Late port-site metastasis of unexpected gallbladder carcinoma after laparoscopic cholecystectomy: A case report.

INTRODUCTION: Incidental gallbladder carcinoma refers to a discovery of gallbladder cancer during or after cholecystectomy. Late port-site metastasis (PSM) following Laparoscopic cholecystectomy (LC) is rare with an incidence rate of 10.3%. PATIENT CONCERNS: We report a case of a 58-year-old man who presented with a painful abdominal wall mass for 6 weeks. He had a history of LC for symptomatic cholelithiasis, 8 years prior. DIAGNOSIS: Histopathological examination revealed a positive result for metastatic adenocarcinoma from the abdominal wall mass. Moreover, Positron emission tomography (PET) showed a small focus of intense fluorodeoxyglucose (FDG) uptake in the gallbladder bed, which was highly suspicious for malignancy. INTERVENTION: Decision was to proceed with surgery owing to uptake in the gallbladder bed with single-site metastasis to the previous port site. In addition, in the board meeting, an agreement was reached for performing distal pancreatectomy with splenectomy owing to uncertainty of malignancy based on what was discovered during the full metastatic workup. Diagnostic laparoscopy followed by midline laparotomy performed. Radical completion cholecystectomy with lymphadenectomy was done. Followed by complete resection of the anterior abdominal wall. Distal pancreatectomy and splenectomy were then performed. OUTCOME: Pathological diagnosis showed metastatic/invasive, moderately differentiated adenocarcinoma with positive margins on the posterior surface of excised port-site mass. The positive margins necessitated further chemoradiotherapy, followed by adjuvant chemotherapy until lung metastasis was identified. After this, the patient was scheduled for palliative chemotherapy. CONCLUSION: Presence of PSM is often associated with peritoneal metastasis. For this reason, it is advised to evaluate the patient for possible metastasis.

Development of multiple input supply based modified SEPIC DC-DC converter for efficient management of DC microgrid.

The development of DC microgrids is reliant on multi-input converters, which offer several advantages, including enhanced DC power generation and consumption efficiency, simplified quality, and stability. This paper describes the development of a multiple input supply based modified SEPIC DC-DC Converter for efficient management of DC microgrid that is powered by two DC sources. Here Multi-Input SEPIC converter offers both versatility in handling output voltage ranges and efficiency in power flow, even under challenging operating conditions like lower duty cycle values. These features contribute to the converter's effectiveness in managing power within a DC microgrid. In this configuration, the DC sources can supply energy to the load together or separately, depending on how the power switches operate. The detailed working states with equivalent circuit diagrams and theoretical waveforms, under steady-state conditions, are shown along with the current direction equations. This paper also demonstrates the typical analysis of large-signal, small-signal, steady-state modeling techniques and detailed design equations. The proposed configuration is validated through the conceptual examination using theoretical and comprehensive MATLAB simulation results. Detailed performance analysis has been done for different cases with various duty ratios. Finally, to show the competitiveness, the multi-input SEPIC topology is compared with similar recent converters.

Design of adaptive hybrid MPPT controllers with universal input voltage DC-DC converter for RES's.

At present, conventional energy production is absent because of the more hazardous gases released into the environment, the high effect on human health, more cost required for maintenance, plus less usefulness for highly populated areas. So, the Renewable Energy Sources are more focused for the present automotive industry application. In this work, the Proton Exchange Membrane Fuel Stack is considered for analyzing the proposed DC-DC converter circuit. The advantages of this fuel stack are high energy density, fast functioning nature, more robustness, and more usefulness for the various water membrane conditions of the fuel stack. However, the disadvantages of the fuel stack are excessive current generation, plus more current conduction losses. So, the wide voltage supply single switch power converter is introduced in this work for optimizing the current production of the fuel stack network. The merits of this converter circuit are high stability, good reliability, low voltage appearing across the switches, plus a uniform power supply. Here, the converter switching pulses are obtained by proposing the Modified Continuous Step Change Adaptive Fuzzy Logic with Grey Wolf Optimization hybrid controller. This controller provides high maximum power extraction efficiency from the fuel stack which is equal to 99.421%. Also, this controller's Maximum Power Point Tracking time is 0.0285 s.

Design and analysis of solitary AC-AC converter using reduced components for efficient power generation system.

