Effects of imidazole derivatives on cellular proliferation and apoptosis in myeloid leukemia.

BACKGROUND: Acute promyelocytic leukemia (APL) is the sub-type of Acute myeloid leukemia (AML) which is described by differentiation block at promyelocytic stage and t(15; 17) translocation with All trans retinoic acid (ATRA) and arsenic trioxide (ATO) as standard treatments. Chronic myeloid leukemia (CML) translocation t (19; 22) causes a rise in granulocytes and their immature precursors in the blood. Different mutations cause resistance to first-line tyrosine kinase therapies in CML. Beside drug resistance, leukemia stem cells (LSC) are critical resources for relapse and resistance in APL and CML. The drug toxicity and resistant profile associated with LSC and current therapeutics of APL and CML necessitate the development of new therapies. Imidazoles are heterocyclic nitrogen compounds with diverse cellular actions. The purpose of this research was to assess the anti-leukemic properties of four novel imidazole derivatives including L-4, L-7, R-35, and R-NIM04. METHODS AND RESULTS: Pharmacological and biochemical approaches were used which showed that all four imidazole derivatives interfere with the NB4 cells proliferation, an APL cell line, while only L-7 exhibit anti-proliferative activity against K562 cells, a CML cell line. The anti-proliferative effect of imidazole derivatives was linked to apoptosis induction. Further real-time polymerase chain reaction (RT-PCR) analysis revealed downregulation of AXL-Receptor Tyrosine Kinase (AXL-RTK) and target genes of Wnt/beta-catenin pathway like c-Myc, Axin2 and EYA3. An additive effect was observed after combinatorial treatment of L-7 with standard drugs ATRA or Imatinib on the proliferation of NB4 and K562 cells respectively which was related to further downregulation of target genes of Wnt/beta catenin pathway. CONCLUSION: Imidazole derivatives significantly reduce proliferation of NB4 and K562 cells by inducing apoptosis, down regulating of AXL-RTK and Wnt/ß-catenin target genes.

Plant-Based Nutraceutical Formulation Modulates the Human Gut Microbiota and Ferulic Acid Esterase Activity During In Vitro Fermentation.

Oxidative stress is an imbalance between free reactive oxygen species and antioxidant defences leading to neurological and other chronic disorders. The interaction between food and gut microbiota and their metabolites significantly reduces oxidative stress and influences host physiology and metabolism. This process mainly involves enzymes that hydrolyse complex polysaccharides and produce metabolites. Ferulic acid esterases (FAE) one of the most important enzymes of the gut microbiome, release ferulic acid from feruloylated sugar ester conjugates, that occur naturally in grains, fruits, and vegetables. FA is crucial in combating oxidative stress resulted from free radical formation. This study investigated the effect of two plant-based nutraceutical formulations, cereal-millet-based (PC1) and fruit-vegetable-based (PC2), on gut microbiota and the production of FAE, short chain fatty acids (SCFA) and other small metabolites in in vitro fermentation using human faecal samples. After in vitro fermentation, both nutraceutical formulations increased the abundance of Bifidobacterium, Lactobacillus, Prevotella, Feacalibacteria, and Clostridium leptum. Furthermore, they induced the production of FAE, xylanase and pectinase enzymes, SCFA and other small metabolites, resulting in increased antioxidation activity of the fermentate. PC1 stimulated FAE and xylanase production more effectively. These results demonstrated a positive correlation between the feruloylated nutraceutical formulation and the production of FAE and other accessory enzymes, suggesting that PC1 and PC2 stimulate the proliferation of the FAE-producing microbial consortium of the gut microbiome and therefore, increase FA and SCFA concentration. From this study it is evident that FA-rich plant-based formulation can be used as a prophylactic nutraceutical supplement to alleviate oxidative stress by modulating the gut microbiota.

Impact of COVID-19 on polio vaccination in Pakistan: a concise overview.

