Quality of life of patients undergoing chemotherapy: a tertiary care hospitalbased study from Karachi.

The quality of life (QoL) of cancer patients is of paramount concern due to the enduring effects of chemotherapy on the physical, emotional, spiritual, and social aspects of life. This study aims to examine the factors influencing QoL among cancer patients. A cross-sectional analysis encompassing 200 chemotherapy patients aged 18 and above was conducted, using self-reported surveys and clinical records. The results indicate higher social wellbeing and lower physical well-being scores. Significantly, patients in joint families, with income above Rs25,000, limited pre-diagnosis check-ups, over four chemotherapy cycles, showed better QoL. Engaging diversions like art and internet usage alleviated worries. Conversely, comorbidities correlated with lower FACT-G scores. QoL is still compromised, even with the developments of advanced cancer treatments. Managing mental, emotional, social, and physical health is vital. Future research should focus on evidence-based policies, innovative strategies, psychiatric assessments, mindfulness interventions, and exploring the impact of social interactions on QoL, aiming to enhance the wellbeing of newly diagnosed cancer patients.

Semantics Aware Dynamic SLAM Based on 3D MODT.

The idea of SLAM (Simultaneous Localization and Mapping) being a solved problem revolves around the static world assumption, even though autonomous systems are gaining environmental perception capabilities by exploiting the advances in computer vision and data-driven approaches. The computational demands and time complexities remain the main impediment in the effective fusion of the paradigms. In this paper, a framework to solve the dynamic SLAM problem is proposed. The dynamic regions of the scene are handled by making use of Visual-LiDAR based MODT (Multiple Object Detection and Tracking). Furthermore, minimal computational demands and real-time performance are ensured. The framework is tested on the KITTI Datasets and evaluated against the publicly available evaluation tools for a fair comparison with state-of-the-art SLAM algorithms. The results suggest that the proposed dynamic SLAM framework can perform in real-time with budgeted computational resources. In addition, the fused MODT provides rich semantic information that can be readily integrated into SLAM.

Clothoid: An Integrated Hierarchical Framework for Autonomous Driving in a Dynamic Urban Environment.

In recent years, research and development of autonomous driving technology have gained much interest. Many autonomous driving frameworks have been developed in the past. However, building a safely operating fully functional autonomous driving framework is still a challenge. Several accidents have been occurred with autonomous vehicles, including Tesla and Volvo XC90, resulting in serious personal injuries and death. One of the major reasons is the increase in urbanization and mobility demands. The autonomous vehicle is expected to increase road safety while reducing road accidents that occur due to human errors. The accurate sensing of the environment and safe driving under various scenarios must be ensured to achieve the highest level of autonomy. This research presents Clothoid, a unified framework for fully autonomous vehicles, that integrates the modules of HD mapping, localization, environmental perception, path planning, and control while considering the safety, comfort, and scalability in the real traffic environment. The proposed framework enables obstacle avoidance, pedestrian safety, object detection, road blockage avoidance, path planning for single-lane and multi-lane routes, and safe driving of vehicles throughout the journey. The performance of each module has been validated in K-City under multiple scenarios where Clothoid has been driven safely from the starting point to the goal point. The vehicle was one of the top five to successfully finish the autonomous vehicle challenge (AVC) in the Hyundai AVC.

Dynamic Multi-LiDAR Based Multiple Object Detection and Tracking.

Environmental perception plays an essential role in autonomous driving tasks and demands robustness in cluttered dynamic environments such as complex urban scenarios. In this paper, a robust Multiple Object Detection and Tracking (MODT) algorithm for a non-stationary base is presented, using multiple 3D LiDARs for perception. The merged LiDAR data is treated with an efficient MODT framework, considering the limitations of the vehicle-embedded computing environment. The ground classification is obtained through a grid-based method while considering a non-planar ground. Furthermore, unlike prior works, 3D grid-based clustering technique is developed to detect objects under elevated structures. The centroid measurements obtained from the object detection are tracked using Interactive Multiple Model-Unscented Kalman Filter-Joint Probabilistic Data Association Filter (IMM-UKF-JPDAF). IMM captures different motion patterns, UKF handles the nonlinearities of motion models, and JPDAF associates the measurements in the presence of clutter. The proposed algorithm is implemented on two slightly dissimilar platforms, giving real-time performance on embedded computers. The performance evaluation metrics by MOT16 and ground truths provided by KITTI Datasets are used for evaluations and comparison with the state-of-the-art. The experimentation on platforms and comparisons with state-of-the-art techniques suggest that the proposed framework is a feasible solution for MODT tasks.

Helicobacter pylori Induces Serine Phosphorylation of EGFR via Novel TAK1-p38 Activation Pathway in an HB-EGF-Independent Manner.

BACKGROUND: The interaction of Helicobacter pylori with gastric epithelial cells can result in the activation of transcription factor NF-κB via TGF-ß-activated kinase 1 (TAK1). In this study, we have demonstrated the role of H. pylori in the activation of EGFR via TAK1-mediated phosphorylation of p38. MATERIALS AND METHODS: Gastric epithelial AGS or MKN-45 cells were co-cultured with wild-type or cagA(-) H. pylori strains. H. pylori was added to the cells, and the activation of EGFR, p65 (NF-κB) subunit, p38, ERK, and TAK1 was examined by Western blotting. Infected cells were pretreated with or without ligands, chemical inhibitors, anti-HB-EGF antibody, and siRNAs to evaluate the effects on phosphorylation of various EGFR residues. Fluorescence microscopy and flow cytometry were performed to detect the internalization of EGFR. RESULTS: Incubating cells with wild-type and CagA(-) H. pylori strains resulted in the rapid and transient phosphorylation of serine residues of EGFR. RNAi experiments using siRNA against TAK1 and p38 pathways blocked the phosphorylation of serine residue. Immunofluorescence and flow cytometry revealed that EGFR was internalized in H. pylori-infected cells after EGFR phosphorylation in a p38-dependent manner. In contrast, pretreatment with gefitinib and anti-HB-EGF antibody did not block both the phosphorylation and internalization of EGFR. CONCLUSION: Helicobacter pylori induces internalization of EGFR via novel TAK1-p38-serine activation pathway which is independent of HB-EGF. The interaction between TAK1 and EGFR in H. pylori-infected cells might open new dimensions in understanding H. pylori-associated gastric carcinogenesis.

