Pathology-based radiation dose in computed tomography: investigation of the effect of lung lesions on water-equivalent diameter, CTDIVol and SSDE in COVID-19 patients.

Lung lesions can increase the CT number and affect the water-equivalent diameter (Dw), Dw-based conversion factor (CFw), and Dw-based size-specific dose estimate (SSDEw). We evaluated the effect of COVID-19 lesions and total severity score (TSS) on radiation dose considering the effect of automatic tube current modulation (ATCM) and fixed tube current (FTC). A total of 186 chest CT scans were categorised into five TSS groups, including healthy, minimal, mild, moderate and severe. The effective diameter (Deff), Dw, CFw, Deff-based conversion factor (CFeff), volume computed tomography dose index (CTDIVol), pathological dose impact factor (PDIF) 1 and SSDEw were calculated. TSS was correlated with Dw (r = 0.29, p-value = 0.001), CTDIVol (ATCM) (r = 0.23, p = 0.001) and PDIF (r = - 0.51, p-value = 0.001). $\overline{{\mathrm{SSDE}}_{\mathrm{w}}}$ (FTC) was significantly different among all groups. $\overline{{\mathrm{SSDE}}_{\mathrm{w}}}$ (ATCM) was greater for moderate (13%) and mild (14%) groups. Increasing TSS increase the Dw and causes a decrease in CFw and $\overline{{\mathrm{SSDE}}_{\mathrm{w}}}$ (FTC), and can increase $\overline{{\mathrm{SSDE}}_{\mathrm{w}}}$ (ATCM) in some Dw ranges.

Effects of Probiotics on Growth and Immunity of Piglets.

Growth promoting antibiotics are used in modern animal husbandry to promote growth and avoid infections. Negative effects of these antibiotics on human health are a big concern and they need to be replaced. Probiotics are expected to be a good replacement for growth promoting antibiotics. In this study, we evaluated effects of probiotics on growth and immune status of liver and secondary lymphoid organs of piglets. Body weights of probiotic-fed piglets were heavier than those of control piglets (p < 0.05) at days 30 and 45 of the experiment. Relative populations of CD4+ and IgM+ cells isolated from the liver were significantly increased (p < 0.05 and p < 0.01, respectively) in probiotic-fed piglets compared to control piglets. CD4+CD8+ T cells were significantly decreased (p < 0.05) in jejunal Peyer's patches of treated piglets. Phagocytosis of MHC class II+ cells isolated from the liver of probiotic-fed piglets was significantly higher (p < 0.05) than that of control piglets. Phagocytosis of granulocytes isolated from the liver and peripheral blood of probiotic-fed piglets were also higher than those of control piglets. These results indicate excellent effects on growth and immune status of piglets. In conclusion, probiotics have beneficial effects on the growth and health of piglets and could be good replacement for growth promoting antibiotics.

COVID-19 Vaccination Efforts: Is Afghanistan Prepared?

A country's preparedness for a prompt and successful implementation of vaccination programs plays a pivotal role in disease control and prevention. As it stands now, Afghanistan seems to be ill-prepared to embrace a successful implementation of the COVID-19 vaccination program because of a spate of challenges. These include, but are not limited to, the insufficient number of vaccinators, a dearth of fully integrated functioning cold chain, challenging geographical barriers, cultural issues, insecurity, and protracted conflict. The COVID-19 infodemic along with vaccine mistrust in the country will lead to a pervasive public vaccine hesitancy in Afghanistan, which will present serious obstacles to the COVID-19 immunization efforts. The politicization of the Ministry of Public Health (MoPH) and the complaints of embezzlement and misuse of the pandemic aid have already eroded public trust during the pandemic. To ensure a large-scale and equitable distribution of COVID-19 vaccines, the cold chain infrastructure should be strengthened, and the immunization personnel trained. Antivaccination propaganda and misinformation should be tackled with effective communication approaches and effective community engagement, which consider culturally relevant messages appropriate to the culture and people. The allegations of corruption should be addressed to revive public trust in public health interventions, including COVID-19 vaccination.

Biochemical and functional attributes of raw and boiled potato flesh and peel powders for suitability in food applications.

