A Rare Presentation of Cardiac Aspergilloma in an Immunocompetent Host: Case Report and Literature Review

Cardiac aspergilloma is exceptionally rare with only a handful of cases reported and majority of them being in immunocompromised patients. Here, we present a case of cardiac aspergilloma involving the right and left ventricle in an immunocompetent patient that initially presented with acute limb ischemia. He was later found to have a cardiac mass with histopathological diagnosis confirming Aspergillus species. Despite aggressive medical and surgical interventions, the patient had an unfavorable outcome due to low suspicion of invasive fungal endocarditis given his immunocompetent status. Cardiac aspergilloma should remain in the differential diagnosis of immunocompetent patients as early clinical suspicion will result in early treatment and decreased mortality. Novel therapies are required to decrease mortality in the future from this fatal disease

MTHFR gene C677T and A1298C polymorphisms and homocysteine levels in primary open angle and primary closed angle glaucoma

Contains fulltext : 79920.pdf (publisher's version ) (Open Access)PURPOSE: To investigate the methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C genotypes and plasma concentrations of total homocysteine (tHcy) in Pakistani patients with primary open angle glaucoma (POAG) and primary closed angle glaucoma (PCAG). METHODS: This was a prospective case-control study. A total of 295 patients (173 POAG, 122 PCAG) and 143 age- and sex-matched controls were subdivided into two ethnic groups, Punjabis (Punjab province, central Pakistan) and Pathans (North-West Frontier Province, northern Pakistan). Genotypes of the MTHFR C677T and A1298C polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). An enzyme-linked immunosorbent assay was used to determine the total serum homocysteine (tHcy) levels. Associations were determined by logistic regression analysis. RESULTS: Frequency distributions of genotypes and combined genotypes as well as homocysteine levels were obtained. The overall distribution of the C677T genotype was found to be significantly associated with PCAG (CC 69%, CT 21%, TT 10%; p=0.001, chi(2)=12.6), but not with POAG (CC 71%, CT 28%, TT 1%; p=0.98, chi(2)=0.02) as compared to the controls (CC 71%, CT 29%, TT 1%). The Pathan cohorts revealed no association with the disease; however, the Punjabis demonstrated a significant association with PCAG (CC 75%, CT 11%, TT 13%; p<0.001, chi(2)=17.2). PCAG in the Punjabi subjects was also significantly associated with the A1298C polymorphism (AA 43%, AC 54%, CC 3%; p<0.001, chi(2)=33.9) as compared to the controls. Combined genotype data showed no association with POAG; however, a significant association with all combined genotypes was observed in the overall PCAG subjects (p<0.05, chi(2)=20.1). This difference was particularly apparent in the TTAA and TTAC combinations that were completely absent in the control groups (p<0.05. chi(2)=49.6). Mean serum tHcy levels were found to be significantly increased in the POAG (15.2+/-1.28 micromol/l, p<0.001) and PCAG (20.8+/-4.8 micromol/l) groups as compared to the controls (10.0+/-0.97 micromol/l). The tHcy levels in the TT and AC genotype were significantly elevated in the PCAG group (67+/-12.39 micromol/l, p<0.001; 23+/-5.94 micromol/l, p=0.027) as compared to the controls. CONCLUSION: The TT and AC genotypes of MTHFR C677T and A1298C polymorphisms and the combined genotype TTAC were associated with PCAG in Punjabi subjects of Pakistani origin and correlated with the high serum tHcy levels seen in these patients

The association of glutathione S-transferase GSTT1 and GSTM1 gene polymorphism with pseudoexfoliative glaucoma in a Pakistani population

Contains fulltext : 88996.pdf (publisher's version ) (Open Access)PURPOSE: The aim of the present study was to investigate the association of glutathione S-transferase GSTT1 and GSTM1 genotypes with pseudoexfoliative glaucoma (PEXG) in a group of Pakistani patients. METHODS: Multiplex polymerase chain reaction was used to study the GSTT1 and GSTM1 polymorphisms in 165 PEXG patients and 162 unaffected controls. RESULTS: In the current study we describe a significant gender-specific association of GSTT1 and GSTM1 null genotypes with PEXG. The three null genotype combinations (i.e., T1M0, T0M1, and T0M0) were found at significantly higher frequencies in the PEXG patients as compared to the controls (chi(2)=21.82, p0.05). CONCLUSIONS: The results suggest that there is a significant involvement of the GSTT1 and GSTM1 polymorphisms in female Pakistani patients having PEXG, which suggests a possible gender-specific impairment of detoxification in this group