The pandemic of coronavirus disease 2019 (COVID-19) has disrupted immunization programs around the globe, potentially increasing life-threatening vaccine-preventable diseases. Pakistan and Afghanistan are the only countries, which are still struggling to eradicate wild poliovirus. All vaccination campaigns in Pakistan were suspended in April due to the COVID-19 outbreak, leading 40 million children to miss out on polio vaccination. Like the climate crisis, the COVID-19 pandemic could be regarded as a child-rights crisis because it could have life-threatening impact over children, who need immunization, now and in the long-term. Delays in polio vaccination programs might not have immediate impact but, in the long-term, the increase in polio cases in Pakistan could result in the global export of infections. Therefore, healthcare authorities must intensify their efforts to track and vaccinate unvaccinated children in countries like Pakistan and Afghanistan. Polio vaccination campaigns need to resume immediately, so we suggest applying social distancing measures along with standard operating procedure to flatten the transmission curve of COVID-19. Furthermore, the concurrent emergence of cVDPV2 means that tOPV should temporarily be used for primary immunization. In the current review, we have discussed delays in polio vaccination, surveillance of polio viruses, reported cases in Pakistan along with recommendations to overcome interrupted immunization.

Trends and projections of land use land cover and land surface temperature using an integrated weighted evidence-cellular automata (WE-CA) model.

Land use land cover (LULC) change has become a major concern for biodiversity, ecosystem alteration, and modifying the climatic pattern especially land surface temperature (LST). The present study assessed past and predicted future LULC and LST change in the Swabi District of Pakistan. LULC maps were generated from satellite data for years 1987, 2002, and 2017 using supervised classification. Mean LST and its areal change were estimated for different LULC classes from thermal bands of satellite images. LULC and LST were projected for the year 2047 using the integrated weighted evidence-cellular automata (WE-CA) model and a regression equation developed in this study, respectively. LULC change revealed an increase of > 5% in the built-up while a decrease in the agricultural area by ~ 9%. There was an increase of ~ 63% area in the LST class ≥ 27 °C which may create urban heat island (UHI). Simulation results indicated that the built-up area will further be increased by ~ 3% until 2047. Area associated with LST class > 30 °C indicated a further increase of ~ 38% till 2047 with reference to year 2017. Findings of this study suggested proper utilization of LULC in order to mitigate the creation of UHIs associated with urbanization and built-up areas.

CRISPR Cas System: An efficient tool for cancer modelling.

The Clustered Regularly Interspaced Short Palindromic Repeats-Cas-9 (CRISPR-Cas9) system has been a revolutionising tool in the field of molecular genetics, which provides a versatile range of editing potentials. Researchers can produce breaks or alter genomes with ease using the system. Cancer is one of the multi-gene diseases whose genes need to be studied in detail. The CRISPR-Cas9 technology may also provide a promising potential in the field of cancer genetics. The current narrative review comprised 50 research articles which were keenly analysed and the applications and outcomes of CRISPR-Cas9 system in cancer genetics were comprehensively and critically discussed. It was concluded that application of the system had great potential to help understand cancer biology of various types and could be used for its genetic modelling. However, much work is still needed to be done to apply the technology for understanding the mechanism of cancers and to help in the designing of appropriate therapies.

Asymmetrical dimethyl arginine in type 2 diabetic patients with coronary artery disease.

OBJECTIVE: To compare clinical and biochemical parameters for type 2 diabetic patients having coronary artery disease with controls. METHODS: The analytical, cross-sectional study was conducted at Khyber Medical College, Peshawar, Pakistan, for a period of one year between 2010 and 2011, and comprised two groups; Group A had normal controls, while Group B had type 2 diabetic patients with coronary artery disease. Clinical parameters were blood pressure and body mass index. Blood was centrifuged for blood sugar, glycosylated haemoglobin, total cholesterol, high-density lipoprotein, low-density lipoprotein, triglyceride and asymmetrical dimethylarginine. SPSS 15 was used to analyse data. RESULTS: Of the 150 subjects, there were 75(50%) each in Group A and Group B, which had the mean age of 50.8±80 years and 53.4±52 years, respectively. Both systolic and diastolic blood pressure and body mass index were raised and an elevated level of serum asymmetric dimethylarginine, fasting blood sugar, total cholesterol, triglycerides, glycosylated haemoglobin was noted among Group B patients (p<0.05). . CONCLUSIONS: All clinical and biochemical parameters were found raised among diabetic patients with coronary artery disease.

