Cockroaches as carriers of human medically important parasites.

Cockroaches have been identified as mechanical carriers of pathogens capable of infesting humans. The primary objective of this research was to detect and separate medically significant parasites found within the collected cockroaches. A total of 185 cockroaches were captured. In the laboratory, cockroaches underwent a series of steps. Initially, they were washed in a saturated salt solution and rinsed with 70% alcohol, dried, and subsequently dissected to examine endoparasites. In this study, a transport rate of 29.729% was documented, and four types of helminths were identified, which included Ascaris lumbricoides (47.27%), Enterobius vermicularis (30.91%), Trichuris spp. (7.27%), and Hymenolepis nana (14.55%). The parasites were more frequently found on the external surface of cockroaches (38/69.09%), compared to the internal surface (17/30.91%). Cockroaches captured in toilets were found to carry a higher percentage of parasites (31/16.75%) compared to those from kitchens (11/5.94%) and houses (13/7.02%). These findings suggest that cockroaches can serve as carriers for intestinal parasites and potentially act as mechanical agents in the dissemination of these parasites.

Waldenström macroglobulinemia: a review of pathogenesis, current treatment, and future prospects.

Waldenström macroglobulinemia (WM) is a chronic B-cell lymphoproliferative disorder characterized by lymphoplasmacytic cell overgrowth in the bone marrow and increased secretion of IgM immunoglobulins into the serum. Patients with WM have a variety of clinical outcomes, including long-term survival but inevitable recurrence. Recent advances in disease knowledge, including molecular and genetic principles with the discovery of MYD88 and CXCR4 mutations, have rapidly increased patient-tolerable treatment options. WM patients may benefit from chemotherapy regimens that include rituximab-based regimens, alkylating drugs, proteasome inhibitors, monoclonal antibodies, and drugs targeting Bruton tyrosine kinase inhibitors. In light of these advancements, patients can now receive treatment customized to their specific clinical characteristics, focusing on enhancing the depth and durability of their response while limiting the adverse effects. Despite the rapidly developing therapeutic armament against WM, a lack of high-quality evidence from extensive phase 3 trials remains a significant challenge in the research. We believe clinical outcomes will keep improving when new medicines are introduced while preserving efficacy and minimizing toxicity.

Physical properties and photocatalytic activity of Cr-doped TiO2 nanoparticles.

Nanocrystalline Ti1- x Crx O2 (0 ≤ x ≤ 0.20) samples were synthesised via acid-modified sol-gel process and characterised with various techniques, such as HRTEM, FESEM, Raman, XPS, DTA and VSM. The TEM image of TiO2 exhibits elongated nanoparticles with an average size of 10 nm. The HRTEM in combination with selected area electron diffraction (SAED) reveals the interplanar spacing and polycrystalline nature of the samples, respectively. FESEM micrographs divulge nonuniform morphologies and less aggregation of the particles in the doped sample. Raman spectra ensure the phase purity of the samples and a blue shift on Cr doping. X-ray photoelectron spectra (XPS) predict the chemical state of the elements and oxygen vacancies in the prepared samples. Room temperature magnetic measurements exhibit a significant variation in the magnetic parameters on Cr doping in TiO2 . The differential thermal analysis (DTA) shows the structural phase transition at ∼630°C. The photocatalytic performance is studied for the degradation of methylene blue (MB) dye under visible light irradiation. A higher photocatalytic efficiency is found for the 20% of Cr-doped TiO2 . These studies propose that the appropriate incorporation of Cr ions makes TiO2 very efficient for visible light-driven photocatalysts required for applications in wastewater treatment. LAY DESCRIPTION: In the present study, nanoparticles of TiO2 and Cr-doped TiO2 have been synthesised by a cost-effective acid-modified sol-gel process. The effect of Cr doping on the microstructure, thermal, magnetic and photocatalytic properties of TiO2 were explored in detail. The transmission electron microscopy (TEM) images exhibit the presence of elongated nanoparticles with an average size of 10 nm. Field emission scanning electron microscopy (FESEM) was used to study the surface morphology of the synthesised materials, which revealed nonuniform morphologies and less aggregation of the particles in the Cr-doped sample. Energy dispersive x-ray spectroscopy (EDS) confirms the elemental compositions with the appropriate stoichiometry of the elements. Raman spectra ensure the phase purity of the materials and also a blue shift with the incorporation of Cr ions in TiO2 . X-ray photoelectron spectra (XPS) predict the chemical state of the elements and oxygen vacancies in the prepared samples. The magnetic nature of all the synthesised samples was examined through the vibrating sample magnetometer (VSM) and revealed weak ferromagnetic behaviour of the samples. These results signify that the oxygen vacancies and defects play a crucial role in developing the ferromagnetic nature of oxide semiconductors. The differential thermal analysis (DTA) shows the structural phase transition at ∼630°C. The photocatalytic performance of the prepared samples was studied for the degradation of methylene blue (MB) dye under irradiation of visible light. A higher photocatalytic efficiency was found for the 20% of Cr-doped TiO2 . These studies propose that the appropriate incorporation of Cr ions makes TiO2 very efficient for visible light-driven photocatalysts required for applications in wastewater treatment.

