Highly efficient aramid fiber supported polypropylene membranes modified with reduced graphene oxide based metallic nanocomposites: antimicrobial and antiviral capabilities.

Polypropylene hybrid polymeric membranes with aramid support have been fabricated using Thermally Induced Phase Separation (TIPS). Different modifying materials, such as metallic nanoparticles and reduced graphene oxide (rGO), improve the properties of these membranes. The nanomaterials and the fabricated membranes have been characterized with FTIR spectrometer, SEM and UV-Vis Spectrophotometer. Following that, the disinfection capabilities of the fabricated hybrid membranes were investigated. The antibacterial capability of the membranes is established through the testing of the membranes against bacterial strains S. aureus and E. coli, whereas the antiviral evaluation of the membranes was made against H9N2 and IBV strains. This research aims to develop advanced hybrid membranes that effectively disinfect water by incorporating novel nanomaterials and optimizing fabrication techniques.

Sequence based model using deep neural network and hybrid features for identification of 5-hydroxymethylcytosine modification.

RNA modifications are pivotal in the development of newly synthesized structures, showcasing a vast array of alterations across various RNA classes. Among these, 5-hydroxymethylcytosine (5HMC) stands out, playing a crucial role in gene regulation and epigenetic changes, yet its detection through conventional methods proves cumbersome and costly. To address this, we propose Deep5HMC, a robust learning model leveraging machine learning algorithms and discriminative feature extraction techniques for accurate 5HMC sample identification. Our approach integrates seven feature extraction methods and various machine learning algorithms, including Random Forest, Naive Bayes, Decision Tree, and Support Vector Machine. Through K-fold cross-validation, our model achieved a notable 84.07% accuracy rate, surpassing previous models by 7.59%, signifying its potential in early cancer and cardiovascular disease diagnosis. This study underscores the promise of Deep5HMC in offering insights for improved medical assessment and treatment protocols, marking a significant advancement in RNA modification analysis.

Salicylic acid- and ethylene-dependent effects of the ER stress-inducer tunicamycin on the photosynthetic light reactions in tomato plants.

Plant hormones such as ethylene (ET) and salicylic acid (SA) have an elementary role in the regulation of ER stress and unfolded protein response (UPR) in plants via modulating defence responses or inducing oxidative stress. Chloroplasts can be sources and targets of reactive oxygen species (ROS) that affect photosynthetic efficiency, which has not been investigated under tunicamycin (Tm)-induced ER stress. In this study, the direct and indirect effects of Tm on chloroplastic ROS production were first investigated in leaves of wild-type tomato (Solanum lycopersicum L.) plants. Secondly changes in activities of photosystem II and I were analysed under Tm exposure and after application of the chemical chaperone 4-phenylbutyrate (PBA) in different genotypes, focusing on the regulatory role of SA and ET Tm treatments significantly but indirectly induced ROS production in tomato leaves and in parallel it decreased the effective quantum yield of PSII [Y(II)] and PSI [Y(I)], as well as the photochemical quenching coefficient (qP) and the quantum yield of non-photochemical energy dissipation in PSI due to acceptor-side limitation [Y(NA)]. At the same time, Tm increased non-photochemical quenching (NPQ) and cyclic electron flow (CEF) in tomato leaves after 24 h. However, the photosynthetic activity of the SA hydroxylase-overexpressing NahG tomato plants was more severely affected by Tm as compared to wild-type and ET-insensitive Never ripe (Nr) plants. These results suggest the protective role of SA in the regulation of photosynthetic activity contributing to UPR and the survival of plants under ER stress. Interestingly, the activation of photoprotective mechanisms by NPQ was independent of SA but dependent on active ET signalling under ER stress, whereas CEF was reduced by ET due to its higher ratio in Nr plants.

Outcomes of initial 100 cases of laparoscopic nephrectomy at tertiary care center (PKLI).

