A spatiotemporal atlas of mouse liver homeostasis and regeneration

The mechanism by which mammalian liver cell responses are coordinated during tissue homeostasis and perturbation is poorly understood, representing a major obstacle in our understanding of many diseases. This knowledge gap is caused by the difficulty involved with studying multiple cell types in different states and locations, particularly when these are transient. We have combined Stereo-seq (spatiotemporal enhanced resolution omics-sequencing) with single-cell transcriptomic profiling of 473,290 cells to generate a high-definition spatiotemporal atlas of mouse liver homeostasis and regeneration at the whole-lobe scale. Our integrative study dissects in detail the molecular gradients controlling liver cell function, systematically defining how gene networks are dynamically modulated through intercellular communication to promote regeneration. Among other important regulators, we identified the transcriptional cofactor TBL1XR1 as a rheostat linking inflammation to Wnt/β-catenin signaling for facilitating hepatocyte proliferation. Our data and analytical pipelines lay the foundation for future high-definition tissue-scale atlases of organ physiology and malfunction.

Association of APO B gene polymorphisms with the development of myocardial infarction in Pakistani population

Myocardial infarction (MI) is when a blood clot in the coronary artery obstructs blood flow to a specific part of the heart, leading to the death of myocardium in that area. The development of MI is influenced by various environmental factors, genetic components, and their interactions, even though the exact cause has not been fully established. This is the first case-control study examining the possible association between the human Apo B gene and MI in the Punjab region of Pakistan. The study included 100 patients and 50 healthy individuals. Genomic DNA was isolated from blood samples using manual extraction methods. Subsequently, primers were optimized, and genotyping was performed using PCR, followed by DNA sequencing and RFLP analysis. The research focused on two specific APO B gene SNPs, codon 4154 G/A (rs1801701) and codon 2488 G/A (rs1042031). Both SNPs involved the substitution of guanine with adenine. It was found that individuals carrying the minor allele A of SNP rs1801701 (p < 0.001) and the minor allele A of rs1042031 (p < 0.001) had a significantly higher risk of developing MI. Additionally, haplotype analysis revealed that the AA haplotype (comprising both rs1801701 and rs1042031 SNPs) was associated with a substantially increased risk of MI (OR = 3.845). In conclusion, the study provides evidence supporting the association between specific mutations in the APOB gene and the risk of myocardial infarction in the Pakistani population.

Multi-Locus Microsatellite Typing of Colonising and Invasive Aspergillus fumigatus Isolates from Patients Post Lung Transplantation and with Chronic Lung Disease

Aspergillus fumigatus can cause different clinical manifestations/phenotypes in lung transplant (LTx) recipients and patients with chronic respiratory diseases. It can also precipitate chronic lung allograft dysfunction (CLAD) in LTx recipients. Many host factors have been linked with the severity of A. fumigatus infection, but little is known about the contribution of different A. fumigatus strains to the development of different phenotypes and CLAD. We used multi-locus microsatellite typing (MLMT) to determine if there is a relationship between strain (i.e., genotype) and phenotype in 60 patients post LTx or with chronic respiratory disease across two time periods (1 November 2006-31 March 2009 and 1 November 2015-30 June 2017). The MLMT (STRAf) assay was highly discriminatory (Simpson's diversity index of 0.9819-0.9942) with no dominant strain detected. No specific genotype-phenotype link was detected, but several clusters and related strains were associated with invasive aspergillosis (IA) and colonisation in the absence of CLAD. Host factors were linked to clinical phenotypes, with prior lymphopenia significantly more common in IA cases as compared with A. fumigatus-colonised patients (12/16 [75%] vs. 13/36 [36.1%]; p = 0.01), and prior Staphylococcus aureus infection was a significant risk factor for the development of IA (odds ratio 13.8; 95% confidence interval [2.01-279.23]). A trend toward a greater incidence of CMV reactivation post-A. fumigatus isolation was observed (0 vs. 5; p = 0.06) in LTx recipients. Further research is required to determine the pathogenicity and immunogenicity of specific A. fumigatus strains.

Crash modification factors of rumble strips on horizontal curves of two-lane rural roads: A propensity scores potential outcomes approach

Horizontal curves are known to be more crash-prone than tangent sections particularly with respect to roadway departure crashes. Rumble strips are an effective countermeasure to mitigate various types of roadway departure crashes. While existing studies on the safety effectiveness of rumble strips have primarily used before-after study designs or cross-sectional methods for crash modification factor (CMF) estimation, these methods often suffer from imbalanced datasets and larger standard errors, especially when the sample size is small. To address this, this study applies the propensity score potential outcome (PSPO) framework to estimate CMFs for centerline rumble strips, shoulder rumble strips, and their combined application on horizontal curves. In addition to contributing to the development of CMFs by crash severity, this study also examines the effects of rumble strips on collision types, highlighting their impact on vehicle maneuvering and collision characteristics. The analysis is conducted on horizontal curves on two-lane rural roads in Pennsylvania, utilizing crash data from 2017 to 2021. The PSPO method effectively reduces bias between sites with and without rumble strips, and the resulting statistical models align with engineering judgment. The findings indicate that centerline rumble strips reduce opposite direction sideswipe and head-on crashes but increase run off the road and hit fixed object crashes. Shoulder rumble strips, either alone or in combination with centerline rumble strips, decrease crash frequencies for most types except opposite direction sideswipe and head-on crashes. However, shoulder rumble strips alone are more effective at reducing crash frequencies on horizontal curves than when combined with centerline rumble strips.

Salivary transforming growth factor beta in oral submucous fibrosis: A diagnostic and predictive marker

CONTEXT

Growth factors and cytokines like transforming growth factor beta (TGF-β) play a key role in the pathogenesis of oral submucous fibrosis.

AIMS

To elucidate the role of Salivary TGF-β isoforms as a predictive and diagnostic marker for oral submucous fibrosis.

SETTINGS AND DESIGN

A total of 30 OSMF and 10 control patients were included in this study, and their clinic-epidemiological data was recorded.

METHODOLOGY

The expression of TGF-β genes-TGF-β1, TGF-β2, TGF-β3-was studied by a real-time polymerase chain reaction in tissue and saliva. Patients were given medicinal intervention for 12 weeks along with jaw-opening exercises. Expression of salivary TGF-β genes was studied at 12 weeks.

STATISTICAL ANALYSIS USED

SPSS software version 20.

RESULT

Expression of salivary TGF beta isoforms in OSMF was more than in the control group. There was an increase in salivary TGF-β1, β2, β3 expressions with increasing clinical grades of OSMF and advancing the stage of the disease. Expression of all the TGF beta isoforms was decreased after treatment with statistically significant results. Statistically significant correlations were found between the mean difference of TGF-β1 and the mean difference between mouth opening and tongue protrusion.

CONCLUSION

Salivary TGF-β isoforms may be used in diagnosis, risk assessment, and screening of the entire population at risk of OSMF after its clinical validation. However, adequate sample size and segmental assessment of the expression of TGF-β isoforms are needed for further evaluation.