The CDX2 G allele and the FoKI F allele of the VDR gene are more prevalent and related to changes in vitamin D levels in patients with psoriasis vulgaris: A pilot study.

BACKGROUND AND AIMS: Psoriasis is a chronic, non-contagious autoimmune condition marked by dry, itchy,erythematous and scaly plaques. From modest, localized plaques to total body coverage, the severity of psoriasis varies. Plaque, guttate, inverted, pustular, and erythrodermic psoriasis are the five primary kinds. About 90% of cases are of plaque psoriasis, commonly known as psoriasis vulgaris. Study aims to determine the impact of an rs2228570 (FokI) variant and an rs11568820 (CDX2) variant on serum vitamin D levels (SVD) in patients with psoriasis, and the correlation between the two variants and disease severity. METHODS: A case-control study consisting of 95 psoriasis vulgaris patients and 84 healthy controls. The clinical investigation, molecular genetics analysis, and biochemical analysis were done for both groups. RESULTS: SVD levels were significantly decreased in psoriasis patients group. FokI genotypes analysis, we found no significant variance between groups. CDX2 G/G genotype is more prevalent in patients than controls. Moderate psoriasis vulgaris patients with CDX2 G/G genotypes have higher SVD levels than CDX2 G/A, and CDX2 A/A p = 0.003. CONCLUSION: The study found a difference in vitamin D levels between patients and healthy subjects, as well as a difference in vitamin D levels with different FoKI and CDX2 genotypes.

Neuroendocrine hyperplasia of infancy; a rare form of childhood interstitial lung disease: a case report.

Interstitial lung disease in infancy is rare. In this case report, we discuss the case of a six-week-old male infant who presented with persistent tachypnoea, retraction and mild hypoxaemia corrected by low-dose supplemental oxygen since the age of 2 weeks. Birth history was unremarkable. Routine workup was done which turned out to be non-contributory. The child received multiple rounds of antibiotics along with bronchodilators and corticosteroids. There was no evidence of severe gastroesophageal reflux. Computed tomography of chest showed ground glass appearance, which was especially prominent in the right middle lobe and lingula ,and accompanied with air trapping. He was managed with mild respiratory supportive care, without positive pressure ventilation and nutritional management. He was discharged home, with instructions for in clinic follow up. A distinctive topographical picture and typical clinical symptoms were consistent with neuroendocrine hyperplasia of infancy (NEHI), which has a favourable prognosis. A high index of suspicion may enable a timely diagnosis. Adequate long-term respiratory and nutritional management without lung biopsy improves the outcome.

Cerebral vascular malformations and their imaging modalities.

