Individual transmembrane domains of SfABCC2 from Spodoptera frugiperda do not serve as functional Cry1F receptors.

The fall armyworm (Spodoptera frugiperda) is a major global pest causing severe damage to various crops, especially corn. Transgenic corn producing the Cry1F pesticidal protein from the bacterium Bacillus thuringiensis (Cry1F corn) showed effectiveness in controlling this pest until S. frugiperda populations at locations in North and South America evolved practical resistance. The mechanism for practical resistance involved disruptive mutations in an ATP binding cassette transporter subfamily C2 gene (SfABCC2), which serves as a functional Cry1F receptor in the midgut cells of susceptible S. frugiperda. The SfABCC2 protein contains two transmembrane domains (TMD1 and TMD2), each with a cytosolic nucleotide (ATP) binding domain (NBD1 and NBD2, respectively). Previous reports have demonstrated that disruptive mutations in TMD2 were linked with resistance to Cry1F, yet whether the complete SfABCC2 structure is needed for receptor functionality or if a single TMD-NBD protein can serve as functional Cry1F receptor remains unknown. In the present study, we separately expressed TMD1 and TMD2 with their corresponding NBDs in cultured insect cells and tested their Cry1F receptor functionality. Our results show that the complete SfABCC2 structure is required for Cry1F receptor functionality. Moreover, binding competition assays revealed that Cry1F specifically bound to SfABCC2, whereas neither SfTMD1-NBD1 nor SfTMD2-NBD2 exhibited any significant binding. These results provide insights into the molecular mechanism of Cry1F recognition by SfABCC2 in S. frugiperda, which could facilitate the development of more effective insecticidal proteins.

A study on the epidemiology of brucellosis in bovine population of peri-urban and rural areas of district Multan, southern Punjab, Pakistan.

BACKGROUND: Brucellosis is a zoonotic disease caused by a bacterial pathogen belonging to the genus Brucella. It is one of the most frequent bacterial zoonoses globally but unfortunately, it is still considered as a neglected disease in the developing world. Keeping in view, this study was conducted to determine the prevalence and risk determinants of brucellosis in large ruminants of peri-urban and rural areas of district Multan-Pakistan. For this purpose, blood samples (n = 490) were collected from the cattle (n = 245) and buffalo (n = 245) population of the study area and subjected to preliminary screening of brucellosis using local and imported RBPT reagents. All the samples were further analyzed using commercially available multi-specie indirect ELISA kit followed by their confirmation by PCR using genus and species-specific primers. Data obtained from lab analysis and questionnaires were subjected to statistical analysis for Pearson Chi-square, Odds Ratio and Confidence intervals (95%). RESULTS: The results showed that the maximum seropositivity was recorded with local RBPT reagent (VRI, Pakistan; 12.45%; 95%CI = 9.72-15.65%) followed by RBPT-IDEXX (12.24%; 95%CI = 9.52-15.45%) and RBPT-ID.vet (11.84%; 95%CI = 9.18-14.95%) however statistical difference was non-significant (P = 0.956). The ELISA results showed an overall seroprevalence rate of 11.22% (95%CI = 8.59-14.33%) with comparatively higher rate in cattle (12.65%; 95%CI = 8.82-17.44%) as compared to buffaloes (9.80%; 95%CI = 6.49-14.15%). The PCR analysis confirmed the presence of genus Brucella in all seropositive samples whereas frequency of B. abortus and B. melitensis in seropositive samples was 80% and 20%, respectively. The co-existence of both species was also observed in 5.45% samples. The statistical analysis showed a significant association of bovine brucellosis with herd size, breed, reproductive disorders, mode of insemination, educational status and farmers' awareness about brucellosis (P < 0.05). Conversely, locality, age, weight, gender, pregnancy status, parity and puberty status had no associations with brucellosis (P > 0.05). CONCLUSION: In conclusion, brucellosis is prevalent in large ruminants of district Multan, Pakistan. It is suggested to devise and implement stringent policies for the effective control and prevention of brucellosis in the region. Further, the current situation also warrants the need to strengthen interdisciplinary coordination among veterinarians and physicians in one health perspective to ensure and strengthen the human and animal health care systems in the region.