Studies on bioaccumulation patterns, biochemical and genotoxic effects of copper on freshwater fish, Catla catla: an in vivo analysis

Abstract During present study, the copper (Cu) mediated oxidative stress was measured that induced DNA damage by concentrating in the tissues of fish, Catla catla (14.45±1.24g; 84.68±1.45mm) (Hamilton,1822). Fish fingerlings were retained in 5 groups for 14, 28, 42, 56, 70 and 84 days of the exposure period. They were treated with 2/3, 1/3, 1/4 and 1/5 (T1-T4) of 96h lethal concentration of copper. Controls were run along with all the treatments for the same durations. A significant (p < 0.05) dose and time dependent concentration of Cu was observed in the gills, liver, kidney, muscles, and brain of C. catla. Among organs, the liver showed a significantly higher concentration of Cu followed by gills, kidney, brain, and muscles. Copper accumulation in these organs caused a significant variation in the activities of enzymes viz. superoxide dismutase (SOD), catalase (CAT) and peroxidase (POD). The SOD activity varied significantly in response to the exposure time of Cu as 56 > 70 > 42 > 84 > 28 > 14 days while CAT activity exhibited an inverse relationship with the increase in Cu concentration. POD activity showed a significant rise with an increase in Cu exposure duration. Comet assay exhibited significant DNA damage in the peripheral erythrocytes of Cu exposed C. catla. Among four exposure concentrations, 2/3rd of LC50 (T1) caused significantly higher damage to the nuclei compared to control. Increased POD and SOD activity, as well as a decrease in CAT activity in response to Cu, demonstrates the involvement of a protective mechanism against reactive oxygen species (ROS), whereas increased ROS resulted in higher DNA damage. These above-mentioned molecular markers can be efficiently used for the biomonitoring of aquatic environments and conservation of edible fish fauna.

Which curve is better? A comparative analysis of trauma scoring systems in a South Asian country

Objectives

A diverse set of trauma scoring systems are used globally to predict outcomes and benchmark trauma systems. There is a significant potential benefit of using these scores in low and middle-income countries (LMICs); however, its standardized use based on type of injury is still limited. Our objective is to compare trauma scoring systems between neurotrauma and polytrauma patients to identify the better predictor of mortality in low-resource settings.

Methods

Data were extracted from a digital, multicenter trauma registry implemented in South Asia for a secondary analysis. Adult patients (≥18 years) presenting with a traumatic injury from December 2021 to December 2022 were included in this study. Injury Severity Score (ISS), Trauma and Injury Severity Score (TRISS), Revised Trauma Score (RTS), Mechanism/GCS/Age/Pressure score and GCS/Age/Pressure score were calculated for each patient to predict in-hospital mortality. We used receiver operating characteristic curves to derive sensitivity, specificity and area under the curve (AUC) for each score, including Glasgow Coma Scale (GCS).

Results

The mean age of 2007 patients included in this study was 41.2±17.8 years, with 49.1% patients presenting with neurotrauma. The overall in-hospital mortality rate was 17.2%. GCS and RTS proved to be the best predictors of in-hospital mortality for neurotrauma (AUC: 0.885 and 0.874, respectively), while TRISS and ISS were better predictors for polytrauma patients (AUC: 0.729 and 0.722, respectively).

Conclusion

Trauma scoring systems show differing predictability for in-hospital mortality depending on the type of trauma. Therefore, it is vital to take into account the region of body injury for provision of quality trauma care. Furthermore, context-specific and injury-specific use of these scores in LMICs can enable strengthening of their trauma systems.

Level of evidence

Level III.

Association between oxidative stress, antioxidant enzymes, and homocysteine in patients with polycystic ovary syndrome

OBJECTIVE

Polycystic ovary syndrome (PCOS) is a prevalent health condition that commonly affects adolescent girls and young women. The purpose of this study was to evaluate the correlation between levels of total glutathione (TG), reduced glutathione (GSH), superoxide dismutase (SOD), lipid peroxidation, and homocysteine with PCOS.

PATIENTS AND METHODS

This study employed a cross-sectional case-control design, involving a target population of 305 Sudanese females. Among them, 205 individuals were categorized as cases, and 100 served as controls. The TG, GSH, SOD, lipid peroxidation, and homocysteine levels were measured in the serum of study participants through enzyme-linked immunosorbent essay.

RESULTS

Total glutathione (1,174.5 ± 271.4 vs. 986.1 ± 191.5, p = 0.01), GSH (801.3 ± 132.2 vs. 748.6 ± 103.1, p = 0.007), SOD (225.2 ± 57.8 vs. 195.5 ± 49.6, p = 0.009), lipid peroxidation (3.4 ± 1.1 vs. 2.4 ± 0.7, p = 0.03), and homocysteine (14.9 ± 2.1 vs. 13.5 ± 1.6, p = 0.04), showed significant differences between the two groups (cases vs. controls). A moderate positive correlation between TG, GSH, SOD, lipid peroxidation, homocysteine, BMI, age, and duration of PCOS was observed. Furthermore, a strong positive correlation between BMI, age, and duration of PCOS was noted within the patient group.

CONCLUSIONS

In conclusion, this study demonstrates that patients with PCOS have elevated levels of TG, GSH, SOD, lipid peroxidation, and homocysteine compared to the control group. These findings suggest a potential association between PCOS and oxidative stress, lipid metabolism, and homocysteine pathways. Moreover, the observed positive correlation with BMI, age, and duration of PCOS indicates the importance of these factors in disease progression.

Wide-range and area-selective threshold voltage tunability in ultrathin indium oxide transistors

The scaling of transistors with thinner channel thicknesses has led to a surge in research on two-dimensional (2D) and quasi-2D semiconductors. However, modulating the threshold voltage (VT) in ultrathin transistors is challenging, as traditional doping methods are not readily applicable. In this work, we introduce a optical-thermal method, combining ultraviolet (UV) illumination and oxygen annealing, to achieve broad-range VT tunability in ultrathin In2O3. This method can achieve both positive and negative VT tuning and is reversible. The modulation of sheet carrier density, which corresponds to VT shift, is comparable to that obtained using other doping and capacitive charging techniques in other ultrathin transistors, including 2D semiconductors. With the controllability of VT, we successfully demonstrate the realization of depletion-load inverter and multi-state logic devices, as well as wafer-scale VT modulation via an automated laser system, showcasing its potential for low-power circuit design and non-von Neumann computing applications.

Greening for greater good: investigating the critical factors for customer satisfaction with sustainable e-banking

This study investigated the impact of efficiency, reliability, responsiveness, safety, and security on customer satisfaction with sustainable e-banking. The study used a quantitative methodology, with data collected from customers of commercial banks in South Punjab, Pakistan. A Likert scale questionnaire was used to collect cross-sectional data. A sample of 350 was analyzed using the Statistical Package for the Social Sciences (SPSS) for testing descriptive statistics, correlation analysis, and regression results. The study's results revealed that efficiency, reliability, responsiveness, safety, and security significantly impacted customer satisfaction with e-banking services. Efficiency and reliability were the most crucial factors influencing customer satisfaction, followed by safety, security, and responsiveness. The research findings have important implications for commercial banks, as they highlight the critical role of these factors in the development of sustainable e-banking practices. Overall, the study provides valuable insights for commercial banks seeking to improve their e-banking services and ensure customer satisfaction. Commercial banks can enhance their competitiveness and achieve sustainable growth in the highly competitive e-banking sector by prioritizing efficiency, reliability, responsiveness, and safety and security.