Objective: Laparoscopic nephrectomy has been adopted by many centers in the last few decades. However, there are a few inherent challenges while adopting laparoscopic nephrectomy in a new unit. These include a significant learning curve required to adopt this modality. This study aimed to share the initial experience of adopting laparoscopic nephrectomy at our center. Methods: In total, 101 patients were analyzed in the study. These patients underwent laparoscopic radical or simple nephrectomy (for renal mass and noncancer renal cases respectively) at Department of Urology, Pakistan Kidney and Liver Institute and Research Centre, Lahore from April 2018 till January 2021. Data were entered in the statistical analysis software file. Analysis was attained by utilizing SPSS version 20. Implementation of Mean along with standard deviation values was utilized in the case of the continuous variables. While frequency/percentages represented categorical factors. Results: The mean age of patients was 42.81±15.49 years and their overall BMI was 26.41±5.30 kg/m2. Out of these, 57 (56.43%) were males and 44(43.56%) were female. Eighteen percent of patients had a previous surgical history on the ipsilateral side. Total operative time was 163.98±58.02 minutes while mean hospital stay reached 3.2±0.87 days. The tumor-free margin was attained in all cases of radical nephrectomy. Based on Clavien-Dindo classification, Grade-1 (n=3; 2.97%), Grade-2 (n=6; 5.94%), Grade-3A (n=1; 0.99%), and Grade-3B (n=1; 0.99%) complications were observed. Conclusion: In a newly developed urology center, laparoscopic nephrectomy can be a daunting task. Good teamwork among the surgical team members and careful selection of cases can result in satisfactory procedural outcomes.

Primary retroperitoneal teratoma in a young woman: a case report.

Teratomas are usually seen in gonads but they do occur in other extra gonadal regions such as sacrococcygeal region, mediastinum, head and neck, and retroperitoneum. Rarely in the retroperitoneal area, such tumours mostly develop in the pararenal area and usually on the left side. They have bimodal presentation at the age of six months and then in early adulthood. They originate from the germ cells that have failed to migrate to normal anatomical destinations. Many of such patients are diagnosed incidentally. Here, we report a case of symptomatic primary retroperitoneal mature teratoma in a young lady managed at Pakistan kidney and Liver Institute, Lahore.

Ethylene-dependent regulation of oxidative stress in the leaves of fusaric acid-treated tomato plants.

The mycotoxin fusaric acid (FA) induces rapid oxidative burst leading to cell death in plants. At the same time, plant defence reactions are mediated by several phytohormones for instance ethylene (ET). However, previously conducted studies leave research gaps on how ET plays a regulatory role under mycotoxin exposure. Therefore, this study aims to the time-dependent effects of two FA concentrations (0.1 mM and 1 mM) were explored on the regulation of reactive oxygen species (ROS) in leaves of wild-type (WT) and ET receptor mutant Never ripe (Nr) tomatoes. FA induced superoxide and H2O2 accumulation in both genotypes in a mycotoxin dose- and exposure time-dependent pattern. 1 mM FA activated NADPH oxidase (+34% compared to the control) and RBOH1 transcript levels in WT leaves. However, superoxide production was significantly higher in Nr with 62% which could contribute to higher lipid peroxidation in this genotype. In parallel, the antioxidative defence mechanisms were also activated. Both peroxidase and superoxide dismutase activities were lower in Nr but ascorbate peroxidase showed one-fold higher activity under 1 mM FA stress than in WT leaves. Interestingly, catalase (CAT) activity decreased upon FA in a time- and concentration-dependent manner and the encoding CAT genes were also downregulated, especially in Nr leaves at 20%. Ascorbate level was decreased and glutathione remained lower in Nr than WT plants under FA exposure. Conclusively, Nr genotype showed more sensitivity to FA-induced ROS suggesting that ET serves defence reactions of plants by activating several enzymatic and non-enzymatic antioxidants to detoxify excess ROS accumulation.

Giardiasis: An Overlooked Cause of Recurrent Abdominal Pain.

Recurrent abdominal pain is defined as at least three episodes of abdominal pain, lasting for three months or more and affecting the daily activities of an individual. Giardiasis is one of the causes of recurrent abdominal pain but is often overlooked. We report the case of an 11-year-old girl who presented with complaints of severe abdominal pain and two episodes of fresh blood in stool in one day. She had recurrent episodes of abdominal pain, occasional bloating, and diarrhea over the past two years. Workup for differentials like appendicitis and ovarian torsion was done. She was initially treated for an ovarian cyst with oral contraceptives, but her symptoms showed no improvement. Therefore, a laparoscopic ovarian cystectomy and appendectomy were attempted. Despite surgical intervention, the abdominal pain failed to resolve. A duodenal biopsy was performed, which showed vegetative growths of Giardia lamblia (G. lamblia). This report highlights the unusual presentation of giardiasis as an acute abdomen, making it a diagnostic challenge.

Massive Gastrointestinal Hemorrhage Secondary to Typhoid Fever.

