VEXAS syndrome presenting as diffuse alveolar haemorrhage.

We report the case of a man in his late 30s who presented with a history of breathlessness and cough with haemoptysis. Complete blood counts revealed pancytopenia. High-resolution CT showed diffuse bilateral ground glass opacities. Sequential bronchoalveolar lavage confirmed alveolar haemorrhage. Bone marrow aspiration showed vacuoles in erythroid and myeloid precursor cells. The genome was sequenced, and the UBA1 gene revealed a c.121 A>G mutation (p.Met41Val), confirming vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic syndrome. The patient was managed with high-dose prednisolone pulse therapy. He improved with the complete resolution of the alveolar haemorrhage and an improvement in lung function and cytopenias.

Fine particulate matter from brick kilns site and roadside in Lahore, Pakistan: Insight into chemical composition, oxidative potential, and health risk assessment.

Background: Human health is seriously threatened by particulate matter (PM) pollution, which is a major environmental problem. A better indicator of biological responses to PM exposure than its mass alone is the PM "oxidative potential (OP)," or ability to oxidize target molecules. When reactive oxygen species (ROS) are generated in the OP in excess of the antioxidant capacity of body due to PM components such metals and organic species, it causes inflammation, deoxyribonucleic acid (DNA), proteins, and lipids damage. Method: The samples of fine particulate matter (PM2.5) are collected from the brick kiln site and the roadside in Lahore, Pakistan. The organic carbon (OC) and elemental carbon (EC) were estimated by carbon analyzer (DRI 2001A) using the thermal/optical transmittance (TOT) protocol. The water-soluble organic carbon (WSOC) concentration was determined using a total organic carbon analyzer (Shimadzu TOC-L CPN). Ion chromatography (Dionex ICS-900) with a conductivity detector was used to analyze the water-soluble anions (Cl-, NO3-, and SO42-) and cations (NH4+, Na+, K+, Mg2+, and Ca2+). Inductively coupled plasma-mass spectrometry (iCAP TQ ICP-MS, Thermo Scientific) was used to determine the concentrations of metals in the solution. The dithiothreitol (DTT) consumption rate was calculated using a spectrophotometer at a wavelength of 412 nm. Results: The mean concentrations of PM2.5 at the brick kiln site and roadside reported are 509.3 ± 32.3 µg/m3 and 467.5 ± 24.9 µg/m3, and the average OC/EC ratio is 1.9 ± 0.4 and 2.1 ± 0.1. primary organic carbon (POC) contributed more to OC than secondary organic carbon (SOC), which indicated the dominance of primary combustion sources. The anion equivalent (AE) to cation equivalent (CE) ratio indicated that PM2.5 is acidic at both sites due to the dominance of NO3- and SO42-. The DTT consumption rate normalized by PM2.5 mass (DTTm) and DTT consumption rate normalized by air volume (DTTv) of PM2.5 at the roadside samples are higher than at the brick kiln site due to the higher contribution of ionic species to the mass of PM2.5. Carbonaceous species of PM2.5 at both sampling sites are significantly correlated with DTTv of PM2.5, while metallic species behaved differently. The incremental lifetime cancer risk (ILCR) values (lung cancer) of As and Cr at both sampling sites, while the ILCR value of Cd at the roadside samples is exceeding the permissible limits for adults and children. The lifetime average daily dose (LADD) value for adults is higher than that for children, indicating that children are less vulnerable to metals. Conclusion: The concentration of PM2.5 at both sampling sites were exceeding the permissible limits of Pakistan' National Environmental Quality Standard (NEQS) and posing risk to the health of the local population. The POC and SOC contribution to OC at the brick kiln site and roadside in Lahore were 84.6%, 15.4% and 84.4%, 15.6%. POC at both sampling sites were the dominant carbon species indicating the dominance of primary combustion sources. The residence of Lahore poses the lung cancer risk due to Cr, As, and Cd at both sampling sites. The results of this study provide important data and evidence for further evaluation of the potential health risks of PM2.5 from brick kiln site and road side in Pakistan and formulation of efficient air-pollution control measures.

Postoperative delirium in 47 379 individuals undergoing transcatheter aortic valve replacement: a systematic review and meta-analysis.