Determination of histological and genotoxic parameters of Nile Tilapia, Oreochromis niloticus exposed to lead (Pb)

This study investigates the hazardous effects of lead on the histological and genotoxic parameters of the fish, Oreochromis niloticus. Present work was conducted in a series of three steps. In first step, acute toxicity, LC50 and lethal lead concentration were measured using Probit analysis method. LC50 value and lethal concentration for O. niloticus was measured as 77.673 mgL-1 and 150.924 mgL-1, respectively. In second step, histological changes were assessed by preparing slides of tissues of the gills, liver and kidney of both control and Pb-stressed O. niloticus and examining the respective tissues under the light microscope. The inferences showed significant histological alterations (p<0.05) in the gills of Pb-exposed fish including necrosis, edema, vascular congestion, shortening and curling and lifting of the epithelium of secondary lamella in gills. The cellular degeneration and dilation of sinusoids in liver and loss of hemopoietic tissue, necrosis and edema in kidney was observed. Histomorphometry of the liver showed a decrease in diameter of the central vein and hepatocyte along with an increase in width of sinusoids. The histomorphometry of kidney showed an increase in the diameter of renal corpuscle, glomerulus, proximal and distal convoluted tubules. The nuclear anomalies were studied in the RBCs of fish. Non-parametric Mann-Whitney U-test was conducted to compare nuclear abnormalities and the frequency of micronuclei among the control and lead-treated fish groups. Results declared an increased micronucleus, notched and de-shaped nuclei frequency, in RBCs of fish exposed to lead as compared to control group.

Mathematical modelling and analysis of COVID-19 and tuberculosis transmission dynamics

In this paper, a mathematical model for assessing the impact of COVID-19 on tuberculosis disease is proposed and analysed. There are pieces of evidence that patients with Tuberculosis (TB) have more chances of developing the SARS-CoV-2 infection. The mathematical model is qualitatively and quantitatively analysed by using the theory of stability analysis. The dynamic system shows endemic equilibrium point which is stable when R 0 < 1 and unstable when R 0 > 1 . The global stability of the endemic point is analysed by constructing the Lyapunov function. The dynamic stability also exhibits bifurcation behaviour. The optimal control theory is used to find an optimal solution to the problem in the mathematical model. The sensitivity analysis is performed to clarify the effective parameters which affect the reproduction number the most. Numerical simulation is carried out to assess the effect of various biological parameters in the dynamic of both tuberculosis and COVID-19 classes. Our simulation results show that the COVID-19 and TB infections can be mitigated by controlling the transmission rate γ .

Bright and Efficient Light-Emitting Devices Based on Two-Dimensional Transition Metal Dichalcogenides

Two-dimensional (2D) monolayer transition metal dichalcogenides (TMDCs) show great promise for the development of snext-generation light-emitting devices (LEDs) owning to their unique electronic and optoelectronic properties. The dangling bond-free surface and direct bandgap structure of monolayer TMDCs allow for near-unity photoluminescence quantum efficiencies. The excellent mechanical and optical characteristics of 2D TMDCs offer great potentials to fabricate TMDC-based LEDs featuring good flexibility and transparency. Great progress has been made in the fabrication of bright and efficient LEDs with varying device structures. In this review article, we aim to provide a comprehensive summary on the state-of-the-art progress made in the construction of bright and efficient LEDs based on 2D TMDCs. After a brief introduction on the research background, the preparation of 2D TMDCs used for LEDs is briefly discussed. The requirements and the corresponding challenges to achieve bright and efficient LEDs based on 2D TMDCs are introduced. Thereafter, various strategies to enhance the brightness of monolayer 2D TMDCs are described. Following that, the carrier injection schemes enabling bright and efficient TMDC-based LEDs along with the device performance are summarized. Finally, the challenges and future prospects regarding the accomplishment of TMDC-LEDs with ultimate brightness and efficiency are discussed. This article is protected by copyright. All rights reserved.

Effects of Non-Thermal Processing Methods on Physicochemical, Bioactive, and Microbiological Properties of Fresh Pineapple (Ananas comosus L. Merr.) Juice

Background: Pineapple juice processing is an art of preservation, and the processing technologies play important role in pineapple juice quality. Therefore, this study aimed to explore the potential impacts of non-thermal processing methods on the physicochemical, bioactive, and microbiological properties of fresh pineapple juice. Methods: Extracted juices were subjected to several non-thermal processes including microwave processing, vacuum evaporation, mild pasteurization, pulsed electric field, and ultra-sonication. Physicochemical properties including Total Soluble Solids (TSS), pH, titratable acidity, and color; Total Phenolic Content (TPC); Total Anthocyanin Content (TAC); antioxidant capacity; and microbiological properties were evaluated. Data were statistically analyzed by Minitab statistical software (version: 18.1). Results: TSS, pH, acidity (%) of processed juices ranged from 11.03-12.03, 4.07-4.27, and 0.42-0.49, respectively. In terms of color properties both ultra-sonication and microwave processing showed the highest values of L (luminosity), a* (redness), and b* (yellow). The highest TPC was reported in ultra-sonication treatment 11.996±0.002 mg Gallic Acid Equivalents (GAE)/100 ml. The TAC varied from 0.179-0.235 mg Total Anthocyanin (TA)/100 ml, where ultra-sonication and mild pasteurization treatment yielded the highest and lowest contents, respectively. Conclusion: Perfect phenolic content, antioxidant capacity, retention of anthocyanin content, and attractive color in pineapple juices when treated with non-thermal techniques.

Blunt abdominal trauma patients presenting to a tertiary care facility of Pakistan: A three years' experience

Blunt abdominal trauma (BAT) refers to injuries without wounds entering the peritoneal cavity due to road traffic accidents (RTA) and falls, as a result of collision or counter collision. The objective of the present study was to determine the frequency of patients with visceral injuries in blunt abdominal trauma. This study was carried out in the Department of Surgery, including ward-3 of Jinnah Post Graduate Medical Centre, Karachi, from November 2017 till November 2020. The study design was descriptive case series. During the study period, the data of 112 patients was collected, which comprised of 102 males and 10 females. All the patients between 12 to 65 years of age (mean age:31.84±13.14 years) presenting to the emergency with < 24 hours of abdominal trauma, were included in the study. Organs involved during blunt abdominal trauma were observed and frequency was recorded. Liver injuries were found in 48(42.28%) patients, intestinal injuries in 40(35.7%), splenic injuries in 32(28.5%), kidney injuries in 24(21.4%), pancreatic injuries in 8(7.1%) and stomach injuries in 4(3.5%) patients. Grade 4 liver injury was found in 80(71%) patients, Grade 2 and 3 splenic injuries in 56(50%) patients whereas 47(42%) patients had grade 1 kidney injury. Liver was found to be the most frequent organ involved, followed by intestine and spleen.

