diagnostic accuracy using histopathology as gold standard in differentiating neoplastic and non-neoplastic focal brain lesions. METHODS: The study was conducted in Department of Radiology, Aga Khan University Hospital, Karachi from Dec 2006 till Jan 2009. Fifty three patients found to have focal brain lesions on magnetic resonance imaging (MRI) were included in the study. Magnetic Resonance spectroscopy (MRS) was performed in these focal lesions. These lesions were deemed neoplastic and non-neoplastic on MR Spectrum findings. Correlation of all these findings was done with histopathology obtained in all these patients. Sensitivity, specificity, positive, negative predictive values and diagnostic accuracy of MR Spectroscopy was calculated. Percentage agreement between spectroscopy and histopathology was also calculated using kappa statistics. RESULTS: Increase Choline/creatine and Choline/NAA ratio noted in neoplastic lesions compared to nonneoplastic lesion with significant p-value. MR Spectroscopy has a sensitivity of 93.02%, specificity of 70%, positive predictive value of 93.02%, negative predictive value of 70% and diagnostic accuracy of 88.67% in differentiating neoplastic and non-neoplastic brain lesions. Kappa statistics shows a good agreement between MR Spectroscopy and histopathology (k = 0.630). CONCLUSION: Magnetic Resonance spectroscopy (MRS) is non-invasive sensitive, however, relatively nonspecific modality in differentiating neoplastic and non-neoplastic brain lesions. This modality should be considered as an adjunct to conventional imaging rather than replacement for histopathological evaluation

Role of multidetector computed tomography (MDCT) in patients with ovarian masses

Objective:To evaluate the diagnostic accuracy of multidetector 64-slice computed tomography (MDCT) in the diagnosis and differentiation of benign and malignant ovarian masses using histopathology and surgical findings as the gold standard. Material And Methods: This study was conducted in Aga Khan University Hospital, Karachi, Pakistan. Data was reviewed retrospectively from 1 November 2008 to 12 December 2009. One hundred Patients found to have ovarian masses on CT scan were included in the study. CT scan was performed in all these Patients after administration of oral and IV contrast. Ovarian masses were classified as benign and malignant on scan findings. Imaging findings were compared with histopathologic results and surgical findings. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of MDCT were calculated. Results: MDCT was found to have 97% sensitivity, 91% specificity, and an accuracy of 96% in the differentiation of benign and malignant ovarian masses, while PPV and NPV were 97% and 91%, respectively. Conclusion: MDCT imaging offers a safe, accurate and noninvasive modality to differentiate between benign and malignant ovarian masses

Band Ligation VersusGlue Injection for Bleeding Gastric Varices

Background : To compare endoscopic variceal sclerotherapy with N-butyl-2-cyanoacrylate- Histoacryl (EVS) and endoscopic variceal band ligation (EBL) for treatment of bleeding gastric varices (GV).Methods: In this  randomized control trial 140 patients  with bleeding gastric varices were included.Bleeding GV patients diagnosed endoscoically were treated with EVS or EBL in two equal groups after randomization. Bleeding control or otherwise was confirmed during the procedure. Patients were followed for 1 month for re-bleeding. Comparison of the patients undergoing EVS or EBL was done in terms of bleeding control and re-bleeding during follow up period. Chi2 test was used to seek statistically significant association in this regard. Results: Endoscopic bleeding control was confirmed in all except 1 of EBL patients who expired. 4 (5.7%) of EVS 10 (14.28%) EBL patients had re-bleeding (P >0.05).Conclusion: EVS and EBL are comparative procedures for treatment ofbleeding GV for control of active bleeding and re-bleeding over one month follow up

Accuracy of magnetic resonance imaging in pretreatment lymph node assessment for gynecological malignancies

Objective: To determine the accuracy of magnetic resonance imaging (MRI) in detection of metastasis in pelvic and para-aortic lymph nodes from different gynecological malignancies.MATERIALS AND Methods: This retrospective cross sectional analytic study was conducted at the Department of Diagnostic Radiology, Aga Khan University Hospital Karachi Pakistan from January 2011 to December 2012. A sample of 48 women, age range between 20-79 years, fulfilling inclusion criteria were included. All patients had histopathologically proven gynecological malignancies in the cervix, endometrium or ovary and presented for a pretreatment MRI to our radiology department.Results: MRI was 100% sensitive and had a 100% positive predictive value to detect lymph node metastasis in lymph nodes with spiculated margins and 100% sensitive with a 75% positive predictive value to detect lymph node metastasis in a lymph node with lobulated margins. The sensitivity and positive predictive value of MRI to detect heterogeneous nodal enhancement were 100% and 75% respectively.CONCLUSIONS: Our study results reinforce that MRI should be used as a modality of choice in the pretreatment assessment of lymph nodes in proven gynaecological malignancies in order to determine the line of patient management, distinguishing surgical from non-surgical cases