Objective: The study aims to discuss the assessment methods used for the incidence of in-hospital postoperative delirium (IHPOD) in transcatheter aortic valve replacement (TAVR) patients and explore possible strategies for preventing and reducing postoperative complications in the geriatric population. Methodology: An electronic search of PubMed, Embase, BioMedCentral, Google Scholar, and the Cochrane Central Register of Controlled Trials was conducted up to August 2021, to identify studies on the IHPOD following TAVR in patients above 70 years. The primary objective of the study was to determine the incidence of delirium following TAVR and procedures like transfemoral (TF) and non-TF approaches. The secondary objectives were to determine the incidence of stroke and incidence according to the confusion assessment method (CAM) diagnostic tool. The authors only included studies published in English and excluded patients with comorbidities and studies with inaccessible full-text. Results: Among the selected 42 studies with 47 379 patients, the incidence of IHPOD following TAVR was 10.5% (95% CI: 9.2-11.9%, I2=95.82%, P<0.001). Incidence based on CAM was 15.6% (95% CI: 10.5-20.7%, I2=95.36%, P<0.001). The incidence of IHPOD after TF-TAVR was 9.3% (95% CI: 7.6-11.0%, I2=94.52%, P<0.001), and after non-TF TAVI was 25.3% (95% CI: 15.4-35.1%, I2=92.45%, P<0.001). The incidence of stroke was 3.7% (95% CI: 2.9-4.5%, I2=89.76%, P<0.001). Meta-regression analyses between mean age (P=0.146), logistic EuroSCORE (P=0.099), or percentage of participants treated using the TF approach (P=0.276) were nonsignificant while stroke (P=0.010) was significant. When considering these variables, the residual heterogeneity remained high indicating that other variables influence the heterogeneity. Conclusion: IHPOD following TAVR was observed in 10.5% of individuals and in 15.6% using CAM. Its incidence was found to be three times higher after non-TF TAVR (25.3%) compared to TF TAVR (9.3%). Stroke showed an incidence of 3.7% after TAVR and was found to be significantly associated with the risk of developing delirium following TAVR. Further studies are needed to evaluate possible causes and risk factors responsible for delirium and to assess the role of anesthesia and cerebral embolic protection in preventing delirium after TAVR.

Jasmonic acid boosts the salt tolerance of kidney beans (Phaseolus vulgaris L.) by upregulating its osmolytes and antioxidant mechanism.

As a lipid-derived compound, jasmonic acid (JA) regulates growth and defense against environmental stresses. An exogenous foliar JA application was investigated in our study (HA; 0.5 mM) on kidney bean plants (Phaseolus vulgaris L.) grown under different salinity stress concentrations (0, 75, and 150 mM NaCl). According to the results, salt concentrations were related to an increase in malondialdehyde (MDA) levels, whereas they declined the chlorophyll content index. In contrast, JA application decreased the level of MDA but increased the chlorophyll content index. Moreover, increasing salinity levels increased proline, phenolic compounds, flavonoids, free amino acid concentrations, and shikimic acid concentrations, as well as the activities of polyphenol oxidase (PPO), ascorbate peroxidase (APX), catalase (CAT), and peroxidase (POD). In addition, JA applications further increased their concentrations with increasing salinity stress levels. JA application increases salt-induced osmolytes and non-enzymatic antioxidants while increasing enzymatic antioxidant activity, suggesting kidney beans have a strong antioxidant mechanism, which can adapt to salinity stress. Our results showed that exogenous JA foliar applications could enhance the salt tolerance ability of kidney bean plants by upregulating their antioxidant mechanism and osmolytes.

Methyl esters synthesis from Luffa cylindrica seeds oil using green copper oxide nanoparticle catalyst in membrane reactor.