Burn Admissions Across Low- and Middle-income Countries: A Repeated Cross-sectional Survey

Burn injuries have decreased markedly in high-income countries while the incidence of burns remains high in Low- and Middle-Income Countries (LMICs) where more than 90% of burns are thought to occur. However, the cause of burns in LMIC is poorly documented. The aim was to document the causes of severe burns and the changes over time. A cross-sectional survey was completed for 2014 and 2019 in eight burn centers across Africa, Asia, and Latin America: Cairo, Nairobi, Ibadan, Johannesburg, Dhaka, Kathmandu, Sao Paulo, and Guadalajara. The information summarised included demographics of burn patients, location, cause, and outcomes of burns. In total, 15,344 patients were admitted across all centers, 37% of burns were women and 36% of burns were children. Burns occurred mostly in household settings (43-79%). In Dhaka and Kathmandu, occupational burns were also common (32 and 43%, respectively). Hot liquid and flame burns were most common while electric burns were also common in Dhaka and Sao Paulo. The type of flame burns varies by center and year, in Dhaka, 77% resulted from solid fuel in 2014 while 74% of burns resulted from Liquefied Petroleum Gas in 2019. In Nairobi, a large proportion (32%) of burns were intentional self-harm or assault. The average length of stay in hospitals decreased from 2014 to 2019. The percentage of deaths ranged from 5% to 24%. Our data provide important information on the causes of severe burns which can provide guidance in how to approach the development of burn injury prevention programs in LMIC.

Prosthetic Aortic Valve Thrombosis: Surgery or Thrombolysis

Mechanical prosthetic valve thrombosis is a serious complication which necessitates immediate intervention. The presenting signs and symptoms of this illness are somewhat variable, but physical examination and trans-esophageal-echocardiography enable rapid diagnosis. Valve replacement or thrombolysis in the correct hospital setting must be performed to avoid life-threatening complication without delay. But it is not proven entirely which therapy is superior. For any given patient, the risks of thrombolytic therapy, including bleeding, systemic embolism and failure to restore valvular function, must be weighed against the risks of surgical intervention. In spite of aggressive therapy, morbidity and mortality from prosthetic valve thrombosis and its treatment are not less indeed. This report describes the case of a woman with aortic prosthetic valves who presents with heart failure and evidence of severe prosthetic aortic valve dysfunction after a period of suboptimal anticoagulation.

Evaluation of Methylation Panel in the Promoter Region of p16INK4a , RASSF1A, and MGMT as a Biomarker in Sputum for Lung Cancer

Lung cancer is the most common cause of cancer death in the world. Effective early detection and appropriate medications can help treat this deadly cancer. Therefore, early detection of lung cancer is of utmost importance, especially in screening high-risk populations (such as smokers) with an urgent need to identify new biomarkers. The present study aimed to demonstrate the potential of using the panel of DNA methylation as a biomarker for the early diagnosis of lung cancer from sputum samples. The methylated promoter of p16^INK4a , RASSF1A, and MGMT genes was estimated by the methylation-specific polymerase chain reaction in a sample of 84 lung cancer patients (65 smokers and 19 non-smokers). Based on the results, p16^INK4a promoter methylation was significantly associated with smoking habit and lung cancer progression in terms of histological grading and patient staging. The sensitivity and specificity of the p16^INK4a gene as a biomarker for lung cancer were 71% and 90%, respectively. The methylated promoter of RASSF1A was less sensitive (48%) as a biomarker for lung cancer with 83%. The results demonstrated a strong association between promoter methylation of RASSF1A and late stages of lung cancer (P=0.0007). The sensitivity of the MGMT gene as a biomarker for lung cancer was 61% with high specificity (92%), compared to other candidate genes in this study. The epigenetic alteration in the promoter region of p16^INK4a , RASSF1A, and MGMT genes is highly associated with cancer cell development. It is suggested that the use of these candidate biomarkers can be used as an adjunct to computed tomography screening to diagnose patients at high risk for lung cancer after validation.

Emergence and Evolution of the Journal of Bangladesh College of Physicians and Surgeons: Igniting the Professionalism

Journal of Bangladesh College of Physicians and Surgeons (JBCPS), all the go by ‘BCPS Journal’, is the official organ of BCPS inclusive of academic, extra-academic and official matters. The journal started its journey in August 1983, now in the fourth decades is embedded in the fanfare of Golden Jubilee of BCPS. It commensurate with the fellows’ desire that a supplement of the JBCPS shall be published as the official organ of the college on behalf of the education, training, research and publication to Showcase the college image in the academic arena. The special editorial board is tasked to marinate a document of the sojourn of the JBCPS, for now and then. The authors have tried to pick up pieces of information from all available local libraries and online resources to build up an edifice to be added on from time to time. It has been tried to fullfill the mandate through expanded and extended search and find the tenets of the emergence and evolution of the JBCPS with an endeavor to bring out a canvas of the paintings of the stories of the Odyssey. Bangladesh Medical Journal (BMJ) published by Bangladesh Medical Association (BMA) is the oldest journal of the country first published 50 years ago in July 1972. Then the Bangladesh Medical Research Council Bulletin (BMRC Bulletin), published in December 1975. JBCPS is the third in this sequence. Prof Golam Rasul was the first editor in chief and so far, fifteen chiefs navigated the journal so far. The first editorial board consisted of five members and present editorial board embracing almost all the subjects including editors from abroad. JBCPS is online since 2004 and is available in the Bangladesh Journals Online (BanglaJOL) since 2006. With Continued relentless untiring efforts of the editorial board and collaboration from the executive committee of BCPS the JBCPS is now one of the top ranked & prestigious peer reviewed journal of the country. The next endeavor shall be to enlist the journal in PubMed which is expected very soon. J Bangladesh Coll Phys Surg 2022; 40: 28-38

NLR and PLR Ratios - Accessible and Affordable Predictors of Disease Severity in COPD

COPD is currently the fourth leading cause of death the world but is projected to be 3rd leading cause of death by 2020. It is characterized by limitation of airflow which is not fully transformable to normal along with increased long term inflammatory response in airways of the tracts of lungs. Acute exacerbations of COPD (AECOPD) are the most common causes of hospitalization and death among COPD patients. CRP, leukocytes, IL-6, IL-8 and fibrinogen are associated with COPD. However, while these biomarkers may be helpful, many of them are time consuming with extra cost, and some of the tests are not readily clinically available. Neutrophil-to-Lymphocyte Ratio (NLR) and platelet lymphocyte ratio (PLR) are effortless and basic parameters that are readily obtained from the simplest and easily obtainable complete blood count, even in peripheral hospitals. Material: Study was conducted at NMCH &amp;RC, Raichur, patients attending NMCH for a duration of 18 months. 100 patients with a confirmed diagnosis of COPD confirmed with pulmonary function test according to GOLD criteria were included in the study. Observation: Mean age of the study population was 67.14±8.03 years. Males were predominant with male to female ratio as 9:1.Mean NLR of the AECOPD patients from stage 1 was 3.73±0.18, stage 2 was 6.07±1.27, stage 3 was 6.02±1.14 and stage 4 was 8.19±2.66. When we compared the mean NLR of the patients between different stages of COPD, the difference was found to be statistically significant (p&lt;0.05). It means mean NLR was higher in stage 4 as compared to other groups. Mean PLR of the AECOPD patients from stage 1 was 12690.48±3978.45, stage 2 was 22219.93±7797.9, stage 3 was 19158.73±5070.88 and stage 4 was 19544.87±10207.59. When we compared the mean PLR of the patients between different stages of COPD, the difference was found to be statistically significant (p&lt;0.05). It means mean PLR was higher in stage 2 followed by stage 4 as compared to other groups Conclusion: The NLR and PLR may be used as a useful and easily accessible tool for evaluating the ongoing inflammation during stable period and the disease severity during acute exacerbations in COPD patients. NLR ratio is more specific to severity of COPD compared to PLR ratio.