Pathological effects of feeding aflatoxin-contaminated feed on immune status and reproductive performance of juvenile white leghorn males and its mitigation with ∝-tocopherol and Moringa oleifera.

This study was planned to detect the adverse pathological consequences of aflatoxin B1 in White Leghorn (WLH) layer breeder males. Eight-week-old male layer cockerels were separated into six experimental categories: A group was kept as negative control, offered with normal feed only; group B was fed with 400 ppb amount of aflatoxin, while groups F and D fed with normal feed and supplemented with vitamin E 100 ppm and 1% Moringa oleifera, respectively, whereas groups E and C were fed with 400 ppb aflatoxin containing feed and ameliorated with vitamin E 100 ppm and 1% Moringa oleifera, respectively. This study was continued for 2 months and immunologic disorders and reproductive parameters were observed during the trial. To find out immunological status lymphoproliferative response to phytohemagglutinin-P (PHA-P), antibody titers against sheep red blood cells (SRBCs) and carbon clear assay were performed by collecting samples from five birds from each group. The whole data was measured by ANOVA test, and group means were compared by DMR test by using M-Stat C software. Regarding the reproductive status, spermatogenesis, blood testosterone level, testes weight, testes histology, sperm motility, and morphology were negatively affected by aflatoxins, but these deviations positively ameliorated by vitamin E and Moringa. Vitamin E and Moringa found advantageous in boosting the immune status of affected bird. All the immunological parameters including antibody titers against sheed red blood cells, lymphoproliferative response to avian tuberculin and phagocytic potential of macrophages were suppressed by AFB1 however in control, Moringa and vitamin E groups these immunological responses were significantly higher.

Pleomorphic adenomia of lower lip: A case report.

Pleomorphic adenoma is a benign tumor of the salivary glands. It commonly occurs in the parotid gland, palate, upper lip and cheek. The authors present a rare case of a pleomorphic adenoma of the lower lip in a 30 years old female admitted on 20th of July, 2022 at Akbar Niazi Teaching Hospital, Islamabad with a complaint of painless, slightly itchy swelling on the lower lip for the last four months. Careful history and examination revealed a swelling of the lower lip which had gradually increased in size but was static for the last three months. As the patient complained of cosmetic and social inconvenience, it was surgically managed. Any post-operative complications were ruled out and the patient was sent home in a good condition. Much research is warranted to know the exact etiopathogenesis and appropriate management of pleomorphic adenoma of the lower lip.

Comparative Analysis of the GNAI Family Genes in Glioblastoma through Transcriptomics and Single-Cell Technologies.

Glioblastoma multiforme (GBM) is one of the most aggressive cancers with a low overall survival rate. The treatment of GBM is challenging due to the presence of the blood-brain barrier (BBB), which hinders drug delivery. Invasive procedures alone are not effective at completely removing such tumors. Hence, identifying the crucial pathways and biomarkers for the treatment of GBM is of prime importance. We conducted this study to identify the pathways associated with GBM. We used The Cancer Genome Atlas (TCGA) GBM genomic dataset to identify differentially expressed genes (DEGs). We investigated the prognostic values of the guanine nucleotide-binding protein G(i) alpha subunit (GNAI) family of genes in GBM using a Chinese Glioma Genome Atlas (CGGA) dataset. Within this dataset, we observed the association in the tumor microenvironment between the gene expression of GNAI subunit 3 (GNAI3) and a poor prognosis. MetaCore and gene ontology (GO) analyses were conducted to explore the role of GNAI3 in co-expressed genes and associated signaling pathways using a transcript analysis. Notable pathways included "Cytoskeleton remodeling regulation of actin cytoskeleton organization by the kinase effectors of Rho GTPases" and "Immune response B cell antigen receptor (BCR) pathway". A single-cell analysis was used to assess GNAI3 expression in GBM. The results demonstrated that GNAI family genes, specifically GNAI3, were significantly associated with carcinogenesis and malignancy in GBM patients. Our findings suggest that the GNAI3 gene holds potential as a prognostic biomarker for GBM.

Spectrum Evaluation in CR-Based Smart Healthcare Systems Using Optimizable Tree Machine Learning Approach.

