To evaluate the complication and patency rate of superficial femoral vein transposition in tertiary care center.

INTRODUCTION: When all access options in the upper extremity have been exhausted, an autologous access can be created in lower extremity. The purpose of this study is to report our experience with superficial femoral vein transposition (SFVT) results in terms of postoperative complication and patency rate. MATERIALS AND METHODS: In the time period from January 1, 2019 to April 30, 2021, thirty-five cases of SFVT performed at our large tertiary care center Sindh Institute of Urology and Transplantation (SIUT). All patients had exhausted upper arm veins or had central vein obstructions. Medical records of all patients were traced, patients were interviewed using a standard proforma and evaluated the current AVF function in the OPD clinic or by telephone calls. Data including demographics and postoperative complications were collected. RESULTS: Thirty-nine cases of SFVT performed at our institute. Three were immediately lost to follow up so they were excluded from the study. Mean patient age was 30 ± 13.4 years. Most of our patients were females (57%) and 15 males (43%) with an average age of 29.05 years. The most common underlying renal diseasewas unknown in 16 (45%).Thirty-five patients included in the analysis; out of which primary failure observed in 4 patients, three patients were expired before fistula maturation and 3 were expired before 6 months. The remaining 25 fistulas patency rates were estimated. No any patient died due to fistulas related complication; patients died due to their primary disease. CONCLUSION: Our study shows that with appropriate patient selection, SFVT have low infection rates and patency that is comparable with other access types.

Phytochemical and antioxidant studies of Berberis lycium.

Six compounds have been isolated from methanolic and petroleum ether extracts of Berberis lycium (Barberry). Four out of six isolated compounds are reported for the first time from this plant. Purification of different compounds has been accomplished by conventional extraction and chromatographic techniques. The compounds have been structurally characterized by IR, Low Resolution MS, (1)H-NMR and (13)C-NMR spectroscopic techniques. All plant extracts and isolated compounds were assayed for the first time for their antioxidant activity.

Single stage versus two stage basilic vein transposition for hemodialysis access: A retrospective observational study.

BACKGROUND: The basilic vein transposition is a brachio basilic arteriovenous fistula (AVF) made after the mobilization and transferring of basilic vein to the ventral aspect of arm inside a subcutaneous pocket by direct dissection. The procedure can be performed either in single stage or two stages. This study compares the clinical efficacy and long term utility of single-stage and two-stage basilic vein transposition among patients of renal failure and to evaluate failure rate, primary patency rates, and postoperative complications. METHOD: Patients who underwent basilic vein transposition at Sindh Institute of Urology and Transplantation, Karachi from January 2021 to December 2021 were retrospectively reviewed. Patients were divided into two groups according to single stage or two-stage procedure. After the surgical procedure, assessment of fistula maturation and surveillance were undertaken using ultrasound and physical examination. Patients were requested to visit the out-patient clinic for assessment of fistula patency and post-operative complications at regular intervals of 3, 6, and 12 months respectively. RESULT: During the 12 months' interval, 82 (39.04%) basilic vein transpositions were performed in single-stage and 128 (60.95%) were two-staged transposition. In our analysis we have found that as compared to single stage, two-stage basilic vein transpositions showed significantly better primary patency rates (76.82% vs 96%; p-value 0.000) and required less interventions for maintaining fistula patency. More post-operative sequelae were noted in the single stage version of the procedure as compared to the two stage procedure. CONCLUSION: Two stage procedure of basilic vein transposition is found to have better patency rate and lesser post-surgical complications. However, a matched cohort prospective study is still needed to further strengthen the conclusion.

Exploiting Feature Selection and Neural Network Techniques for Identification of Focal and Nonfocal EEG Signals in TQWT Domain.

For drug resistance patients, removal of a portion of the brain as a cause of epileptic seizures is a surgical remedy. However, before surgery, the detailed analysis of the epilepsy localization area is an essential and logical step. The Electroencephalogram (EEG) signals from these areas are distinct and are referred to as focal, while the EEG signals from other normal areas are known as nonfocal. The visual inspection of multiple channels for detecting the focal EEG signal is time-consuming and prone to human error. To address this challenge, we propose a novel method based on differential operator and Tunable Q-factor wavelet transform (TQWT) to distinguish the focal and nonfocal signals. For this purpose, first, the EEG signal was differenced and then decomposed by TQWT. Second, several entropy-based features were derived from the TQWT subbands. Third, the efficacy of the six binary feature selection algorithms, binary bat algorithm (BBA), binary differential evolution (BDE) algorithm, firefly algorithm (FA), genetic algorithm (GA), grey wolf optimization (GWO), and particle swarm optimization (PSO), was evaluated. In the end, the selected features were fed to several machine learning and neural network classifiers. We observed that the PSO with neural networks provides an effective solution for the application of focal EEG signal detection. The proposed framework resulted in an average classification accuracy of 97.68%, a sensitivity of 97.26%, and a specificity of 98.11% in a tenfold cross-validation strategy, which is higher than the state of the art used in the public Bern-Barcelona EEG database.

Influence of Bentonite on Mechanical and Durability Properties of High-Calcium Fly Ash Geopolymer Concrete with Natural and Recycled Aggregates.

In this study, bentonite (a naturally occurring pozzolana) was incorporated as a partial replacement (up to 20%) for high-calcium fly ash (HCFA)-based geopolymeric natural aggregate concrete (GNAC) and geopolymeric recycled aggregate concrete (GRAC). The mechanical (compressive strength and splitting tensile strength), durability (chloride migration coefficient, water absorption, and acid attack resistance), and rheological properties (slump test, fresh density, and workability) were investigated. The results revealed that incorporation of bentonite (10 wt % with ordinary Portland cement) showed appreciable improvement in the strength and durability of both the GNAC and GRAC, though its effect is more significant for GRAC than the GNAC.

Angiomyolipoma of the scrotum: report of a rarely seen case and review of the literature.

Angiomyolipoma (AML) is a benign, histologically complex mesenchymal tumor arising mainly from the kidney and liver. The majority (80%) of these tumors arise as sporadic tumors, while 20% of them are associated with tuberous sclerosis. Extra-renal sites of AML, though rare, have been reported in literature. In this report, we describe a case of AML arising from the scrotal skin, and presenting as a scrotal mass. Although skin is the most commonly reported site after kidney and liver, scrotal skin AML presents as an intriguing mass in a region known for germ cell tumors which has been reported only once before. A 35-year-old male presented with scrotal swelling. His physical examination, laboratory investigations and imaging studies were non-specific. Excision of the lesion with subsequent histopathological examination revealed the true nature of the lesion. This lesion should be included in the differential diagnosis of scrotal masses.