Defect Inspection Techniques in SiC

With the increasing demand of silicon carbide (SiC) power devices that outperform the silicon-based devices, high cost and low yield of SiC manufacturing process are the most urgent issues yet to be solved. It has been shown that the performance of SiC devices is largely influenced by the presence of so-called killer defects, formed during the process of crystal growth. In parallel to the improvement of the growth techniques for reducing defect density, a post-growth inspection technique capable of identifying and locating defects has become a crucial necessity of the manufacturing process. In this review article, we provide an outlook on SiC defect inspection technologies and the impact of defects on SiC devices. This review also discusses the potential solutions to improve the existing inspection technologies and approaches to reduce the defect density, which are beneficial to mass production of high-quality SiC devices.

The Impact of Empowering Leadership on Job Performance of Higher Education Institutions Employees: Mediating Role of Goal Clarity and Self-Efficacy

Purpose

The main objective of existing research is to assess empowering leadership effects on employees’ job performance at the academic level through mediating variables’ goal clarity and self-efficacy.

Methods

Data were congregated from 400 employees belonging to higher education institutions of Pakistan through research assistants, hired for data collection. Statistical procedures, such as factor analysis via statistical package for the social sciences (SPSS 23), structural equation modeling with bootstrapping via statistical tool analysis of moment structures (AMOS 24), were used to evaluate data and assess the relationship among the constructs.

Results

The structural equation modeling analysis uncovered several results. For instance, it shows the positive influence of empowering leadership behaviors on goal clarity, self-efficacy, and employees’ job performance. Moreover, the bootstrap investigation showed that goal clarity and self-efficacy mediate empowering leadership behaviors’ influence on workers’ job performance. Therefore, conferring to existing study results empowering leadership is significantly associated with employees’ job performance in the presence of mediators goal clarity and self-efficacy at the academic level of higher education institutions of Sindh, Pakistan.

Conclusion

The main research question of existing research is to assess empowering leadership effects on employees’ job performance through mediating variables’ goal clarity and self-efficacy. To investigate this research question, we have conducted this study and empirically established that empowering leadership can affect employees’ job performance with and without mediation. We have also shown empowering leadership as collaborative effects produce advanced levels of self-efficacy, goal clarity, and employees’ job performance than either leadership behavior could accomplish by itself.

The mTORC1-eIF4F axis controls paused pluripotency

Mouse embryonic stem cells (mESCs) can self-renew indefinitely and maintain pluripotency. Inhibition of mechanistic target of rapamycin (mTOR) by the kinase inhibitor INK128 is known to induce paused pluripotency in mESCs cultured with traditional serum/LIF medium (SL), but the underlying mechanisms remain unclear. In this study, we demonstrate that mTOR complex 1 (mTORC1) but not complex 2 (mTORC2) mediates mTOR inhibition-induced paused pluripotency in cells grown in both SL and 2iL medium (GSK3 and MEK inhibitors and LIF). We also show that mTORC1 regulates self-renewal in both conditions mainly through eIF4F-mediated translation initiation that targets mRNAs of both cytosolic and mitochondrial ribosome subunits. Moreover, inhibition of mitochondrial translation is sufficient to induce paused pluripotency. Interestingly, eIF4F also regulates maintenance of pluripotency in an mTORC1-independent but MEK/ERK-dependent manner in SL, indicating that translation of pluripotency genes is controlled differently in SL and 2iL. Our study reveals a detailed picture of how mTOR governs self-renewal in mESCs and uncovers a context-dependent function of eIF4F in pluripotency regulation.

A Review on Emerging Therapeutic Interventions for Corona Virus

The Coronavirus (SARS-CoV-2) is one of the deadliest viruses of current era and is identified as the causative agent of novel coronavirus disease-2019 (COVID-19). This disease stances a severe risk to mankind due to its unexplored pathologies. It was declared as a COVID-19 pandemic by the world health organization. This outbreak has challenged the public health concerns at large, killing the most vulnerable person, causing generalized panic and become a top debate among scientists, clinicians, physicians, pathologists, economists, athletes and politicians. Anti-viral vaccines and target drugs to treat this virus are unavailable due to its diverse genetic instability.  Currently, its prevention, control and treatment are questionable as no proven remedies have been effective for its cure so far. From a research assessment, many number of drugs or medicines are being manufactured and tested at fast pace, goals and objectives are being celebrated on daily basis, and also many drugs are be subjected to clinical tests. Scientists are interested about how to provide the better care to everyone before a vaccine can be made available to common community. To stop COVID-19, effective solutions (i.e., personal protection elements, vaccines, drugs, etc.) are needed urgently. Red bells are ringing but there is no way out. Current review focuses on the ongoing regimes and therapeutic interventions for better combat with COVID-19.

Impact of COVID-19 on global burn care

Background

Worldwide, different strategies have been chosen to face the COVID-19-patient surge, often affecting access to health care for other patients. This observational study aimed to investigate whether the standard of burn care changed globally during the pandemic, and whether country´s income, geographical location, COVID-19-transmission pattern, and levels of specialization of the burn units affected reallocation of resources and access to burn care.

Methods

The Burn Care Survey is a questionnaire developed to collect information on the capacity to provide burn care by burn units around the world, before and during the pandemic. The survey was distributed between September and October 2020. McNemar`s test analyzed differences between services provided before and during the pandemic, χ2 or Fisher’s exact test differences between groups. Multivariable logistic regression analyzed the independent effect of different factors on keeping the burn units open during the pandemic.

Results

The survey was completed by 234 burn units in 43 countries. During the pandemic, presence of burn surgeons did not change (p = 0.06), while that of anesthetists and dedicated nursing staff was reduced (<0.01), and so did the capacity to manage patients in all age groups (p = 0.04). Use of telemedicine was implemented (p < 0.01), collaboration between burn centers was not. Burn units in LMICs and LICs were more likely to be closed, after adjustment for other factors.

Conclusions

During the pandemic, most burn units were open, although availability of standard resources diminished worldwide. The use of telemedicine increased, suggesting the implementation of new strategies to manage burns. Low income was independently associated with reduced access to burn care.

Trends and instigators among young adolescent suicide in the United States

OBJECTIVES

The present investigation examined the role of factors involved in suicide ideation and suicide attempt using a nationally representative sample of US high school students.

METHODS

Data were collected from students in Grades 9-12 as part of the Youth Behavioral Survey (n = 11,328). Logistic regression models were used to examine factors associated with suicide ideation and suicide attempt. Variables included demographic characteristics (grade, sex, and race), psychosocial factors (physical fighting, sexual violence, sports participation, bullying, and electronic bullying), and substance use (cigarette usage, marijuana usage, and alcohol usage).