Typhoid fever is caused by Salmonella typhi, a gram-negative organism. The disease usually presents with high-grade fever, abdominal pain, and diarrhea. Gastrointestinal hemorrhage is a frequent complication of the disease. However, adequate treatment with antibiotics has lowered the rate of complications. We present the case of a 21-year-old male who was admitted to the hospital with high-grade fever and per rectal bleeding. A few hours after admission, the patient had episodes of massive per rectal bleeding which resulted in hemodynamic instability. The bleeding was then successfully controlled with endoscopic hemoclipping. Concurrently, his blood culture results showed growth of Salmonella typhi for which antibiotic therapy was initiated, and the patient's condition improved thereafter. This report highlights the rare occurrence of massive lower gastrointestinal bleeding in patients with typhoid fever. It also signifies the use of endoscopic therapy with endoclips for the management of massive lower gastrointestinal bleeding.

Delayed Presentation of a Retained Fecalith.

A fecalith is a common cause of acute appendicitis, and laparoscopic surgery is the mainstay of its management. Literature review shows that a fecalith may be retained in the gut following a laparoscopic appendectomy in some rare cases. In most cases, the fecalith becomes symptomatic with time due to the formation of an abscess, fistulous tract, or inflammation of the appendicular stump (stump appendicitis). We report a case of retained appendicular fecalith presenting with symptoms similar to acute appendicitis, 15 years after laparoscopic appendectomy.

Role of ethylene and light in chitosan-induced local and systemic defence responses of tomato plants.

Plant defence responses can be triggered by the application of elicitors for example chitosan (ß-1,4-linked glucosamine; CHT). It is well-known that CHT induces rapid, local production of reactive oxygen species (ROS) and nitric oxide (NO) resulting in fast stomatal closure. Systemic defence responses are based primarily on phytohormones such as ethylene (ET) and salicylic acid (SA), moreover on the expression of hormone-mediated defence genes and proteins. At the same time, these responses can be dependent also on external factors, such as light but its role was less-investigated. Based on our result in intact tomato plants (Solanum lycopersicum L.), CHT treatment not only induced significant ET emission and stomatal closure locally but also promoted significant production of superoxide which was also detectable in the distal, systemic leaves. However, these changes in ET and superoxide accumulation were detected only in wild type (WT) plants kept in light and were inhibited under darkness as well as in ET receptor Never ripe (Nr) mutants suggesting pivotal importance of ET and light in inducing resistance both locally and systemically upon CHT. Interestingly, CHT-induced NO production was mostly independent of ET or light. At the same time, expression of Pathogenesis-related 3 (PR3) was increased locally in both genotypes in the light and in WT leaves under darkness. This was also observed in distal leaves of WT plants. The CHT-induced endoplasmic reticulum (ER) stress, as well as unfolded protein response (UPR) were examined for the first time, via analysis of the lumenal binding protein (BiP). Whereas local expression of BiP was not dependent on the availability of light or ET, systemically it was mediated by ET.

Outcomes Of Percutaneous Nephrolithotomy In Elder Age Patients-Single Center Experience.

BACKGROUND: Urolithiasis is a prevailing ailment affecting all age groups across global population. In modern innovative industry endoscopic instruments alterations and miniaturization has simplified the interventional strategy for undertaking these procedures for renal stones. However, there has been paucity of studies regarding outcomes of Percutaneous Nephrolithotomy (PCNL) in elder age group. We aimed to report success rates and complications in elder age group. METHODS: This was a retrospective review of the charts for subjects that underwent unilateral PCNL from 2012 till 2018 November at a tertiary care hospital at capital of Pakistan. Patients of age ≥60 years were chosen for this study. PCNL procedures were done in prone position. We implemented the Guy stone scoring (stone complexity) to forecast the net results of PCNL. Information regarding variables were recorded in specified proforma and then processed in SPSS version 16 for the statistical computations. RESULTS: On the whole 79 patients were incorporated for this study. Most common presenting complaint in clinic was flank pain followed by haematuria and fever respectively. Mean age in this analysis was calculated as 63.36±5.19 years. Mean size for calculi was 449±163mm2. One patient underwent transfusion after surgery while only 2.5% of these patients had sepsis (post PCNL procedure). Stone free rate was significantly affected by Guys stone score (GSS). CONCLUSIONS: PCNL can be undertaken safely and effectually for achieving treatment goals even in elder subjects. Stone free rates are higher in lower Guys stone score as compared to the higher scores.

Managing Patient With Coexisting Emphysematous Pyelonephritis And Cystitis.

Emphysematous pyelonephritis (EPN) is a type of critical renal infection having dire consequences at times. It is said to be result of gases produced inside renal parenchymal tissue or pelvicalyceal system. Rarely coexistence of emphysematous pyelonephritis and emphysematous cystitis (EC) may lead to an intimidating condition in case it is not dealt with swiftly. The resent case report narrates the management of a 45-year-old female patient who suffered from EPN with concomitant EC. Right-sided emergency percutaneous nephrostomy was passed. Afterwards, Double J stent was passed under general anaesthesia. Although she had an initial improvement clinically but later on due to recurrent urinary tract infections and non-resolving right kidney abscess and fever right sided nephrectomy was done. This is a very rare presentation and has not previously reported much in literature.