This study investigates the potential role of Juglans sp. root extract-mediated copper oxide nanoparticles of Luffa cylindrica seed oil (LCSO) into methyl esters. The synthesized green nanoparticle was characterized by Energy-dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FT-IR), and Scanning electron microscopy (SEM) spectroscopies to find out the crystalline size (40 nm), surface morphology (rod shape), particle size (80-85 nm), and chemical composition (Cu = 80.25% & O = 19.75%), accordingly. The optimized protocol for the transesterification reaction was adjusted as oil to methanol molar ratio (1:7), copper oxide nano-catalyst concentration (0.2 wt %), and temperature (90 °C) corresponding to the maximum methyl esters yield of 95%. The synthesized methyl esters were characterized by GC-MS, 1H NMR, 13C NMR, and FT-IR studies to know and identify the chemical composition of newly synthesized Lufa biodiesel. The fuel properties of Luffa cylindrica seed oil biofuel were checked and compared with the American Biodiesel standards (ASTM) (D6751-10). Finally, it is commendable to use biodiesel made from wild, uncultivated, and non-edible Lufa cylindrica to promote and adopt a cleaner and sustainable energy method. The acceptance and implementation of the green energy method may result in favourable environmental effects, which in turn may lead to better societal and economic development.

Angle of concavity in planning target volume can be adopted as selection criteria for intensity-modulated radiation therapy or three-dimensional conformal radiotherapy technique in brain tumors.

Introduction: With innovation of medical imaging, radiotherapy attempts to conform the high dose region to the planning target volume (PTV). The present work aimed to assess the angle of concavity in PTV can be adopted as selection criteria for intensity-modulated radiation therapy (IMRT) or three-dimensional conformal radiotherapy (3DCRT) technique in Brain tumors. Materials and Methods: Thirty previously irradiated patients with brain tumors were replanned with both 3DCRT and IMRT technique. Angle of concavity (dip) in the PTV near the organs at risk was measured in the contoured structure set images of each patient. These cases were divided into three groups where angles were 0°, >120° and <120°. Dose of 60 Gy/30# was fixed. Results: In Group 1, the IMRT plan had better TV95% as compared to 3DCRT respectively with significant P value (P = 0.002). Mean of conformity index (CI) and Homogeneity Index (HI) were comparable. For Group 2 (angle >120°), the IMRT plan had better TV95% as compared to 3DCRT respectively with a significant P value (P = 0.021). HI and CI were not significant. For Group 3 (<120°), IMRT plan had better TV95% as compared to 3DCRT respectively with a significant P value (P = 0.001). HI and CI were better in IMRT arm with significant P value. Conclusion: The results from this study showed that the angle of concavity can be considered as an additional objective tool for selection criteria whether tumor can be treated with IMRT or 3DCRT. Tumors where angle of concavity was <120°, HI and CI provided more uniformity and conformity of dose distribution inside PTV with significant P values.

Membrane reactor for production of biodiesel from nonedible seed oil of Trachyspermum ammi using heterogenous green nanocatalyst of manganese oxide.

Conventional homogeneous-based catalyzed transesterification for the production of biodiesel can be replaced with a membrane reactor that has an immobilized heterogeneous catalyst. Combining reaction with separation while utilizing membranes with a certain pore size might boost conversion process. this investigation to study the effectiveness of membrane reactor in combination with heterogeneous green nano catalysis of MnO2. Techniques such as XRD, EDX, FTIR, SEM, and TGA were used to characterize the synthesized MnO2 nano catalyst. The highest conversion of around 94% Trachyspermum ammi oil was obtained by MnO2. The optimum process variables for maximum conversion were catalyst loading of 0.26 (wt.%), 8:1 M ratio, 90 °C reaction temperature, and time 120 min. The green nano catalyst of MnO2 was reusable up to five cycles with minimum loss in conversion rate of about 75% in the fifth cycle. Nuclear magnetic resonance validated the synthesis of methyl esters. It was concluded that membrane reactor a promising technique to efficiently transesterify triglycerides into methyl esters and enable process intensification uses MnO2 as a catalyst.

Characteristics and Risk Assessment of Environmentally Persistent Free Radicals (EPFRs) of PM2.5 in Lahore, Pakistan.