RESULTS

The factor most associated with suicide ideation was bullying (either electronic or physical), whereas the factor most associated with suicide attempt was sexual violence followed closely by physical bullying.

CONCLUSIONS

The multitude of instigators and commonality among gender, ethnicity, and socio-economic status give an indication of how to prevent suicide and who to target information regarding the hazards of suicide.

Renal Allograft Biopsy Findings in Live-related Renal Transplant Recipients

OBJECTIVE

 To determine the pattern of histopathology in living-related, kidney transplant recipients (KTRs) from a transplant centre in Khyber Pakhtunkhwa (KPK), Pakistan.

STUDY DESIGN

Descriptive, observational study.

PLACE AND DURATION OF STUDY

Institute of Kidney Diseases, Peshawar, from August 2008 to July 2018.

METHODOLOGY

A retrospective review of graft biopsy reports and clinical charts from living-related, kidney transplant recipients was carried out. Allograft biopsies were done for graft dysfunction with no apparent cause. The biopsy pathology was classified according to updated Banff classifications. The descriptive statistics were used to tabulate the results.

RESULTS

Out of the 55 biopsies, 51 (92.73%) were from males with mean age of 34.35±9.40 years. Out of 52 percutaneous biopsies, 10 (19.23%) belonged to the normal category. Category 2 (borderline rejection) and 3 (acute/active cellular rejection) were seen in three (5.7%) and one (1.9%) cases, respectively. Interstitial fibrosis/tubular atrophy (Banff Category 5) was observed in 18 (34.62%) cases. Banff Category 6 (others) was seen in 19 (36.5%) cases, in which calcineurin inhibitors (CNI) toxicity was commonest (17 [89.4%] of 19 cases). Mixed lesions were found in 19 (36.5%) cases. Out of the 19 mixed category cases, 12 (63.16%) showed both Category 3 and Category 5 changes with most of the cases showing mild to moderate IF/TA; while one case had severe IF/TA. Three graft nephrectomies were done, one each for recurrent oxalosis, nephroblastoma and fungal infection.

CONCLUSION

Among the studied specimens, mixed lesions were the predominant findings, followed by others (mostly CNI toxicity) and IFTA categories. The frequency of acute/active rejections was low and that of chronic changes higher, in keeping with delayed biopsies. Key Words: Allograft biopsy, Graft dysfunction, Rejection, Kidney.

Recent Advances in Two-Dimensional Quantum Dots and Their Applications

Two-dimensional quantum dots have received a lot of attention in recent years due to their fascinating properties and widespread applications in sensors, batteries, white light-emitting diodes, photodetectors, phototransistors, etc. Atomically thin two-dimensional quantum dots derived from graphene, layered transition metal dichalcogenide, and phosphorene have sparked researchers' interest with their unique optical and electronic properties, such as a tunable energy bandgap, efficient electronic transport, and semiconducting characteristics. In this review, we provide in-depth analysis of the characteristics of two-dimensional quantum dots materials, their synthesis methods, and opportunities and challenges for novel device applications. This analysis will serve as a tipping point for learning about the recent breakthroughs in two-dimensional quantum dots and motivate more scientists and engineers to grasp two-dimensional quantum dots materials by incorporating them into a variety of electrical and optical fields.

Dengue outbreak 2019: clinical and laboratory profiles of dengue virus infection in Dhaka city

Background

Dengue fever has been one of the most common mosquito-transmitted diseases in the world, affecting more than 128 countries in both tropical and subtropical regions. Bangladesh has been sufferring from dengue outbreaks almost annually since 2000, and in 2019, Bangladesh faced the worst outbreak of dengue to date. This study aimed to provide clinical and biochemical profiles of Bangladesh's dengue-infected patients.

Methods

This cross-sectional study was conducted from August through December 2019 in three tertiary private hospitals in Dhaka, Bangladesh. We collected information on demographic data, clinical characteristics, and laboratory profiles for 542 confirmed hospitalized acute dengue cases using a structured questionnaire.

Results

The average age of the enrolled patients was 26.15 years, and about 50% of patients belonged to the age group of 20–40 years. The most frequent among the prevalent clinical symptoms were fever (93.1%), abdominal pain (29.5%), skin rash (25.3%), and diarrhea (19.7%). 316 patients had some complications, such as breathing problems (41.4%), pleural effusion (38.9%), gum bleeding (11.1%), etc. More than 90% of the patients showed seropositivity for the DENV-NS1 antigen.

Conclusions

Over the last couple of years, dengue fever has become a major health issue for Bangladesh. To reduce the burden of this disease, timely diagnosis and prompt treatment are necessary. This analysis thus yields the clinical features, laboratory profiles, and seropositivity test results of dengue patients from Bangladesh. The research results may help clinicians understand the circumstantial diagnosis of dengue patients and facilitate early intervention.

Predicting recurrence in patients with sentinel node-negative melanoma: validation of the EORTC nomogram using population-based data

BACKGROUND

Identifying patients with sentinel node (SN)-negative melanoma who are at greatest risk of recurrence is important. The European Organization for Research and Treatment of Cancer (EORTC) Melanoma Group proposed a prognostic model that has not been validated in population-based data. The EORTC nomogram includes Breslow thickness, ulceration status and anatomical location as parameters. The aim of this study was to validate the EORTC model externally using a large national data set.

METHODS

Adults with histologically proven, invasive cutaneous melanoma with a negative SN biopsy in the Netherlands between 2000 and 2014 were identified from the Dutch Pathology Registry, and relevant data were extracted. The EORTC nomogram was used to predict recurrence-free survival. The predictive performance of the nomogram was assessed by discrimination (C-statistic) and calibration.

RESULTS

A total of 8795 patients met the eligibility criteria, of whom 14·7 per cent subsequently developed metastatic disease. Of these recurrences, 20·9 per cent occurred after the first 5 years of follow-up. Validation of the EORTC nomogram showed a C-statistic of 0·70 (95 per cent c.i. 0·68 to 0·71) for recurrence-free survival, with excellent calibration (R2 = 0·99; P = 0·999, Hosmer-Lemeshow test).

CONCLUSION

This population-based validation confirmed the value of the EORTC nomogram in predicting recurrence-free survival in patients with SN-negative melanoma. The EORTC nomogram could be used in clinical practice for personalizing follow-up and selecting high-risk patients for trials of adjuvant systemic therapy.

Predicting sentinel node positivity in patients with melanoma: external validation of a risk-prediction calculator (the Melanoma Institute Australia nomogram) using a large European population-based patient cohort

BACKGROUND

A nomogram to predict sentinel node (SN) positivity [the Melanoma Institute Australia (MIA) nomogram] was recently developed and externally validated using two large single-institution databases. However, there remains a need to further validate the nomogram's performance using population-based data.

OBJECTIVES

To perform further validation of the nomogram using a European national patient cohort.

METHODS

Patients with cutaneous melanoma who underwent SN biopsy in the Netherlands between 2000 and 2014 were included. Their data were obtained from the Dutch Pathology Registry. The predictive performance of the nomogram was assessed by discrimination (C-statistic) and calibration. Negative predictive values (NPVs) were calculated at various predicted probability cutoffs.

