Distribution of commensal rodents in rain-fed and irrigated areas of Swat district, Khyber Pakhtunkhwa, Pakistan

Distribution pattern and relative abundance of the agricultural rodent pests of rain-fed and irrigated areas of district Swat Khyber Pakhtunkhwa, Pakistan were recorded from April 2011 to November 2013 using wire mesh live traps. A total of 350 rodents (269 Rattus rattus and 81 Mus musculus) were captured under 2268 trap nights (trap success: 0.15). Regression of daily captures on cumulative captures revealed an estimate of 350 rodents from all the sampled structures with an average of 21.8 rodents per crop field. House rats (R. rattus; 76.8% of captures) were numerically dominant in almost all types of agricultural fields, and were significantly different from the mice (Mus musculus; 23.1% of captures). Both species were found together in some fields. The sex ratio revealed that males outnumbered the females in both of the reported species.

Design of Geiger Muller detector system for searching lost γ-ray source

If a radiation source is lost, it will do harm to human being, especially for the searching person. In order to find the lost radiation source easily, a detector system, including 3 detectors, was designed to search the lost c-ray radiation source autonomously in any environment. First, based on GEANT4 simulation, the radiation dose rates in 3 Geiger Muller (GM) counters were simulated at the different source-detector distances, distances between detectors and angles. Various analyses were performed by experimentally and verified the simulated detector designed system. A Mono-energetic 137Cs c-ray source with energy 662 keV and activity of 1.11 GBq was used for the observation. The simulated results were compared with the experimental dose rate values and obtained good agreements for various cases. Only based on the dose rates in three detectors, the radiation source was searched in a different location at a specific source activity and angle. The corresponding angles of deviation and detection limit were calculated for sensitivity and ability of detector designed system. The proposed detector designed system can be used to navigate radiation sources in the low level and high radiation environments.

Morphometrics of the indian false vampire bat (Megaderma lyra) from district Jhelum, Pakistan

During the present study thirteen Megaderma lyra bats were observed roosting in dark, domed shaped room of Rohtas Fort, district Jhelum. Out of these, six specimens were captured from the roosting site, using hand net. All captured specimens were male. These bats were identified through their unique facial features, an erect and elongated nose-leaf, large oval ears that joined above the forehead and no tail. Mean head and body length of captured specimens was 80 mm, forearm length was 67 mm while average lengths of 3rd, 4th and 5th metacarpals were 51.73 mm, 55.17 mm and 60.42 mm, respectively. Mean skull length was 29.84 mm, breadth of braincase was 12.77 mm. Average Penis length of two specimens was 6.6 mm and total bacular length was 3.08 mm respectively. This is the first record of Megaderma lyra from district Jhelum.

Roosting ecology and morphometric analysis of Pteropus medius (Indian flying fox) in Lower Dir, district, Pakistan

The present study was conducted to explore morphometric variations of Pteropus medius (the Indian flying fox) and the roosting trees in Lower Dir, Pakistan. The bats were captured from Morus alba, Morus nigra, Brousonetia papyrifera, Pinus raxburghii, Hevea brasiliensis, Platanus orientalis, Populous nigra, Melia azedarach, Eucalyptus camaldulensis and Grevillea robusta through sling shot and mess net methods. A total of 12 bats were studied for the differential morphological features based on age and sex. Male bats were recorded higher in weight than females. The variations were found in body mass (821.1±34.65gm), circumference of body with wings (25.43±0.39cm), wingspan (112.58±1.90cm), Body length (20.73±0.68cm), Snout length (3.42±0.04cm), Eye length (1.45±0.033cm), Length of ear (3.56±0.05cm), Width of ear (2.46±0.04cm), Length b/w ear (5.51±0.11cm), Circumference of neck (12.23±0.24cm), Circumference of body without wings (18.68±0.31cm), Arm wing length (23.2±1.03cm), Length of thumb (5.43±0.1cm), Length of nail (1.89±0.05cm), Hand wing length (29.1±0.51cm), Maximum width of wing (21.03±0.68cm), Length b/w tip of wing to 5th digit (29.39±0.30cm), Length b/w 5th digit to foot (22.97±1.09cm), Length b/w feet (18.31±0.74cm) and Length of foot claw (4.23±0.05cm). This study was designed for analysis of external morphological variations for P. medius (the Indian flying fox) that may help in identification of these bats and their roosting sites.