The rapid technological advancements in the current modern world bring the attention of researchers to fast and real-time healthcare and monitoring systems. Smart healthcare is one of the best choices for this purpose, in which different on-body and off-body sensors and devices monitor and share patient data with healthcare personnel and hospitals for quick and real-time decisions about patients' health. Cognitive radio (CR) can be very useful for effective and smart healthcare systems to send and receive patient's health data by exploiting the primary user's (PU) spectrum. In this paper, tree-based algorithms (TBAs) of machine learning (ML) are investigated to evaluate spectrum sensing in CR-based smart healthcare systems. The required data sets for TBAs are created based on the probability of detection (Pd) and probability of false alarm (Pf). These data sets are used to train and test the system by using fine tree, coarse tree, ensemble boosted tree, medium tree, ensemble bagged tree, ensemble RUSBoosted tree, and optimizable tree. Training and testing accuracies of all TBAs are calculated for both simulated and theoretical data sets. The comparison of training and testing accuracies of all classifiers is presented for the different numbers of received signal samples. Results depict that optimizable tree gives the best accuracy results to evaluate the spectrum sensing with minimum classification error (MCE).

Cervical Mediastinoscopy as a Diagnostic Tool for Mediastinal Lymphadenopathy.

OBJECTIVE: To determine the yield of cervical mediastinoscopy in determining causes of mediastinal lymph node enlargement. STUDY DESIGN: Observational study. Place and Duration of the Study: CMH Rawalpindi, Lahore and Multan, from January 2010 to December 2021. METHODOLOGY: Patients who underwent lymph node biopsy through cervical mediastinoscopy approach were included. Record of the patients including age, gender, clinical presentation, and findings on CT scan chest were noted along with the record of preoperative complications and duration of surgery. Histopathology report was also recorded. RESULTS: Out of 398 patients, 259 (65%) were males and 139 (35%) were females. Out of 338 patients who were operated for diagnostic purpose, 157 (46%) had tuberculosis and 34 (10.1%) had sarcoidosis. Fifty-two (15.3%) were diagnosed to have malignancy including non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), and metastatic carcinoma of unspecified origin. Amongst staging group (n=60), 33 (55%) patients had negative mediastinal disease. Complication rate was 3.8%, including hoarseness of voice in three patients while 2 patients had wound infection requiring intervention. CONCLUSION: Cervical mediastinoscopy is a safe and efficacious means of diagnosis in indeterminate mediastinal lymphadenopathy and staging of lung malignancy. KEY WORDS: Mediastinoscopy, Lymph nodes, Tuberculosis, Lung cancer, Staging.

Impact of technological innovation and renewable energy on ecological footprint in G20 countries: The moderating role of institutional quality.

The connection between ecological footprint and economic complexity has significant implications for environmental sustainability regarding the policy. Additionally, institutional quality is crucial in ensuring environmental sustainability and moderating the link between economic complexity and ecological footprint. The task of achieving sustainable environmental development and preventing further degradation of the environment poses a formidable challenge to policymakers. This study delves into the significance of technology innovation and renewable energy in creating a more sustainable environment. Recognizing the need for a more critical review, this research establishes the dynamic linkage between ecological footprint, renewable energy consumption, and technological innovation, especially in conjunction with a moderating component, particularly institutional quality, in G20 countries from 1990 to 2021. We employ advanced panel approaches to address panel data analysis concerns, such as cross-sectional dependence, slope heterogeneity, unit root, cointegration test and CS-ARDL. The long-term estimator indicates that renewable energy and technological innovation negatively but significantly impact the ecological footprint. Whilst economic growth, FDI, and urbanization have shown a positive and significant impact on ecological footprint; institutional quality negatively moderates the relationship between ecological footprint, renewable energy, and technological innovation in the G20 countries. Further evidence from the Dumitrescu-Hurlin Granger causality test shows that efforts to expand access to renewable energy, technological advancements, and economic growth will significantly affect environmental impacts. Based on our results, it is imperative to introduce more favorable legislation and encourage technological advancements in the field of renewable energy if we want to achieve our sustainable development objectives.