RELATIONSHIP OF ADIPONECTIN LEVEL WITH LIPID PROFILE IN TYPE-2 DIABETIC MEN WITH CORONARY HEART DISEASE.

BACKGROUND: Cerebro-vascular disease is a commonest long term complication of type-2 diabetes mellitus. The study was done to determine concentration of serum adiponectin and lipid profile in type-2 diabetic men with coronary heart disease (CHD) in the region of Khyber Pakhtunkhwa (KPK), and to find possible relationship between them. METHODS: This was a cross-sectional study comprising of randomly selected thirty six healthy adult males and thirty six type-2 diabetic males with coronary heart disease. Their fasting blood samples were analysed for serum adiponectin, fasting blood glucose, glycosylated haemoglobin and lipid profile which included total cholesterol (T-C), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). The relationship of adiponectin with other variables in type-2 diabetic men with coronary heart disease was determined with Pearson correlations coefficient (r). RESULTS: Type-2 diabetic males with coronary heart disease when compared to healthy males showed significantly low levels of serum adiponectin (p=<0.001) and HDL-C (p=<0.001) and significantly high level of FBG (p=<0.001), HbAlc (p=<0.001), TC (p=<0.05), TG (p=<0.05) and LDL-C (p=<0.05). Serum adiponectin level showed a significant negative correlation with FBG (r = -0.332; p= 0.04), HbAlc (r = -0.818; p=<0.01) and TG (r = -0.640; p=<0.01) in type-2 diabetic men with coronary heart disease. Adiponectin showed a significant positive association with HDL-C in controls (r = 0.948; p=<0.01) and patients of type-2 diabetes with CHD (r = 0.650; p=<0.01). CONCLUSION: Serum adiponectin concentration is markedly decreased in patients of type-2 diabetes with coronary heart disease. Hypoadiponectinemia is related with deranged lipid profile, i.e., high TG and low HDL-C levels in type-2 diabetic men with CHD. Moreover, adiponectin is associated positively with HDL-C and negatively with HbAlc and TG levels in the studied population.

An automatic diagnostic model for the detection and classification of cardiovascular diseases based on swarm intelligence technique.

Globally, cardiovascular diseases (CVDs) rank among the leading causes of mortality. One out of every three deaths is attributed to cardiovascular disease, according to new World Heart Federation research. Cardiovascular disease can be caused by a number of factors, including stress, alcohol, smoking, a poor diet, inactivity, and other medical disorders like high blood pressure or diabetes. In contrast, for the vast majority of heart disorders, early diagnosis of associated ailments results in permanent recovery. Using newly developed data analysis technology, examining a patient's medical record could aid in the early detection of cardiovascular disease. Recent work has employed machine learning algorithms to predict cardiovascular illness on clinical datasets. However, because of their enormous dimension and class imbalance, clinical datasets present serious issues. An inventive model is offered in this work for addressing these problems. An efficient decision support system, also known as an assistive system, is proposed in this paper for the diagnosis and classification of cardiovascular disorders. It makes use of an optimisation technique and a deep learning classifier. The efficacy of traditional techniques for predicting cardiovascular disease using medical data is anticipated to advance with the combination of the two methodologies. Deep learning systems can reduce mortality rates by predicting cardiovascular illness based on clinical data and the patient's severity level. For an adequate sample size of synthesized samples, the optimisation process chooses the right parameters to yield the best prediction from an enhanced classifier. The 99.58% accuracy was obtained by the proposed method. Also, PSNR, sensitivity, specificity, and other metrics were calculated in this work and compared with systems that are currently in use.

Performance optimization for an optimal operating condition for a shell and heat exchanger using a multi-objective genetic algorithm approach.

