COMPARISON OF ARGON PLASMA COAGULATION AND FORMALIN INSTILLATION IN THE TREATMENT OF RADIATION INDUCED HAEMORRHAGIC PROCTOCOLITIS

Background: Radiotherapy is routinely used in the treatment of pelvic malignancies and about 2–5% of these patients develop radiation-induced proctitis or proctocolitis. This complication of radiotherapy is treated in different ways. Two of these treatments, argon plasma coagulation (APC) and formalin instillation, have both been reported as to be successful modalities, but data comparing them are scarce. We conducted this study to compare these two treatment options. Methods: We reviewed the charts of patients who had radiation-induced proctocolitis and who were treated endoscopically at our tertiary care cancer centre with either APC or formalin instillation. Outcomes of the two treatments were compared in terms of bleeding control after the first session of treatment, the number of sessions required and the nal response to therapy. Results: Out of a total of 26 patients presenting with haemorrhagic radiation proctocolitis, 11 were treated with APC and 15 with formalin instillation. Success after the rst session was 53% in the formalin instillation group compared to 18% in the APC-treated group. On repeated sessions, the final response to both treatment modalities was comparable. Conclusion: Efficacy of APC and formalin instillation in the treatment of haemorrhagic radiation proctocolitis is comparable although formalin showed a better outcome after the first session. Key words: Argon plasma coagulation, formalin instillation, proctitis, radiation-induced colitis

The Spectrum of Oesophagal Varices, Portal Hypertensive Gastropathy and Child Pugh’s Class in Cirrhotic Patients at Tertiary CareHospital

Objective: To find the association of Child-Pugh’s Class with oesophagal varices and portal hypertensive gastropathy in cirrhotic patients at CMH Lahore. Study Design: Cross sectional study Place and Duration of Study: Department of Gastroenterology and Department of Pathology, Combined Military Hospital Lahore Pakistan, from Feb to May 2021. Methodology: All patients with cirrhosis of the liver, irrespective of aetiology, who underwent upper gastrointestinal endoscopy, were included in the study. Lab data was retrieved from the Pathology Department to calculate Child Pugh’s score. Endoscopic findings of oesophagal varices and portal gastropathy were recorded and their correlation/association with Child-Pugh’s Class was calculated separately by using Pearson’s coefficient. Results: A total of 148 patients were included in the study. Male patients were 90(60.8%) and female were 58(39.2%). The age range was 27-85 years, with the mean of patients being 55.93±13.19 years. Association of Child Pugh’s Class with oesophagal varices and portal hypertensive gastropathy revealed that higher grades of oesophagal varices (Grade-lll) and severe portal hypertensive gastropathy were found in Child Pugh’s Class-B (13.51%, 14.18%) and C (15.54%, 16.2%) as compared to Class- A (4.72 %, 1.35%). Child-Pugh’s Class positively correlates with both oesophagal varices and portal hypertensive gastropathy by Pearson’s coefficient r=0.594 and 0.035, respectively; both have significant p values (p <0.05). Conclusion: Child-Pugh’s Class has a positive correlation with both oesophagal varices and portal hypertensive gastropathy in patients with cirrhosi

Clinical Characteristics, Racial Inequities, and Outcomes in Patients with Breast Cancer and COVID-19: A COVID-19 and Cancer Consortium (CCC19) Cohort Study

BACKGROUND: Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations. METHODS: This is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity. RESULTS: 1383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32-1.67]); Black patients (aOR 1.74; 95 CI 1.24-2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70-6.79) and Other (aOR 2.97; 95 CI 1.71-5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 [95% CI, 4.83-12.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63-3.15])/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20-2.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66-3.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89-22.6]). Hispanic ethnicity, timing, and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status. CONCLUSIONS: Using one of the largest registries on cancer and COVID-19, we identified patient and BC-related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to non-Hispanic White patients. FUNDING: This study was partly supported by National Cancer Institute grant number P30 CA068485 to Tianyi Sun, Sanjay Mishra, Benjamin French, Jeremy L Warner; P30-CA046592 to Christopher R Friese; P30 CA023100 for Rana R McKay; P30-CA054174 for Pankil K Shah and Dimpy P Shah; KL2 TR002646 for Pankil Shah and the American Cancer Society and Hope Foundation for Cancer Research (MRSG-16-152-01-CCE) and P30-CA054174 for Dimpy P Shah. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH). The funding sources had no role in the writing of the manuscript or the decision to submit it for publication. CLINICAL TRIAL NUMBER: CCC19 registry is registered on ClinicalTrials.gov, NCT04354701

Knowledge, Awareness, and Attitudes of Pakistani Population towards Second Wave of COVID-19 - A Questionnaire Based Survery

