Abdominal cocoon syndrome. A rare cause of mechanical intestinal obstruction: A case report.

INTRODUCTION AND IMPORTANCE: Abdominal Cocoon Syndrome (ACS) also known as Idiopathic. Sclerosing Peritonitis, is a rare cause of Mechanical Intestinal Obstruction. CASE PRESENTATION: We present a 59-year-old man with severe intestinal blockage symptoms for three days. Rectum had a noticeable amount of abdominal fat. To rule out the more common causes of mechanical blockage, a CT scan revealed the presence of a rare condition called Cocoon Syndrome, which necessitated exploratory laparotomy and adhesiolysis surgery. After the surgery, the patient was declared stable and was released from the hospital. CLINICAL DISCUSSION: The diagnosis of a tuberculous abdominal cocoon before surgery is a real challenge. CONCLUSION: Recognizing and understanding this entity, as well as the usual radiological findings, may help in its appropriate treatment.

Terminal digit preference and the accuracy of breast cancer diameter reporting based on Benford's law.

Background: Breast cancer is the most frequent cancer in women all over the world, and it is one of the leading causes of cancer-related deaths in women. A pathologist's partiality for the last digit of a patient's name can lead to errors in the measurement of malignancies. This means that, rather than recording the exact measurement of a tumor, a pathologist might round it off to his preferred terminal digit. Methods: It is a retrospective cross-sectional study in which data on primary tumor resection for 1000 breast cancer patients was obtained from KRL Hospital's patient directory from November 2016 to December 2020. The tumors were measured in cm to one decimal point along their longest dimension. Ki-67 markers were used to categorize the tumors into nine categories. Terminal digit preference was evaluated using Benford's law. Results: The recording of the Ki-67 index revealed evidence of pentameric preference. The numbers three, five, and six appeared more frequently in the histogram of the Ki-67 index distribution measured in percentage. The frequency of nine dropped dramatically. However, the influence of tumor size terminal digits on Ki-67 staining scores (low proliferative vs high proliferative) assessed using the Mann-Whitney U Test demonstrated that tumor size terminal digits had no significant effect on Ki-67 staining scores (p = 0.114). Conclusion: The Ki-67 index shows evidence of pentameric preference for digits three, five, and six. The frequency of nine has dropped dramatically. The influence of tumor size on terminal digits on staining scores (low proliferative vs. high proliferative) was assessed using the Mann-Whitney U Test.

Twelve-year trend of Escherichia coli antibiotic resistance in the Islamabad population.

Objective: Increasing rates of antimicrobial resistance among E. coli is a growing concern worldwide. We aimed to assess the changing antibiotic sensitivity pattern in Uropathogenic E. coli over a period of 12 years with special emphasis on ESBL-producing E. coli. Methods: A retrospective study was done on the population of Islamabad from 1st Jan 2005 to Dec 2010 and then continued from 1st Jan 2016 to 31st May 2021. A total of 12000 samples were analyzed for isolation and identification of bacteria and antimicrobial susceptibility testing, from patients having uncomplicated urinary tract infections. Our primary was to find the antibiotics with the highest sensitivity against E. Coli in 2021, while our secondary outcome was to find the overall sensitivity pattern of E. Coli to antibiotics from 2005 to 2021. Results: There was a decrease in susceptibility rates of E. coli to Amoxicillin-Clavulanic Acid 47%, Trimethoprim-Sulfamethoxazole (TMP-SMX) 27%, Fluoroquinolones 24% & Cephalosporins 38%. There was a significant increase in the use of Nitrofurantoin and Fosfomycin. High resistance rates to Fluoroquinolones (76%), TMP-SMX (73%), Cephalosporins (62%), and Amoxicillin (53%) were documented. However, significantly high degree of sensitivity rates to Fosfomycin (92%), Aminoglycosides (90%) & Nitrofurantoin (80%) were recorded. Conclusions: Uropathogenic E. coli shows the highest sensitivity to Fosfomycin and Aminoglycosides in the year 2021, followed by Nitrofurantoin and Sulbactam. Cephalosporins, Amoxicillin/Cluvalanic acid, TMP-SMX, and Fluoroquinolones show a declining sensitivity pattern. UTIs can be prevented well by lifestyle changes, taking vitamins, trace elements, and carbohydrates.