Four different potato cultivars, namely, Kufri Chipsona 1 and Kufri Frysona (processing purpose), Kufri Jyoti and Kufri Bahar (table purpose) were converted into flesh and peel powder (raw and after boiling) and studied for their respective biochemical and functional attributes to get an idea of possible dynamics of their utilization in different food formulation as bioadditives. The 16 variants of powder obtained retained less than 10% moisture content and demonstrated 'very good' to 'fair' flowability. Peel powders recorded a higher total mineral, fiber, phenolic contents and total antioxidant activity than the flesh powders which were significantly affected by boiling. Among raw and boiled flesh powders, highest reducing and total sugars were recorded for Kufri Bahar while least was observed in Kufri Chipsona 1. Colour coordinate showed that boiling imparts brightness to flesh powder while peel powder got darkened. Boiling of the tubers resulted in an increase in the resistant starch (~ 29% maximum) and flavour (~ 180% maximum) component. Peel exhibited a total glycoalkaloid content in the range of 0.75 (Kufri Frysona) to 1.7 mg/100 g (Kufri Bahar) that is well within the acceptable limits. Rheological study of the flesh powders revealed a reduction of about 11-18 °C in pasting temperature and about 87-90% in peak viscosity, setback, breakdown value and final viscosity upon boiling. This study revealed that the traditional processing method such as boiling can significantly modify the techno-functional characteristics of potato flesh and peel powders which can further govern their end use in various food formulations.

Effect of maternal supplementation with seaweed powder on immune status of liver and lymphoid organs of piglets.

This study was performed to evaluate the effect of maternal supplementation with seaweed powder (SWP) on the immune status of piglets. Sows were supplementary fed SWP from 85-days of gestation until delactation. Forty-days old piglets were euthanized and lymphocyte subsets were analyzed. The results showed a significantly higher relative population of CD4+CD8+ T cells in the thymus, lymph node, tonsil (P<0.05), peripheral blood mononuclear cells, spleen and liver (P<0.01) of piglets derived from treated sows. A higher relative population of CD8+ T cells was also observed in the liver and spleen (P<0.05) of the piglets. The data suggested the enhancing effects of maternal supplementation with SWP on immune status of piglets.

Arthroscopic assisted ankle arthrodesis: A retrospective study of 32 cases.

PURPOSE: The arthroscopic assisted ankle arthrodesis (AAAA) is a minimally invasive procedure for end-stage ankle arthritis with numerous benefits like faster time of union, insignificant blood loss, less morbidity, less infection rate, and less soft tissue complications. A shorter hospital stay decreases the cost and results in early mobilization compared to open methods. We present a retrospective series of 32 patients, who underwent AAAA during a period of 8 years. METHODS: Thirty-two patients were reviewed retrospectively from 2008 to 2015. We calculated the Karlsson and Peterson ankle function scoring system pre-operatively and at 3 and 12 months after the surgery, in all the patients. All the patients were operated using arthroscopic denuding of degenerated cartilage followed by percutaneous criss-cross screw fixation through the tibia crossing the ankle joint into the talus. RESULTS: The mean age at operation time was 43.7 years. Four patients were excluded from the study. 18 were male, and 10 were female patients. All the 28 cases were followed up for a minimum of 1 year (mean 1.7 years). The average time to union was 14 weeks. The complications included four cases requiring removal of a screw for prominence, and one superficial infection. There were 20 (71.4%) patients with excellent, 4 (14.2%) with good, 3 (10.7%) with fair and 1 (3.5%) with poor clinical outcome. The average tourniquet time for the surgery was 70 min. The mean hospital stay was 2 days. The average Karlsson and Peterson's scoring was 32.71 pre-operatively and 74.10 and 89.00 postoperatively measured at 3 months and 1-year follow-up. CONCLUSION: With the high incidence of soft-tissue problems and the young age of onset of post-traumatic arthritis, AAAA remains the treatment of choice in most cases with numerous advantages over open technique.

A Computer Based Model in Comparison with Sonography Imaging to Diagnosis of Acute Appendicitis in Iran.