RESULTS

Of the 3049 patients who met the eligibility criteria, 23% (691) were SN positive. Validation of the MIA nomogram (including the parameters Breslow thickness, ulceration, age, melanoma subtype and lymphovascular invasion) showed a good C-statistic of 0·69 (95% confidence interval 0·66-0·71) with excellent calibration (R² = 0·985, P = 0·40). The NPV of 90·1%, found at a 10% predicted probability cutoff for having a positive SN biopsy, implied that by using the nomogram, a 16·3% reduction in the rate of performing an SN biopsy could be achieved with an error rate of 1·6%. Validation of the MIA nomogram considering mitotic rate as present or absent showed a C-statistic of 0·70 (95% confidence interval 0·68-0·74).

CONCLUSIONS

This population-based validation study in European patients with melanoma confirmed the value of the MIA nomogram in predicting SN positivity. Its use will spare low-risk patients the inconvenience, cost and potential risks of SN biopsy while ensuring that high-risk patients are still identified.

Impact of blanching pretreatment on physicochemical properties, and drying characteristics of cabbage (Brassica oleracea)

Cabbage (Brassica oleracea) is popular winter vegetables cultivated all over Bangladesh and contains essential nutrients. This study aimed to evaluate the efficacy of pre-blanching on the preservation of cabbage by drying. In this research work, cabbage was blanched at 80°C, 90°C, and 100°C temperature for 12, 8, and 2 mins, respectively. Then the samples were dried at 60°C maintaining 60% relative humidity. The moisture and ash content of untreated and treated dried samples was in the range of 16.07±0.04 to 10.80±0.01% and 5.71±0.06 to 3.81±0.02%, respectively. The total phenolic content in cabbage was 74.47±0.63 mg GAE/100g at 100°C blanching temperature for a short time of 2 mins, which was higher compared to 61.91±0.48 mg GAE/100g at 80°C for 12 mins. It was observed that the antioxidant activity and two water-soluble vitamins-ascorbic acid and beta carotene decreased in pre-blanched dried samples in contrast with fresh ones. Blanching at higher water temperature and a short period was found useful for the retention of total phenolic content and greenness of cabbage. Blanching pre-treatments were also found to have better color retention capacity than untreated dried cabbage. A proper combination of drying time and temperature, along with the incorporation of blanching pretreatment, might be useful to preserve cabbage for a long time.

Enhancing a nutrition and self-management: An intervention program via teletherapy for teenager with ADHD. A pilot case study

Introduction

Several ADHD teenagers had difficult behavioral problems during countries closing down due to Covid-19 pandemic. One of these negative outcomes that parents cannot control children’s behavior toward desired unhealthy food and the impulsive consequences. It was a great opportunity to convention a teletherapy program as a tool of intervention seeking for help to reduce uncontrolled self- management and nutrition, which may affect all sorts of childhood growth, development, health and behavior. Furthermore, it can affects daily life and academic success.

Objectives

We tried through our study to enhance the teletherapy as a therapeutic tool, during the first and second phase of Covid-19 pandemic, trying to help parents and patient to overcome the impulsive behavior by using a specific therapy technique based on nutrition and behavioral therapy

Methods

Our case study is a young girl aged 12:4 Yrs. In middle bilingual Arabic/ American School. The therapeutic program designed via teletherapy program using multi-media and thru multi phases sessions, to increase focus attention, emotional control and reduce impulsivity.

Results

The outcomes of the enhancing nutrition and behavior teletherapy program, showed significant improvement for the specific goal. Sensible change in the girl’s impulsive behavior, more focusing, emotional control and more accepting about health nutrition habits.

Conclusions

The important finding that intensive, focused nutation and self-management techniques provided via teletherapy as solitary program brought benefits to individual’s, family and reduced impulsivity outcomes. In addition, family education to become an expert at learning simple techniques in daily life can brining a sense of pleasure for long life wellbeing.

Disclosure

No significant relationships.

Evaluation of the in vitro Antimicrobial Activity As well As Preservative Capacity of Several Popular Cosmetic Products Available in the Neighbouring Shops in Bangladesh

Cosmetic products are often inadequately preserved that provide favourable environment for microbial growth. These emphasize the need for regular investigation of cosmetics in terms of microbial quality and preservative capacity. This study aimed to evaluate the microbial quality, in vitro antibacterial activity and preservative capacity of several popular cosmetics collected from the neighbouring health-care stationary shops in Dhaka city from October 2019 to December 2019. Here, a total of five categories of seven different cosmetic products were subjected to evaluate microbial load, in vitro antibacterial activity and preservative capacity. Among the seven cosmetic products, the viable bacterial count in two cosmetics (All Clear and Sunsilk Shampoo) were found within the acceptable range that was <10³ CFU/ml. None of the cosmetics were found contaminated with fungus and pathogenic organisms. Conversely, three (one Mouthwash and two shampoo) products showed in vitro antibacterial activity against E. coli, S. aureus, Pseudomonas spp., Salmonella spp., Shigella spp. Only single cosmetic product (Cute coconut oil) did not meet the criteria of preservative capacity, while rest six products fulfil the requirements. Thus, our findings revealed a huge load of microorganisms in spite of having adequate preservative capacity in most of the tested products.

An incentive-based mitigation strategy to encourage coexistence of large mammals and humans along the foothills of Indian Western Himalayas

Escalation of human–wildlife conflict (HWC) is a barrier to the conservation of ecological corridors across the globe. The existing mechanisms to counter HWC are either economically and socially taxing, or ineffective for long-term management. We assessed HWC in the corridor linking the Rajaji and Corbett Tiger Reserves in Uttarakhand, India, and its drivers, along with the benefits derived by local communities from the forest. We designed an innovative incentive-based mitigation mechanism to encourage coexistence of people and wildlife around the corridor. Costs incurred due to conflict and benefits derived from the forest were assessed using semi-structured questionnaire-based personal interviews (n = 757) with representatives from forest dependent households (hh). Fuelwood (1678.7 ± 131 kg hh⁻¹ year⁻¹), fodder (4772 ± 186 kg hh⁻¹ year⁻¹) and green/dry grass (3359 ± 104 kg hh⁻¹ year⁻¹) contributed 3 ± 1%, 6 ± 0.5% and 9 ± 1%, respectively, to the annual income of dependent households. 69% of the households practising agriculture reported crop damage by wild animals, 19% of the households that owned livestock reported livestock loss, and 1.58% reported attack on humans resulting in injuries. The cost incurred due to crop raiding and livestock depredation was US $ 159.83 ± 1.0 hh⁻¹ year⁻¹ and US $ 229.32 ± 34.0 hh⁻¹ year⁻¹, respectively. Crop loss was positively associated with the number of crops grown per season and cultivation of sugarcane, wheat and pulses, and negatively with distance from forest and cultivation of fodder and finger millet. Livestock depredation was negatively associated with distance from forest and positively with number of livestock owned, primarily calves. The accounting profit from cultivating a hectare of land, in the absence of crop depredation by wild animals, was estimated at US $ 3571.84 ha⁻¹ year⁻¹ and US $ 361.44 ha⁻¹ year⁻¹ for the plains and hills, respectively. This value can be used to calculate the payments to be paid to local communities to encourage them to adopt HWC resistant agricultural and pastoralism practices. The net present value of benefits from participating in the payments to encourage coexistence programme for 5 years, discounted at 12%, was US $ 12,875.7 ha⁻¹ for the plains and US $ 1302.9 ha⁻¹ for the hills.