Amplifying the photovoltaic properties of phenylene dithiophene core based non-fused ring by engineering the terminal acceptors modification to enhance the efficiency of organic solar cells.

In this study, a series of eight non-fused rings-based semiconducting acceptors (AR1-AR8) were computationally developed by making modifications to the parent molecule (PTICO). In this study, a DFT analysis was conducted at an accurately chosen level of theory to gather a comprehensive inventory of the optoelectronic characteristics of AR1-AR8 and PTICO. The findings indicate that all recently developed molecules exhibit a bathochromic shift in their maximum UV-visible absorbance (λmax) with a smaller band gap (Eg). AR1 has demonstrated the most significant red shift in UV-visible absorbance and possesses the smallest Eg when compared to other recently developed acceptors. AR2 acceptor has shown the best results both as electron and hole-transporting materials owing to its smallest value of reorganization energy for electrons and holes. J61 donor was engaged to calculate the open-circuit voltage (VOC) and the highest VOC with maximum FF % value was observed in AR4. The investigation of charge transfer was also conducted utilizing J61 in conjunction with the AR4 acceptor. Natural transition orbitals (NTO) have also been inspected to recognize the percentage electron transport contribution (% ETC) from the ground state to the first excites state (S0 to S1). The findings of this research suggest that the modified acceptors exhibit potential for practical implementation in the development of organic solar cells that possess improved photovoltaic performance.

Microwave-assisted sustainable exploration of cocklebur leaves (Xanthium strumarium L.) as a novel source of distinct yellow natural colorant for dyeing cotton fabric.

During current times, the use of bio-colorants attained public acceptance as a sustainable alternative to synthetic ones which in turn reduced the environmental contamination. The present study focused on the green, safe, and clean technology for the resurgence of natural colorant from cocklebur (Xanthium strumarium L.) leaves and their application to cotton fabric. Natural colorants were extracted by employing an eco-friendly microwave-assisted extraction process using an aqueous and alkaline medium. Dyeing of cotton fabric was carried out using irradiated and unirradiated cotton fabric with irradiated and unirradiated natural dyes of cocklebur leaves. The results of extraction experiments revealed that 4 min microwave-assisted alkaline extract exhibited significantly outstanding color strength onto microwave-treated cotton fabric compared to aqueous one. Further to investigate the optimum dyeing conditions for cotton fabric, various dyeing variables such as dyeing time, dyeing temperature, dye concentration, and exhausting agent were monitored and found a superior result using a dye concentration of 45 ml, for dyeing cotton fabric at 75 °C for 50 min in the presence of 4 g/100 ml of table salt. For improvement in color strength and color fastness properties, the effects of various bio-mordants, such as eucalyptus bark, acacia bark, turmeric rhizome, and onion shells, and chemical mordants (aluminum and copper) on dyed cotton fabric were also evaluated. It was also observed that cotton fabric dyed with alkaline extract of cocklebur leaves using bio-mordants as pre-mordants (4% acacia, 4% eucalyptus, 2% onion) and post-mordants (3% onion, 3% eucalyptus, 4% acacia) exhibited the highest color strength and various hues with acceptable colorfastness properties against light, washing, and rubbing in comparison to chemical mordants. The ISO standard for fastness also revealed that bio-mordanting has enhanced the rating from good to excellent in comparison to chemical mordants. The results provide ample scope for the extraction of yellow natural dye from the cocklebur leaves for eco-friendly coloration of fabrics using bio-mordants.

Sequence, Secondary Structure, and Phylogenetic Conservation of MicroRNAs in Arabidopsis thaliana.