St Andrew's COVID-19 surgery safety (StACS) study: The Burns Centre experience

Background

The COVID-19 pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has the potential to significantly impact burns patients both directly through infective complications of an immunocompromised cohort, and indirectly through disruption of care pathways and resource limitations. The pandemic presents new challenges that must be overcome to maintain patient safety; in particular, the potential increased risks of surgical intervention, anaesthesia and ventilation. This study comprehensively reviews the measures implemented to adapt referral pathways and mitigate the risk posed by COVID-19 during the height of the pandemic, within a large Burns Centre.

Methods

A prospective cohort study was designed to assess patients treated at the Burns Centre during the UK COVID-19 pandemic peak (April–May 2020), following implementation of new safety measures. All patients were analysed for 30-day mortality. In addition, a prospective controlled cohort study was undertaken on all inpatients and a random sample of outpatients with telephone follow-up at 30 days. These patients were divided into three groups (operative inpatients, non-operative inpatients, outpatients). COVID-19 related data collected included test results, contact with proven cases, isolation status and symptoms. The implemented departmental service COVID-19 safety adaptations are described.

Results

Of 323 patients treated at the Burns Centre during the study period, no 30-day COVID-19 related deaths occurred (0/323). Of the 80 patients analysed in the prospective controlled cohort section of the study, 51 underwent COVID-19 testing, 3.9% (2/51) were positive. Both cases were in the operative group, however in comparison to the non-operative and outpatient groups, there was no significant increase in COVID-19 incidence in operative patients.

Conclusions

We found no COVID-19 related mortality during the study period. With appropriate precautions, burns patients were not exposed to an increased COVID-19 risk. Similarly, burns patients undergoing operative management were not at a significantly increased risk of contracting COVID-19 in comparison to non-operative groups.

Seroprevalence of low avidity anti-Toxoplasma IgG in pregnant women and its relationship with their age and contact with cats

Toxoplasma gondii is a protozoan parasite that can infect all mammals, serving as intermediate hosts. The cause of congenital toxoplasmosis is transplacental transmission of the parasite to the foetus, resulting in wide range of manifestations from mild chorioretinitis to miscarriage. Its frequency can be reduced by early screening of pregnant women which is based mainly on tests for anti-Toxoplasma antibodies. We collected serum samples of 594 pregnant women (subjects) after taking their consent over a period of two years (2016-2018) and analyzed them for anti-Toxoplasma IgG by ELISA. The positive samples were then analyzed for IgG avidity test which could differentiate between recent and past infections. The seroprevalence was also correlated with the age of the subjects and their contact with cats. 162 subjects were found positive out of which only three showed a recent infection. After following up until delivery, one of them delivered a baby who had jaundice and was diagnosed with anti-Toxoplasma IgM at birth. The foetus of the second subject died in-utero, while the third woman delivered a normal baby after being given spiramycin when diagnosed with toxoplasmosis in the first trimester. It was found that most of the positive subjects had frequent contact with cats. Invasion of the parasite during third trimester resulted in death in-utero and jaundice. Most common cause of pregnancy wastage during our study was spontaneous abortions while pregnancy loss due to congenital anomalies was rare.

The impact of COVID-19 on emergency general surgery admissions and operative volumes: A single centre experience

Introduction

The COVID-19 pandemic has placed a significant strain on healthcare resources and utilisation globally. The appearance of the disease in the Republic of Ireland resulted in a broad postponement of scheduled and routine surgical care. The influence of the novel coronavirus, and the associated imposition of public health measures such as school closures and social distancing, on the burden of emergency surgical disease is less clear.

Aim

The aim of this study was to examine the impact of COVID-19 on the number of patients presenting to our institution with emergent surgical illnesses or requiring emergency general surgical procedures.

Methods

All patients attending our service between March 1st 2020 and April 30th 2020 were identified retrospectively by examining electronic handover and electronic discharge summaries, and data were collected relating to demographics, presenting illness, critical care utilisation, length of stay, operative or endoscopic procedure performed, and in-hospital mortality. Similar data were collected March 1st to April 30th 2019, 2018, and 2017 respectively to allow direct comparison.