Environmentally persistent free radicals (EPFRs) are an emerging pollutant and source of oxidative stress. Samples of PM2.5 were collected at the urban sites of Lahore in both winter and summertime of 2019. The chemical composition of PM2.5, EPRF concentration, OH radical generation, and risk assessment of EPFRs in PM2.5 were evaluated. The average concentration of PM2.5 in wintertime and summertime in Lahore is 15 and 4.6 times higher than the national environmental quality standards (NEQS) of Pakistan and WHO. The dominant components of PM2.5 are carbonaceous species. The concentration of EPFRs and reactive oxygen species (ROS), such as OH radicals, is higher in the winter than in the summertime. The secondary inorganic ions do not contribute to the generation of OH radicals, although the contribution of SO42+, NO3-, and NH4+ to the mass concentration of PM2.5 is greater in summertime. The atmospheric EPFRs are used to evaluate the exposure risk. The EPFRs in PM2.5 and cigarette smoke have shown similar toxicity to humans. In winter and summer, the residents of Lahore inhaled the amount of EPFRs equivalent to 4.0 and 0.6 cigarettes per person per day, respectively. Compared to Joaquin County, USA, the residents of Lahore are 1.8 to 14.5 times more exposed to EPFRs in summer and wintertime. The correlation analysis of atmospheric EPFRs (spin/m3) and carbonaceous species of PM2.5 indicates that coal combustion, biomass burning, and vehicle emissions are the possible sources of EPFRs in the winter and summertime. In both winter and summertime, metallic and carbonaceous species correlated well with OH radical generation, suggesting that vehicular emissions, coal combustion, and industrial emissions contributed to the OH radical generation. The study's findings provide valuable information and data for evaluating the potential health effects of EPFRs in South Asia and implementing effective air pollution control strategies.

Definitive chemoradiation in nonmetastatic squamous cell carcinoma anal canal: A single-institution experience.

Purpose: The purpose of the study was to analyze the survival outcomes and toxicities in squamous cell carcinoma anal canal treated with definitive chemoradiotherapy. Materials and Methods: Retrospective analysis of 51 patients with squamous cell carcinoma anal canal treated with chemoradiotherapy was done. Data were collected and analyzed for disease-free survival (DFS), colostomy-free survival (CFS), overall survival (OS), and acute/late toxicities. Results: Out of total 51 patients, only 44 patients had a follow-up of more than 36 months and were analyzed. After a median follow-up of 46 months (range 10-68 months), the 3-year DFS was 73.9%. Three patients developed locoregional recurrence, while one patient developed distant metastasis. At 3-year OS rate was 77%. Out of 44 patients, six patients lost to follow-up, while two patients died due to progressive disease and two due to noncancer causes. 3-year CFS rate was 59%. Most common grade >3 acute toxicities were skin reactions in nine (18%), followed by hematological in eight (16%) patients. Conclusion: Definitive chemoradiotherapy in anal canal results in good oncological outcomes with sphincter preservation. No severe treatment-related toxicities were observed.

Chemical Composition, Sources, and Health Risk Assessment of PM2.5 and PM10 in Urban Sites of Bangkok, Thailand.

Of late, air pollution in Asia has increased, particularly in built-up areas due to rapid industrialization and urbanization. The present study sets out to examine the impact that pollution can have on the health of people living in the inner city of Bangkok, Thailand. Consequently, in 2021, fine particulate matter (PM2.5) and coarse particulate matter (PM10) chemical composition and sources are evaluated at three locations in Bangkok. To identify the possible sources of such particulates, therefore, the principal component analysis (PCA) technique is duly carried out. As determined via PCA, the major sources of air pollution in Bangkok are local emission sources and sea salt. The most significant local sources of PM2.5 and PM10 in Bangkok include primary combustion, such as vehicle emissions, coal combustion, biomass burning, secondary aerosol formation, industrial emissions, and dust sources. Except for the hazard quotient (HQ) of Ni and Mn of PM2.5 for adults, the HQ values of As, Cd, Cr, Mn, and Ni of both PM2.5 and PM10 were below the safe level (HQ = 1) for adults and children. This indicates that exposure to these metals would have non-carcinogenic health effects. Except for the carcinogenic risk (HI) value of Cr of PM2.5 and PM10, which can cause cancer in adults, at Bangna and Din Daeng, the HI values of Cd, Ni, As, and Pb of PM2.5 and PM10 are below the limit set by the U.S. Environmental Protection Agency (U.S. EPA). Ni and Mn pose non-carcinogenic risks, whereas Cr poses carcinogenic risks to adults via inhalation, a serious threat to the residents of Bangkok.

