Intelligent image-based deformation-assisted cell sorting with molecular specificity.

Although label-free cell sorting is desirable for providing pristine cells for further analysis or use, current approaches lack molecular specificity and speed. Here, we combine real-time fluorescence and deformability cytometry with sorting based on standing surface acoustic waves and transfer molecular specificity to image-based sorting using an efficient deep neural network. In addition to general performance, we demonstrate the utility of this method by sorting neutrophils from whole blood without labels.

Hepatitis C prevalence and elimination planning in Pakistan, a bottom-up approach accounting for provincial variation.

In Pakistan, substantial changes to hepatitis C virus (HCV) programming and treatment have occurred since the 2008 nationwide serosurvey estimated a 4.8% anti-HCV prevalence. In the absence of an updated national study, this analysis uses provincial data to estimate a national prevalence and the interventions needed to achieve elimination. Using a Delphi process, epidemiologic HCV data for the four provinces of Pakistan (accounting for 97% of the population) were reviewed with 21 subject-matter experts in Pakistan. Province-level estimates were inputted into a mathematical model to estimate the national HCV disease burden in the absence of intervention (Base), and if the World Health Organization (WHO) elimination targets are achieved by 2030 (80% reduction in new infections, 90% diagnosis coverage, 80% treatment coverage, and 65% reduction in mortality: WHO Elimination). An estimated 9,746,000 (7,573,000-10,006,000) Pakistanis were living with viraemic HCV as of January 1, 2021; a viraemic prevalence of 4.3% (3.3-4.4). WHO Elimination would require an annual average of 18.8 million screens, 1.1 million treatments, and 46,700 new infections prevented anually between 2022 and 2030. Elimination would reduce total infections by 7,045,000, save 152,000 lives and prevent 104,000 incident cases of hepatocellular carcinoma from 2015 to 2030. Blood surveys, programmatic data, and expert panel input uncovered more HCV infections and lower treatment numbers in the provinces than estimated using national extrapolations, demonstrating the benefits of a bottom-up approach. Screening and treatment must increase 20 times and 5 times, respectively, to curb the HCV epidemic in Pakistan and achieve elimination by 2030.

Role of rifaximin in the management of alcohol-associated hepatitis: A systematic review and meta-analysis.

BACKGROUND AND AIM: Alcohol-associated hepatitis (AAH) is an acute, inflammatory liver disease with severe short-term and long-term morbidity and mortality. AAH can lead to severe complications including hepatic failure, gastrointestinal bleeding, sepsis, and the development or decompensation of cirrhosis. Rifaximin is an antibiotic that reduces bacterial overgrowth and gut translocation, and it may have a role in decreasing systemic inflammation and infection in patients with AAH. Therefore, we conducted a systematic review and meta-analysis to evaluate the role of rifaximin in the management of AAH. METHODS: A comprehensive search strategy was used to identify studies that met our inclusion criteria in Embase, MEDLINE (PubMed), Cochrane Library, Web of Science Core Collection, and Google Scholar. Outcomes of interest included rates of infection, 90-day mortality, and overall mortality between the rifaximin versus non-rifaximin group. Open Meta Analyst software was used to compute the results. RESULTS: Three studies with a total of 162 patients were included in the final meta-analysis. Of the three studies, two were randomized control trials (RCTs), and one was a case-control study. There was a significantly lower rate of infection in the rifaximin group versus the non-rifaximin group (RR: 0.331, 95% CI: 0.159-0.689, I2  = 0%, P = 0.003). There was no significant difference in 90-day mortality in the rifaximin versus non-rifaximin group (RR: 0.743, 95% CI: 0.298-1.850, I2  = 24%, P = 0.523), nor was there a significant difference in overall mortality (RR: 0.624, 95% 95% CI: 0.299-1.3, I2  = 7.1%, P = 0.208). CONCLUSIONS: The use of rifaximin in AAH is associated with a lower rate of infection rate than the non-rifaximin group. Additional research is needed to determine whether this effect is more pronounced in patients concurrently being treated with prednisolone. Differences in 90-day or overall mortality did not reach statistical significance. Further studies, particularly large randomized controlled trials, are needed to establish the role of rifaximin in AAH, especially as an adjunct therapy with prednisolone.