Results

151 patients were admitted during the study period, compared to a total of 788 during the proceeding three years (mean 2.49 admissions per night versus 4.35 per night, 42.8% reduction, p < 0.001). Median age of admitted patients was 51.8 years, compared to 50.3 years formerly (p = 0.35). 53 emergency procedures were performed, compared to a median of 70 over the same period in the previous years (mean 0.87 per day versus 1.16 per day, 25.4% reduction, p = 0.05).

Conclusion

A significant overall reduction in the number of patients being admitted to our unit and requiring emergency surgical procedures during March and April 2020 was seen, in line with patterns reported internationally.

EMA-amplicon-based sequencing informs risk assessment analysis of water treatment systems

Illumina amplicon-based sequencing was coupled with ethidium monoazide bromide (EMA) pre-treatment to monitor the total viable bacterial community and subsequently identify and prioritise the target organisms for the health risk assessment of the untreated rainwater and rainwater treated using large-volume batch solar reactor prototypes installed in an informal settlement and rural farming community. Taxonomic assignments indicated that Legionella and Pseudomonas were the most frequently detected genera containing opportunistic bacterial pathogens in the untreated and treated rainwater at both sites. Additionally, Mycobacterium, Clostridium sensu stricto and Escherichia/Shigella displayed high (≥80%) detection frequencies in the untreated and/or treated rainwater samples at one or both sites. Numerous exposure scenarios (e.g. drinking, cleaning) were subsequently investigated and the health risk of using untreated and solar reactor treated rainwater in developing countries was quantified based on the presence of L. pneumophila, P. aeruginosa and E. coli. The solar reactor prototypes were able to reduce the health risk associated with E. coli and P. aeruginosa to below the 1 × 10^-4 annual benchmark limit for all the non-potable uses of rainwater within the target communities (exception of showering for E. coli). However, the risk associated with intentional drinking of untreated or treated rainwater exceeded the benchmark limit (E. coli and P. aeruginosa). Additionally, while the solar reactor treatment reduced the risk associated with garden hosing and showering based on the presence of L. pneumophila, the risk estimates for both activities still exceeded the annual benchmark limit. The large-volume batch solar reactor prototypes were thus able to reduce the risk posed by the target bacteria for non-potable activities rainwater is commonly used for in water scarce regions of sub-Saharan Africa. This study highlights the need to assess water treatment systems in field trials using QMRA.

Seasonal abundance and distribution of dragonflies in upper Siran valley of District Mansehra Pakistan

Present study was conducted to study seasonal abundance and distribution of dragonflies in upper Siran valley district Mansehra Pakistan. To collect data, eleven localities were visited for three consecutive years (2016-2018). Results come up with a sum of 300 specimens identified under three families, eight genera and twenty species. Highest seasonal abundance recorded during summer and spring were 80.67% and 13.33% respectively while minimum 6.00% was recorded during early autumn. Dominant species observed were, Orthetrum chrysis (14.00%), followed by O. gluacum (12.00%), Palpoleura sexmaculata sexmaculata (11.33%) and O. cancellatum cancellatum (8.00%). However the highest population of dragonflies was found in Munda Gucha with a percentage of 11.33 followed by Jabbar (11.00%) and Sachan (9.67%). The lowest populations were recorded in Suham (6.00%), Dadar (7.67%) and Jabori (7.67%). The surveyed valley showed diverse Anisopterous fauna and thus further extensive surveys are recommended that can come up with more important species from the area.

Assessment of ecto and endo parasites of Schizothorax plagiostomus inhabiting river Panjkora, Khyber Pakhtunkhwa, Pakistan

Fish provides main source of high quality protein to more than one billion people in the world. Fish parasites directly affect the productivity of fish and indirectly on human health. This research was aimed to assess the helminth parasites in Schizothorax plagiostomus (the snow trout) from river Panjkora, KP, Pakistan. A total of 88 fish samples (n= 88) were collected from the upper, middle and lower regions of the river through cast nets, hand nets and hooks. All the collected fish samples were examined in the Parasitology Laboratory, Department of Zoology, University of Malakand for helminth parasites during July 2018 to February 2019.Among these fishes nematodes, trematodes, cestodes and acanthocephalan were isolated and identified. Overall prevalence of the fish parasites was 60.22% (53/88). The intensity of the parasite was observed from 1.7% to 4.61%. Highest prevalence was reported in summer season 86.36% while lowest in the winter season 36.36%. This study shows that summer season affects the fish business and result in poor quality fish meat with risk of zoonotic diseases. Adults were highly infected 82.25% while no infection was found in juvenile specimens. Female fish samples had higher prevalence 68.22% than males 48.22%. Fishes of the lower reaches had highest prevalence 60.22% than the upper reaches 40.0%. Fish samples with maximum length and weight were highly 76.92% infected than small sized fish with low body weight. Present study addresses that Rhabdochona schizothoracis in the intestine and Diplozoon paradoxum in gills of snow trout fish has a long term relationship and call as a natural infection in cyprinids and it is zoonotic threat to human.