Socio-Economic Determinants of Employment: A Case study of Pakistan

This research is the foremost determination to investigate the long and short run affiliation amongst the variables of employment. For this purpose we use ARDL bound tests. The data from the period of 1972 to 2016 has been used in this research. These results indicate that employment has statistically significant and positive relationship between the variables of employment. Orders of integration of variables used in this analysis are I (O) and I (1). The results of this study show that per capita of GDP and expenditures of government have significant positive relationship with the employment in both time periods, the short and long run. Thenoteworthyempirical relationship is found in long run between GFCF, while in short period of time it shows destructive relation with employment. While FDI shows a high level of significant and positive relation both in long run and short run. Secondary school enrolment has significant and positive relation with employment in both time periods the long and short run time period. The relationship of money supply with employment in long run is positive while in short run it shows significant but negative relation with employment. Trade and political stability both are the main factors to estimate the strength of an economy. According to this study trade and political stability shows significant and positive relation with employment in long run while in short run both shows negative relationship with employment

Association of tumor necrosis factor alpha gene polymorphism G-308A with pseudoexfoliative glaucoma in the Pakistani population

Contains fulltext : 80274.pdf (publisher's version ) (Open Access)PURPOSE: The purpose of the present study was to determine the role of the tumor necrosis factor alpha (TNF-alpha) gene polymorphism G-308A and total serum immunoglobulin E (TsIgE) levels in the onset of pseudoexfoliation glaucoma (PEXG) in Pakistani patients. METHODS: The TNF-alpha polymorphism G-308A was analyzed in 122 patients with PEXG and 126 healthy unrelated controls by using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). TsIgE levels were determined by solid-phase enzyme-linked immunosorbent assay (ELISA). RESULTS: The AA and GA genotypes were strongly associated with PEXG (p<0.001), with an odds ratio (OR) of 0.07 (95% confidence interval [CI]=0.02-0.27) and 0.24 (95% CI=0.12-0.51), respectively, while the GG genotype was found at a higher frequency in controls as compared to patients (p<0.001) OR=8.95 (95% CI=4.55-17.81). No significant difference was found in TsIgE levels of both patients and controls (p=0.86). CONCLUSION: The present study concludes that the TNF-alpha polymorphism G-308A is strongly associated with PEXG. To our knowledge this is the first study in southeast Asia which demonstrates a strong association of a TNF-alpha polymorphism with PEXG

Role of Lysyl oxidase-like 1 gene polymorphisms in Pakistani patients with pseudoexfoliative glaucoma

Contains fulltext : 109429.pdf (publisher's version ) (Open Access)PURPOSE: Single nucleotide polymorphisms (SNPs) rs1048661 (p.R141L) and rs3825942 (p.G153D) in the lysyl oxidase-like 1 (LOXL1) gene have been previously reported to be associated with pseudoexfoliation glaucoma (PEXG) in various Asian and European populations, but these SNPs have not yet been studied in the Pakistani population. Therefore the aim of the present study was to investigate the association of these two coding LOXL1 SNPs in Pakistani PEXG patients. METHODS: One hundred twenty-eight Pakistani patients diagnosed with PEXG and 180 healthy controls were recruited for the study. Genomic DNA was extracted and both SNPs were genotyped by direct sequencing. Association of genotype and allele frequencies with PEXG were analyzed using the Chi-square (chi(2)) test. RESULTS: Genotype and allele frequencies of both rs1048661 and rs3825942 were found to be significantly associated with PEXG. The GG genotypes of both LOXL1 SNPs were associated with an increased risk of developing PEXG. In addition the G alleles of rs1048661 and rs3825942 confer an increased risk for PEXG with an odds ratio (OR) of 2.98 (95% CI 1.94-4.57) and OR 6.83 (95% CI 2.94-16.67), respectively. CONCLUSIONS: A significant association was found for the G allele of rs1048661 and rs3825942 in PEXG patients of Pakistani origin