Idiopathic myointimal hyperplasia of the mesenteric veins: A systematic review and individual patient data regression analysis.

BACKGROUND AND AIM: Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is an uncommon cause of colonic ischemia for which surgical treatment is typically curative. We describe clinical, radiologic, and endoscopic findings in IMHMV patients to provide clinicians with a framework for pre-surgical identification of this rare disease. METHODS: We performed a systematic review of seven databases for IMHMV cases and identified additional cases from Yale New Haven Hospital records. To identify features specifically associated with colonic ischemia due to IMHMV, we performed multivariate logistic regression analysis incorporating data from a large cohort of patients with biopsy-proven ischemic colitis. RESULTS: A total of 124 patients with IMHMV were identified (80% male, mean age 53 years, 56% Caucasian). Presenting symptoms were most commonly abdominal pain (86%) and diarrhea (68%). The most affected areas were the sigmoid colon (91%) and rectum (61%). Complications associated with diagnostic delay occurred in 29% of patients. Radiologic vascular abnormalities including non-opacification of the inferior mesenteric vein were observed in 35% of patients. Of the patients, 97% underwent curative surgical resection. Compared with non-IMHMV colonic ischemia, IMHMV was significantly associated with younger age, male sex, absence of rectal bleeding on presentation, rectal involvement, and mucosal ulcerations on endoscopy. CONCLUSION: IMHMV is a rare, underreported cause of colonic ischemia that predominantly involves the rectosigmoid. Our findings suggest younger age, rectal involvement, and absence of rectal bleeding as clinical features to help identify select patients presenting with colonic ischemia as having higher likelihood of IMHMV and therefore consideration of upfront surgical management.

A national study of pregnancy-related maternal and fetal outcomes in women with inflammatory bowel disease.

BACKGROUND AND AIMS: The incidence of inflammatory bowel disease (IBD) among women is highest during their reproductive years and current estimates suggest that the rate of conception is low in female IBD patients. The aim of our study was to assess the burden of adverse maternal and perinatal outcomes among female IBD patients. METHODS: Using the national inpatient sample database from 2016 to 2018, we recruited all female patients above the age of 15 years admitted with a primary diagnosis of pregnancy and a secondary diagnosis of IBD. We adjusted our results for hospital and patient level variables including age, race, socioeconomic status, hypertension, diabetes mellitus, obesity, smoking, hyperlipidemia, alcohol use, and malnutrition. Multivariable regression analysis was used for analysis. RESULTS: Pregnant women with IBD had greater odds of gestational diabetes (adjusted odds ratio [AOR] 1.55, 95% confidence interval [CI] 1.04-2.3, p 0.02), hypertensive complications (AOR 1.35, 95% CI 1.06-1.72, p 0.01), and pre-term delivery (AOR, 1.41 95% CI 1.13-1.76, p 0.003). Pregnancies with co-existent IBD were associated with fetal growth restriction (AOR 1.27, 95% CI 1-1.63, p 0.04) and fetal death (AOR 3.21, 95% CI 1.72-6.00, p < 0.01). Odds of experiencing postpartum hemorrhage or large for gestational age infant were comparable to general population. Crohn's disease was independently associated with increased odds of worse maternal and fetal outcome. IBD patients had increased mean length of stay by 0.14 days and increased mean hospital charges of $2741. CONCLUSIONS: Women with IBD had greater likelihood of poor maternal and fetal outcomes and increased hospital resource utilization.

Safety of anticoagulation use for treatment of portal vein thrombosis in liver cirrhosis and its effect on hospital-based outcomes: an insight from a US nationwide database.