Evaluation of ecto and endo parasitic fauna of Schizothorax plagiostomus inhabitants of river Swat, Khyber PakhtunKhwa, Pakistan

Fish is consumed as a rich and cheaper source of white meat and proteins all over the world. Fish farming is the leading source of income generation throughout the world. The present research study was conducted with aims to investigate the ecto and endo parasitic fauna of S. plagiostomus (snow trout) in River Swat. A total of 96 fish samples were collected on monthly basis from July-2018 to February-2019, from upper, middle and lower reaches. Fish samples were collected with the help of cast net, hand net and fishing rods. Local fishermen and experts help were also sought out for fish collection. 61 out of 96 fishes were found infected by helminth parasites. The total prevalence and intensity of 63.54% and 2.90 was observed respectively during data analysis. Highest monthly prevalence of 83.33% was recorded during July and August, while lowest prevalence of 33.33% was noted during February. Five species of helminths parasites were detected from S. plagiostomus, of which two were trematodes (Rhabdochona shizothoracis and Rhabdochona species), one species of Monogenia (Diplozoon paraddoxum), one species of Cestodes (Nippotaenia species), and one species of Acanthocephalan (Neoechynorhynchus devdevi). Highest parasite wise prevalence, intensity and relative density of 21.87%, 4.09 and 0.895 was noted for R. schizothoracis while the lowest prevalence, intensity and relative density of 4.16%, 1.25 and 0.052 was noted for N. devdevi. Highest infection of 76.08% was observed in adults host while lowest, 40% infestation rate was observed in young fish samples. 73.68% prevalence was observed in female hosts while only 56.90% prevalence was observed in male individuals. Higher infection (83.33%) was noticed during summer season, while lowest infection (44.44%) was observed during winter season. Similarly 71.79% fishes were found infected that were collected from lower reaches of the River Swat than the fish samples collected from upper reaches (52%).

Change in malate dehydrogenase and alpha amylase activities in Rubus fruticosus and Valeriana jatamansi treated granary weevil, Sitophilus granarius

Poor storage conditions provide favorable environment to stored grain pests for their growth. The bio-pesticides are the best alternatives to synthetic pesticides. Present study was conducted to compare toxicity of Rubus fruticosus and Valeriana jatamansi against granary weevil, Sitophilus granarius and subsequent changes in enzyme activity responsible for grain damage. In current research 5 g of R. fruticosus fruit and V. jatamansi rhizome powders were tested separately against S. granarius, in 50 g wheat whole grains for seven days in comparison with the control. The enzymatic activity of malate dehydrogenase and α-amylase was observed in the cellular extracts of S. granarius. The insects were crushed and homogenized in phosphate-buffer solution and centrifuged at 10000 rpm for 5 minutes. For the enzymatic measurement supernatant was tested; the spectrophotometer was adjusted at 340 nm. The reagents were mixed and incubated at 25 °C for five minutes. The cuvettes were placed in the experimental and reference sites of spectrophotometer and recorded the change in absorbance for 3-4 minutes. There was 5.60% and 14.92% reduction in the activity of malate dehydrogenase in R. fruticosus and V. jatamansi, treated insects, respectively. The alpha amylase enzyme activity was 6.82% reduced and 63.63% increase in R. fruticosus and V. jatamansi, treated insects, respectively. Present study addresses that both plant powders are effective against granary weevil by altering enzyme activities so both the plant powders can be used as bio-pesticides against the stored grains pests.

0420 Fibre-Specific White Matter Neurodegeneration is Associated with Long Sleep Duration After Stroke

Introduction

Long sleep duration in aging populations has recently been proposed as a key modifiable risk factor and sequela of stroke. It is unclear whether the pathogenesis of post-stroke sleep-wake dysfunction is due to focal infarction to regional sleep-wake hubs in the brain, or to accelerated whole-brain neurodegeneration. We utilise a novel technique known as whole-brain fixel-based analyses (FBA) to characterize the first fibre-specific white-matter markers of long sleep duration after stroke.