Laparoscopic Orchiopexy For Management Of Bilateral Non-Palpable Testes

BACKGROUND: Despite numerous clinical studies regarding the management of unilateral impalpable testes by laparoscopy, there is a paucity of such studies regarding the management of bilateral 'non-palpable' testes. We shared the outcome of the laparoscopic management of bilateral 'non-palpable' testes in terms of successful orchiopexy and complications in children. METHODS: A total of 22 children underwent bilateral diagnostic laparoscopy for undescended testes who presented to our department from January 2010 till March 2018. We did chart review for variables such as the age of children, operative time, hospital stay, single-stage or 2 stage procedure, and operative complications. Preoperatively history and physical examination were done along with baseline investigations and Ultrasound abdomen and scrotum before surgery for general anaesthesia fitness. They were managed by single or two steps laparoscopic orchiopexy according to suitability for each case. RESULTS: We performed bilateral laparoscopic orchidopexies in 22 children having a mean age of 4.1±1.98 years (49.2 months) Mean operative time for single setting bilateral single-stage orchiopexy was 136±32 minutes. Out of twenty-two children with bilateral impalpable testes, 12 boys (54.5%) were managed with a single-stage Bilateral Laparoscopic technique while the other 10 (45.45%) were managed in 2 staged laparoscopic intervention using Fowler-Stephens technique. Testicular atrophy was seen in 2/44 testes (4.54%). While 1 /44 (2.27%) testis had ascended to the inguinal region requiring redo surgery. CONCLUSIONS: Laparoscopic management of bilateral 'non-palpable' testes in a single or double setting is a safe and effective method of bringing testes down to the scrotum. It has no major morbidities.

Incidental Findings Of Polypoid Cystitis In A 6-Year Old Child Without Any History Of Lower Urinary Tract Symptoms And Previous Urinary Catheterization.

A 6-year-old boy presented to ER with acute pain in right iliac fossa without any history of lower urinary tract symptoms, haematuria and urinary catheterization. Ultrasound showed loculated cystic area in pelvis with non-visualized appendix. A CT scan abdomen and pelvis revealed loculated, multi-septated cystic lesion in right hemipelvis thought to be a collection from possible appendicular inflammation / perforation. The laboratory findings revealed raised CRP and normal urine routine examination and culture. Exploratory laparotomy revealed cystic urinary bladder growth involving dome with normal appendix, partial cystectomy was done. Histopathology confirmed polypoid cystitis with no evidence of malignancy. This is a very rare presentation of polypoidal cystitis, not previously reported in literature.

Small-cell neuroendocrine carcinoma of the urinary bladder: A case report.

Primary neuroendocrine carcinomas of the urinary bladder are rare. A 60-year-old male presented with gross hematuria for the past 3 months. Diagnostic flexible cystoscopy revealed a papillary lesion above the right ureteric orifice. Transurethral resection of bladder tumor was performed and resected tissue was sent for histopathology that revealed high-grade urothelial carcinoma with small-cell neuroendocrine differentiation. Lamina propria, muscularis propria, and perineural invasion was seen which was later also confirmed by immunohistochemistry. The patient received neoadjuvant four cycles of chemotherapy and then underwent radical cystoprostatectomy with ileal conduit. The patient's recovery was uneventful and he is on regular follow-up from the past 12 months without any disease recurrence. Early detection and aggressive management can improve the survival and prognosis of these patients.

Petri Net modelling approach for analysing the behaviour of Wnt/[inline-formula removed]-catenin and Wnt/Ca2+ signalling pathways in arrhythmogenic right ventricular cardiomyopathy.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart muscle disease that may result in arrhythmia, heart failure and sudden death. The hallmark pathological findings are progressive myocyte loss and fibro fatty replacement, with a predilection for the right ventricle. This study focuses on the adipose tissue formation in cardiomyocyte by considering the signal transduction pathways including Wnt/[inline-formula removed]-catenin and Wnt/Ca2+ regulation system. These pathways are modelled and analysed using stochastic petri nets (SPN) in order to increase our comprehension of ARVC and in turn its treatment regimen. The Wnt/[inline-formula removed]-catenin model predicts that the dysregulation or absence of Wnt signalling, inhibition of dishevelled and elevation of glycogen synthase kinase 3 along with casein kinase I are key cytotoxic events resulting in apoptosis. Moreover, the Wnt/Ca2+ SPN model demonstrates that the Bcl2 gene inhibited by c-Jun N-terminal kinase protein in the event of endoplasmic reticulum stress due to action potential and increased amount of intracellular Ca2+ which recovers the Ca2+ homeostasis by phospholipase C, this event positively regulates the Bcl2 to suppress the mitochondrial apoptosis which causes ARVC.