In this study, shell and heat exchangers are optimized using an integrated optimization framework. In this research, A structured Design of Experiments (DOE) comprising 16 trials was first conducted to systematically determine the essential parameters, including mass flow rates (mh, mc), temperatures (T1, t1, T2, t2), and heat transfer coefficients (€, TR, U). By identifying the first four principal components, PCA was able to determine 87.7% of the variance, thereby reducing the dimensionality of the problem. Performance-related aspects of the system are the focus of this approach. Key outcomes (€, TR, U) were predicted by 99% R-squared using the RSM models. Multiple factors, such as the mass flow rate and inlet temperature, were considered during the design process. The maximizing efficiency, thermal resistance, and utility were achieved by considering these factors. By using genetic algorithms, Pareto front solutions that meet the requirements of decision-makers can be found. The combination of the shell and tube heat exchangers produced better results than expected. Engineering and designers can gain practical insight into the mass flow rate, temperature, and key responses (€, TR, U) if they quantify improvements in these factors. Despite the importance of this study, it has several potential limitations, including specific experimental conditions and the need to validate it in other situations as well. Future research could investigate other factors that influence system performance. A holistic optimization framework can improve the design and engineering of heat exchangers in the future. As a result of the study, a foundation for innovative advancements in the field has been laid with tangible improvements. The study exceeded expectations by optimizing shell and heat exchanger systems using an integrated approach, thereby contributing significantly to the advancement of the field.

The Efficacy of Cabazitaxel in Treating Prostate Cancer: A Systematic Review and Meta-Analysis.

Cabazitaxel, a second-generation taxane chemotherapy agent, has demonstrated efficacy in treating metastatic castration-resistant prostate cancer (mCRPC) in patients who have previously received docetaxel-based therapy. By targeting microtubule dynamics, cabazitaxel inhibits cancer cell division and induces apoptosis, thereby extending survival and delaying disease progression in this challenging patient population. A systematic review and meta-analysis were done by searching the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE (including MEDLINE InProcess; OvidSP), Web of Science, Embase (OvidSP), and Scopus databases. ROB2 Cochrane tools assessment for RCTs. In the analysis, we used RevMan Cochrane software. Our research reveals significantly improved outcomes in terms of patient survival rates, both progression-free survival (PFS) and overall survival (OS), for cabazitaxel over comparative treatment (PFS HR 0.77 [0.61, 0.97]) (OS HR 0.79 [0.70, 0.88]). The treatment response rates were also favorable for cabazitaxel, reported as PSA Reduction Response of more than 50% (PRR) (odds ratio (OR) = 1.59 [0.56, 4.52]) and tumor response rate (TRR) (OR = 2.34 [1.28, 4.28]). Cabazitaxel was associated with significantly more incidence of adverse events. The risk ratio (RR) for serious adverse events was 1.64 [1.14, 2.35] for cabazitaxel compared to the current regimen. A systematic review and meta-analysis were done by searching in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE (including MEDLINE InProcess; OvidSP), Web of Science, Embase (OvidSP), and Scopus databases. ROB2 Cochrane tools assessment for RCTs. In the analysis, we used RevMan Cochrane software.

A featureless approach for object detection and tracking in dynamic environments.

One of the challenging problems in mobile robotics is mapping a dynamic environment for navigating robots. In order to disambiguate multiple moving obstacles, state-of-art techniques often solve some form of dynamic SLAM (Simultaneous Localization and Mapping) problem. Unfortunately, their higher computational complexity press the need for simpler and more efficient approaches suitable for real-time embedded systems. In this paper, we present a ROS-based efficient algorithm for constructing dynamic maps, which exploits the spatial-temporal locality for detecting and tracking moving objects without relying on prior knowledge of their geometrical features. A two-prong contribution of this work is as follows: first, an efficient scheme for decoding sensory data into an estimated time-varying object boundary that ultimately decides its orientation and trajectory based on the iteratively updated robot Field of View (FoV); second, lower time-complexity of updating the dynamic environment through manipulating spatial-temporal locality available in the object motion profile. Unlike existing approaches, the snapshots of the environment remain constant in the number of moving objects. We validate the efficacy of our algorithm on both V-Rep simulations and real-life experiments with a wide array of dynamic environments. We show that the algorithm accurately detects and tracks objects with a high probability as long as sensor noise is low and the speed of moving objects remains within acceptable limits.