Cerebrovascular malformations are uncommon diverse group of dysmorphic vascular communications that may occur sporadically or as part of genetic syndromes. These include non-neoplastic lesions such as arteriovenous malformations (AVM), cavernous malformations (CM), developmental venous anomalies (DVA), and telangiectasias as well as others like arteriovenous fistulas (AVF), vein of Galen malformations (VOGM), and mixed or unclassified angiomas. These lesions often carry a high degree of morbidity and mortality often requiring surgical or endovascular interventions. The field of cerebrovascular anomalies has seen considerable advancement in the last few years. Treatment and management options of various types of brain anomalies have evolved in neurological, neurosurgical, and neuro-interventional radiology arena. The use of radiological imaging studies is a critical element for treatment of such neurosurgical cases. As imaging modalities continue to evolve at a rapid pace, it is imperative for neurological surgeons to be familiar with current imaging modalities essential for a precise diagnosis. Better understanding of these cerebrovascular lesions along with their associated imaging findings assists in determining the appropriate treatment options. In the current review, authors highlight various cerebrovascular malformations and their current imaging modalities.

Evaluation of solubility and dissolution of lamotrigine using lipid based microparticulate carriers: An in-vitro analysis.

The present study was designed to develop novel lipid microparticles in order to improve solubility, dissolution and bioavailability of a lipophilic drug of BCS class II, lamotrigine. For that purpose, increase in solubility of the model drug was investigated using different lipids and the promising lipids were further used for the fabrication of microparticles. Solid lipid (GMS) and liquid lipid (olive oil) were used along with an emulsifier (Tween 80) and a stabilizer (Poloxamer 188) to prepare mircoparticles by melt emulsification method. Prepared formulations were characterized for physicochemical properties such as solubility, particle size, zeta potential, polydispersity index and entrapment efficiency. In vitro dissolution studies were carried out in 0.01 N HCl for 24 h. The findings provided that the solubility of lamotrigine was reasonably increased in GMS, olive oil, Tween 80 and poloxamer 180. The lamotrigine solubility was increased 4.92 fold with G4 microparticles formulation. Size analysis revealed that the microparticles were in range of 11.1 to 178.8 µm and the zeta potential values were from -13 to -20 mV. Microparticles prepared with solid and liquid lipids exhibited satisfactory entrapment efficiency ranging from 59 to 87%. Conclusively, the outcomes of the studies suggest the appropriateness of selected ingredients for improving solubility as well as loading of lamotrigine in microparticles for its sustained and effective delivery.

Knowledge and attitude of physicians about antimicrobial resistance and their prescribing practices in Services hospital, Lahore, Pakistan.

A cross sectional study was conducted in Services Hospital, Lahore using a self administered questionnaire to test the knowledge, attitude and prescribing practices of residents and attending physicians using non-probability convenience sampling. A total of 116 questionnaires were filled (Response rate=77.3%). Knowledge was below average (mean score of 3.66±1.1). Only 18 physicians (16%) could correctly estimate the rates of resistance of Klebsiella pneumoniae and pseudomonas aeruginosa to cephalosporin. Mostly physicians reviewed their decisions to prescribe an antibiotic by discussing with a senior colleague (n=93; 80%). When they did, the senior colleague sometimes recommended a different antibiotic (n=106; 91%). Seventy seven physicians (66%) reported that they prescribed more than one antibiotic per day. Physicians also stated that their decision of antimicrobial prescription was influenced by patient's socioeconomic status (n=108; 93.1%) and patients' demands (n=24; 20.7%). This study highlighted the importance of Antimicrobial stewardship and revealed topics to address during future antimicrobial prescribing interventions such as dissemination of information about local resistance rates and encouraging knowledge about antimicrobials.

Eupalitin induces apoptosis in prostate carcinoma cells through ROS generation and increase of caspase-3 activity.

Prostate cancer is the second most common malignancy in the human reproductive system. Eupalitin is one of the O-methylated flavonol-exhibited enhanced cancer chemopreventive agents. The current study highlights the structural determination of eupalitin and aims to explore the antitumor activity of eupalitin in human prostate cancer cell (PC3) and its underlying mechanism. Eupalitin structure was determined by using FTIR, (1)H NMR, and (13)C NMR. PC3 cells were treated with increasing concentrations of eupalitin, followed by analysis of the cell viability with an MTT assay. The results demonstrated that eupalitin markedly inhibited the proliferation of PC3 cells in a concentration-dependent manner. The results from fluorescent microscopic analysis of nuclear condensation and intracellular ROS generation determined that eupalitin significantly induced ROS level lead to nuclear apoptosis. Cell cycle analysis revealed that eupalitin-induced cell cycle progression as a percentage of cells in G0/G1 phase decreased whereas S phase increased. Caspase-3 immunofluorescence analysis confirms the efficacy of eupalitin-inducing apoptotic pathway and cell death. Thus, our study is helpful in understanding the mechanism underlying these effects in prostate cancer and it may provide novel molecular targets for prostate cancer therapy.

