Ultrasound based evaluation of hepatic steatosis and fibrosis in hepatitis C non-responders

Objective: To determine the accuracy of ultrasound in the diagnosis and grading of steatosis and fibrosis in Hepatitis C (HCV) patients not responding to ribavarin-interferon therapy.Study design: A cross-sectional, analytical study.Place and duration of study: Radiology Department, Civil Hospital, Karachi, from March 2008 to August 2010.Methodology: Patients with positive HCV RNA despite 24 weeks ribavarin-interferon therapy (non-responders) were subjected to ultrasound and biopsy prior to institution of pegylated interferon therapy for detection and grading of steatosis and fibrosis. Using histopathology as the gold standard, sensitivity, specificity, negative and positive predictive values for ultrasound were determined.Results: The sensitivity of ultrasound for hepatic steatosis was 90.9% for no steatosis (NS), 100% for moderate and gross steatosis and 84.4% for mild steatosis with 100% specificity. The sensitivity for fibrosis was 25% for no fibrosis, 100% for mild fibrosis, 89.74% for moderate fibrosis and 100% for gross fibrosis. The overall accuracy for detection of steatosis was 95.39% and that for fibrosis was 98.02%. Hepatic vein showed increased dampening of flow with advancing grades of steatosis and fibrosis.Conclusion: Ultrasound has a high accuracy in the diagnosis and grading of steatosis and fibrosis in HCV nonresponders. Mild fibrosis may confound the diagnosis of mild steatosis

Storage stability of clarified banana juice fortified with inulin and oligofructose.

Clarified banana juice fortified with inulin and oligofructose were stored for 8 weeks at 4, 25 and 35C. Changes in physicochemical characteristics (pH, total soluble solids [TSS], titratable acidity, sucrose, reducing sugars and turbidity), microbial count and sensory quality were determined. No differences were observed for pH and titratable acidity for all the stored juice samples. However, increase in turbidity was observed in all the juice samples, whereas juice samples stored at 35C recorded highest increases. Increase in reducing sugars (glucose and fructose) was also observed during storage, particularly at 25 and 35C. TSS values were observed fluctuating for all the samples. No microbial growth was recorded for all the juice samples stored at three different temperatures. Sensory results for taste, flavor and odor revealed no difference until the seventh week of storage; however, the overall acceptability of the juice stored at 4C was rated highest as compared with juice samples stored at 25 and 35C. Overall, the quality of juice stored at 4C was rated highest not only for all the sensory characteristics but also less turbidity problem compared with juices stored at 25 and 35C

Risk Factors and the Incidence of Diabetes Insipidus after Pituitary Surgery

Background:  To improve patient care, determining the post-surgery risk factors for diabetes insipidus are extremely significant. We demonstrated the pre-operative factors and postoperative incidence of diabetes insipidus in pituitary surgery. Materials and Methods:  Patients of both genders with ages between 18-65 years having pituitary adenoma amenable to surgery were included. The sample size mainly constitutes macroadenomas and giant adenomas i.e., greater than 1 cm and equal to or greater than 4 cm, respectively. The Hosmer-Lemeshow test was used to measure model fit. The receiver operator characteristic curve was used to evaluate the model and variables such as preoperative serum sodium and urine specific gravity. Results:  Only 210 of 279 patients met the selection criteria. Most of the patients have lesions greater than 1cm, as a result of which a greater number of patients had undergone transcranial approach. Out of these patients, 27% have developed diabetes insipidus. The mean age was 53 years in the non-DI group, whereas, 47 years was the mean age in the patients with DI. 25% of females and 31% of males developed diabetes insipidus. 75% of females and 64% of males did not develop DI. The highest percentage (61%) of patients who developed DI came from giant adenomas.  Conclusion:  Giant adenomas, aggressively primarily treated adenomas, and those lesions that were approached transcranially, showed an increased risk of diabetes insipidus and those who have undergone redo surgery have reduced incidence of diabetes insipidus

Comparison of One vs. Two Burr Hole Craniostomy in Chronic Subdural Hematoma Recurrence

Introduction/Objective:  Chronic subdural hematoma (CSDH) is most frequent neurosurgical conditions. To find the recurrence rate of chronic subdural hematoma in patients who underwent one vs. two burr craniostomy. Material And Methods:  A randomized controlled trial was conducted at the Neurosurgery department, Ayub Teaching Hospital, Abbottabad. In the current study, a total of 76 (38 in each group) patients were observed. ASA-I, ASA-II, ASA III patients, symptomatic radiologically proven Chronic subdural hematoma. Patients were randomly allocated into two groups of 38 patients each. randomization with blocks. Group A was treated with intraoperative epidural methylprednisolone while Group B was treated with normal saline only. Clinical information was recorded on a pre-designed proforma. Results:  Mean age was 54 years in group A, and 56 years in group B. In group A, 74% were male and 26% of patients were female. In Group B, 76% were male and 24% were female. The group A, 5% of patients had recurrence while in Group B, 13% of patients had a recurrence. There existed a significant difference between effectiveness and not-effectiveness of one/two burr hole craniostomy among patients who were less than 40 years. Conclusion:  The recurrence rate of chronic subdural hematoma is higher in patients undergoing two burr hole craniostomy as compared to one burr craniostomy

