Surgical Outcome of Anterior Skull Base Approach for Combined ENT and Neurosurgical Lesions

Objective:  To determine surgical outcome of Anterior Skull Base approach for combined ENT   and Neurosurgical Lesions. Material and Methods:  This descriptive study was conducted at the departments of ENT, Head, Neck Surgery and Neurosurgery Postgraduate Medical Institute (PGMI) Lady Reading Hospital Peshawar from March 2003 to Feb. 2008, with a total duration of five years. All these patients were admitted in ENT department. These patients were evaluated in terms of detailed history, thorough examination and radiological investigations. Incisional biopsy of the nasal mass was taken in cases where angiofibroma was excluded clinically, and then proper approach for excision of the lesion was planned. A well informed consent was taken from patient explaining the procedure, its risks, benefits and associated complications. The intracranial lesion was completely excised by neurosurgeons with help of microscope while the extracranial portion of the lesion was excised by ENT surgeon .The specimen of the lesions was examined by Histopathologist. Results:  This study included 23 patients in the age range of 12-51 years, mean age 25 years. Eighteen patients were male and five were female with female to male ratio of 1:3.6. These patients presented mainly with complaints of nasal obstruction, epistaxis and headache. CT scans were performed in all 23 cases (100%) while MRI in 5 cases (21.73%). These patients presented with advanced disease on radiological findings and they were treated by combined approach by Neurosurgeons and Otorhinolaryngologists. On histopathology of the specimen angiofibroma was on top. Two patients were subjected to radiotherapy postoperatively. There was no mortality and no recurrence of the disease. Conclusion:  The anterior skull base approach has good surgical outcome in terms of complete clearance of the disease and minimum morbidity for combined neurosurgical and ENT lesions irrespective of the nature of the lesion

Surgical Outcome of Anterior Skull Base Approach for Combined ENT and Neurosurgical Lesions

Objective: To determine surgical outcome of Anterior Skull Base approach for combined ENT and Neurosurgical Lesions.Material and Methods: This descriptive study was conducted at the departments of ENT, Head, Neck Surgery and Neurosurgery Postgraduate Medical Institute (PGMI) Lady Reading Hospital Peshawar from March 2003 to Feb. 2008, with a total duration of five years. All these patients were admitted in ENT department. These patients were evaluated in terms of detailed history, thorough examination and radiological investigations. Incisional biopsy of the nasal mass was taken in cases where angiofibroma was excluded clinically, and then proper approach for excision of the lesion was planned. A well informed consent was taken from patient explaining the procedure, its risks, benefits and associated complications. The intracranial lesion was completely excised by neurosurgeons with help of microscope while the extracranial portion of the lesion was excised by ENT surgeon. The specimen of the lesions was examined by Histopathologist.Results: This study included 23 patients in the age range of 12 – 51 years, mean age 25 years. Eighteen patients were male and five were female with female to male ratio of 1:3.6. These patients presented mainly with comp-laints of nasal obstruction, epistaxis and headache. CT scans were performed in all 23 cases (100%) while MRI in 5 cases (21.73%). These patients presented with advanced disease on radiological findings and they were treated by combined approach by Neurosurgeons and Otorhinolaryngologists. On histopathology of the specimen angiofibroma was on top. Two patients were subjected to radiotherapy postoperatively. There was no mortality and no recurrence of the disease.Conclusion: The anterior skull base approach has good surgical outcome in terms of complete clearance of the disease and minimum morbidity for combined neurosurgical and ENT lesions irrespective of the nature of the lesion

Protein tyrosine phosphatase 1B inhibitors isolated from Artemisia roxburghiana

Artemisia roxburghiana is used in traditional medicine for treating various diseases including diabetes. The present study was designed to evaluate the antidiabetic potential of active constituents by using protein tyrosine phosphatase 1B (PTP1B) as a validated target for management of diabetes. Various compounds were isolated as active principles from the crude methanolic extract of aerial parts of A. roxburghiana. All compounds were screened for PTP1B inhibitory activity. Molecular docking simulations were performed to investigate the mechanism behind PTP1B inhibition of the isolated compound and positive control, ursolic acid. Betulinic acid, betulin and taraxeryl acetate were the active PTP1B principles with IC50 values 3.49 ± 0.02, 4.17 ± 0.03 and 87.52 ± 0.03 µM, respectively. Molecular docking studies showed significant molecular interactions of the triterpene inhibitors with Gly220, Cys215, Gly218 and Asp48 inside the active site of PTP1B. The antidiabetic activity of A. roxburghiana could be attributed due to PTP1B inhibition by its triterpene constituents, betulin, betulinic acid and taraxeryl acetate. Computational insights of this study revealed that the C-3 and C-17 positions of the compounds needs extensive optimization for the development of new lead compounds

