Telangiectasias, recurrent epistaxis and a strong family history-a case of Osler- Weber-Rendu Syndrome in Pakistan.

Osler-Weber-Rendu syndrome or Hereditary Haemorrhagic Telangiectasia (HHT) is a rare condition, with very few reported cases, especially in Pakistan. As healthcare workers, we encounter multiple cases of recurrent epistaxis in the emergency as well as outpatient departments. However, patients are usually treated symptomatically without a thorough workup. HHT should be considered among the differentials for recurrent epistaxis, as a clinical diagnosis can be made with detailed family history and physical examination. Here is the case of a 58-year-old male who presented to the Gastroenterology OPD, Combined Military Hospital, Lahore, in November 2021, with complaints of generalised weakness and blood in stools. He had a history of recurrent epistaxis and telangiectasias, and further inquiry revealed a strong family history of similar symptoms. He was diagnosed as a case of Osler-Weber- Rendu Syndrome. Informed consent was taken from the patient prior to the writing of the manuscript.

Coherent Surface Plasmon Hole Burning via Spontaneously Generated Coherence.

Surface plasmon (SP)-induced spectral hole burning (SHB) at the silver-dielectric interface is investigated theoretically. We notice a typical lamb dip at a selective frequency, which abruptly reduces the absorption spectrum of the surface plasmons polaritons (SPP). Introducing the spontaneous generated coherence (SGC) in the atomic medium, the slope of dispersion becomes normal. Additionally, slow SPP propagation is also noticed at the interface. The spectral hole burning dip is enhanced with the SGC effect and can be modified and controlled with the frequency and intensity of the driving fields. The SPP propagation length at the hole-burning region is greatly enhanced under the effect of SGC. A propagation length of the order of 600 µm is achieved for the modes, which is a remarkable result. The enhancement of plasmon hole burning under SGC will find significant applications in sensing technology, optical communication, optical tweezers and nano-photonics.

Outcome of patients with acute severe necrotizing pancreatitis in a dedicated hepato-biliary unit of Pakistan.

OBJECTIVE: To analyze the management of severe necrotizing pancreatitis in a specialized center of a lower middle-income country, Pakistan using multiple outcome measures. METHODS: All the patients in this prospective observational study with severe necrotizing pancreatitis being referred to Pak Emirates Military Hospital from January 2017 to December 2019 were followed over the course of their admission. Demographic data and disease outcomes were duly noted. Cox regression analysis was used to predict fatality outcome. RESULTS: A total of 57 patients with 48 (84.6%) infected necrotizing pancreatitis were managed in our set up. The most common etiology reported was gall-stones (37%) with male preponderance (72%) and a mean age of 50±11.3 years. The most common complications were acute-kidney-injury (63%), splenic-vein-thrombosis (21%) and ascites (21%). Fourteen patients required mechanical-ventilation with a mean duration of 7±1.4 days on respiratory support. Eight (14%) patients required Endoscopic-Ultra-Sound guided drainage and six (10.5%) underwent surgical-necrosectomy depending upon the patients' condition and collections characteristics. Mortality, as one of the main outcome measures, was reported to be 12.3% and was statistically related to mechanical-ventilation, organ failure and surgical-necrosectomy while 22 (38.6%) patients were discharged on pancreatic enzymes supplements and 7% required insulin. CONCLUSION: Survival outcomes with acute severe necrotizing pancreatitis are improving in a dedicated hepato-biliary unit internationally in lieu with a multidisciplinary team approach. Percutaneous and EUS guided drainage of pancreatic collections have turned out to be an important procedure to manage infected pancreatic necrosis that helps to avoid a morbid procedure in the form of necrosectomy.

Synthesis and electrochemical properties of stannous oxide clinopinacoid as anode material for lithium ion batteries.

Tin monoxide is a significant functional semiconductor material which employed to a wide area of applications especially optical and energy storage devices. Presently, template free hydrothermal technique has been employing to synthesize stannous oxide (SnO) clinopinacoid type controlled morphology using SnCl2 x 2H2O, NH3, and H2O as raw materials. The crystalline phase, morphology, particle size and component were characterized by X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy (EDS) and field-emission scanning electron microscopy (FESEM). FESEM results exhibited the large scale homogeneous growth of clinopinacoid architecture with the obvious size of 5 - 7 micrometers. The XRD results showed that the average crystallite size of the tetragonal phase romarchite SnO was about 29 nm calculated from the FWHM of X-ray diffraction pattern. The dominant Raman active modes A(1g) = 205 cm(-1), B(1g) = 105-107 cm(-1) and about 6 cm(-1) redshift were observed by the Raman spectroscopy, which further confirmed the existence of the nano tetragonal phase SnO. The electrochemical performance of as-synthesized SnO clinopinacoid structure as the anode material for lithium ion batteries was investigated. It was observed that the first discharge capacity of the two samples could reach a very high value of 1502 mA h g(-1) and 1422 mA h g(-1) respectively. The effect of nitrogen concentration on morphology as well as cyclic performance of Li-Ion-batteries was also discussed.

Enhanced magneto-optical rotation of probe field in thermal medium via spontaneous generated coherence.

A four-level double lambda closed atomic configuration is considered to study the polarization plane rotation of the probe beam through cold as well as thermal Rb[Formula: see text] atomic medium by varying the spontaneously generated coherence (SGC). Magnetic field and strong coupling field are applied to the atomic configuration. The light-matter interaction leads to enhanced the magneto-optical rotation. The intensity of the applied fields plays promising role in the generation and enhancement of birefringence. It ultimately enhances the polarization plane rotation of the probe beam in the Doppler medium. In the presence of both SGC and Doppler broadening effects, the optical rotation and transmission of the weak light beam are modified and controlled as well, which have potential applications in magnetometery and laser frequency stabilization.