BACKGROUND AND AIM: Anticoagulation use for portal vein thrombosis (PVT) in patients with advanced liver disease is controversial. We investigated the effect of anticoagulation on outcomes in patients with PVT with cirrhosis. METHODS: We reviewed National Inpatient Sample data from 2016 to 2018 to identify patients with PVT. Our outcomes were in-hospital mortality, variceal bleeding, hepatic encephalopathy, acute kidney injury (AKI), hepatorenal syndrome (HRS), spontaneous bacterial peritonitis (SBP), sepsis and hospital resource utilisation. RESULTS: We included 60 505 patients with PVT, out of whom 6.63% (4015) were on anticoagulation. The overall mortality in the anticoagulation group was 2.12% compared with 9.72% in the no anticoagulation group. The adjusted odds of mortality were low in the anticoagulation group (adjusted OR (AOR) 0.27, 95% CI 0.15 to 0.46, p<0.001). Patients on anticoagulation had 29% lower odds of variceal bleeding (AOR 0.71, 95% CI 0.53 to 0.96, p=0.03). Lower odds of HRS (AOR 0.56, 95% CI 0.37 to 0.85, p=0.01) and AKI (AOR 0.57, 95% CI 0.48 to 0.69, p<0.001) were also seen in the anticoagulation group. Patients in the anticoagulation group also showed lower odds of SBP (AOR 0.62, 95% CI 0.43 to 0.89, p=0.01) and sepsis (AOR 0.57, 95% CI 0.35 to 0.93, p=0.03). Anticoagulation use resulted in shorter hospital stay by 1.15 days (adjusted length of stay -1.15, 95% CI -1.51 to -0.79, p<0.001). The mean difference in total hospital charges between the anticoagulation and the no anticoagulation group was -$20 034 (95% CI -$27 077 to -$12 991, p<0.001). CONCLUSION: Our analysis found that anticoagulation use is safe and associated with better outcomes in patients with PVT with advanced liver disease.

Evaluating humidity sensing response of graphene quantum dots synthesized by hydrothermal treatment of glucose.

Graphene quantum dots (GQDs) were prepared using a single-step hydrothermal treatment of glucose (C6H12O6) powder. X-ray diffraction patterns confirmed the random stacking or amorphous character of GQDs. Additionally, the UV-vis spectra confirmed the formation of GQDs with evident absorption peaks at 237 and 305 nm, which is attributed toπ-π* andn-π* transitions correspondingly. The average size and surface roughness of graphene quantum dots were estimated by atomic force microscopy images and found to be 27.0 ± 1.0 and 2.3 nm, respectively. Afterwards, the effect of increasing relative humidity (RH) from 0%-95%, and frequency, was analyzed using the capacitive and resistive responses of synthesized GQDs. The capacitive output at 0.1 kHz revealed that initially capacitance remains constant (15.0 ± 1.0 pF) up to a humidity level ranging between 0%-50%. Likewise, capacitance also displayed stabilized behavior after frequency levels were increased i.e., 1.0 and 10 kHz, at a humidity ranging from 0%-55%. Moreover, capacitance showed a 115,455, 22,480 and 3,620% improvement from their stable values at each respective frequency level i.e., 0.1, 1.0 and 10 kHz. The capacitive sensitivity decreased to 84.20 and 96.83% at greater frequencies (1.0 and 10 kHz) in comparison to the sensitivity at 0.1 kHz facing similar variations in a humid environment. In contrast, resistance displayed an exponential decline by 99.9900, 99.9796 and 99.9925%, accordingly, when RH increases from 0 to 95% at 0.1, 1.0 and 10 kHz, respectively. However, with the rise in frequency level from 0.1 to 1.0 kHz, resistive sensitivity increased considerably to 69 and 158.5%, respectively, in two prominent humidity ranges i.e., 0 ≤ RH ≤ 25% and 25% ≤ RH ≤ 50%. A further increase in testing frequency to 10 kHz enhances the resistive sensitivity by 598.5 and 178.5% when compared with the lowest sensitivity values at two noticeable humidity levels, 0%-25% and 25%-50%. The response and recovery times of our specimen were better than most of previously fabricated GQDs and other carbon-derived nanomaterials, which makes the nano-GQDs of our study more suitable for RH sensor application.