Machine learning-based assessment and simulation of land use modification effects on seasonal and annual land surface temperature variations.

Rapid urban sprawl adversely impacts the local climate and the ecosystem components. Islamabad, one of South Asia's green and environment-friendly capitals, has experienced major Land Use Land Cover (LULC) changes over the past three decades consequently, elevating the seasonal and annual Land Surface Temperature (LST) in planned and unplanned urban areas. The focus of this study was to quantify the fluctuations in LULC and LST in planned and unplanned urban areas using Landsat data and Machine Learning algorithms involving the Support Vector Machine (SVM) over the 1990-2020 data period. Moreover, hybrid Cellular Automata-Markov (CA-Markov) and Artificial Neural Network (ANN) models were employed to project the future changes in LULC and annual LST, respectively, for the years 2035 and 2050. The findings of the study reveal a distinct difference in seasonal and annual LST in planned and unplanned areas. Results showed an increase of ∼22 % in the built-up area but vegetation and bare soil decreased by ∼10 % and ∼12 %, respectively. Built-up land showed a maximum annual mean LST followed by bare-soil and vegetative surfaces. Seasonal analysis showed that summer months experience the highest LST, followed by spring, autumn and winter. Future projections revealed that the built-up areas (∼27 % in 2020) are likely to increase to ∼37 % and ∼50 %, and the areas under the highest annual mean LST class i.e., ≥28 °C are likely to increase to ∼19 % and ∼21 % in planned, and ∼38 % and ∼42 % in unplanned urban areas for the years 2035 and 2050, respectively. Planned areas have better temperature control with urban green spaces, and controlled infrastructure. The Capital Development Authority of Islamabad may be advised to control the expansion of built-up areas, grow urban forests, and thus mitigate the possible Urban Heat Island (UHI) effect.

Cancer Stem Cells and Treatment of Cancer: An Update and Future Perspectives.

Cancer stem cells (CSCs) play an essential role in tumour progression and metastasis. These cells have the unique ability to self-renew and differentiate into specific tissue cell types. Their capacity for self-renewal enables CSCs to persist over time, thereby contributing to cancer relapse and therapy resistance. Therefore, targeting CSCs has emerged as a promising cancer treatment strategy. CSCs exhibit differentiation, self-renewal, and plasticity, and they contribute to multiple aspects of malignant tumours, such as recurrence, metastasis, heterogeneity, multidrug resistance, and radiation resistance. While conventional treatments predominantly target cancer cells that are not CSCs, CSCs frequently survive, resulting in tumour recurrence and relapse. This article concentrates on the development of novel therapeutic strategies that combine conventional treatments with CSC inhibitors to eradicate cancer cells and CSCs, thereby treating cancer and preventing its recurrence. However, the diversity of CSCs poses a significant obstacle to the development of CSC-targeted therapies, necessitating extensive research for a better understanding and exploration of therapeutic approaches. Future development of CSC-targeted therapies will rely heavily on overcoming this obstacle.

The Prevalence of Blood Borne Diseases in Blood Donors of Peshawar, Khyber Pakhtunkhwa, Pakistan.

BACKGROUND: The goal of the study was to investigate the burden of transfusion- transmitted infections (TTIs) hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), syphilis, and malarial parasite (MP) in ABO Blood Groups and Rh Type System among voluntarily blood donors in Khyber Pakhtunkhwa (KPK), Pakistan. It is a retrospective single center cross sectional study. This study was conducted from June 2020 to September 2021 (16 months) at the frontier foundation thalassemia center Peshawar KPK. Donors were physically healthy and fit for donation. Donors with physical disabilities and/or having co-morbid conditions were excluded from the report. METHODS: All the samples were screened for anti-HIV, anti-HCV, HBsAg, Syphilis, and Malarial Parasite via ELISA kit and Immune Chromatographic Technique (ICT), respectively. A total of 6311 blood donations were evaluated. The majority of the donations (92%) were from (VNRBD) voluntary non-remunerated blood donation, while only 8% came from replacement donors. RESULTS: Amongst 6311 blood donations, 1.50 % (n = 95) were infected at least with one pathogen, HBV positive cases were 0.855 % (n = 54), HCV positive cases were 0.316% (n = 20), syphilis positive were 0.30% (n = 19) and MP positive cases were only 0.031% (n = 2). HBV, HCV, syphilis and malaria infections rates were found to be low as compared to the previous data published, while no case was reported for HIV. The study also revealed the distribution pattern of the aforementioned pathogens in blood groups and the Rh type system of the reactive samples. CONCLUSION: The lower reported in our study indicates the awareness among the people of Peshawar about TTIs and their precautions. The prevalence rate that we are reporting is less than previously published articles in the same domain.