Background and Objective:&nbsp;&nbsp;COVID-19 hit 2020 as one of the worst pandemics which happens over 100 years. Although people across the globe did not respond effectively to the pandemic yet Pakistani population responded to this pandemic with a different mindset as it was difficult for them to accept the infectious nature, spread, and associatedrestrictions. This study was designed to determine the awareness and attitudes of the Pakistani population towards the second wave of COVID-19 pandemic regarding reservation to quarantineand trust in healthcare system. Methods:&nbsp;&nbsp;The study was carried out from November-December 2020 during the second wave of COVID-19. The data was collected through a self-administered online questionnaire and included subjects from all provinces across Pakistan. Responses about awareness, attitudes, and trust in health care were recorded. The social stigma associated with COVID-19 was also recorded through this questionnaire. Data was entered in SPSS-20 and results were interpreted accordingly. Results:&nbsp;Of all the participants,&nbsp;70-80% of individuals knew about the disease and its spread, 48.8% of participants knew about the severity and prognosis of the disease, only 45-46% of patients were comfortable in getting themselves or their families tested if advised and reporting to healthcare about COVID-19. Out of all participants, 57.9% people admitted that there was a stigma associated with COVID-19 diagnosis, 37.8% believed that lack of testing and reporting was associated with this stigma, 46.6% individuals believed in rumors of false COVID-19 diagnosis and wrong treatment in Pakistani hospitals, 46.9% showed that they did not trust healthcare for patient management,65.9% attributed hiding disease to mistrust in healthcare and 57.5% participants did not want to be quarantined in government centers, if needed. Conclusion:&nbsp;Knowledge of COVID-19 among people in Pakistan was nearly sufficient, their attitudes were mainly positive, while their practices needed approach that is more satisfactory. There exists a gap in the trust in government policies and local health care system. Pakistani people need more education to beat the stigma associated with COVID-19 to ensure early reporting and prompt treatment for these types of infectious diseases in the future.</p

Identification and Validation of Pathogenic Genes in Sepsis and Associated Diseases by Integrated Bioinformatics Approach

Sepsis is a clinical syndrome with high mortality and morbidity rates. In sepsis, the abrupt release of cytokines by the innate immune system may cause multiorgan failure, leading to septic shock and associated complications. In the presence of a number of systemic disorders, such as sepsis, infections, diabetes, and systemic lupus erythematosus (SLE), cardiorenal syndrome (CRS) type 5 is defined by concomitant cardiac and renal dysfunctions Thus, our study suggests that certain mRNAs and unexplored pathways may pave a way to unravel critical therapeutic targets in three debilitating and interrelated illnesses, namely, sepsis, SLE, and CRS. Sepsis, SLE, and CRS are closely interrelated complex diseases likely sharing an overlapping pathogenesis caused by erroneous gene network activities. We sought to identify the shared gene networks and the key genes for sepsis, SLE, and CRS by completing an integrative analysis. Initially, 868 DEGs were identified in 16 GSE datasets. Based on degree centrality, 27 hub genes were revealed. The gProfiler webtool was used to perform functional annotations and enriched molecular pathway analyses. Finally, core hub genes (EGR1, MMP9, and CD44) were validated using RT-PCR analysis. Our comprehensive multiplex network approach to hub gene discovery is effective, as evidenced by the findings. This work provides a novel research path for a new research direction in multi-omics biological data analysis

Synchronized electrochemical detection of hydroquinone and catechol in real water samples using a Co@SnO2-polyaniline composite

The conductive composite Co@SnO2-PANI was successfully synthesized using hydrothermal/oxidative synthesis. Using differential pulse voltammetry, a glassy carbon electrode modified with a CoSnO2-PANI (polyaniline)-based electrochemical biosensor has been created for the quick detection of two phenolics, hydroquinone (Hq) and catechol (Cat). Differential pulse voltammetry (DPV) measurements revealed two well-resolved, strong peaks for GCE@Co-SnO2-PANI, which corresponded to the oxidation of Hq and Cat at 275.87 mV and +373.76 mV, respectively. The oxidation peaks of Hq and Cat mixtures were defined and separated at a pH of 8.5. High conductivity and remarkable selectivity reproducibility was tested by electrochemical impedance spectroscopy, chronoamperometry, and cyclic voltammetry techniques in standard solution and real water samples. The proposed biosensor displayed a low detection limit of 4.94 nM (Hq) and 1.5786 nM (Cat), as well as a large linear range stretching from 2 × 10−2 M to 2 × 10−1 M. The real-sample testing showed a good recovery for the immediate detection of Hq (96.4% recovery) and Cat (98.8% recovery) using the investigated sensing apparatus. The synthesized biosensor was characterized by XRD, FTIR, energy dispersive spectroscopy and scanning electron microscopy

Design of a highly efficient heterostructure of transition metal tellurides with outstanding photocatalytic and antimicrobial potential

This work aimed to synthesize an effective material having greater potential to reduce water pollution caused by industrial waste and exhibit efficient antibacterial potential. The transition metals (Manganese-Mn, Zinc-Zn) and post transition metal (Tin-Sn) reacted with TeO2 in a stoichiometric ratio by adopting a solid-state reaction. The crystallite size of the synthesized compounds MnTeO3 (D1), ZnTeO3 (D2), and SnTe3O8 (D3) was measured by the Debye-Scherrer formula by extracting data from the FWHM. D1 and D2 exhibit the orthorhombic structure whereas D3 has a simple cubic structure and crystalline size was measured by FWHM i.e., 221 nm, 458 nm, and 153 nm. Catalytic degradation efficiency for the removal of MB dye was found to be in the range of 66%-73%. Additionally, these substances have strong antimicrobial action alongside both bacteria and fungi, such as Escherichia coli, Staphylococcus aureus with maximal zone inhibitions of 35.0 mm and 12.5 mm for each kind of bacterium. The highest antifungal activity of Mn integrated was estimated to be 37.2 mm versus Aspergillus niger and 15.1 mm alongside Coccidioides. According to the findings, the manufactured material has effective photocatalytic and antimicrobial activities