Impact of Cadmium Stress on Growth and Physio-Biochemical Attributes of Eruca sativa Mill.

Plants may experience adverse effects from Cadmium (Cd). As a result of its toxicity and mobility within the soil-plant continuum, it is attracting the attention of soil scientists and plant nutritionists. In this study, we subjected young Eruca sativa Mill. seedlings to different levels of Cd applications (0, 1.5, 6 and 30 µmol/L) via pot experiment to explore its morpho-physio-biochemical adaptations. Our results revealed a significant Cd accumulation in leaves at high Cd stress. It was also demonstrated that Cd stress inhibited photosynthetic rate and pigment levels, ascorbate peroxidase (APX), guaiacol peroxidase (GPX), catalase (CAT), and superoxide dismutase (SOD) enzyme activities, and increased malondialdehyde (MDA) levels. Conversely, the concentration of total ascorbate (TAS) increased at all levels of Cd application, whereas that of ascorbic acid (ASA), and dehydroascorbate (DHA) increased at 1.5 (non-significant), 6, 30 and 6 µmol/L (significant), though their concentrations decreased non-significantly at 30 µmol/L application. In conclusion, Cd-subjected E. sativa seedlings diverted much energy from growth towards the synthesis of anti-oxidant metabolites and osmolytes. However, they did not seem to have protected the E. sativa seedlings from Cd-induced oxidative stress, causing a decrease in osmotic adjustment, and an increase in oxidative damage, which resulted in a reduction in photosynthesis and growth. Accordingly, we recommend that the cultivation of E. sativa should be avoided on soil with Cd contamination.

Membrane reactor based synthesis of biodiesel from Toona ciliata seed oil using barium oxide nano catalyst.

Membrane technology has been embraced as a feasible and promising substitute to the traditional technologies employed for biodiesel synthesis which are energy and time consuming. It needs less energy, has high stability, is environmentally friendly, and is simple to operate and control. Therefore, in our current study membrane technology was employed to synthesize biodiesel from Toona ciliate novel and non-edible seed oil. Since Toona ciliata has affluent oil content (33.8%) and is effortlessly and extensively available. In fact, we intended to scrutinize the effects of green synthesized barium oxide nanoparticles for one step transesterification of biodiesel production using membrane technology followed by characterization of prepared catalyst via innovative techniques. Optimal yield of biodiesel attained was 94% at 90 °C for 150 min with methanol to oil molar ratio of 9:1 and amount of about 0.39 wt %. Quantitative analysis of synthesized Toona ciliata oil biodiesel was carried out by advance techniques of Gas chromatography mass spectrometry (GC-MS), Fourier-transform infrared (FTIR) spectroscopy and Nuclear magnetic resonance (NMR) which authorize the synthesis of fatty acid methyl ester compounds using oil from Toona ciliata seeds. Values of Toona ciliata fuel properties for instance flash point (70°C), density (0.89 kg/m3), viscosity (5.25 mm2/s), cloud point (-8°C) and pour point (-11°C) met the specifications of international standards i. e American (ASTM D-6751), European (EN-14214) and China (GB/T 20,828). Subsequently, it is concluded that membrane technology is environmentally friendly and efficient technique for mass-production of sustainable biodiesel using green nano catalyst of barium oxide.

Biodiesel Production Using Wild Apricot (Prunus aitchisonii) Seed Oil via Heterogeneous Catalysts.

We confined the formation and characterization of heterogenous nano-catalysts and then used them to produce biodiesel from the novel non-edible seed oil of Prunus aitchisonii. P. aitchisonii seeds' oil content was extracted at about 52.4 ± 3% with 0.77% FFA. Three different heterogenous nano-catalysts-calcined (CPC), KPC, and KOH-activated P. aitchisonii cake Titanium Dioxide (TiO2)-were synthesized using calcination and precipitation methods. The mentioned catalysts were characterized through XRD, SEM, and EDX to inspect their crystallin dimension, shape, and arrangement. Titanium dioxide has morphological dimensions so that the average particle size ranges from 49-60 nm. The result shows that the crystal structure of TiO2 is tetragonal (Anatase). The surface morphology of CPC illustrated that the roughness of the surface was increased after calcination, many macropores and hollow cavities appeared, and the external structure became very porous. These changes in morphology may increase the catalytic efficiency of CPC than non-calcined Prunus aitchisonii oil cake. The fuel belonging to PAOB stood according to the series suggested by ASTM criteria. All the characterization reports that P. aitchisonii is a novel and efficient potential source of biodiesel as a green energy source.