Disposition of youth in predicting sustainable development goals using the Neuro - fuzzy and random forest algorithms

This paper evaluates the inclination of Asian youth regarding the achievement of Sustainable Development Goals (SDGs). As the young population of a country holds the key to its future development, the authors of this study aim to provide evidence of the successful application of machine learning techniques to highlight their opinions about a sustainable future. This study’s timing is critical due to rapid developments in technology which are highlighting gaps between policy and the actual aspirations of citizens. Several studies indicate the superior predictive capabilities of neuro-fuzzy techniques. At the same time, Random Forest is gaining popularity as an advanced prediction and classification tool. This study aims to build on the previous research and compare the predictive accuracy of the adaptive neuro-fuzzy inference system (ANFIS) and Random Forest models for three categories of SGDs. The study also aims to explore possible differences of opinion regarding the importance of these categories among Asian and Serbian youth. The data used in this study were collected from 425 youth respondents in India. The results of data analysis show that ANFIS is better at predicting SDGs than the Random Forest model. The SDG preference among Asian and Serbian youth was found to be highest for the environmental pillar, followed by the social and economic pillars. This paper makes both a theoretical and a practical contribution to deepening understanding of the predictive power of the two models and to devising policies for attaining the SDGs by 2030

Machine Learning-Enabled Multimodal Fusion of Intra-Atrial and Body Surface Signals in Prediction of Atrial Fibrillation Ablation Outcomes

Background: Machine learning is a promising approach to personalize atrial fibrillation management strategies for patients after catheter ablation. Prior atrial fibrillation ablation outcome prediction studies applied classical machine learning methods to hand-crafted clinical scores, and none have leveraged intracardiac electrograms or 12-lead surface electrocardiograms for outcome prediction. We hypothesized that (1) machine learning models trained on electrograms or electrocardiogram (ECG) signals can perform better at predicting patient outcomes after atrial fibrillation ablation than existing clinical scores and (2) multimodal fusion of electrogram, ECG, and clinical features can further improve the prediction of patient outcomes

A genome-wide association study in Europeans and South Asians identifies five new loci for coronary artery disease

n/

Genome-wide association identifies nine common variants associated with fasting proinsulin levels and provides new insights into the pathophysiology of type 2 diabetes.

OBJECTIVE: Proinsulin is a precursor of mature insulin and C-peptide. Higher circulating proinsulin levels are associated with impaired β-cell function, raised glucose levels, insulin resistance, and type 2 diabetes (T2D). Studies of the insulin processing pathway could provide new insights about T2D pathophysiology. RESEARCH DESIGN AND METHODS: We have conducted a meta-analysis of genome-wide association tests of ∼2.5 million genotyped or imputed single nucleotide polymorphisms (SNPs) and fasting proinsulin levels in 10,701 nondiabetic adults of European ancestry, with follow-up of 23 loci in up to 16,378 individuals, using additive genetic models adjusted for age, sex, fasting insulin, and study-specific covariates. RESULTS: Nine SNPs at eight loci were associated with proinsulin levels (P < 5 × 10(-8)). Two loci (LARP6 and SGSM2) have not been previously related to metabolic traits, one (MADD) has been associated with fasting glucose, one (PCSK1) has been implicated in obesity, and four (TCF7L2, SLC30A8, VPS13C/C2CD4A/B, and ARAP1, formerly CENTD2) increase T2D risk. The proinsulin-raising allele of ARAP1 was associated with a lower fasting glucose (P = 1.7 × 10(-4)), improved β-cell function (P = 1.1 × 10(-5)), and lower risk of T2D (odds ratio 0.88; P = 7.8 × 10(-6)). Notably, PCSK1 encodes the protein prohormone convertase 1/3, the first enzyme in the insulin processing pathway. A genotype score composed of the nine proinsulin-raising alleles was not associated with coronary disease in two large case-control datasets. CONCLUSIONS: We have identified nine genetic variants associated with fasting proinsulin. Our findings illuminate the biology underlying glucose homeostasis and T2D development in humans and argue against a direct role of proinsulin in coronary artery disease pathogenesis