MicroRNAs are small non-coding RNA molecules that are produced in a cell endogenously. They are made up of 18 to 26 nucleotides in strength. Due to their evolutionary conserved nature, most of the miRNAs provide a logical basis for the prediction of novel miRNAs and their clusters in plants such as sunflowers related to the Asteraceae family. In addition, they participate in different biological processes of plants, including cell signaling and metabolism, development, growth, and tolerance to (biotic and abiotic) stresses. In this study profiling, conservation and characterization of novel miRNA possessing conserved nature in various plants and their targets annotation in sunflower (Asteraceae) were obtained by using various computational tools and software. As a result, we looked at 152 microRNAs in Arabidopsis thaliana that had already been predicted. Drought tolerance stress is mediated by these 152 non-coding RNAs. Following that, we used local alignment to predict novel microRNAs that were specific to Helianthus annuus. We used BLAST to do a local alignment, and we chose sequences with an identity of 80% to 100%. MIR156a, MIR164a, MIR165a, MIR170, MIR172a, MIR172b, MIR319a, MIR393a, MIR394a, MIR399a, MIR156h, and MIR414 are the new anticipated miRNAs. We used MFold to predict the secondary structure of new microRNAs. We used conservation analysis and phylogenetic analysis against a variety of organisms, including Gossypium hirsutum, H. annuus, A. thaliana, Triticum aestivum, Saccharum officinarum, Zea mays, Brassica napus, Solanum tuberosum, Solanum lycopersicum, and Oryza sativa, to determine the evolutionary history of these novel non-coding RNAs. Clustal W was used to analyze the evolutionary history of discovered miRNAs.

Mitigation potential of individual and combined dietary supplementation of local Bentonite Clay and Distillery Sludge against Ochratoxin-A induced toxicity in broilers.

BACKGROUND: This study aimed to evaluate the ameliorative effects of dietary supplementation of local bentonite clay (BN) and distillery sludge (DS) alone and in combination on ochratoxin-A (OTA) induced toxicity in broilers. For this purpose, day-old-broiler chicks (n = 270) were procured from the local market and reared under standard management conditions. After 7 days of acclimatization, birds were divided into 2 main groups A and B with respect to OTA inclusion level in feed, each with four sub-groups viz. A1-A4, each challenged with OTA at a dietary inclusion level of 250 µg/kg feed and B1-B4, each challenged with OTA at the level of 500 µg/kg feed and a common control group that was fed with basal feed throughout the experiment. In groups A and B, BN and DS were administered with feed at the rate of 10 g/kg of feed and 5 g/kg of feed alone and in combination, respectively. RESULTS: Results showed that OTA administration alone resulted in poor feed conversion ratio (FCR) and immunological responses along with increased serum levels of alanine transaminase (ALT), Aspartate transaminase (AST), urea and creatinine (P < 0.05). A significant decrease (P < 0.05) in serum protein levels (albumin, globulin and total protein) was also observed in OTA-fed groups in a dose-dependent manner. The addition of BN at 10 g/kg of OTA-contaminated feed resulted in better FCR and immunological responses as compared to those fed OTA only. The BN supplementation also conferred protection against elevation of serum biochemical parameters when compared with OTA-fed groups. However, the addition of DS could not provide significant protection (P > 0.05) on alteration of serum biochemical parameters in response to the OTA induced toxicity. The combined supplementation of BN and DS resulted in amelioration of OTA-induced toxicity and showed improved FCR, immunological, hematological and serum biochemical parameters (P < 0.05) when compared with other groups. Similarly, BN and DS resulted in a significant decline (P < 0.05) in the OTA tissue residues compared with other groups and control. CONCLUSION: In conclusion, combined dietary supplementation of BN (10 mg/kg) and DS (05 mg/kg) in feed reduced the toxic effects of OTA contamination at levels of 250 and 500 µg/kg of feed in broilers. So, the combination products of BN and DS may be successfully developed for use in poultry for protection against OTA-induced toxicity in broilers.

Assessing the Dynamic Outcomes of Containment Strategies against COVID-19 under Different Public Health Governance Structures: A Comparison between Pakistan and Bangladesh.