Methods

We included 98 radiologically-confirmed ischemic stroke participants (67 male; mean age = 68) and 40 age-matched controls with no history of neurodegenerative disease imaged 3-months post-stroke. Sleep-wake was measured for one week using BodyMedia’s SenseWear armband. Diffusion-weighted MRI (DWI) were acquired using echoplanar imaging and preprocessed using MRtrix3. FBA were employed to identify tracts with altered white-matter fibre-density and fibre-bundle cross-section (FDC) in the long sleep duration (&gt;8 hr, n=20) and normal sleep duration groups (between &gt;6 hr and &lt;8 hr, n=59) compared to controls. Statistical comparisons of FDC between groups were performed at each FDC fixel by a general linear model controlling for age, sex, and intracranial volume.

Results

Stroke participants with long sleep duration exhibited significant FDC reductions of up to 40% within the cortico-ponto-cerebellar tract when compared to healthy controls (family-wise-error-corrected p=&lt;0.05). Bilateral pontine degeneration was observed at the decussation of the superior cerebellar peduncles. Stroke participants with normal sleep duration exhibited diffuse whole-brain degeneration most apparent along the corpus collosum and cingulum; however, the distribution was less extensive relative to long sleepers (i.e., no cortico-cerebellar projections) and percentage effect reductions did not exceed 20%.

Conclusion

Long sleep duration after stroke is associated with cortico-ponto-cerebellar degeneration when compared to controls or stroke-participants with normal sleep duration. Excessively long sleep may contribute to post-stroke neurodegeneration beyond the effects of direct infarction and may be a modifiable pharmacological target for abating brain volume loss after stroke.

Support

This work was supported by the National Health and Medical Research Council project grant (APP1020526), the Brain Foundation, Wicking Trust, Collie-Trust, and Sidney and Fiona Myer Family Foundation. NE was supported by the Australian Research Council DECRA award DE180100893.

Validation of large-volume batch solar reactors for the treatment of rainwater in field trials in sub-Saharan Africa

The efficiency of two large-volume batch solar reactors [Prototype I (140 L) and II (88 L)] in treating rainwater on-site in a local informal settlement and farming community was assessed. Untreated [Tank 1 and Tank 2-(First-flush)] and treated (Prototype I and II) tank water samples were routinely collected from each site and all the measured physico-chemical parameters (e.g. pH and turbidity, amongst others), anions (e.g. sulphate and chloride, amongst others) and cations (e.g. iron and lead, amongst others) were within national and international drinking water guidelines limits. Culture-based analysis indicated that Escherichia coli, total and faecal coliforms, enterococci and heterotrophic bacteria counts exceeded drinking water guideline limits in 61%, 100%, 45%, 24% and 100% of the untreated tank water samples collected from both sites. However, an 8 hour solar exposure treatment for both solar reactors was sufficient to reduce these indicator organisms to within national and international drinking water standards, with the exception of the heterotrophic bacteria which exceeded the drinking water standard limit in 43% of the samples treated with the Prototype I reactor (1 log reduction). Molecular viability analysis subsequently indicated that mean overall reductions of 75% and 74% were obtained for the analysed indicator organisms (E. coli and enterococci spp.) and opportunistic pathogens (Klebsiella spp., Legionella spp., Pseudomonas spp., Salmonella spp. and Cryptosporidium spp. oocysts) in the Prototype I and II solar reactors, respectively. The large-volume batch solar reactor prototypes could thus effectively provide four (88 L Prototype II) to seven (144 L Prototype I) people on a daily basis with the basic water requirement for human activities (20 L). Additionally, a generic Water Safety Plan was developed to aid practitioners in identifying risks and implement remedial actions in this type of installation in order to ensure the safety of the treated water.

Discordance between fine-needle aspiration cytology and histopathology in patients with mucoepidermoid carcinoma of parotid gland

INTRODUCTION

Fine-needle aspiration cytology (FNAC) is an important diagnostic tool used preoperatively for the diagnosis of parotid lump. Mucoepidermoid carcinoma comprises 5-10% of all salivary gland tumours. It poses a diagnostic challenge on FNAC with high false negative rate. The objective of this study was to evaluate the discordance between cytology/FNAC and histopathology in patients with mucoepidermoid carcinoma.