Antimicrobial profile of some novel keto esters: Synthesis, crystal structures and structure-activity relationship studies.

Rapid increase in bacterial resistance has become a major public concern by escalating alongside a lack of development of new anti-infective drugs. Novel remedies in the battle against multidrug-resistant bacterial strains are urgently needed. So, in this context, the present work is towards the investigation of antimicrobial efficacy of some novel keto ester derivatives, which are prepared by the condensation of substituted benzoic acids with various substituted phenacyl bromides in dimethylformamide at room temperature using triethylamine as a catalyst. The structural build-up of the target compounds was accomplished by spectroscopic techniques including FTIR, (1)H and (13)C NMR spectroscopy and mass spectrometry. The purity of the synthesized compounds was ascertained by elemental analysis. The molecular structures of compounds (4b) and (4l) were established by X-ray crystallographic analysis. The prepared analogues were evaluated for their antimicrobial activity against Gram-positive (Staphylococcus aureus, Micrococcus leuteus) and Gram-negative (Pseudomonas picketti, Salmonella setuball) bacteria and two fungal pathogenic strains (Aspergillus niger, Aspergillus flavus), respectively. Among the screened derivatives, several compounds were found to possess significant activity but (4b) and (4l) turned out to be lead molecules with remarkable antimicrobial efficacy. The structure-activity relationship analysis of this study also revealed that structural modifications on the basic skeleton affected the antimicrobial activity of the synthesized compounds.

Classic central nervous system Hodgkin lymphoma masquerading as left sphenoid wing meningioma- A case report.

INTRODUCTION AND IMPORTANCE: Classic Hodgkin Lymphoma with an incidence of 2-3 cases per 100,000 population affects the Central Nervous System in 0.02 % of cases (Gerstner et al., 2008; Brice et al., 2021; Morawa et al., 2007). CNS lymphoma, contributing to 0.22 % of Central Nervous System tumors, is the uncommon extra-nodal manifestation of Hodgkin's Disease (Brice et al., 2021; Henkenberens et al., 2014). It affects the nervous system secondary to systemic lymphoma or the relapse of the disease (Gerstner et al., 2008). Only 17 cases of CNS lymphoma are reported which were limited to the CNS at the time of diagnosis (Paul et al., 2017). Only two cases of Dural-Based Hodgkin Lymphoma were reported in the literature (Paul et al., 2017). CASE PRESENTATION: We are reporting the third case of dural-attached extra-axial secondary CNS Hodgkin Lymphoma in a 33 years old female, which appeared and was operated as Left Sphenoid Wing Meningioma. CLINICAL DISCUSSION: Only 17 cases of CNS lymphoma are reported which were limited to the CNS at the time of diagnosis (Paul et al., 2017). Only two cases of Dural-Based Hodgkin Lymphoma were reported in the literature (Paul et al., 2017). Our case consists the third case of dural attached Classic CNS Hodgkin lymphoma and the first case of Classic CNS Hodgkin Lymphoma locating in the Sphenoid Wing. CONCLUSION: It is important to differentiate CNS Hodgkin Lymphoma from other types of brain tumors especially when it resides in an unusual location because the treatment of CNS Hodgkin Lymphoma is mainly combined chemo-radiotherapy than surgical intervention.

Upper Thoracic Spine (D2-D3) Fracture With Unilateral Lock Facets Without Associated Neurological Deficits: Case Report & Literature Review.

Introduction: Upper thoracic spine fractures are rare as compared to other spine segments due to anatomical landmarks. If they occur, they are usually associated with paraplegia or any other neurological dysfunction. We report upper thoracic fracture without neurological dysfunction which is a rare entity along with its radiological imaging, and management plan. Case Description: Forty-years old male presented after RTA. CT spine showed T2 vertebral body fracture with dislocation/locking of the right T2-T3 facet joint. The patient underwent surgical fixation and was neurologically intact. Conclusion: Upper thoracic spine fracture is a rare entity due to its anatomical location. And sometimes it is missed as well. Proper imaging should be considered if there is high suspicion and early surgery is warranted to prevent permanent damage.