Conservation tillage practices affect soil microbial diversity and composition in experimental fields.

Introduction: Conservation tillage is a widely used technique worldwide, but the effects of conservation tillage on bacterial community structure are poorly understood. We explored proportional alterations in the bacterial community under different tillage treatments. Methodology: Hence, this study utilized high-throughput sequencing technique to investigate the structure and assembly processes of microbial communities in different tillage treatments. Results and discussion: Tillage treatments included tillage no-straw retention (CntWt), no-tillage with straw retention (CntWntS), tillage with straw retention (CntWtS), no-tillage and no-straw retention (CntWnt). The influence of tillage practices on soil bacterial communities was investigated using Illumina MiSeq sequencing. Different tillage methods and straw retention systems significantly influenced soil parameters such as total potassium and pH were not affected by tillage practices, while straw retention significantly affected soil parameters including nitrogen content, available phosphorus and available potassium. Straw retention decreased bacterial diversity while increased bacterial richness. The effect of straw retention and tillage on bacterial communities was greater than with no tillage. Phylogenetic ß-diversity analysis showed that deterministic homogeneous selection processes were dominated, while stochastic processes were more pronounced in tillage without straw retention. Ecological network analysis showed that microbial community correlation was increased in CntWntS and CntWnt. Straw retention treatment significantly increased the relative abundance of bacterial taxa Proteobacteria, Bacteroidetes, and OD1, while Nitrospirae, Actinobacteria, and Verrucomicrobia significantly decreased. Conclusion: The conservation tillage practices significantly affect soil properties, bacterial composition, and assembly processes; however, further studies are required to investigate the impact of different crops, tillage practices and physiological characteristics on bacterial community structure and functions.

Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India.

BACKGROUND: While India has made significant progress in reducing maternal mortality, attaining further declines will require increased skilled birth attendance and institutional delivery among marginalized and difficult to reach populations. METHODS: A population-based survey was carried out among 16 randomly selected rural villages in rural Mysore District in Karnataka, India between August and September 2008. All households in selected villages were enumerated and women with children 6 years of age or younger underwent an interviewer-administered questionnaire on antenatal care and institutional delivery. RESULTS: Institutional deliveries in rural areas of Mysore District increased from 51% to 70% between 2002 and 2008. While increasing numbers of women were accessing antenatal care and delivering in hospitals, large disparities were found in uptake of these services among different castes. Mothers belonging to general castes were almost twice as likely to have an institutional birth as compared to scheduled castes and tribes. Mothers belonging to other backward caste or general castes had 1.8 times higher odds (95% CI: 1.21, 2.89) of having an institutional delivery as compared to scheduled castes and tribes. In multivariable analysis, which adjusted for inter- and intra-village variance, Below Poverty Line status, caste, and receiving antenatal care were all associated with institutional delivery. CONCLUSION: The results of the study suggest that while the Indian Government has made significant progress in increasing antenatal care and institutional deliveries among rural populations, further success in lowering maternal mortality will likely hinge on the success of NRHM programs focused on serving marginalized groups. Health interventions which target SC/ST may also have to address both perceived and actual stigma and discrimination, in addition to providing needed services. Strategies for overcoming these barriers may include sensitization of healthcare workers, targeted health education and outreach, and culturally appropriate community-level interventions. Addressing the needs of these communities will be critical to achieving Millennium Development Goal Five by 2015.