Effective adsorption of cadmium and lead using SO3H-functionalized Zr-MOFs in aqueous medium.

Cadmium (Cd) and Lead (Pb) from industrial wastewater can bioaccumulate in the living organisms of water bodies, posing serious threats to human health. Therefore, efficient remediation of heavy metal ions of Cd (II) and Pb (II) in aqueous media is necessary for public health and environmental sustainability. In the present study, water stable Zirconium (Zr) based metal organic frameworks (MOFs) with SO3H functionalization were synthesized by solvothermal method and used first time for the adsorption of Cd (II) and Pb (II). Synthesis of UiO-66-SO3H, nano-sized (<100 nm) MOFs, was confirmed by FTIR, XRD, FESEM and BET. Effects of contact time, pH and temperature were investigated for adsorption of Cd (II) and Pb (II) onto SO3H-functionalized Zr-MOFs. The UiO-66-SO3H displayed notable rejections of 97% and 88% towards Cd (II) and Pb (II), respectively, after 160 min at 25 °C and pH (6) with an initial concentration of 1000 mg/L. Adsorption capacities of Cd (II) and Pb (II) were achieved as 194.9154 (mg/g) and 176.6879 (mg/g), respectively, at an initial concentration of 1000 mg/L. The Pseudo second-order kinetic model fitted well with linear regression (R2) of value 1. The mechanism was confirmed mainly as a chemisorption and coordination interaction between sulfone group (-SO3H) and metal ions Cd (IIa) and Pb (II). These results may support effective adsorption and can be studied further to enrich and recycle other heavy metals from wastewater.

Biodiesel from Dodonaea Plant Oil: Synthesis and Characterization-A Promising Nonedible Oil Source for Bioenergy Industry.

In this work, Dodonaea oil was studied as a potential biodiesel source. Dodonaea (Dodonaea viscosa Jacq.) is an evergreen shrubby plant that thrives in tropical and subtropical conditions. The plant produces high-grade biodiesel in terms of both quantity and quality despite its naturally high fat content. In the transesterification followed by esterification reaction, varied ratios of oil to methanol, constant temperature (60°), reaction duration (1 h), and different catalyst concentrations (0.25-0.75% (w/w) were utilized. A maximum biodiesel yield of 90% was achieved. For fuel characteristic analysis, the prepared biodiesel was specified and compared to ASTM criteria. The chemical composition was verified using analytical techniques such as FT-IR and NMR spectroscopy. As a result of the foregoing, Dodonaea is considered a possible bioenergy source, particularly in the transport sector.

Scanning electron microscopic identification of ten novel, non-edible oil seeds for bioenergy production.

Biodiesel is a sustainable, inexpensive, and alternative energy source produced from vegetable oils and animal fats. Precise and authentic identification of oil yielding plant species is very crucial. Therefore, scanning electron microscopy (SEM) was employed in our current investigation to study micromorphological characteristics of ten novel oil yielding seeds for their reliable identification. Macromorphological characters of sample seeds were explored by light microscopy. Seed size varied from 16 to 6.2 mm in length and 18.4-4.5 mm in width. Seed shape varied from ovoid to cordial and color from beige to brown. Seed oil content ranged from 25% to 45% (w/w). Whereas free fatty acid (FFA) content of seed oil varied from 0.42 to 3.4 mg KOH/g. Biodiesel potential of Chamaerops humilis was found to be highest (98%) in all. Besides, ultra-structural observation of seeds demonstrated variation in surface sculpturing which varied from rugous, reticulate, perforate, striate, and webby. Periclinal wall arrangements varied from rough, ridged, depressed, thick and curved whereas, anticlinal walls pattern showed variation from wavy, smooth, raised, deep and depressed. It was ultimately concluded that Scanning electron microscopy could serve as an advanced tool representing hidden ultra-structural characters of seeds. It offers significant knowledge to researchers and local community for their accurate and genuine identification. RESEARCH HIGHLIGHTS: Non-edible oil yielding seeds as promising source of bioenergy. Scanning electron microscopy (SEM) as reliable tool for identification. Variation in Micromorphological characters among selected seeds. Classification of non-edible oil yielding plants via micromorphological characters.