Considering different applications that require varied power and voltage conversion levels between AC grids and AC loads, AC-AC power conversion between AC grids has become an inevitable technology of energy management systems. An isolated converter for performing AC-to-AC transmission is proposed with minimal components for reduced losses and enhanced system efficiency. Single-phase direct buck-boost AC to AC converter with minimum components constituted with two dual IGBT control units (IGBT 1-IGBT 4), inductor (Lf), and capacitor (Cf) is proposed in this work. The MATLAB/Simulink platform is used to provide in-depth analysis of the circuit and components along with the design guidelines, and simulation outcomes of this proposed model. The voltage gains of G = 2.13, power factor of 0.97, and overall efficiency of 98% are achieved in the proposed system with minimum components of 4 switches, 2 conductors, and 1 capacitor and inductor respectively. The obtained results are compared with existing technology to evaluate the proposed system.

Performance optimization of interleaved boost converter with ANN supported adaptable stepped-scaled P&O based MPPT for solar powered applications.

Solar energy is the most promising among many renewable energy sources to meet the increasing demand. Photovoltaic (PV) based power generating solutions are expected to gain popularity as a power source for different applications, including independent and grid connected loads, due to their cleanliness, high performance, and high dependability. The efficacy of photovoltaic systems is impacted by several elements, including geographical location, positioning, shadowing effects, and local climate conditions. In order to fulfil the demands of loads, an interleaved boost converter is utilized, which has a reduced number of filters with less stress on the devices. Solar powered systems employ several maximum power point tracking (MPPT) methodologies. However, when there is partial shading, many power peaks arise, which complicates the identification of the overall peak. Although MPPT approaches are designed to measure and maintain the global maximum power point (GMPP), there are still significant oscillations observed around the GMPP with subpar settling time, tracking efficiency, and conversion efficiency. In this work, novel hybrid MPPT technique called artificial neural network supported adaptable stepped-scaled perturb and observe (ANN-ASSPO) method and water cycle optimization based perturb and observe (WCO-PO) have been proposed. Artificial neural network (ANN) has been used to determine the best scaling factor in ANN-ASSPO MPPT. Performance is enhanced in ANN-ASSPO MPPT by using the optimum scaling factor, particularly in situations when the irradiance is rapidly changing/partial shading conditions. Similarly, in WCO-PO MPPT water cycle optimization is used to determine the peak power when the PV panel is subjected to partial shading conditions. The performances of proposed hybrid MPPT ANN-ASSPO and WCO-PO techniques have been compared in terms of power generated, output voltage, average settling time and conversion efficiency. The MATLAB/Simulink tool is employed to carry out the experiment for this study.

Development of grey wolf optimization based modified fast terminal sliding mode controller for three phase interleaved boost converter fed PV system.

The conventional MPPT method has drawbacks, such as that under partial shading conditions, several peaks occur and identifying the global peak is difficult. It may converge to a local peak and lead to poor conversion efficiency and tracking efficiency. Implementation of a hybrid algorithm by integrating P&O and metaheuristic algorithms can perform better under partial shading conditions. But the tracking speed is low and the response time is longer. To mitigate the issues mentioned above, a new hybrid algorithm has been suggested that integrates GWO and a modified fast terminal sliding mode controller (MFTSMC). The suggested method with three phase ILBC is incorporated into the PV system. The MATLAB tool is employed to experiment with this study. The performance of GWO-MFTSMC is analysed through MATLAB/ SIMULINK and compared with the performance of ANN-FTSMC and PSO-FTSMC algorithm based MPPT techniques. A hardware prototype is developed and tested for 5 × 200 W solar PV modules with the GWO-MFTSMC algorithm. The proposed method conversion efficiency is 99.72% and 96.15% under simulation and hardware realisation, respectively, which is higher than the ANN-FTSMC and PSO-FTSMC methods.

Hybrid multimodule DC-DC converters accelerated by wide bandgap devices for electric vehicle systems.

