A Rare Case of Rectal Metastasis from Sarcomatoid Variant of Urothelial Carcinoma: A Case Report

Introduction: Urothelial carcinoma of the bladder with sarcomatoid differentiation is known to display aggressive biological behaviour. To our knowledge, this is the first reported case of isolated rectal metastasis from sarcomatoid urothelial carcinoma of the bladder following curative surgery.Presentation of Case: A 72-year-old male presented with tenesmus 6 months after radical cystoprostatectomy, lymph node dissection and ileal conduit formation for pathological T1N0M0 bladder carcinoma.Digital rectal examination revealed thickening of the distal rectum with no bleeding. Computerised tomography demonstrated thickening in the rectal mucosa and submucosa with intact perirectal fat. Rectal biopsy performed via colonoscopy confirmed metastases of urothelial carcinoma origin. The patient was treated with palliative radiation.Conclusion: This case report illustrates an unusual location of urothelial carcinoma metastasis. A high clinical suspicion in patients with this aggressive variant of cancer is required

Biopharmaceutics and pharmacokinetics of [D-ala2, D-leu5]enkephalin after various routes of administration

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31917/1/0000870.pd

Disturbance gradient and mosquito diversity pattern in areas surrounding Chini Lake - the second largest freshwater lake in Peninsular Malaysia

Malaysia is a tropical country that has consistently been facing a prevalent threat of mosquito-borne diseases. Amongst the plethora of diseases, the most common mosquito borne disease in the country is dengue fever, transmitted by Aedes spp. mosquitoes. This study aims to examine the effects of human activity associated with different land use on mosquito population composition and diversity. Our study site is Chini Lake, a naturally occurring lake and the second-largest freshwater body in Malaysia. The areas surrounding the Lake have been subjected to various human activities, such as economic development and conversion into rubber plantations, while some areas remain pristine, making Chini Lake an ideal location to examine the gradient of human disturbances on mosquito composition and diversity. We sampled adult mosquitoes and larvae across a range of sites with different levels of human disturbance. As expected, in areas with high disturbance scores, the species richness of adult and larval mosquitoes were reduced while the abundance was higher. The results also revealed minimal overlap between species captured for adult and larval samplings, suggesting that land-use changes affect both life stages differently. Different resource requirements of adult and larval mosquitoes likely led to the observed diversity pattern in this small survey. We suggest future work to look into how habitat heterogeneity affects both life stages and sexes of mosquito diversity patterns and distribution

Microwave-assisted pyrolysis with chemical activation, an innovative method to convert orange peel into activated carbon with improved properties as dye adsorbent

Microwave-assisted pyrolysis with chemical activation was developed and optimized to transform orange peel into activated carbon (AC) desirable for use as a dye adsorbent. The orange peel was first carbonized via microwave-assisted pyrolysis to produce a biochar, which was then activated and converted into AC via chemical impregnation coupled with microwave-assisted pyrolysis. The process parameters involved was optimized to maximize the yield of AC and its adsorption efficiency on malachite green dye using response surface methodology adopting central composite design. The use of microwave-assisted pyrolysis provided a fast heating rate and short process time in converting orange peel into AC, recording a heating rate of up to 112 °C/min in a process taking about 25 min, representing a method that is potentially faster and more energy efficient compared to that shown by the method commonly performed using conventional heating source (≥1 h). The results showed that AC with the highest yield (87 wt% of biochar) and optimal adsorption efficiency (28.5 mg of dye/g of AC) can be obtained by performing chemical impregnation at an impregnation ratio of 1:1 coupled with microwave-assisted pyrolysis under microwave irradiation (heating) for 5 min using 550 W of microwave power. The addition of chemical activation with alkali metal hydroxides resulted in the production of AC with improved properties. The AC showed a highly porous structure containing high content of fixed carbon (83 wt%) and high BET surface area (1350 m 2 /g). The adsorption–desorption isotherm showed a combination of Type I and Type II isotherms, which indicates the presence of microporous-mesoporous structure, thus exhibiting a characteristic of improved pores accessibility and high adsorption capacity. Combined with the detection of low ash (3.2 wt%) and moisture content (5 wt%), the AC shows great promise as a high-grade dye adsorbent with high adsorption capacity and potentially increased durability since a low moisture content could increase the rate of adsorption of dye contaminants and a high ash content could promote undesirable catalytic reactions and reduce the adsorption capacity and reactivation efficiency of AC. The recovery of AC with improved properties and the desirable process features (fast heating rate, short process time) suggest the great potential of this method as an alternative for the treatment and recovery of fruit peel