Clinical, Radiological, and Outcome Characteristics of Acute Pulmonary Embolism: A 5-year Experience from an Academic Tertiary Center.

BACKGROUND: Acute pulmonary embolism (PE) is a common and potentially life-threatening condition. This comprehensive study from a Gulf Cooperation Council (GCC) country aimed to evaluate the clinical, radiological, and outcome characteristics associated with acute PE. METHODS: This retrospective observational study analyzed data of patients with confirmed acute PE who were admitted to the largest academic tertiary center in the State of Qatar from January 1, 2014, to December 31, 2018. Data on the clinical presentation, radiologic, and echocardiographic findings, as well as outcomes were collected. RESULTS: A total of 436 patients were diagnosed with acute PE during the study period (male, 53%). Approximately 56% of the patients were < 50 years old at presentation, with a median age of 47 years. In approximately 69% of cases, the PE occurred outside the hospital. The main associated comorbidities were obesity (34.6%), hypertension (29.4%), and diabetes (25%). Immobilization (25.9%) and recent surgery (20.6%) were the most common risk factors. The most frequent presenting symptom was dyspnea (39.5%), and the most frequent signs were tachycardia (49.8%) and tachypnea (45%). Cardiac arrest was the initial presentation in 2.2% of cases. Chest X-ray findings were normal in 41%. On computed tomography pulmonary angiography (CTPA), 41.3% of the patients had segmental PE, 37.1% had central PE, and 64.1% had bilateral PE. The main electrocardiographic (ECG) abnormality was sinus tachycardia (98%). In patients who underwent echocardiography, right ventricular (RV) enlargement was the main echocardiographic finding (36.4%). Low-, intermediate-, and high-risk PE constituted 49.8%, 31.4%, and 18.8% of the cases, respectively. Thrombolysis was prescribed in 8.3% of the total and 24.4% of the high-risk PE cases. Complications of PE and its treatment (from admission up to 6 months post-discharge) included minor bleeding (14%), major bleeding (5%), PE recurrence (4.8%), and chronic thromboembolic pulmonary hypertension (CTEPH) (5%). A total of 15 (3.4%) patients died from PE. CONCLUSIONS: Acute PE can manifest with complex and variable clinical and radiological syndromes. Striking findings in this study are the younger age of acute PE occurrence and the low PE-related mortality rate.

Microscopic techniques for characterization and authentication of oil-yielding seeds.

Investigation of alternative energy sources is need of current time due to growing power crisis and associated environmental issues. Biodiesel is considered as sustainable power source and promising alternative to fossil fuels. Therefore, our current investigation aimed to identify micromorphological characters of 10 novel nonedible oil-yielding seeds through scanning electron microscopy. It was revealed from light microscopic study that there is variation in seed size from 3 to 15 mm in length and 2 to 11 mm in width. Likewise, a huge variation in color was observed such as light green, greenish yellow, blackish brown, and various shades of brown. Presence and absence of Hilum was observed, and compression of seeds varied from depressed, lateral, and dorsoventral. Seed's shape differs from ovate, clavate, triangular ovate, cuneiform, ovoid, and elliptical shape. Seed oil content fall in range of 18-58% (wt/wt). Free fatty acid content of the seeds varies from 0.3 to 3.1 mg KOH/g. Ultrastructure of seeds exhibited huge variation in shape, size, periclinal wall, anticlinal wall, and surface ornamentation. Nonedible seeds varied in wall structure from angular, wavy, dentate entire, irregular, puzzled, elongated, even, and polygonal. The periclinal wall arrangements show alteration from flat, looped, raised, depressed, lofty, even, pentagonal, polygonal, and undulate seed margins. Outcomes of this investigation recommended that scanning electron microscopy could act as a helpful tool in disclosing the hidden micromorphological characters among nonedible oil-yielding seeds and subsequently helping in correct, authentic seed identification and classification as potential feedstock for biodiesel.