COVID-19 scenarios were run using an epidemiological mathematical model (system dynamics model) and counterfactual analysis to simulate the impacts of different control and containment measures on cumulative infections and deaths in Bangladesh and Pakistan. The simulations were based on national-level data concerning vaccination level, hospital capacity, and other factors, from the World Health Organization, the World Bank, and the Our World in Data web portal. These data were added to cumulative infections and death data from government agencies covering the period from 18 March 2020 to 28 February 2022. Baseline curves for Pakistan and Bangladesh were obtained using piecewise fitting with a consideration of different events against the reported data and allowing for less than 5% random errors in cumulative infections and deaths. The results indicate that Bangladesh could have achieved more reductions in each key outcome measure by shifting its initial lockdown at least five days backward, while Pakistan would have needed to extend its lockdown to achieve comparable improvements. Bangladesh's second lockdown appears to have been better timed than Pakistan's. There were potential benefits from starting the third lockdown two weeks earlier for Bangladesh and from combining this with the fourth lockdown or canceling the fourth lockdown altogether. Adding a two-week lockdown at the beginning of the upward slope of the second wave could have led to a more than 40 percent reduction in cumulative infections and a 35 percent reduction in cumulative deaths for both countries. However, Bangladesh's reductions were more sensitive to the duration of the lockdown. Pakistan's response was more constrained by medical resources, while Bangladesh's outcomes were more sensitive to both vaccination timing and capacities. More benefits were lost when combining multiple scenarios for Bangladesh compared to the same combinations in Pakistan. Clearly, cumulative infections and deaths could have been highly impacted by adjusting the control and containment measures in both national settings. However, COVID-19 outcomes were more sensitive to adjustment interventions for the Bangladesh context. Disaggregated analyses, using a wider range of factors, may reveal several sub-national dynamics. Nonetheless, the current research demonstrates the relevance of lockdown timing adjustments and discrete adjustments to several other control and containment measures.

Nutrient sensing mechanism of short-chain fatty acids in mastitis control.

Bovine mastitis is a disease that is widespread in dairy cows worldwide, and its impact is significant due to economic losses at all levels of the dairy value chain. For a long time, antibiotics have been the main tool for curing mastitis, however the cure rate is not very high, and sometime side effects may occur. Therefore, an in-depth understanding of mastitis and effective solutions are urgently needed to resolve the problem that in what way to prevent and treat mastitis in order to protect the profitability of dairy farms. The importance of diet in the regulation of health are not novel. Dietary control of the intestinal flora provides a promising approach to prevent or treat certain deadly diseases. Ample amount of studies has been conducted on the role of short-chain fatty acids (SCFAs) in the maintenance of health. SCFAs are the type of dietary substance that has the ability to restore blood-milk barrier permeability, inhibit the development of mammary inflammation, and are also effective epigenomic modifiers with histone deacetylases inhibitory activity. To date, the detailed mechanism of action of SCFAs in treating mastitis is unclear, but preliminary evidences are emerging. To assess the effectiveness of this recommendation, we examined the overall mammary gland health knowledge related to SCFAs by scrutinizing their potential role and evaluating its compatibility with the immunobiology of mammary gland inflammation. We then considered preliminary in vivo and in vitro experiments and analyzed the literature on the subject. Here, we outline the production of SCFAs and its protective effect on the mammary gland, with particular emphasis on their relevance to mastitis. In addition, we also discussed the therapeutic potential of SCFAs for mammary gland inflammation. Expectantly, this theory will provide new perception for the treatment of mastitis and other infectious diseases.

Pathological effects of graded doses of aflatoxin B1 on the development of the testes in juvenile white leghorn males.

Current experiment was planned to investigate the deleterious effects of the graded doses of aflatoxin B1 (AFB1) on white leghorn male birds. For this purpose, one-hundred birds of 8 weeks of age were divided into 4 equal groups and reared on feed contaminated with different doses of AFB1 for 10 weeks. Group A was kept as a control group and was fed with normal toxin-free diet; groups B, C, and D were offered feed containing 100 ppb, 200 ppb, and 400 ppb of AFB1, respectively. The birds were euthanized at the 4th and 10th week of the experiment. Clinical signs, behavioral changes, absolute and relative organ weight of the testes, and sperm motility were measured. Cellular immune response was observed through carbon clearance assay (CCA), P-HAP, and antibody response against sheep red blood cells (SRBC). Results showed a dose-dependent decline in the immune response of birds with the increase in the level of AFB1 in the feed. A significant decrease in the serum levels of testosterone, prolactin, and LH were observed at the end of the study. Grossly, testicular size and volume were reduced in ABF1 fed birds, while histological examination showed moderate to severe necrosis of testicular parenchyma, with partial to complete arrest of spermatogenesis. Very few spermatozoa were found in group C, while they were almost absent in group D which was offered a diet containing 400 ppb AFB1. The motility of sperms was reduced in all treated groups except control. The abovementioned results showed that AFB1 had severe toxic effects on the reproductive and immunological parameters of WLH male birds in a dose-dependent manner.