A step towards sustainable environment in China: The role of eco-innovation renewable energy and environmental taxes.

In the contemporary environment, developing countries are more focused on how economic factors can reasonably utilize technological advancement and carbon neutrality target as effective mechanisms in achieving sustainable production and consumption patterns. The effort to attain carbon neutrality target on natural environment in terms of lower carbon emission (CO2), haze pollution, and greenhouse gas (GHG) requires measures like the usage of non-renewable energy, ecological innovation, and environmental taxes. In doing so, this study considers the sustainability of China's natural environment in terms of CO2 emission, haze pollution through PM2.5, and greenhouse gas emission as well as factors like ecological innovation (ECO), environmental taxes (ERT), renewable energy, and globalization as the key determinants. The Quantile ARDL approach was used to examine both long- and short-run relationships between the explanatory and outcome variables. The results confirmed that there is a significant and negative impact of ECO, renewable energy, and ERT on CO2 emission in the region of China under different quantiles. Whereas, the globalization factor was observed as positively and significantly linked with CO2 emission but only for the higher quantiles. The long-run estimation further showed that ECO, renewable energy, and ERT can significantly help to decrease haze pollution in terms of PM2.5 in China. Furthermore, QARDL also confirms the negative and long-run estimation between the ECO, REN, and ERT, whereas globalization is causing more GHG in China, subsequently creating more environmental sustainability issues. Thus, it is concluded that effective innovation, renewable energy consumption, and environmental taxes reduce carbon emission while globalization increases the carbon emission in the country.

Antiviral activity of green silver nanoparticles produced using aqueous buds extract of Syzygium aromaticum.

In the present study, we synthesized silver (Ag) nanoparticles using aqueous extracts of clove (Syzygium aromaticum) (SAE). This synthesis of green silver nanoparticles (AgNP) was a novel and effectual tool against the Newcastle Viral Disease (NDV). Syzygium aromaticum extract was used as reducing and stabilizing agent for synthesis of silver nanoparticles. AgNP were characterized using diversity of biophysical methods inclusive of Fourier transform infrared spectroscopy (FTIR), UV-VIS spectroscopy and Transmission electron microscopy (TEM) for morphology and size. Furthermore, XRD analysis confirmed the crystalline nature of the particles. In current investigations, the antiviral activity of clove buds silver nanoparticles was inspected in-vitro and in-ovo. Embryonated chicken eggs were used to perform the cytotoxicity assay of the clove extract silver nanoparticles (CESN). CESN showed in vitro antiviral activity against NDV in embryonated eggs.

High-Throughput Microfluidic Characterization of Erythrocyte Shapes and Mechanical Variability.

The motion of red blood cells (RBCs) in microchannels is important for microvascular blood flow and biomedical applications such as blood analysis in microfluidics. The current understanding of the complexity of RBC shapes and dynamics in microchannels is mainly based on several simulation studies, but there are a few systematic experimental investigations. Here, we present a combined study that systematically characterizes RBC behavior for a wide range of flow rates and channel sizes. Even though simulations and experiments generally show good agreement, experimental observations demonstrate that there is no single well-defined RBC state for fixed flow conditions but rather a broad distribution of states. This result can be attributed to the inherent variability in RBC mechanical properties, which is confirmed by a model that takes the variation in RBC shear elasticity into account. This represents a significant step toward a quantitative connection between RBC behavior in microfluidic devices and their mechanical properties, which is essential for a high-throughput characterization of diseased cells.

Evaluation of physiological markers for assessing drought tolerance and yield potential in bread wheat.