In response to the growing demand for fast-charging electric vehicles (EVs), this study presents a novel hybrid multimodule DC-DC converter based on the dual-active bridge (DAB) topology. The converter comprises eight modules divided into two groups: four Insulated-Gate Bipolar Transistor (IGBT) modules and four Metal-Semiconductor Field-Effect Transistor (MESFET) modules. The former handles high power with a low switching frequency, while the latter caters to lower power with a high switching frequency. This configuration leverages the strengths of both types of semiconductors, enhancing the converter's power efficiency and density. To investigate the converter's performance, a small-signal model is developed, alongside a control strategy to ensure uniform power sharing among the modules. The model is evaluated through simulation using MATLAB, which confirms the uniformity of the charging current provided to EV batteries. The results show an impressive power efficiency of 99.25% and a power density of 10.99 kW/L, achieved through the utilization of fast-switching MESFETs and the DAB topology. This research suggests that the hybrid multimodule DC-DC converter is a promising solution for fast-charging EVs, providing high efficiency, power density, and switching speed. Future studies could explore the incorporation of advanced wide bandgap devices to handle even larger power fractions.

Protocol of the process evaluation of cluster randomised control trial for estimating the effectiveness and cost-effectiveness of a complex intervention to increase care home staff influenza vaccination rates compared to usual practice (FluCare).

BACKGROUND: Influenza (flu) vaccination rates in UK care home staff are extremely low. Less than 40% of staff in care homes are vaccinated for influenza (flu), presenting risks to the health of frail residents and potential staff absence from cross-infection. Staff often do not perceive a need for vaccination and are unaware they are entitled to free flu vaccination. The FluCare study, a cluster randomised control trial (RCT), uses behavioural interventions to address barriers. Videos, posters, and leaflets are intended to raise awareness of flu vaccination benefits and debunk myths. On-site staff vaccination clinics increase accessibility. Financial incentives to care homes for improved vaccination rates and regular monitoring influence the environment. This paper outlines the planned process evaluation which will describe the intervention's mechanisms of action, explain any changes in outcomes, identify local adaptations, and inform design of the implementation phase. METHODS/DESIGN: A mixed method process evaluation to inform the interpretation of trial findings. OBJECTIVES: • Describe the intervention as delivered in terms of dose and fidelity, including adaptations and variations across care homes. • Explore the effects of individual intervention components on primary outcomes. • Investigate the mechanisms of impact. • Describe the perceived effectiveness of relevant intervention components (including videos, leaflets, posters, and flu clinics) from participant perspectives (care home manager, care home staff, flu clinic providers). • Describe the characteristics of care homes and participants to assess reach. A purposive sample of twenty care homes (ten in the intervention arm, ten in the control arm) for inclusion in the process evaluation. Data will include (1) study records including care home site profiles, (2) responses to a mechanism of action questionnaire, and (3) semi-structured interviews with care home staff and clinic providers. Quantitative data will be descriptively reported. Interview data will be thematically analysed and then categories mapped to the Theoretical Domains Framework. DISCUSSION: Adopting this systematic and comprehensive process evaluation approach will help ensure data is captured on all aspects of the trial, enabling a full understanding of the intervention implementation and RCT findings. TRIAL REGISTRATION: ISRCTN ISRCTN22729870. Registered on 24 August 2022.

A systematic review of barriers and enablers associated with uptake of influenza vaccine among care home staff.

Barriers and enablers to vaccination of care home (CH) staff should be identified in order to develop interventions to address them that increase uptake and protect residents. We aimed to synthesis the evidence describing the barriers and enablers that affect the influenza vaccination uptake of care home (CH) staff. METHOD: We searched PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, AMED, IBSS, SCOPUS to identify quantitative, qualitative or mixed-method studies. Data related to health or social care workers in CHs reported barriers or enablers were extracted and mapped to the Theoretical Domains Framework (TDF); the data within each domain were grouped and categorized into key factors affecting influenza vaccine uptake among CH staff. RESULTS: We screened 4025 studies; 42 studies met our inclusion criteria. Thirty-four (81 %) were surveys. Five theoretical domains were frequently reported as mediators of influenza vaccine uptake: Beliefs about consequences (32 studies), Environmental context and resources (30 studies), Emotions (26 studies), Social influences (25 studies), Knowledge (22 studies). The low acceptance rate of the influenza vaccine among CH staff can be attributed to multiple factors, including insufficient understanding of the vaccine, its efficacy, or misconceptions about the vaccine (knowledge), perceiving the vaccine as ineffective and unsafe (beliefs about consequences), fear of influenza vaccine and its side effects (emotions), and experiencing limited accessibility to the vaccine (environmental context and resources). CONCLUSION: Interventions aimed at increasing influenza vaccine uptake among CH staff should focus on addressing the barriers identified in this review. These interventions should include components such as enhancing knowledge by providing accurate information about vaccine benefits and safety, addressing negative beliefs by challenging misconceptions, managing concerns and fears through open communication, and improving accessibility to the vaccine through convenient on-site options. This review provides a foundation for the development of tailored Interventions to improve influenza vaccine uptake among CH staff.