Triphasic computed tomography (CT) scan in focal tumoral liver lesions

OBJECTIVE: To assess the diagnostic accuracy of triphasic spiral CT in differentiating benign from malignant focal tumoral liver lesions. METHODS: The study was conducted in Department of Radiology of Aga Khan University Hospital and Sind Institute of Urology and Transplantation, Karachi from Feb 2006 to Feb 2007. By convenient sampling, 45 patients found to have focal tumoral liver lesions were recruited for one year period and their triphasic CT scans findings were evaluated and later correlated with histopathology. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of triphasic CT scan were calculated. RESULTS: Among 45 patients, 136 liver lesions (11 benign and 125 malignant) were detected with the help of different enhancement patterns. Out of these, 37(82.2%) patients had malignant while 8 (17.8%) had benign lesions. On later histopathological examination, 35 (77.8%) of the total 45 cases had malignant lesions while 10 (22.2%) were diagnosed as benign lesions. Based on these results, it could be assessed that triphasic CT Scan has a sensitivity of 100%, specificity of 80%, positive predictive value of 94.5%, negative predictive value of 100% and diagnostic accuracy of 95.5% in differentiating benign from malignant liver lesions. CONCLUSION: Triphasic CT Scan is a good non-invasive tool in characterizing and differentiating benign from malignant liver lesions

Trauma epidemiology after easing of lockdown restrictions: experience from a level-one major trauma centre in England.

PURPOSE: The COVID-19 pandemic transformed the delivery of trauma care. We examined the effect of lockdown easing on trauma presentation and management from one Major Trauma Centre (MTC). METHODS: Data was retrospectively analysed from Trauma Audit and Research Network (TARN) on patients presenting to our MTC with trauma. The first 47 days of lockdown (23rd March-9th May 2020, period 1) were compared with the next 47 (10th May-26th June 2020, period 2) and last (27th June-13th August 2020, period 3). Data collected included demographics, mechanism and severity of injury, management and length of stay. RESULTS: 1249 patients were included; 62.2% were male with a mean age of 57.73. Footfall declined in April 2020 compared with 2019 (56 vs. 143) but rebounded by May (123 vs. 120 patients). Road traffic collisions increased over periods one-three (18.8% vs. 23% vs. 30.1%, p = 0.038); deliberate self-harm (DSH) increased in period two compared with one and three (6.3% vs. 3.4% vs. 1.4%, p = 0.03), respectively. When compared with 2019, the 2020 patient age was lower, with less trauma relating to alcohol (7.3% vs. 13.2%, p = 0.009), but more from DSH (3.6% vs. 2.1%, p = 0.10). In 2020 less patients were assessed by a consultant and trauma team, with a shorter stay in hospital and critical care. CONCLUSION: This is the first study to document trauma trends through a lockdown and thereafter. After lockdown easing, trauma footfall rapidly rebounded to 2019 levels. This should be acknowledged in resource allocation decisions if future lockdowns are necessitated

Transcriptome Analysis Reveals Vimentin-Induced Disruption of Cell–Cell Associations Augments Breast Cancer Cell Migration

In advanced metastatic cancers with reduced patient survival and poor prognosis, expression of vimentin, a type III intermediate filament protein is frequently observed. Vimentin appears to suppress epithelial characteristics and augments cell migration but the molecular basis for these changes is not well understood. Here, we have ectopically expressed vimentin in MCF-7 and investigated its genomic and functional implications. Vimentin changed the cell shape by decreasing major axis, major axis angle and increased cell migration, without affecting proliferation. Vimentin downregulated major keratin genes KRT8, KRT18 and KRT19. Transcriptome-coupled GO and KEGG analyses revealed that vimentin-affected genes were linked to either cell–cell/cell-ECM or cell cycle/proliferation specific pathways. Using shRNA mediated knockdown of vimentin in two cell types; MCF-7FV (ectopically expressing) and MDA-MB-231 (endogenously expressing), we identified a vimentin-specific signature consisting of 13 protein encoding genes (CDH5, AXL, PTPRM, TGFBI, CDH10, NES, E2F1, FOXM1, CDC45, FSD1, BCL2, KIF26A and WISP2) and two long non-coding RNAs, LINC00052 and C15ORF9-AS1. CDH5, an endothelial cadherin, which mediates cell–cell junctions, was the most downregulated protein encoding gene. Interestingly, downregulation of CDH5 by shRNA significantly increased cell migration confirming our RNA-Seq data. Furthermore, presence of vimentin altered the lamin expression in MCF-7. Collectively, we demonstrate, for the first time, that vimentin in breast cancer cells could change nuclear architecture by affecting lamin expression, which downregulates genes maintaining cell–cell junctions resulting in increased cell migration

Natural Treatment Systems as Sustainable Ecotechnologies for the Developing Countries

The purpose of natural treatment systems is the re-establishment of disturbed ecosystems and their sustainability for benefits to human and nature. The working of natural treatment systems on ecological principles and their sustainability in terms of low cost, low energy consumption, and low mechanical technology is highly desirable. The current review presents pros and cons of the natural treatment systems, their performance, and recent developments to use them in the treatment of various types of wastewaters. Fast population growth and economic pressure in some developing countries compel the implementation of principles of natural treatment to protect natural environment. The employment of these principles for waste treatment not only helps in environmental cleanup but also conserves biological communities. The systems particularly suit developing countries of the world. We reviewed information on constructed wetlands, vermicomposting, role of mangroves, land treatment systems, soil-aquifer treatment, and finally aquatic systems for waste treatment. Economic cost and energy requirements to operate various kinds of natural treatment systems were also reviewed