Carbon isotope discrimination (Δ) has been recognized as a valuable phenotyping tool in wheat breeding. However, technical expertise and analysis cost restrict its large-scale use. We examined the associations of ash content (AC), minerals content (Ca, K, Mg, Fe and Mn) and leaf chlorophyll content (Chl) with grain Δ and grain yield (GY) to assess their potential as substitute to grain Δ. We evaluated 49 wheat genotypes under two water deficit regimes (W120 and W200) in a rain-out shelter. Leaf chlorophyll content (Chl) was strongly correlated with grain Δ and GY under moderate water deficit regime (W200). Significant and negative correlations (P < 0.01) of AC and potassium concentration (K) with grain Δ, and between AC and GY was observed under both water regimes, while manganese concentration (Mn) was negatively correlated with grain Δ under W120 regime only and magnesium concentration (Mg) correlated negatively under the W200 regime only. Grain Δ was correlated (P < 0.01) positively with photosynthesis rate (A), stomatal conductance (gs) and GY, while correlated negatively (P < 0.01) with intrinsic water use efficiency (iWUE) under both water regimes. Results confirm the role of grain Δ as an indirect selection criterion for drought tolerance under a wide range of drought conditions. Additionally, Chl is the most suitable trait to predict yield under moderate water deficit conditions. AC and K concentration in grain proved potentially useful and economical alternative criterion to grain Δ in the evaluation of differences in yield potential and drought tolerance in wheat under drought.

Comparative study of the genetic basis of nitrogen use efficiency in wild and cultivated barley.

To curb the increasing demand for nitrogenous fertilizers, it is imperative to develop new cultivars with comparatively greater nitrogen use efficiency (NUE). Nonetheless, so far very meager information is available concerning the variances among barley (Hordeum vulgare L.) varieties for their response to nitrogen deprivation. The current study was carried out to explore the potential of barley genotypes for higher NUE. A hydroponic experiment was conducted at seedling stage to compare the performance of four barley genotypes, ZD9 and XZ149 (with higher NUE) and HXRL and XZ56 (with lower NUE) in response to low (0.1 mM) and normal nitrogen (2 mM) levels. Under low N, all the genotypes expressed less number of tillers, decreased soluble proteins, chlorophyll and N concentrations in both roots and shoots, in comparison with normal N supply. However, significant differences were found among the genotypes. The genotypes with high NUE (ZD9 and XZ149) showed higher N concentration, increased number of tillers, improved chlorophyll and soluble proteins in both roots and shoots as compared to the inefficient ones (HXRL and XZ56). Furthermore, nitrate transporter gene (NRT2.1) showed higher expression under low N, both in roots and leaves of N efficient genotypes, as compared to the N inefficient ones. However, N assimilatory genes (GS1 and GS2) showed higher expression under normal and low N level, in leaves and roots respectively. The outcome of the study revealed that genotypes with higher NUE (ZD9 and XZ149) performed better under reduced N supply, and may require relatively less N fertilizer for normal growth and development, as compared to those with lower NUE. The study also revealed a time-specific expression pattern of studied genes, indicating the duration of low N stress. The current study suggested that future work must involve the time course as a key factor while studying expression patterns of these genes to better understand the genetic basis of low-N tolerance.

Characterizing bread wheat genotypes of Pakistani origin for grain zinc biofortification potential.