Histopathological Study of Subacute Toxic Effects of Chloroacetic Acid on Albino Rats and its Correlation with Serum Levels of Malondialdehyde

Human beings are increasingly being exposed to chloroacetic acid (CAA), a type of halo acetic acid. It would not be an exaggeration to say that almost the whole humankind today is affected by it or its metabolites. The concern over the carcinogenicity of haloacetic acids led the United States Environmental Protection Agency to regulate the allowable concentration of haloacetic acids in drinking water as part of the Disinfectants and Disinfection Byproducts Rule promulgated in 1998. Keeping this view in mind, the present study on histolopathological evaluation of different types of tissues viz., brain, kidney, liver, spleen and testes of Rattus norvegicus was performed, to find out the subacute toxicity of chloroacetic acid and correlation between CAA administration and changes in malondialdehyde (MDA) level in blood

Optimal learning paradigm and clustering for effective radio resource management in 5G HetNets

Ultra-dense heterogeneous networks (UDHN) based on small cells are a requisite part of the future cellular networks as they are proposed as one of the enabling technologies to handle coverage and capacity problems. But co-tier and cross-tier interferences in UDHN severely degrade the quality of service due to K-tiered architecture. Machine learning based radio resource management either through independent learning or cooperative learning is a proven efficient scheme for interference mitigation and quality of service provision in UDHN in a both distributive and cooperative manner. However, an optimal learning paradigm selection, i.e., either independent or cooperative learning and optimal cooperative cluster size in cooperative learning for efficient radio resource management in UDHN is still an open research problem. In this article, a Q-learning based radio resource management scheme is proposed and evaluated for both distributive and cooperative schemes using independent and cooperative learning. The proposed Q-learning solution follows the $\epsilon -$ greedy policy for optimal convergence. The simulation results for the UDHN in an urban setup show that in comparison to the independent learning paradigm, cooperative learning has no significant impact on macro cell user capacity. However, there is a significant improvement in small cell user capacity and the sum capacity of the cooperating small cells in the cluster. A significant increase of 48.57% and 37.9% is observed in the small cell user capacity, and sum capacity of the cooperating small cells, respectively, using cooperative learning as compared to independent learning which sets cooperative learning as an optimal learning strategy in UDHN. The improvement in small cell user capacity is at cost of increased computational time which is directly proportional to the number of cooperating small cells. To solve the issue of computational time in cooperative learning, an optimal clustering algorithm is proposed. The proposed optimal clustering reduced the computational time by four times in cooperative Q-learning

Neural Networks based Shunt Hybrid Active Power Filter for Harmonic Elimination

The growing use of nonlinear devices is introducing harmonics in the power system networks that results in distortion of current and voltage signals causing damage to the power distribution system. Therefore, in power systems, the elimination of harmonics is of great concern. This paper presents an efficient techno-economical approach to suppress harmonics and improve the power factor in the power distribution network using neural network algorithms-based Shunt Hybrid Active Power Filter (SHAPF), such as Artificial Neural Network (ANN), Adaptive Neuro-Fuzzy Inference System (ANFIS), and Recurrent Neural Network (RNN). The objective of the proposed algorithms for SHAPF is to reduce Total Harmonic Distortion (THD) within an acceptable range to improve system quality. In our filter design approach, we tested and compared conventional pq0 theory and neural networks to detect the harmonics present in the power system. Moreover, for the regulation of the DC supply to the inverter of the SHAPF, the conventional PI controller and neural networks-based controllers are used and compared. The applicability of the proposed filter is tested for three different nonlinear load cases. The simulation results show that the neural networks-based filter control techniques satisfy all international standards with minimum current THD, neutral wire current elimination, and small DC voltage fluctuations for voltage regulation current. Furthermore, all three neural network architectures are tested and compared based on accuracy and computational complexity, with RNN outperforming the rest