Limited Effect of Ground Floor Fogging on Mosquito Distribution in High-Rise Condominia

Fogging with insecticides is one of the main control measures for adult mosquito populations employed in countries that are affected by dengue. In many such countries, urban communities are increasingly characterised by high-density residence in high-rise condominia. Although fogging is typically applied at the ground level, its efficacy in three-dimensional urban environments is poorly understood. Here, we investigated the effect of fogging on vector mosquito distribution and abundance in high-rise condominia by conducting a before-after fogging survey. We showed that although mosquitoes were significantly concentrated at the lower levels in high-rise condominia, they were found throughout the three-dimensional environments. Fogging did not significantly alter this distribution or abundance pattern across any floor level. Thus, any fogging effect was short-lived as mosquito populations recovered within a few days before the subsequent scheduled treatment. In addition, increasing fogging frequency within practicable limits did not prolong the intended control effect. As urban mosquitoes are increasingly insusceptible to fogging due to insecticide resistance and vertical avoidance, this study demonstrates the need to implement other mosquito control strategies for high-rise condominia to manage mosquito populations

Production of value-added liquid fuel via microwave co-pyrolysis of used frying oil and plastic waste

The production of household wastes such as used frying oil (UFO) and plastic waste (PW) are increasing each year, thus representing potential feedstocks for conversion into an energy source. Microwave co-pyrolysis was investigated for its potential to transform a mixture of UFO and polyolefinic-based plastic waste into fuel product with desirable properties. The co-pyrolysis approach demonstrated positive synergistic effects in providing fast heating rate (up to 50 °C/min) and a lower reaction time (≤25 min), and generated up to 81 wt.% yield of liquid oil and 18 wt.% yield of pyrolysis gases for use as potential fuels. The liquid oil showed promising green properties comprising low oxygen content, free of nitrogen and sulphur and higher energy content (42–46 MJ/kg). The oil product also demonstrated improved stability and desirable fuel properties nearly similar to transport-grade diesel, thus indicating the great potential of microwave co-pyrolysis as an approach for transforming household wastes into value-added liquid fuel

Antibiotics prescribing practices in oral implantology among jordanian dentists. A cross sectional, observational study

<p>Abstract</p> <p>Background</p> <p>In oral implantology, there is no consensus on the most appropriate regimen for antibiotics prescribing, the decision to prescribe antibiotic is usually based on procedure, patient and clinician related factors. The aim of this study was to investigate the rationale of antibiotic prescribing among Jordanian clinicians who practice oral implantology.</p> <p>Findings</p> <p>The target sample for the study was the 250 Jordan Dental Implant Group members. A five page questionnaire contained 41 questions, both closed and open questions were used to collect data. Statistical analysis was performed using SPSS Windows 16.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics were generated.</p> <p>The response rate was (70.4%) 176/250. Mean age was 37.2 yrs, 49.4% always prescribe antibiotics mainly oral amoxicillin and amoxicillin with clavulinic acid. Antibiotics prescribing increased with flap raising, multiple implants and sinus or bone augmentation. Patient medical condition, periodontitis and oral hygiene were the most important clinical factors in antibiotic prescribing, non-clinical factors were; reading scientific materials, courses and lectures, knowledge gained during training, and the effectiveness and previous experience with the drug.</p> <p>Conclusions</p> <p>Wide variations in antibiotics types, routes, dose and duration of administration were found. Recommendations on antibiotic prescribing are needed to prevent antibiotic overprescribing and misuse.</p

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P &lt; 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P &lt; 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Design of Malaysian fishing vessel for minimum resistance

Due to the economic and operational reasons, there is a need to reduce resistance of fishing boats. One of the ways to reduce resistance is to modify the boat hull form to reduce its drag in water. However, designers normally have problems in choosing which hull form parameter to change, in which direction, and the degree of changes required. This paper describes a methodology of incorporating resistance optimization in the design of fishing boats. By producing easily understood design charts, the designer is guided in making his choice. An example of application of this method on the design of a Malaysian fishing boat is given. It is shown that by using this method, the hull can be modified without changing the principal dimensions and displacement and this slight modification of the hull form can produce up to 12% saving in fuel consumption