BACKGROUND: Zinc (Zn) is essential for all life forms and its deficiency is a major issue of malnutrition in humans. This study was carried out to characterize 28 wheat genotypes of Pakistani origin for grain zinc biofortification potential, genetic diversity and relatedness. RESULTS: There was low genetic differentiation among the tested genotypes. However, they differed greatly in yield-related traits, grain mineral (Zn, calcium (Ca) and protein) concentrations and Zn bioavailability. Zinc application increased the concentration of Zn in wheat grain (32.1%), embryo (19.8%), aleurone (47%) and endosperm (23.7%), with an increase in bioavailable Zn (22.2%) and a reduction in phytate concentration (6.8%). Application of Zn also enhanced grain protein and Ca concentrations. Among wheat genotypes, Blue Silver had the highest concentration of Zn in grain, embryo, aleurone and endosperm, with high bioavailable Zn, while Kohinoor-83 had low phytate concentration. CONCLUSION: Wheat genotypes of Pakistan are genetically less diverse owing to continuous focus on the development of high-yielding varieties only. Therefore genetically diverse wheat genotypes with high endospermic Zn concentration and better grain yield should be used in breeding programs approaches, aiming at improving Zn bioavailability. © 2018 Society of Chemical Industry.

Seed priming with sorghum extracts and benzyl aminopurine improves the tolerance against salt stress in wheat (Triticum aestivum L.).

Salt stress impedes the productivity of wheat (Triticum aestivum L.) in many parts of the world. This study evaluated the potential role of benzyl aminopurine (BAP) and sorghum water extract (SWE) in improving the wheat performance under saline conditions. Seeds were primed with BAP (5 mg L-1), SWE (5% v/v), BAP + SWE, and distilled water (hydropriming). Soil filled pots maintained at the soil salinity levels of 4 and 10 dS m-1 were used for the sowing of primed and non-primed seeds. Salt stress suppressed the wheat growth; seed priming treatments significantly improved the wheat growth under optimal and suboptimal conditions. Total phenolics, total soluble sugars and proteins, α-amylase activity, chlorophyll contents, and tissue potassium ion (K+) contents were increased by seed priming under salt stress; while, tissue sodium ion (Na+) contents were decreased. Seed priming with SWE + BAP was the most effective in this regard. Under salt stress, the tissue Na+ contents were reduced by 5.78, 28.3, 32.2, 36.7% by hydropriming, seed priming with SWE, seed priming with BAP, and seed priming with SWE + BAP, respectively over the non-primed control. Effectiveness of seed priming techniques followed the order SWE + BAP > BAP > SWE > Hydropriming. In conclusion, seed priming with SWE + BAP may be opted to improve the tolerance against salt stress in wheat.

Enhanced gastric retention and drug release via development of novel floating microspheres based on Eudragit E100 and polycaprolactone: synthesis and in vitro evaluation.

Eudragit E 100 and polycaprolactone (PCL) floating microspheres for enhanced gastric retention and drug release were successfully prepared by oil in water solvent evaporation method. Metronidazole benzoate, an anti-protozoal drug, was used as a model drug. Polyvinyl alcohol was used as an emulsifier. The prepared microspheres were observed for % recovery, % degree of hydration, % water uptake, % drug loading, % buoyancy and % drug release. The physico-chemical properties of the microspheres were studied by calculating encapsulation efficiency of microspheres and drug release kinetics. Drug release characteristics of microspheres were studied in simulated gastric fluid and simulated intestinal fluid i.e., at pH 1.2 and 7.4 respectively. Fourier transform infrared spectroscopy was used to reveal the chemical interaction between drug and polymers. Scanning electron microscopy was conducted to study the morphology of the synthesized microspheres.

Formulation and in vitro evaluation of carbopol 934-based modified clotrimazole gel for topical application.

The aim of present study was to enhance topical permeation of clotrimazole gel preparation by using various permeability enhancers such as coconut oil, pistachio oil and sodium lauryl sulphate (SLS). Clotrimazole gel preparations were prepared and optimized by using three factor, five level central composite design. A second-order polynomial equation was generated in order to estimate the effect of independent variables i.e. coconut oil (X1), pistachio oil (X2) and sodium lauryl sulphate (X3) at various dependent variables i.e. flux (Y1), lag time (Y2), diffusion coefficient (Y3), permeability coefficient (Y4), and input rate (Y5) of clotrimazole gel formulations. Ex vivo skin permeation study was performed through rat skin by using modified Franz diffusion cell system. Optimized formulation F8 exhibited highest flux 2.17 µg/cm2/min, permeability coefficient 0.0019 cm/min and input rate 1.543 µg/cm2/min, along with moderate lag time 77.27 min and diffusion coefficient 0.063 cm2/min, which is further supported by anti-fungal activity that exhibited more prominent zone of inhibition against Candida albicans, Aspergillus niger and Mucor. Thus, it can be concluded that permeation of clotrimazole gel was enhanced by various combination of coconut oil, pistachio oil and sodium lauryl sulphate but optimized formulation F8 containing 0.4 ml pistachio oil, 0.8 ml coconut oil and 0.04 g of SLS exhibited more pronounced and promising effect through rat skin.