Luminal Diameters of Major Coronary Arteries

Abstract Background: To measure the luminal diameters o

Identification of Catalytic Active Sites for Durable Proton Exchange Membrane Fuel Cell: Catalytic Degradation and Poisoning Perspectives

Recent progress in synthetic strategies, analysis techniques, and computational modeling assist researchers to develop more active catalysts including metallic clusters to single-atom active sites (SACs). Metal coordinated N-doped carbons (M-N-C) are the most auspicious, with a large number of atomic sites, markedly performing for a series of electrochemical reactions. This perspective sums up the latest innovative and computational comprehension, while giving credit to earlier/pioneering work in carbonaceous assembly materials towards robust electrocatalytic activity for proton exchange membrane fuel cells via inclusive performance assessment of the oxygen reduction reaction (ORR). M-Nx-Cy are exclusively defined active sites for ORR, so there is a unique possibility to intellectually design the relatively new catalysts with much improved activity, selectivity, and durability. Moreover, some SACs structures provide better performance in fuel cells testing with long-term durability. The efforts to understand the connection in SACs based M-Nx-Cy moieties and how these relate to catalytic ORR performance are also conveyed. Owing to comprehensive practical application in the field, this study has covered very encouraging aspects to the current durability status of M-N-C based catalysts for fuel cells followed by degradation mechanisms such as macro-, microdegradation, catalytic poisoning, and future challenges

Enhancing cryptocurrency price forecasting accuracy: a feature selection and weighting approach with bi-directional LSTM and trend-preserving model bias correction

A cryptocurrency is a digitized, encrypted, and decentralized virtual currency, which is impossible to counterfeit or double-spend. It is one of the very popular investment instruments and traded in blockchain based crypto exchanges on ever growing volume. It is quite volatile due to imbalance of supply and demand, government regulations, investor sentiment and above all media hype. Cryptocurrency price forecasting is an active area of research and several approaches have been proposed recently. This study proposed a price forecasting model based on three vital characteristics (i) a feature selection and weighting approach based on Mean Decrease Impurity(MDI) features. (ii) Bi-directional LSTM and (iii) with a trend preserving model bias correction (CUSUM control charts for monitoring the model performance over time) to forecast Bitcoin and Ethereum values for long and short term spans. The data for both currencies were analyzed in three different intervals: (i) April 01, 2013 to April 01, 2016 (ii) April 01, 2013 to April 01, 2017 and (iii) April 01, 2013 to December 31, 2019. Extensive series of experiments were performed and evaluated on Root Mean Square Errors (RMSE). For bitcoin forecasting, the model achieved RMSE values 3.499 for interval 1, 5.070 for interval 2 and 6.642 for interval 3. Similarly, for Ethereum RSME of 0.094, 0.332, 3.027 are obtained for the three intervals respectively, On a new test-set collected from January 01, 2020 to January 01, 2022 for the two cryptocurrencies we obtained an average RSME of 9.17, with model bias correction, Comparing with the prevalent forecasting models we report a new state of the art in cryptocurrency forecasting

Evaluation of transmission potential and pathobiological characteristics of mallard originated Avian orthoavulavirus 1 (sub-genotype VII.2) in commercial broilers

Newcastle disease (ND), caused by Avian orthoavulavirus 1 (AOAV-1), affects multiple avian species around the globe. Frequent disease outbreaks are not uncommon even in vaccinates despite routine vaccination and, in this regards, viruses of diverse genotypes originating from natural reservoirs (migratory waterfowls) play an important role in a disease endemic setting. Though genomic characterization of waterfowl originated viruses has been well-elucidated previously, there is a paucity of data on clinico-pathological assessment of mallard-originated sub-genotype VII.2 in commercial chickens. Hence, the current study was designed to evaluate its transmission potential, tissue tropism and micro- and macroscopic lesions in commercial broilers. Based on complete genome and complete F gene, phylogenetic analysis clustered the study isolate within genotype VII and sub-genotype VII.2 in close association with those reported previously from multiple avian species worldwide. The study strain was found to be velogenic on the basis of typical residue pattern in the F-protein cleavage site (112R-RQ-K-R↓F117), sever disease induction in chicken, tissue tropism and subsequent clinico-pathological characteristics. Giving a clear evidence of horizontal transmission, a 100% mortality was observed by 4th and 6th day post infection (dpi) in chickens challenged with the virus and those kept with the challenged birds (contact birds), respectively. The observed clinical signs, particularly the greenish diarrhea, and macroscopic lesions such as pinpoint hemorrhages in proventriculus and caecal tonsils were typical of the infection caused by an AOAV-1 in chickens. The virus exhibited a broad tissue tropism where genomic RNA corresponding to study virus was detected in all of the tissues collected from recently mortile and necropsied birds. The study concludes that mallard-originated Avian orthoavulavirus 1 is highly velogenic to commercial chicken and therefore ascertain continuous disease monitoring and surveillance of migratory/aquatic fowls to better elucidate infection epidemiology and subsequent potential impacts on commercial poultry