MATERIAL AND METHODS

A cross-sectional study was conducted from 1 January 2010 to 31 December 2014. Patients aged 18 years and above with FNAC or histopathology suggestive of mucoepidermoid carcinoma were identified. FNAC when compared with histology (gold standard) was classified into true positive (presence of mucoepidermoid carcinoma correctly diagnosed on FNAC), true negative (absence of mucoepidermoid carcinoma correctly diagnosed on FNAC), false positive (FNAC incorrectly diagnosed mucoepidermoid carcinoma), false negative (FNAC failed to diagnose mucoepidermoid carcinoma).

RESULTS

A total of 16 patients fulfilled our eligibility criteria. Seven cytological samples were true positive (ie correctly diagnosed mucoepidermoid carcinoma by FNAC), eight cytological specimens were false negative (ie could not pick up mucoepidermoid carcinoma on FNAC). One case was false positive on cytology (ie diagnosed mucoepidermoid carcinoma on FNAC but was reported to be Warthin's tumour on histopathology) and none were true negative.

CONCLUSION

FNAC is not reliable for diagnosis of mucoepidermoid carcinoma. More than 50% of our patients had discordant results between cytology and histology. We recommend a high index of suspicion for mucoepidermoid carcinoma given the poor yield of cytology.

Functionalized single-walled carbon-nanotube-blended P3HT-based high performance memory behavior thin-film transistor devices

We report on the fabrication and transport properties of single-walled carbon nanotubes (SWCNT) blended with P3HT (poly 3-hexyl thiophene-2, 5-diyl). The composite is used as a hybrid organic active channel transistor. The performances of the fabricated devices were investigated as a function of the SWCNTs' loads in the composite, and their response evaluated under white light illumination. Our results show that for SWCNT loads ≤1.5 wt%, all the devices behave as p-type transistors, exhibiting excellent performance, with an I _on /I _off ratio of 10⁴ and a maximum on-state current (I _on) exceeding 80 μA. Moreover, compared with pristine transistors with a P3HT channel, the Hall mobility of these hybrid TFTs was found to increase by more than one order of magnitude, i.e. increasing from 0.062 to 1.54 cm² V^-1 s^-1. Finally, under light illumination, the transfer characteristics (i.e. I _DS as a function of V _GS) were found to systematically undergo a typical shift together with a fully-reversible memory behavior. A fundamental understanding of this work can assist in providing new routes for the development of reliable efficient hybrid organic-based optoelectronic devices.

Predatory bacteria in combination with solar disinfection and solar photocatalysis for the treatment of rainwater

The predatory bacterium, Bdellovibrio bacteriovorus, was applied as a biological pre-treatment to solar disinfection and solar photocatalytic disinfection for rainwater treatment. The photocatalyst used was immobilised titanium-dioxide reduced graphene oxide. The pre-treatment followed by solar photocatalysis for 120 min under natural sunlight reduced the viable counts of Klebsiella pneumoniae from 2.00 × 10⁹ colony forming units (CFU)/mL to below the detection limit (BDL) (<1 CFU/100 μL). Correspondingly, ethidium monoazide bromide quantitative PCR analysis indicated a high total log reduction in K. pneumoniae gene copies (GC)/mL (5.85 logs after solar photocatalysis for 240 min). In contrast, solar disinfection and solar photocatalysis without the biological pre-treatment were more effective for Enterococcus faecium disinfection as the viable counts of E. faecium were reduced by 8.00 logs (from 1.00 × 10⁸ CFU/mL to BDL) and the gene copies were reduced by ∼3.39 logs (from 2.09 × 10⁶ GC/mL to ∼9.00 × 10² GC/mL) after 240 min of treatment. Predatory bacteria can be applied as a pre-treatment to solar disinfection and solar photocatalytic treatment to enhance the removal efficiency of Gram-negative bacteria, which is crucial for the development of a targeted water treatment approach.

Reasons for intravesical instillation postponement during adjuvant treatment of non-muscle-invasive bladder cancer: A prospective study

INTRODUCTION

Intravesical instillations for adjuvant treatment of non-muscle-invasive bladder cancer (NMIBC) may be postponed of necessity. However, the frequency and reasons for postponement are unclear.