EVALUATION OF PERIPAPILLARY RETINAL NERVE FIBRE LAYER AND CENTRAL MACULAR THICKNESS INADULTS WITH HYPEROPIC ANISOMETROPIC AMBLYOPIA

Objective: To study per-papillary retinal nerve fibre layer (pRNFL) and central macular thickness (CMT) changesin adults with hyperopic anisometropic amblyopia using optical coherence tomography. Study Design: Cross sectional study. Place and Duration of Study: Combined Military Hospital, Lahore, Pakistan, from Oct 2019 to Feb 2020. Methodology: In this study 30 adults, 18-40 years of age were included who presented in our clinic with monocular poor vision. They underwent detailed ophthalmic clinical examination: including corrected and uncorrected distance visual acuity, slit lamp bio-microscopy and fundus examination with 90 diopter lens. After fulfilling criteria of anisometropic amblyopia, central maular thickness (CMT) and per-papillary retinal nerve fibre layer (pRNFL) thickness was measured by using RS-3000 SLO, NIDEK Co, Japan spectral domain optical coherence tomography device and compared the central maular thickness (CMT) and per-papillary retinal nerve fibre layer (pRNFL) thickness in amblyopic and fellow eye of same individual. Results: The mean change in per-papillary retinal nerve fibre layer (pRNFL) thickness in amblyopic eyes, 121.48± 4.90 μm and non amblyopic eyes was 112.92 ± 4.72 μm with statistical significance (p<0.001). The mean change in central macular thickness (CMT) in amblyopic eyes was 198.50 ± 5.30 μm and non amblyopic eyes was 206.80 ± 3.11 μm with statistical significance (p<0.001). There was significant increase in per-papillary retinal nerve fibre layer (pRNFL) thickness and significant decrease in central macular thickness (CMT) on comparing the amblyopic and the fellow eyes of the same patients. Conclusion: Central macular thickness (CMT) decreased.........................

Efficacy of 5-Fluorouracil in the Treatment of Pterygium

Objective To determine the efficacy of 5-Fluorouracil (FU) in the treatment of pterygium. Methodology After meeting the inclusion criteria 101 patients were enrolled in this study. Informed consent and demographic information was taken from all the patients. Patients underwent ophthalmic clinical examination that included slit lamp examination to grade pterygium. Before starting 5-FU injections, all topical medication was stopped. After four weeks the effects of 5-FU and its efficacy was noted. The patients were reviewed again after six months to note any recurrence. All the collected data was entered and analyzed on Statistical Package for Social Sciences (SPSS) version 20 (IBM Corp., Armonk, NY). Results In our study the mean age of the patients was 37.74 ± 10.15 years, male to female ratio of the patients was 1.06:1. The primary type of pterygium was noted in 54 (53.5%) and recurrent was noted in 47 (46.5%) patients. The efficacy achieved in 88 (87.13%) patients, four had recurrence of pterygium and of 101 patients 26 underwent surgical excision. Conclusion The use of 5-FU is safe and effective for the treatment of pterygium and it can be implemented as a primary treatment especially in the hot temperate zone where it is very common and aggressive with high recurrence rate. 5-FU not only halts its progression but also reduces the size and vascularity thus decreasing the need for surgery and steroid use and preventing recurrence.

Imbalanced Breast Cancer Classification Using Transfer Learning

Accurate breast cancer detection using automated algorithms remains a problem within the literature. Although a plethora of work has tried to address this issue, an exact solution is yet to be found. This problem is further exacerbated by the fact that most of the existing datasets are imbalanced, i.e., the number of instances of a particular class far exceeds that of the others. In this paper, we propose a framework based on the notion of transfer learning to address this issue and focus our efforts on histopathological and imbalanced image classification. We use the popular VGG-19 as the base model and complement it with several state-of-the-art techniques to improve the overall performance of the system. With the ImageNet dataset taken as the source domain, we apply the learned knowledge in the target domain consisting of histopathological images. With experimentation performed on a large-scale dataset consisting of 277,524 images, we show that the framework proposed in this paper gives superior performance than those available in the existing literature. Through numerical simulations conducted on a supercomputer, we also present guidelines for work in transfer learning and imbalanced image classification.

HEMOGLOBIN IN RELATION TO BODY MASS INDEX AND SOCIOECONOMIC CHARACTERISTICS AMONG PREGNANT WOMEN

Objective: To determine whether the body mass index (BMI) and hemoglobin (HB) level are associated withsocioeconomic strata among pregnant women belonging to different socioeconomic strata. Study Design: A cross-sectional study. Place and Duration of Study: Sheikh Zayed Hospital, National Hospital & Medical Center, and Hameed LatifHospital Lahore (Punjab; Pakistan), from Mar to Dec 2018. Methodology: A cross-sectional study was conducted on 300 pregnant women of lower, middle and upper class; age range from 15-39 years. Women from all trimesters were included in the study. A self-structured questionnaire was used to collect socio-demographic data about participants of the study. Anthropometric measurements, body mass index (BMI), and hemoglobin (HB) level were evaluated in participants belonging to different socioeconomic status. Results: The study determined that 3% of participants were underweight, 29% had average weight, 45% belong to an overweight category, and 23% were obese as assessed based on BMI values. Hemoglobin level varied from 9.1 mg/dl to 11 mg/dl among participants of different socioeconomic strata. A significant association was observed between BMI, HB level, and socioeconomic status (p=0.000). However, there was no significant association observed between BMI and hemoglobin. Conclusion: It was concluded that the body mass index (BMI) and hemoglobin (HB) were significantly associated with socioeconomic conditions of pregnant women but showed no association with each other. This provided the potential for new avenues to improve health status during pregnancy.

Treatment of leachate through constructed wetlands using Typha angustifolia in combination with catalytic ozonation on Fe-zeolite A

Leachate control and management is a major challenge faced during solid waste management as it may pollute surface and groundwaters. In the current research, constructed wetlands (CWs) vegetated with Typha angustifolia plant in combination with catalytic ozonation by ferrous (Fe)-coated zeolite A was studied for the treatment of leachate. The CWs treatment with 9 days detention reduced the chemical oxygen demand (COD) and biochemical oxygen demand (BOD) up to 75.81% and 69.84%, respectively. Moreover, total suspended solids (TSS), total dissolved solids (TDS), and total kjeldahl nitrogen (TKN) removal of 91.16%, 33.33%, and 25.22% were achieved, respectively. The Fe-coated zeolite A catalytic ozonation further reduced the COD up to 90.7%. Comparison of the processes showed the effective performance of the combined process (CW/O₃/Fe-zeolite) with 97.76% COD reduction of leachate. It is, therefore, concluded that the studied combined process (CW/O₃/Fe-zeolite A) was more efficient as compared with single ozonation and CW alone, hence it can be implied for the leachate treatment in real conditions.