INTRODUCTION: Acute appendicitis overlaps with conditions of other diseases in terms of Symptoms and signs in the first hours of presentation. Ultrasound imaging and laboratory tests are usually used to decrease the diagnosis errors in the case of abdominal pain. However, same results may be happened using the mentioned examination tools for a string of diseases with abdominal pain. Moreover, those tests raise the medical costs for hospitals and patients. Clinical Decision Support Systems (CDSSs) can be used to assist the physicians to make the proper health care decisions particularly in the unreliable conditions. OBJECTIVES: To improve the decision making process by physicians in diagnosis of acute appendicitis, an optimizing model was developed. The main objective is to discover a diagnostic model using the minimum clinical factors available in the first hours of abdominal pain. METHODS: Fuzzy-rule based classifier is a known technique in the Decision Support Systems (DSSs). In this article thus the useful clinical factors were explored and the diagnosis knowledge was discovered using Honey Bee Reproduction Cycle (HRBC) algorithm in the Fuzzy-rule based system. In this model, the proposed algorithm created the Fuzzy rules as the diagnosis knowledge in an optimizing process. To evaluate the accuracy of the proposed model for diagnosing of appendicitis, a collection of data was gathered from abdominal patients who referred to the educational general hospitals in Ahvaz, Iran in 2014 to 2015 years. In this process, the proposed model was optimized first in a training phase using a training dataset, and then it was tested with the testing dataset. Then, the achieved results from the computer base model were compared with ultrasound imaging findings before surgery as well as other detection methods in the previous studies. RESULTS: The comparison results illustrated that the proposed hybrid classification model as a CDSS improves considerably the accuracy of acute appendicitis diagnosis. Experimental outcomes illustrated that the proposed algorithm improves considerably the optimization performance in the diagnostic problem with the accuracy rate of 89.9%. The mentioned rate was achieved while a limited range of factors as the input parameters were used in the hybrid model. CONCLUSION: The proposed differential diagnostic model can be used as a CDSS especially conditions in which access to costly equipment such as CT scans and Sonography tools are limited. The developed model improves the diagnosis time as well as the treatment costs for the patients with acute abdomen suspicious of acute appendicitis.

Haglund's Syndrome: A Commonly Seen Mysterious Condition.

Haglund's deformity was first described by Patrick Haglund in 1927. It is also known as retrocalcaneal exostosis, Mulholland deformity, and 'pump bump.' It is a very common clinical condition, but still poorly understood. Haglund's deformity is an abnormality of the bone and soft tissues in the foot. An enlargement of the bony section of the heel (where the Achilles tendon is inserted) triggers this condition. The soft tissue near the back of the heel can become irritated when the large, bony lump rubs against rigid shoes. The aetiology is not well known, but some probable causes like a tight Achilles tendon, a high arch of the foot, and heredity have been suggested as causes. Middle age is the most common age of affection, females are more affected than males, and the occurence is often bilateral. A clinical feature of this condition is pain in the back of the heel, which is more after rest. Clinical evaluation and lateral radiographs of the ankle are mostly enough to make a diagnosis of Haglund's syndrome. Haglund's syndrome is often treated conservatively by altering the heel height in shoe wear, orthosis, physiotherapy, and anti-inflammatory drugs. Surgical excision of the bony exostoses of the calcaneum is only required in resistant cases.

Apophysitis of the Tibial Tuberosity (Osgood-Schlatter Disease): A Review.

Osgood-Schlatter disease (OSD) is a condition in which the patellar tendon insertion on the tibial tuberosity becomes inflamed. It is a well-known condition in late childhood characterized by pain and a bony prominence over the tibial tuberosity. The pain is usually exacerbated by physical activities like running, jumping, and climbing stairs. In the acute stage, the margins of the patellar tendon become blurred in radiographs due to the soft tissue swelling. After three to four months, bone fragmentation at the tibial tuberosity is viewed. In the sub-acute stage, soft tissue swelling resolves, but the bony ossicle remains. In the chronic stage, the bone fragment may fuse with the tibial tuberosity which can appear normal. The primary goal in the treatment of OSD is the reduction of pain and swelling over the tibial tuberosity. The patient should limit physical activities until the symptoms are resolved. In some cases, the patient should restrict physical activities for several months. The presence of pain with kneeling because of an ossicle that does not respond to conservative measures is the indication for surgery. In these cases, the removal of the ossicle, surrounding bursa, and the bony prominence is the treatment of choice.