Malakoplakia of the Urinary Bladder and Unilateral Ureter.

Malakoplakia is an unusual acquired granulomatous disease that can affect many systems including urogenital tract. It presents a huge diagnostic challenge as it can mimic malignancy. We report a 55-year diabetic woman who presented with history of macroscopic hematuria and right flank pain. On investigations, ultrasound of kidney, ureter and bladder (KUB) showed right hydronephroureter, and CT KUB showed right moderate hydronephroureter and right ureteric stone. Endoscopic examination revealed multiple white plaques involving urinary bladder and right ureter. The diagnosis of malakoplakia was based on microscopic findings that are specific for its diagnosis.

Successful outcome after Pancreaticodoudenectomy in an elderly cirrhotic patient: A case report.

INTRODUCTION: Cirrhosis is a risk factor for poor outcomes in non-hepatic oncological resections. There are only a handful of cases demonstrating outcomes of pancreaticoduodenectomy (PD) in patients with pancreatic cancer and underlying cirrhosis. Moreover, pushing the limits of PD to elderly cirrhotic patients and demonstrating its safety remains under reported. CASE PRESENTATION: Here, we report successful management of a 71 year-old-lady with HCV related liver cirrhosis, obstructive jaundice and poor performance status, who was medically optimized and then underwent PD for adenocarcinoma of the head of pancreas. There was no major post-operative morbidity except minor chyle leak which resolved spontaneously. On her last follow up, she was doing well and undergoing adjuvant chemotherapy. DISCUSSION: Preoperative medical optimization and careful patient selection can yield successful outcomes even after a major abdominal surgery like PD in elderly patients with underlying liver cirrhosis. CONCLUSION: Liver cirrhosis is not a contra indication to PD in elderly patients with good performance status.

Oliguria due to extensive subcapsular hematoma in renal graft: does surgical intervention ensure better outcomes?

A 58-year-old male patient, with end-stage renal disease secondary to hypertension, underwent living-related kidney transplant at our transplant unit. The transplant surgery went uneventful and brisk urine output was recorded. Four hours after the transplant, the output suddenly dropped despite normal central venous pressure. Doppler scan revealed an extensive peri-allograft hematoma and high renal arterial resistive indices (RI). The patient was taken to the operating room where capsulotomy of the subcapsular hematoma was done. Postoperatively, the urine output restored to normal and the patient was sent home on the 5th post-operative day with adequately functioning renal graft. Surgical capsulotomy seems to be a valid approach in the management of such cases.

Real-time differentiation of adenomatous and hyperplastic diminutive colorectal polyps during analysis of unaltered videos of standard colonoscopy using a deep learning model.

BACKGROUND: In general, academic but not community endoscopists have demonstrated adequate endoscopic differentiation accuracy to make the 'resect and discard' paradigm for diminutive colorectal polyps workable. Computer analysis of video could potentially eliminate the obstacle of interobserver variability in endoscopic polyp interpretation and enable widespread acceptance of 'resect and discard'. STUDY DESIGN AND METHODS: We developed an artificial intelligence (AI) model for real-time assessment of endoscopic video images of colorectal polyps. A deep convolutional neural network model was used. Only narrow band imaging video frames were used, split equally between relevant multiclasses. Unaltered videos from routine exams not specifically designed or adapted for AI classification were used to train and validate the model. The model was tested on a separate series of 125 videos of consecutively encountered diminutive polyps that were proven to be adenomas or hyperplastic polyps. RESULTS: The AI model works with a confidence mechanism and did not generate sufficient confidence to predict the histology of 19 polyps in the test set, representing 15% of the polyps. For the remaining 106 diminutive polyps, the accuracy of the model was 94% (95% CI 86% to 97%), the sensitivity for identification of adenomas was 98% (95% CI 92% to 100%), specificity was 83% (95% CI 67% to 93%), negative predictive value 97% and positive predictive value 90%. CONCLUSIONS: An AI model trained on endoscopic video can differentiate diminutive adenomas from hyperplastic polyps with high accuracy. Additional study of this programme in a live patient clinical trial setting to address resect and discard is planned.