Preparation, structural elucidation and biocidal applications of trimethyltin(IV) complexes derived from substituted carboxylic acids.

A series of trimethyltin(IV) carboxylates (1-7), having general formula [(CH3)3SnOOCR], where R = 3-CF3C6H4- (1), 3,4-(OCH2CH3)2 C6H3- (2), 3-FC6H4- (3), 4-ClC6H5- (4), 2,4-(OCH3)2C6H3- (5), 4-NO2C6H4- (6), 5-CH3C4H2N2- (7) have been synthesized and are characterized by using analytical techniques like, FT-IR, 1H, 13C and 119Sn NMR spectroscopy in addition to elemental analyses. To validate the structural motif, one of the complex (2) was also analyzed by single crystal XRD technique. The single crystal X-ray diffraction analysis revealed that the molecular species exist in one dimensional polymeric chain, wherein five coordinated tin is attached to two oxygens of the carboxyl and three carbon atoms of CH3 groups, whereas the bond angles for C-Sn-C (117.20-121.65°), C-Sn-O (87.87-98.60°) and O-Sn-O (173.75°) lie in the predictable range of distorted trigonal bipyramidal geometry. All the synthesized complexes were also subjected to preliminary screening for various biocidal applications such as antimicrobial, anti-diabetic, protein kinase inhibition and brine shrimp lethality test to check their efficacy. The compound 6 exhibits very good antibacterial activity having MIC value 6.25 µg/mL against K. pneumoniae, whereas antidiabetic and protein kinase inhibition data revealed that 1 and 2 may serve as good to moderately effective inhibitors, respectively.

A region growing and local adaptive thresholding-based optic disc detection.

Automatic optic disc (OD) localization and segmentation is not a simple process as the OD appearance and size may significantly vary from person to person. This paper presents a novel approach for OD localization and segmentation which is fast as well as robust. In the proposed method, the image is first enhanced by de-hazing and then cropped around the OD region. The cropped image is converted to HSV domain and then V channel is used for OD detection. The vessels are extracted from the Green channel in the cropped region by multi-scale line detector and then removed by the Laplace Transform. Local adaptive thresholding and region growing are applied for binarization. Furthermore, two region properties, eccentricity, and area are then used to detect the true OD region. Finally, ellipse fitting is used to fill the region. Several datasets are used for testing the proposed method. Test results show that the accuracy and sensitivity of the proposed method are much higher than the existing state-of-the-art methods.

Versatile Platform of Ion Conducting 2D Anionic Germanate Covalent Organic Frameworks with Potential for Capturing Toxic Acidic Gases.

Anionic covalent organic framework is an emerging class of functional materials in which included ionic species of the opposite charges play an important role in the ion conduction and selective gas adsorption. Herein, we reported a facile method to construct a series of germanate-based anionic COFs (Ge-COFs) by reticulating dianionic hexa-coordinated GeO6 nodes with anthracene building blocks adopting a hcb topology in an extended 2D framework. A systematic change of pore properties in Ge-COFs was observed through the incorporation of three different alkali metal cations: Li+, Na+, and K+. The intrinsically negatively charged backbone provides a host matrix with a homogeneous distribution of counter cations and poses variable and exciting features for gas adsorption and ionic conduction. Among the series, K+-based Ge-COF-K with a surface area of 1252 m2/g and pore volume of 0.84 cm3/g shows a maximum CO2 uptake of 126 cm3/g (247.4 mg/g) at 273 K and 1 bar, an IAST selectivity of 140 over N2. Ge-COF-K also exhibits a high SO2 kinetic breakthrough capacity of 154 mg/g at low ppm of SO2 concentration under ambient conditions among recently reported porous materials. Moreover, reasonably high lithium, sodium, and potassium ionic conductivities were observed with the values of 1.2 × 10-4, 3.4 × 10-5, and 2.2 × 10-5 S/cm for propylene carbonate infiltrated Ge-COF-Li, Ge-COF-Na, and Ge-COF-K at 100 °C, respectively.