Neurosurgical landscape in Pakistan: Past, present and future perspectives.

Intricate fields have always posed a challenge for the healthcare department all over the world, particularly in developing countries. This article elaborates on the history of neurosurgery in a developing country like Pakistan. In addition, it provides a summary of a roadmap that a young healthcare practitioner, who inspires to become a respectable neurosurgeon may need. After Pakistan gained its independence, Dr. Omer Wali Jooma became the first healthcare practitioner who planted the seed of an official department of Neurosurgery in Jinnah hospital, Karachi. Various challenges include the absence of a non-standardized curriculum, a non-updated syllabus, severe deficiency of neurosurgeons in a country facing massive growth spurt, lack of facilities for a young trainee etc. These factors contribute to the bleeding of the department from various sites and the wounds needs to be addressed and stitched as soon as possible to make the department successful.

Barriers to accessing surgical care: a cross-sectional survey conducted at a tertiary care hospital in Karachi, Pakistan.

BACKGROUND: The need for surgical care far exceeds available facilities, especially in low income and poor countries. Limited data are available to help us understand the extent and nature of barriers that limit access to surgical care, particularly in the Asian subcontinent. The aim of this study was to understand factors that influence access to surgical care in a low-income urban population. METHODS: An observational cross-sectional study was conducted on 199 consecutive patients admitted for elective surgery from February to April 2010 to identify the presence and causes of delay in accessing surgical care. RESULTS: The median duration of symptoms were 7 and 4 months in women and men, respectively. The odds of delay between the onset of symptoms and seeking initial health care (first interval) is twice as likely for women than for men [52.7 vs. 37.5 %, odds ratio (OR) 1.9]. Lack of knowledge regarding treatment options [OR 3.8; 95 % confidence interval (CI) 1.4-10.3] and about disease implications (OR 2.4; 95 % CI 1.2-4.8) were cited most often. A second interval of delay (time from when surgery was first advised to the surgery) was reported by 123 (61.8 %) patients. Financial constraints (29.6 %) and environment-related delays (10.6 %) were cited most often. More women than men thought there was a second delay interval (73 vs. 58 %). The odds of women having more co-morbid conditions were nearly 4.7 times that of men (95 % CI 1.5-15.1). CONCLUSIONS: A complex interaction of factors limits access to surgical care in developing countries. Women appear to face greater hurdles to accessing health care. Understanding local factors is essential to make care accessible.

Synthesis, characterization, and anti-amoebic activity of N-(pyrimidin-2-yl)benzenesulfonamide derivatives.

A new series of N-(pyrimidin-2-yl)benzenesulfonamide derivatives, 3a-3i and 4a-4i, was synthesized from pyrimidin-2-amines, 2a-2i, with the aim to explore their effects on in vitro growth of Entamoeba histolytica. The chemical structures of the compounds were elucidated by elemental analysis, FT-IR, (1) H- and (13) C-NMR, and ESI mass-spectral data. In vitro anti-amoebic activity was evaluated against HM1 : IMSS strain of Entamoeba histolytica. The IC50 values were calculated by using the double dilution method. The results were compared with the IC50 value of the standard drug 'metronidazole'. The selected compounds were tested for their cytotoxic activities by cell-viability assay using H9C2 cardiac myoblasts cell line, and the results indicated that all the compounds displayed remarkable >80% viabilities to a concentration of 100 µg/ml.

Comparison of knowledge, attitude and practices of betelnut users in two socio-economic areas of Karachi.