PREVALENCE OF HEPATITIS C IN DIABETIC PATIENTS: A PROSPECTIVE STUDY.

There is a strong evidence of the relationship between diabetes and hepatitis C however, there are certain gaps in the literature. Therefore, this study was carried out to determine the prevalence of hepatitis C in diabetic patients and risk factors associated with it, to evaluate the presence of possible relationship between hepatitis C and diabetes. Serological testing for anti HCV antibody was carried out on a sample of 100 diabetic patients visiting the diabetic clinic Nishtar Medical College and Hospital Multan. An anti HCV antibody test was carried out on HCV ELISA 3.0 (third generation) kit, locally purchased. Data about demographic information and history of risk factors for HCV was collected from diabetic patients using a structured questionnaire as an experimental tool, after taking informed consent. Data of about 100 non diabetic subjects (volunteer blood donors) was taken from the blood bank of that hospital. Prevalence rate of HCV infection among diabetic patients was recorded 19% and in the control group (non-diabetics) was 3%. Prevalence of HCV infection is higher in type 2 diabetic patients as compared to type 1 diabetic patients (84% vs. 16%). Diabetic patients between age group 46-55 years of age has high prevalence rates (47%) as compared to healthy individuals. Female diabetic patients have higher seropositivity (74%) as compared to male diabetic patients (26%). High prevalence of HCV infection has been reported among diabetic patients with duration of disease = 11 years (47%). Most of the patients were married (95%) and from urban locality (89%) and almost all were poor (99%). HCV positive diabetic patients have also history of blood transfusion (16%), hospital admissions (84%), major surgical procedure (63%), family history of hepatitis C (16%), razor sharing among males (16%) and comb sharing (79%). There was not any I/V drug addict (or history of I/V drug addiction), and tattooing, nose/ear piercing from contaminated needle and toothbrush sharing have not been seen among the participants of research.The results showed that in the present study the prevalence of HCV infection is six times higher in diabetic patients as compared to non-diabetic subjects (control group).

Early Experience Of Pneumatic Lithoclast For The Management Of Ureteric Stones At Peshawar.

BACKGROUND: Pakistan lies in the Afro-Asia stone belt. Ureteric calculi are common occurrence and a major burden on health care facilities in Pakistan. The objective of this study was to assess the efficacy and safety of pneumatic lithoclast in the management of ureteric calculi. METHODS: Case series study Department of Urology at Institute of Kidney Diseases Hayatabad Peshawar, from 1st Oct 2010 to 1st Oct 2011. One-hundred adult patients with ureteric calculi ≥ 0.7 cm were evaluated by history, physical examination, routine blood and urine examination after taking their written informed consent and approval of ethical committee. Ultrasound and X-ray KUB were done with IVU if required. All patients underwent ureteroscopy within intracorporeal lithotripsy and JJ stenting. Patients were followed up with post-op X-ray KUB at 24 hours and then weekly intervals till they became stone free. Following parameters were assessed: stone size, site, laterality, degree of fragmentation, success rate, stone migration and complications. Inability to reach the calculus with URS, proximal migration of stone or requirement of another/auxiliary procedure was considered failure. RESULTS: One hundred and ten patients were enrolled with a mean age of 38±10 years. There were 72 males and 28 females. Fifty-eight calculi were on right and 42 on left side. 24, 24 and 52 stones were in upper, middle and lower ureter respectively. Forty stones measured 7-10 mm, 52 measured 11-15 mm and 8 measured 16-20 mm in size. 98 stones were broken while 2 calculi migrated proximally. Overall success rate was 90% (Efficiency Quotient =78.95). Success rate in upper, middle and lower ureter was 83.3%, 83.3% and 96.1% respectively. 10 and 2 patients required ESWL and open ureterolithotomy, respectively, as additional treatment. Mean operative time was 33.5 minutes. There were no major complications.. CONCLUSIONS: Pneumatic lithoclast with URS is effective and safe in the management of the ureteric calculi with some limitations in the upper ureter.