Detection of SARS-CoV-2 by using real-time PCR nasopharyngeal swabs in suspected patients and their clinical medication.

BACKGROUND: The corona name derived from their crown like spike proteins attach with cell receptors. It belongs to coronaviradae family and nideovirales order, envelop virus, size range 65-125 â€‹nm and positive single standard RNA between 26.4 and 31.7 â€‹kb and contain 7096 amino acid. There are four subtypes that have been detected these are alpha, beta, gamma and delta. METHODOLOGY: The 267 covid-19 blood and nasopharyngeal samples were collected from Multan region. RNA extraction from nasopharyngeal samples and run the PCR. The blood samples use for clinical tests, Lactate dehydrogenase, serum ferritin level, D-Dimer, TG, cholesterol, thyphoidot, HDL, lymphocyte count and CRP. RESULTS: 127 (47.21%) out of 267 patients were covid-19 PCR positive and showed the amplification of ORF1ab, E, and N gene, while 140 individuals were covid-19 PCR negative and not showed the amplification of ORF1ab, E and N gene. The patients with negative Covid-19 PCR, the other analysis tests such as lactate dehydrogenase, HDL, ferritin, ESR, CBP, D-Dimer, Tg, cholesterol, CRP and CT scan. The patients effected covid-19 have higher values of D-Dimer, ESR, Neutrophils, LDH, CRP and ferritin level than normal ranges. However, the values of HDL, cholesterol and lymphocytes were decreased from the normal range.

Impact of the COVID-19 pandemic on knowledge, perceptions, and effects of telemedicine among the general population of Pakistan: A national survey.

Background: Telemedicine is the provision of healthcare services through information and communication technology with the potential to mobilize all facets of the health sector to prevent the spread of COVID-19, provide quality healthcare, protect patients, doctors, and the public from exposure to disease, and reduce the burden on the healthcare system. This study aims to identify knowledge, perceptions, willingness to use, and the impact of the COVID-19 pandemic on telemedicine awareness. Methods: A cross-sectional study was conducted from 27 May 2020 to 17 June 2020 using the convenient sampling technique in the general population of Pakistan. Data were collected by designing an online questionnaire consisting of demographic information, knowledge, attitude perceptions, barriers, utilization, and the impact of the COVID-19 pandemic on telemedicine. Results: Of the 602 participants included in the study, 70.1% had heard about telemedicine, 54.3% had a good understanding of the definition of "telemedicine," 81.4% had not used telemedicine in the past, 29.9% did not know that telemedicine was available before the COVID-19 pandemic, and 70.4% responded that the COVID-19 pandemic had changed their attitudes toward telemedicine. Gender (p = 0.017) and family income (p = 0.027) had a significant association with the perception of the benefits of telemedicine. Conclusion: The knowledge and usage of telemedicine are lacking due to inadequate awareness and technology. The need of the hour is to maximize the application of telemedicine to overcome the deficiencies of the healthcare system. Hence, it is essential to increase awareness through various means and develop an appropriate infrastructure to attain maximum benefits from telehealth services.

Two Infectious Agents Causing Hemophagocytic Lymphohistiocytosis.

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening immune activation syndrome that should be recognized earlier for effective treatment. Adults usually have secondary HLH. An uncommon cause of secondary HLH is AIDS and simultaneous opportunistic infections. Acute human immunodeficiency virus (HIV) and opportunistic infections are also independent causes of HLH, so the presence of both should raise suspicion, especially if patients fulfill the criteria. HLH secondary to severe babesiosis is a rare entity as well. Some patients might not meet the full criteria of HLH on presentation, especially when some specific lab test results are still pending. A delay in diagnosis can happen in those cases. Here, we present two cases. The first case is of a 35-year-old homosexual male who presented with constitutional symptoms of one-week duration. He was diagnosed and started on the treatment of HIV. His fever was not resolving and further investigations led to a diagnosis of disseminated histoplasma infection. The patient fulfilled the criteria of HLH as well. Prompt therapy resulted in the improvement of clinical and laboratory parameters. The second case is of a 72-year-old female presenting with fever. A diagnosis of severe babesiosis and secondary HLH was made. Treatment of babesia resulted in the improvement of clinical and biochemical parameters.