WITHDRAWN: Original Antigenic Sin in COVID-19: Hoskins Effect and Vaccine

The article has been withdrawn at the request of the authors.Bentham Science apologizes to the readers of the journal for any inconvenience this may have caused.The Bentham Editorial Policy on Article Withdrawal can be found at https://benthamscience.com/editorial-policies-main.php. Bentham Science Disclaimer: It is a condition of publication that manuscripts submitted to this journal have not been published and will not be simultaneously submitted or published elsewhere. Furthermore, any data, illustration, structure or table that has been published elsewhere must be reported, and copyright permission for reproduction must be obtained. Plagiarism is strictly forbidden, and by submitting the article for publication the authors agree that the publishers have the legal right to take appropriate action against the authors, if plagiarism or fabricated information is discovered. By submitting a manuscript the authors agree that the copyright of their article is transferred to the publishers if and when the article is accepted for publication.

A Case of Gastric Outlet Obstruction Secondary to Parastomal Stomach Herniation.

Parastomal hernia (PH) is an abnormal herniation of tissue or intra-abdominal organ through the fascial defect created at the ostomy site. It is a common complication of stoma creation and usually contains bowel, intra-abdominal fat, or omentum. Herniation of a fixed organ like the stomach is very rare and can lead to significant morbidity and mortality. Here, we present a case of an 83-year-old female with a history of sigmoidectomy and subsequent development of parastomal hernia who presented with abdominal pain, nausea, and vomiting and was found to have stomach herniation into the parastomal hernia sac. She was managed conservatively with intravenous (IV) fluids, electrolyte replacement, and decompression with a nasogastric (NG) tube. In this article, we have discussed the incidence, clinical presentation, diagnosis, and management of gastric involvement in the parastomal hernia that can help clinicians identify and treat it early at the time of presentation.

A Case of Heterotopic Gastric Tissue in Duodenal Bulb: An Interesting Endoscopic Finding.

Gastric heterotopia (GH) is a rare, congenital condition where gastric tissue is found outside of its normal location in the gastric mucosa. It is usually benign and can be found throughout the gastrointestinal (GI) tract. In the duodenum, it is usually seen as multiple polyps, specifically in the duodenal bulb. Here, we discuss the case of a 67-year-old male patient who presented with hematemesis, melena, and abdominal pain. Esophagogastroduodenoscopy (EGD) and biopsy revealed a mass consisting of heterotopic gastric mucosa along with an esophageal ulcer. In this article, we will discuss the literature related to the clinical presentation, diagnosis, and management of GH.

Association Of Adiponectin With Total Leukocyte Count In Patients Of Coronary Artery Disease.

Background: Hypoadiponectinemia and raised total leukocyte count have been associated with coronary artery disease. The aim of this study was to investigate association of serum adiponectin levels with total leukocyte count in patients of coronary artery disease belonging to Khyber Pakhtunkhwa. Method: This cross-sectional/analytical study consisted of two groups. Group A contained 100 patients of coronary artery disease while group B contained 100 healthy controls. Consent of the study subjects was obtained, their history was recorded and fasting blood samples were analyzed for serum adiponectin level, total leukocyte count (TLC), serum lipid profile which included serum total cholesterol (T-C), triglyceride level (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Adiponectin level was determined with ELIZA method, TLC was estimated on automated haematology analyzer and lipid profile was determined using enzymatic colorimetric method. SPSS version 21 was used to analyze the data. Results: Subjects with coronary artery disease when compared to healthy subjects showed significantly high level of total leukocyte count (9.26±1.488 vs. 6.37±4.052) and low level of serum adiponectin (4.3±0.80 vs. 9.6±3.69). Moreover, serum lipid profile showed low HDL-C (30.04±9.1 vs. 43.64±7.3) and rose triglyceride (220.1±67.7 vs. 181.86±41.4), total cholesterol (229.3±37.01 vs. 189.4±32.7), and LDL-C (153.78±38.53 vs. 109.16±33.91) levels. Significant negative association of adiponectin with TLC (r -0.826 with p<0.01) was observed in the study subjects. Conclusion: We observed elevated level of total leukocyte count and reduced level of adiponectin in subjects with coronary artery disease. Moreover, hypoadiponectinemia correlated negatively with TLC levels.