Acoustofluidic Fluorescence Activated Cell Sorter.

Selective isolation of cell subpopulations with defined biological characteristics is crucial for many biological studies and clinical applications. In this work, we present the development of an acoustofluidic fluorescence activated cell sorting (FACS) device that simultaneously performs on-demand, high-throughput, high-resolution cell detection and sorting, integrated onto a single chip. Our acoustofluidic FACS device uses the "microfluidic drifting" technique to precisely focus cells/particles three dimensionally and achieves a flow of single-file particles/cells as they pass through a laser interrogation region. We then utilize short bursts (150 µs) of standing surface acoustic waves (SSAW) triggered by an electronic feedback system to sort fluorescently labeled particles/cells with desired biological properties. We have demonstrated continuous isolation of fluorescently labeled HeLa cells from unlabeled cells at a throughput of ∼1200 events/s with a purity reaching 92.3 ± 3.39%. Furthermore, 99.18% postsort cell viability indicates that our acoustofluidic sorting technique maintains a high integrity of cells. Therefore, our integrated acoustofluidic FACS device is demonstrated to achieve two-way cell sorting with high purity, biocompatibility, and biosafety. We believe that our device has significant potential for use as a low-cost, high-performance, portable, and user-friendly FACS instrument.

TREATMENT OF DISTAL URETERIC STONES-COMPARATIVE EFFICACY OF TRANSURETERAL PNEUMATIC LITHOTRIPSY AND EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY.

BACKGROUND: Ureteric stones greater than 6mm require intervention. Extracorporeal shockwave lithotripsy (ESWL) and ureteroscopy (URS) with intra-corporeal lithotripsy (ICL) are two least invasive therapies. Both show acceptable stone clearance. What should be the first line of treatment in distal ureteric stones? We conducted this study to compare the efficacy-of ESWL and pneumatic ICL in order to develop clear cut treatment guidelines. METHODS: This randomized control trial was conducted at Institute of Kidney Diseases, Peshawar from June 2011 to June 2012. Two hundred and twenty-four patients with distal ureteric stones 6-12 mm in size were included. Patients were randomized into two groups. Group-A patients were treated with URS plus ICL and Group-B with ESWL. Patients were evaluated for stone clearance after 2 weeks, with X-ray KUB and ultrasound. All the data were recorded in a pro forma and analysed in SPSS 10. Fisher's exact test was applied to compare the efficacy and a p-value of 0.05 was considered significant. RESULTS: Out of 112 patients in Group-A, 75 (67%) were males and 37 (33%) were females while in Group-B 79 (70.5%) were males and 33 (29.5%) were females. The mean age in Group-A was, 48.73 +/- 16.23 years whereas it was 46 +/- 14.58 years in Group-B. Overall, mean age was 47.36 +/-15.4 years. Mean stone size was 9.18 +/- 1.6 mm. At follow up (2 weeks post-operative) URS with ICL was successful in 101 (90.2%) patients while ESWL was successful in 75 (67%) patients (p-value=0.0001). CONCLUSION: Extracorporeal shockwave lithotripsy shows acceptable stone clearance but ureteroscopy with intra-corporeal lithotripsy shows superior results in distal ureteric stones.