Characterization of Spatter and Sublimation in Alloy 718 during Electron Beam Melting.

Due to elevated temperatures and high vacuum levels in electron beam melting (EBM), spatter formation and accumulation in the feedstock powder, and sublimation of alloying elements from the base feedstock powder can affect the feedstock powder's reusability and change the alloy composition of fabricated parts. This study focused on the experimental and thermodynamic analysis of spatter particles generated in EBM, and analyzed sublimating alloying elements from Alloy 718 during EBM. Heat shields obtained after processing Alloy 718 in an Arcam A2X plus machine were analyzed to evaluate the spatters and metal condensate. Comprehensive morphological, microstructural, and chemical analyses were performed using scanning electron microscopy (SEM), focused ion beam (FIB), and energy dispersive spectroscopy (EDS). The morphological analysis showed that the area coverage of heat shields by spatter increased from top (<1%) to bottom (>25%), indicating that the spatter particles had projectile trajectories. Similarly, the metal condensate had a higher thickness of ~50 µm toward the bottom of the heat shield, indicating more significant condensation of metal vapors at the bottom. Microstructural analysis of spatters highlighted that the surfaces of spatter particles sampled from the heat shields were also covered with condensate, and the thickness of the deposited condensate depended on the time of landing of spatter particles on the heat shield during the build. The chemical analysis showed that the spatter particles had 17-fold higher oxygen content than virgin powder used in the build. Analysis of the metalized layer indicated that it was formed by oxidized metal condensate and was significantly enriched with Cr due to its higher vapor pressure under EBM conditions.

How long should we run the code? Survival analysis based on location and duration of cardiopulmonary resuscitation (CPR) after in-hospital cardiac arrest.

Background: The duration of cardiopulmonary resuscitation (CPR) significantly affects long-term survival in patients with in-hospital cardiac arrests (IHCA). In this study, we questioned the long-term clinical benefits of extending CPR beyond twenty minutes for patients with in-hospital cardiac arrest. Additionally, we aimed to compare the outcomes of CPR at different locations of a large tertiary care community hospital. Methods: This study was a retrospective chart review of 169 patients with IHCA recorded between 1 January 2016, and 31 December 2018, at a large volume tertiary care community hospital. Results: Of the 169 patients suffering from cardiac arrest during hospitalization, 44.4% arrested in the intensive care unit (ICU) and 55.6% in a non-critical care setting. Return of spontaneous circulation (ROSC) was achieved in 60% of ICU and 70.2% of non-ICU patients. While only 20% of ICU patients survived the cardiac arrest, the overall survival for non-ICU patients was 31.9%. Despite the significant difference in percentage survival, survival difference did not reach statistical significance (p = 0.082) due to the small sample size. Overall survival was 26.6%. An initial shockable rhythm was associated with improved survival compared to a non-shockable rhythm (41% vs. 22.5%, p = 0.022). In patients who had cardiac arrest for less than 20 minutes, 60.9% of patients achieved ROSC, compared to 37.9% who arrested for more than 20 minutes. Survival to hospital discharge was significantly lower for patients who had cardiac arrest for more than 20 minutes, compared to patients who were arrested for less than 20 minutes (3.1% vs. 41.3%, p = <0.0001). For patients who had a cardiac arrest for more than 30 minutes, ROSC was achieved in only 14.8% of patients. None of these patients survived to be discharged from the hospital (p = <0.0001). The mean age for the patients in this study was 70 years. 52.6% of subjects were male, and 47.4% were females. Older age was not related to shorter duration of CPR (Pearson correlation: 0.030, P = 0.69). Conclusion: Survival was significantly lower when CPR was unsuccessful for twenty minutes, and there is no survival benefit of extending CRP for more than 30 minutes. Lowest survival after a cardiac arrest on the general medical floor, compared to telemetry and ICU, may be related to delay in recognizing cardiac arrest and barriers in implementing standardized advanced cardiac life support (ACLS) protocol.