OBJECTIVE: To gain an insight on the knowledge, attitude and practices of those who chew betel nut in two different socioeconomic regions of Karachi. METHODS: The cross-sectional study was conducted in Saddar and Defence areas of Karachi over a five-week period in March-April 2012. Individual interviews following verbal consent were conducted using a pre-coded questionnaire, which was divided into 3 sections to analyse the knowledge, attitude and practices of the chewers. The data was entered and analysed using SPSS v. 16.0. Pearson's chi-square was used as the primary statistical test. RESULTS: A total of 370 subjects, 185 (50%) from each area, comprised the study. Majority of the chewers in Defence had higher educational qualification and income. Most of the participants in both areas acknowledged that betel nut chewing can potentially result in mouth (n = 274; 74.1%) and throat cancers (n = 267; 72.2%). A large part of the sample (n = 299; 80.8%) conceded that betel nut chewing is a bad habit, and almost half the sample was addicted to it (n = 194; 52.4%). CONCLUSION: Awareness regarding the detrimental effects of betel nut was satisfactory amongst the subjects, but the population was not willing to quit the habit. We recommend a two-pronged approach, offering widespread educational and awareness campaigns to prevent increased consumption of betel nuts, and professional counselling services for those already addicted.

Delayed cervical spine metastasis from intracranial solitary fibrous tumor.

Cervical spine metastasis from primary intracranial solitary fibrous tumors (SFTs) is an extremely rare clinical entity. This report focuses on its metastatic tendency, radiological imaging, management plan, and follow-up strategies in view of its long latency period for metastasis. A 35-year-old female presented with right-side cervical radiculopathy. Magnetic resonance imaging spine showed C7 vertebral body collapse with retropulsion and neural compression. Two years ago, the patient had surgical resection of intracranial SFT (World Health Organization grade 3) with no evidence of recurrence on follow-up imaging. Cervical C7 metastasis has been decompressed and fused by the anterior cervical approach. Histopathology confirmed SFT metastasis to the spine, and the patient received adjuvant radiotherapy. Cervical metastasis from well-controlled primary intracranial SFT poses a significant challenge for its diagnostic and management planning. Serial pre-emptive surveillance is warranted with regular imaging and appropriate patient counseling.

Nanozymes and nanoflower: Physiochemical properties, mechanism and biomedical applications.

Natural enzymes possess several drawbacks which limits their application in industries, wastewater remediation and biomedical field. Therefore, in recent years researchers have developed enzyme mimicking nanomaterials and enzymatic hybrid nanoflower which are alternatives of enzyme. Nanozymes and organic inorganic hybrid nanoflower have been developed which mimics natural enzymes functionalities such as diverse enzyme mimicking activities, enhanced catalytic activities, low cost, ease of preparation, stability and biocompatibility. Nanozymes include metal and metal oxide nanoparticles mimicking oxidases, peroxidases, superoxide dismutase and catalases while enzymatic and non-enzymatic biomolecules were used for preparing hybrid nanoflower. In this review nanozymes and hybrid nanoflower have been compared in terms of physiochemical properties, common synthetic routes, mechanism of action, modification, green synthesis and application in the field of disease diagnosis, imaging, environmental remediation and disease treatment. We also address the current challenges facing nanozyme and hybrid nanoflower research and the possible way to fulfil their potential in future.

Pneumatic Retinopexy: An Experience of 12 Years at a Tertiary Care Hospital.

Purpose The purpose of this study is to retrospectively analyze single-operation success (SOS) rates of pneumatic retinopexy (PR) for the treatment of rhegmatogenous retinal detachment (RRD) and to identify the predictors of treatment outcomes. Methods Sixty-one eyes of 61 patients who underwent PR for RRD during a period of 12 years were included in this study. Patient demographics along with pre-treatment clinical characteristics were recorded. Treatment outcomes in terms of best-corrected visual acuity (BCVA) and anatomical characteristics were reported including any post-operative complications. Visual outcomes were compared according to pre-treatment characteristics and between groups of the eyes achieving SOS and those requiring additional surgery. Results SOS was achieved in 37 (61%) eyes. Twenty-four (39%) eyes required one (36%) or two (3%) additional procedures. There was no significant association between pre-treatment characteristics and treatment failure. SOS eyes had significantly better visual outcomes (P=0.002), and so did those with macula-on status (P=0.003). New/missed breaks (9.8%) and proliferative vitreoretinopathy (PVR) (4.9%) were the most common causes of failure. Conclusions We found PR to be a beneficial technique for the treatment of RRD in this cohort. PR remains the least invasive treatment modality, and as a cost-effective technique, it is especially useful in low/middle-income countries such as Pakistan.