MATERIALS

We carried out a prospective, epidemiological study in an Urology department of the Île-de-France, between August 2016 and March 2017, to determine the frequency and reasons for postponement of intravesical instillations during adjuvant treatment of NMIBC. One-hundred consecutive patients treated by intravesical instillations of mitomycin C (MMC) or Bacillus Calmette-Guérin (BCG) were included. At each session and in case of instillation postponement, the medical team completed a specially designed questionnaire.

RESULTS

A total of 541 instillations were performed in the 100 patients. Twenty-four instillations (4.4%) were postponed in 19 patients. The major cause of postponement was an untreated positive urine analysis and culture (UAC) in 13/24 (54%) cases. The causes of cancellation did not differ significantly between MMC and BCG. The most frequently cancelled instillations were the first in the therapeutic protocol in 26% of cases. The number of instillations preceding those cancelled did not differ significantly between MMC and BCG (2.1±2.0 instillations for MMC vs. 1.5±1.6 for BCG; P=0.64).

CONCLUSIONS

There was a low rate of postponed instillations (4.4%). The main reasons, namely an untreated UAC and a positive dipstick test, based on the jurisprudence, are not included in the latest CC-AFU guidelines.

LEVEL OF EVIDENCE

3.

P1325 Lymphoma encasing the heart: intra-cardiac or extra-cardiac mass?

A 70-year-old gentleman was referred to our department for atypical chest pains and night sweats. He had an unremarkable past medical history and denied any history of familial disease. There were no complaints of dyspnoea, dizziness or palpitations. A routine echocardiogram showed a suspicious right atrial mass, seemingly extra cardiac in origin. Clinical examination was entirely unremarkable and further investigations were arranged as a matter of urgency.

Contrast echocardiography confirmed a lesion wrapping around the right atrium with possible myocardial infiltration. Trans-oesophageal echocardiography showed extension of the mass into the adjacent atrioventricular groove. The appearances were of a compressive, non-vascular lesion measuring 4.8cm x 5.6cm. Overall cardiac systolic function remained preserved with no significant intra-cardiac abnormalities.

A CT Thorax with contrast was the next step in investigation. This demonstrated nodular soft tissue infiltration of the entire pericardium, mainly involving the right heart chambers with encasement of the aortic root and coronary arteries. Significant lymphadenopathy was also identified suggesting a malignant process.

Cardiac MRI was then performed and this substantiated the findings on CT, raising concern for encasement and external compression of the right coronary artery. Urgent transfer to a tertiary cardiac centre was arranged and subsequent biopsy confirmed histological diagnosis of Stage 4 Lymphoma. After a multi-disciplinary meeting, a non-operative approach was decided. Treatment with steroids and chemotherapy was commenced without delay leading to a significant reduction in the size of the mass.

Abstract P1325 Figure.

Assessment of phenotypic and storage protein diversity in exotic barley cultivated in District Dir (Pakistan)

A total of 198 exotic barley genotypes were collected from the Gene Bank of the Plant Genetic Resource Institute (PGRI), National Agriculture Research Center (NARC), Islamabad, Pakistan, for the assessment of genetic diversity based on morphological and seed storage proteins. Qualitative and quantitative traits were noted as per IPGRI, 1994 descriptor. Among the quantitative parameters, a high level of genetic variability index was noted in seeds per spike at 79.9% of coefficient of variance followed by biomass per plant which shows 37.4% variance, while minimum variance in quantitative traits was noted in days to germination at 5.4% followed by days to maturity at 3.1% with average mean genetic variation in all quantitative traits at 97.6%. Assay of total seed protein in these exotic accessions was analogue through polyacrylamide gel electrophoresis. A high level of variation was noted in loci (bands) B26 (0.98%) followed by B25 (0.89%), B24 (0.78%),B23 (0.69%) and B01 (0.52%). A similarly low level of variation was detected in B03 (0.16%) followed by B06 (0.18%), B13 (0.19%), B12 (0.21%), B11 (0.23%), B05 (0.24%), B07 (0.25%), B21 (0.34%), B20 (0.35%), B17 (0.39%). The results indicate that the mean value of variation in these accessions is 97.6%. Further assessments and exploration were suggested for these genotypes in multi-climatic zones to satisfy farmers’ need, breeders’ interest and malt-industrial requirements.