Studying the Association Between Knowledge of Professionalism and Demographic Characteristics in King Saud University Medical Students.

Objectives To study the association between the level of knowledge regarding professionalism and demographic characteristics among medical students from years three to five at King Saud University, Riyadh, Saudi Arabia. Methods Data for this quantitative observational cross-sectional study were collected using stratified random sampling. The participants included male and female students from years three to five studying at the College of Medicine, King Saud University. Data were collected using a self-administered questionnaire and analyzed using the Student's t-test and a one-way ANOVA test. Results The study comprised 112 female (52%) and 103 male (48%) students who completed 215 questionnaires. The mean percentage values of correct answers by females and males were 59.99% and 59.31%, respectively. Statistical analysis revealed no significant difference between the mean percentage of correct answers given by males and females (p=0.684). The mean percentage of correct answers among the 3rd, 4th, and 5th-year medical students was 59.27%, 56.56%, and 62.72%, respectively. Statistical analysis revealed significant differences between the academic year groups (p<0.05), and the grade point average (GPA) groups showed significant differences (p<0.05). Conclusion A highly significant association was found between knowledge of professionalism and both academic level and performance among medical students. This suggests that professional perception evolves parallel to acquiring basic science and clinical knowledge.

Experience of Sudden Shift from Traditional to Virtual Problem-Based Learning During COVID-19 Pandemic at a Medical College in Saudi Arabia.

Background: COVID-19 pandemic has resulted in a sudden shift to online education. PBL was one of the components that was transformed to online. The aim of the present study was to investigate the impact of the sudden shift to virtual PBL during COVID-19 pandemic in achieving the intended learning objectives of the PBL and to explore the students' perception of the virtual versus traditional PBL. Methods: This is a retrospective study that was conducted in the college of medicine, King Saud University. We compared the perception of third year students who participated in traditional face-to-face PBL in 2019-2020 and in the virtual PBL in 2020-2021. We compared the performance of the students in the traditional face-to-face and in virtual PBL. An online survey was distributed from October to December 2021. The survey contained 7 sections. Each section included several questions comparing virtual and traditional PBL in that aspect. Results: Out of 284 third year medical students, 124 students responded with a response rate of 43.66%. More than half of the students (n = 77, 63%) felt significantly motivated to actively participate in PBL sessions in a virtual learning environment, motivated to learn and support group work and gained critical thinking skills (mean = 3.54 ± 0.12 versus 3.59 ± 0.14, p < 0.001). The majority of students (n = 82, 66%) felt significantly more satisfied about their learning during the virtual PBL versus traditional PBL (mean = 3.48 ± 0.42 versus 3.91 ± 0.59, p < 0.001). There was no significant difference in the students' performance in traditional versus virtual PBL (mean = 4.77 ± 0.22 versus 4.79 ± 0.29, p = 0.2). Conclusion: The results of this study showed that students were significantly more satisfied with the experience in the virtual versus traditional PBL. Medical students' performances in virtual PBL were comparable to the traditional face-to-face approach.

The Successful Implementation of a Modified Pediatric Acute Lymphoblastic Leukemia Protocol to Treat an Elderly Patient With T-cell Lymphoblastic Leukemia: A Case Report.

Acute lymphoblastic leukemia (ALL) is a group of hematological malignancies most commonly seen in pediatrics. The disease process localizes in lymphoid organs, the central nervous system, the mediastinum, and bone marrow (BM). The clinical features of T-cell acute lymphoblastic leukemia (T-ALL) in adults include evidence of generalized lymphadenopathy, hepatosplenomegaly, immunosuppression, and hypercalcemia. There is limited research on the efficacy of using modified pediatric treatment regimens in the elderly over the age of 60 with ALL; this case report aims to illustrate the successful treatment of a 67-year-old male patient diagnosed with T-ALL, using a modified Children's Oncology Group (COG) protocol. Through this, it has been shown to be an effective, safe, and efficacious treatment option for our patient.

Molecular Screening via Sanger Sequencing of the Genetic Variants in Non-Alcoholic Fatty Liver Disease Subjects in the Saudi Population: A Hospital-Based Study.

Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases, along with steatosis and non-alcoholic steatohepatitis (NASH), and is associated with cirrhosis and hepatocellular carcinoma. Candidate gene and genome-wide association studies have validated the relationships between NAFLD, NASH, PNPLA3, TM6SF2, and HFE. The present study utilized five polymorphisms in three genes: PNPLA3 (I148M and K434E) TM6SF2 (E167K), and HFE (H63D and C282Y), based on undocumented case−control studies in the Saudi Arabian population. A total of 95 patients with NAFLD and 78 non-NAFLD subjects were recruited. Genomic DNA was isolated, and polymerase chain reaction and Sanger sequencing were performed using specific primers for the I148M, K434E, E167K, H63D, and C282Y. NAFLD subjects were older when compared to controls and showed the significant association (p = 0.0001). Non-significant association was found between gender (p = 0.26). However, both weight and BMI were found to be associated. Hardy−Weinberg equilibrium analysis confirmed that H63D, I148M, and K434E polymorphisms were associated. Genotype analysis showed only K434E variant was associated with NAFLD and non-NAFLD (OR-2.16; 95% CI: 1.08−4.31; p = 0.02). However, other polymorphisms performed with NAFLD and NASH were not associated (p > 0.05), and similar analysis was found when ANOVA was performed (p > 0.05). In conclusion, we confirmed that K434E polymorphism showed a positive association in the Saudi population.

Prevalence of Delayed Eruption of Permanent Upper Central Incisors at a Tertiary Hospital in Riyadh, Saudi Arabia.

Tooth eruption is defined as the axial movement of the tooth from its site of development in the alveolar bone to its functional position in the oral cavity. A delay in eruption can directly affect the accurate diagnosis, overall treatment planning, and timing of treatment. Thus, Delayed Tooth Eruption can have a significant impact on a patient's proper health care. This study aimed to estimate the prevalence of delayed eruptions of permanent upper central incisors in Riyadh, Saudi Arabia. A retrospective study assessed panoramic radiographs of children between the ages of 6-10 years old who attended the Dental University Hospital clinics at King Saud University in Riyadh, Saudi Arabia between 2014 and 2020. The radiographs were collected and examined to detect any delayed eruption of the permanent upper central incisors. Panoramic radiographs with delayed erupted permanent upper central incisors were identified by tooth developmental stages and eruption sequence. Of the 745 radiographs, 23 (3.09%) presented at least one delayed erupted permanent upper central incisor of which boys and girls comprised 16 (69.5%) and 7 (30.4%), respectively. Retained primary teeth was the most causative factor of delayed eruption (43.4%), followed by the early loss of primary teeth (21.7%) and insufficient arch space. The present study is the first to assess the prevalence of delayed eruption of the permanent upper central incisors on a Saudi population. Boys were found to have more prevalence of delayed eruption of the permanent upper central incisors compared to girls. Clinicians should be aware of such a condition as early diagnosis of delayed eruption is essential for providing optimal dental care.

Evaluation of the Experience of Peer-led Mock Objective Structured Practical Examination for First- and Second-year Medical Students.

Background: The objective structured practical examination (OSPE) is used as an assessment tool of laboratory practical sessions. This study described the design and implementation of peer-led mock OSPE for first- and second-year medical students, investigated the perception of the students of the peer-led mock OSPE and the impact of attending the mock OSPE on the performance. Methods: This is a cross-sectional study. Two mock OSPEs were designed and conducted by third-, fourth- and fifth- year medical students for year one and two. Each mock OSPE involved six stations. Thirty-three medical students facilitated the OSPE. The OSPEs were conducted prior to the summative end of block exams. Following the mock OSPEs, an online survey was sent to the participants to assess their satisfaction, quality and benefits of the mock OSPE. The study also evaluated the impact of the mock OSPE on students' performance. Results: Out of 313 first-year students, 279 (89.1%) attended the mock OSPE and out of 298 second-year students, 213 (71.5%) attended. A total of 192 (68.8%) first-year medical students and 102 (47.9%) second-year medical students completed the questionnaire. There was no significant difference between attending and non-attending the mock OSPE in the students' performance in the summative OSPE. The majority of students felt more confident, less anxious, and lowered the levels of stress after attending the mock OSPE. More than half of the students felt that attending the mock OSPE helped in easing the steps, better preparation, provided sufficient orientation, well explained the materials and helped them to learn the concept of the final OSPE. The majority of students found the mock OSPE stimulating. Conclusion: Attending the mock OSPE did not affect the students' performance in the summative OSPE. However, the peer-assessed mock OSPE improved the medical students' confidence and lowered the anxiety associated with OSPE.