Morphology and ectoparasite spectrum of Pteropus vampyrus (the flying fox) in different parts of Malakand Division, Pakistan

Three districts viz. Lower Dir, Swat and Shangla in Khyber Pakhtunkhwa province, were surveyed for the collection of Pteropus vampyrus (the Indian flying fox) in Malakand division, the north western region of Pakistan from February to November 2018. A total of 35 specimens were captured. Out of the examined specimens 22 were found to be infected with ectoparasites. Three types of ectoparasites were observed including flies 20% (n=7/35), mites 28.5% (n=10/35) and bugs 14.2% (n=5/35). Male bats were more infected 57.1% (n=20/35) as compared to females 42.8% (n=15/35), however, no significant difference (p>0.05) was noted. Flies were recovered from wings membrane and head region, mites were found on wings, ears and around eyes while bugs were found attached on body surface and neck region. Body weight, circumference and wing span of male bats were greater as compared to female bats and were considered a key factor in clear cut identification of male and female Pteropus vampyrus (the Indian flyingfox). It was concluded that Pteropus vampyrus from north western part of Pakistan were parasitized by a varied parasite fauna with high infestation rates. We assume that in male bats the number of parasites is generally higher than in females. Our results revealed new insights into parasite fauna of Pteropus vampyrus.

Gastrointestinal helminths in dog feces surrounding suburban areas of Lower Dir district, Pakistan: A public health threat

Data on environmental contamination of the parasites of zoonotic importance is scarce in Pakistan. Soil contamination with feces of dogs hide infective stages of the parasite represents a health-risk to humans. This study was aimed to assess the eggs of gastrointestinal parasites of stray dogs and household dogs in lower Dir district, Pakistan with special consideration to those that can be spread to humans. One hundred and fifty two stool specimens from (stray dogs=90 and household dogs=62) were collected. The helminth eggs were processed by direct smear method and centrifugation techniques and identified by microscopic examination. Of the total examined dogs 26.8% (n=41 /152) were found to be infected with one or more intestinal parasites. The intestinal helminths detected were Dipylidium caninum (n =18, 11.8%), followed by Toxocara canis (n =16, 10.5%), Taenia spp., (n=10, 6.57%) Ancylostoma caninum (n=6, 3.94), Toxascaris spp., Capillaria spp., and Trichuris vulpis (n=2, 1.31% each) in order of their prevalence. Pattern of infection revealed that 27 (65.8%) dogs have single, 13(31.7%) double and 1(2.43%) triple infection. The stray dogs were highly infected 34.4% (n=31) than house hold dogs 16.1% (n=10). The prevalence of infection with intestinal parasites was significantly different among these two groups (p = 0.0097). This study highlight a severe environmental contamination by frequent parasitic stages infectious to humans. There is a higher risk of zoonotic transmission from dogs which indicate an immediate need for the controlling of these parasites and educating the public to take wise action relating to the parasites and pets.

A mm-Sized Free-Floating Wirelessly Powered Implantable Optical Stimulation Device

This paper presents a mm-sized, free-floating, wirelessly powered, implantable optical stimulation (FF-WIOS) device for untethered optogenetic neuromodulation. A resonator-based three-coil inductive link creates a homogeneous magnetic field that continuously delivers sufficient power (>2.7 mW) at an optimal carrier frequency of 60 MHz to the FF-WIOS in the near field without surpassing the specific absorption rate limit, regardless of the position of the FF-WIOS in a large brain area. Forward data telemetry carries stimulation parameters by on-off-keying the power carrier at a data rate of 50 kb/s to selectively activate a 4 × 4 μLED array. Load-shift-keying back telemetry controls the wireless power transmission by reporting the FF-WIOS received power level in a closed-loop power control mechanism. LEDs typically require high instantaneous power to emit sufficient light for optical stimulation. Thus, a switched-capacitor-based stimulation architecture is used as an energy storage buffer with one off-chip capacitor to receive charge directly from the inductive link and deliver it to the selected μLED at the onset of stimulation. The FF-WIOS system-on-a-chip prototype, fabricated in a 0.35-μm standard CMOS process, charges a 10-μF capacitor up to 5 V with 37% efficiency and passes instantaneous current spikes up to 10 mA in the selected μLED, creating a bright exponentially decaying flash with minimal wasted power. An in vivo experiment was conducted to verify the efficacy of the FF-WIOS by observing light-evoked local field potentials and immunostained tissue response from the primary visual cortex (V1) of two anesthetized rats.