Management of Delayed Eruption in Permanent Incisor Following Intrusion Injury of Primary Dentition: A Case Report.

This article describes the clinical management of delayed eruption of the upper left permanent central incisor of an eight-year-old child with a history of overlooked intrusive trauma to the primary maxillary incisors. Initial conservative management involved simple extraction of the over-retained upper right primary left incisor. At the recall visit, the decision was made to expose permanent incisors surgically aiming to facilitate its eruption. Two years later, the upper right central and lateral incisors have been erupted into the oral cavity, improving patient aesthetics. This case report aims to demonstrate the clinical diagnosis and intervention for delayed eruption of maxillary permanent central incisor as a consequence of an overlooked intrusive trauma in the primary dentition. Additionally, to emphasize the importance of periodic radiographic examination in monitoring the sequence of eruption in mixed dentition.

Predictors of recurrent arteriovenous fistula stenosis in Saudi patients undergoing hemodialysis.

OBJECTIVES: To identify predictors of recurrent arteriovenous fistula (AVF) stenosis. It also seeks to calculate the average primary patency duration in Saudi patients undergoing hemodialysis. METHODS: A retrospective case-control study was conducted at a tertiary care hospital in Riyadh. Data from 180 patients who had undergone angioplasty between May 2009 and May 2020 were analyzed. Following the inclusion/exclusion criteria, 99 patients were included. Based on the presence or absence of recurrent AVF stenosis, the patients were divided into cases and controls, respectively. Recurrence was defined as an occurrence of stenosis within <12 months of a previous stenotic event, or patients who had >3 total stenotic events. Clinical, radiological, and laboratory variables were collected and subjected to multivariate binary regression analysis to assess the odds of a recurrence of fistula stenosis. RESULTS: A total of 29 patients were categorized as cases, while 70 patients were categorized as controls. The median primary patency duration was found to be seven months. Multivariate binary regression analysis revealed higher levels of serum calcium (p=0.012) and BMI (p=0.007) in patients with recurrent stenosis. A positive association was also observed between the use of antiplatelets (0.039) and recurrent stenosis. CONCLUSION: Higher levels of corrected calcium, BMI, and the application of antiplatelet therapy were found to be predictors of recurrent AVF stenosis. No other traditional variables were found to be significant.

High seroprevalence of SARS-CoV-2 among high-density communities in Saudi Arabia.

BACKGROUND: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection had been investigated utilizing serology. MATERIALS AND METHODS: This community-based sero-survey was carried out in the neighborhoods of three cities in Saudi Arabia. RESULTS: Of 5629 participants, 2766 (49.1%) were women; and 2148 (38.1%) were 18-34 years of age, and 3645 (64.7%) were from South East Asia. Positive serology was seen in 2825 (50.2% (95% CI: 48.8-51.5%) for SARS-CoV-2 anti-S1 IgG antibodies by ECLIA. Being in the age category of 18-34 years and being from Eastern Mediterranean Region (country A) were associated with higher COVID-19 seropositivity with estimated odds ratio of 1.3 [95% CI 1.1-1.8] and 2.5 [95% CI 1.1.5-4.2] respectively. Gender, social status, education, nationality, symptoms, presence of comorbidities and activity style were positively associated with increased seropositivity. Factors associated negatively with the rate of seropositivity were higher education and having outdoor activity with estimated OR of 0.92 [95% CI 0.46-0.95] and 0.59 [95% CI 0.47-0.74], respectively. CONCLUSION: The study showed high seroprevalence of SARS-CoV-2 among high density population. Health education campaigns should target middle-aged, those with low education, those living in lower standards and indoor workers.

Repeat Lamellar Keratoplasty Treatment for Positive Rim Lamellar Keratoplasty.

A case describes repeat lamellar keratoplasty (LKP) as a treatment for positive rim of Candida glabrata LKP. As have postulated in the literature, having positive rim is a substantial risk factor for a developing fungal keratitis. Different management approaches of fungal keratitis over a corneal graft have used. Herein, we provide a description of the clinical findings, management approach and used surgical technique with review of the literature.