Hernandezine promotes cancer cell apoptosis and disrupts the lysosomal acidic environment and cathepsin D maturation.

Hernandezine (Her), a bisbenzylisoquinoline alkaloid extracted from Thalictrum flavum, is recognized for its range of biological activities inherent to this herbal medicine. Despite its notable properties, the anti-cancer effects of Her have remained largely unexplored. In this study, we elucidated that Her significantly induced cytotoxicity in cancer cells through the activation of apoptosis and necroptosis mechanisms. Furthermore, Her triggered autophagosome formation by activating the AMPK and ATG5 conjugation systems, leading to LC3 lipidation. Our findings revealed that Her caused damage to the mitochondrial membrane, with the damaged mitochondria undergoing mitophagy, as evidenced by the elevated expression of mitophagy markers. Conversely, Her disrupted autophagic flux, demonstrated by the upregulation of p62 and accumulation of autolysosomes, as observed in the RFP-GFP-LC3 reporter assay. Initially, we determined that Her did not prevent the fusion of autophagosomes and lysosomes. However, it inhibited the maturation of cathepsin D and increased lysosomal pH, indicating an impairment of lysosomal function. The use of the early-stage autophagy inhibitor, 3-methyladenine (3-MA), did not suppress LC3II, suggesting that Her also induces noncanonical autophagy in autophagosome formation. The application of Bafilomycin A1, an inhibitor of noncanonical autophagy, diminished the recruitment of ATG16L1 and the accumulation of LC3II by Her, thereby augmenting Her-induced cell death. These observations imply that while autophagy initially plays a protective role, the disruption of the autophagic process by Her promotes programmed cell death. This study provides the first evidence of Her's dual role in inducing apoptosis and necroptosis while also initiating and subsequently impairing autophagy to promote apoptotic cell death. These insights contribute to a deeper understanding of the mechanisms underlying programmed cell death, offering potential avenues for enhancing cancer prevention and therapeutic strategies.

Risk of restless legs syndrome in low socioeconomic rheumatoid arthritis patients.

OBJECTIVES: Our aim was to determine the frequency of restless leg syndrome (RLS) in rheumatoid arthritis (RA) patients from a low socioeconomic area of Pakistan and compare results with a control group to evaluate the effect of variables on RLS patients. METHODS: A clinical observational study was carried out on 240 RA patients form low socioeconomic group. Controls (n = 210) were frequency-matched by age group to the RA patients. We evaluated the presence of RLS and collected information on characteristics believed to be correlated with RLS in the general population. Multiple logistic regression models were used to study the association between RLS and other risk factors such as age, smoking status, and obesity. RESULTS: Among all rheumatic patients seen at our rheumatology clinic, 70.8% were women. Our study shows that 20% of RA patients were suffering from RLS compared with 10% of the control group with other rheumatic diseases. Multivariate logistic regression adjusted for age, obesity, and smoking also showed that women with RA were more likely to have RLS than control patients. RLS was also significantly associated with increasing age, high body mass index, and smoking status. CONCLUSIONS: Approximately 20% of RA patients were suffering from RLS. Hence, there is need of increase awareness of RLS among rheumatologists to enhance early RLS diagnosis and appropriate management of this treatable condition.

Profile of Geriatric Patients Attending the Emergency Department of a Tertiary Care Hospital in Karachi: A Cross-Sectional Study.

Background and Objectives The emergency department (ED) is the most important unit of a hospital and is often visited by an ever-increasing proportion of geriatric patients. However, in Pakistan, there is an inadequacy of geriatrics specialists. The objective of this study was to assess the profile of geriatric patients in the ED. We considered main diagnoses, frailty, and other factors that help to come up with certain findings that may assist with policymaking and initiatives for better geriatric care in Pakistan. Methods A cross-sectional study was conducted at a hospital in Karachi, Pakistan. The study population comprised 101 patients aged 65 years and older who attended the hospital's ED from July to September 2021. Data were collected by taking the patients' histories. Results The majority of patients were aged between 65 and 70 years. The most common diagnoses were: gastrointestinal disorders, cerebrovascular accidents, and neurologic disorders. More than half of the patients were found to be frail by the five-item FRAIL questionnaire. The mean Charlson Comorbidity Index score was 5.37 ± 1.88. Conclusion It was concluded that the need for geriatric care is worth mentioning since it imposes a significant burden on the ED. The geriatric patients had a higher risk of being on the critical list as most of them were frail and suffered from multiple severe comorbidities. Our results can assist in the development of geriatric emergency medicine and acute care systems in Pakistan.

Impact of COVID-19 Vaccination on Menstrual Cycle: A Cross-Sectional Study From Karachi, Pakistan.

Background The coronavirus disease 2019 (COVID-19) disease triggered a worldwide health catastrophe. To deal with this deadly situation multiple vaccines were developed and a mass immunization program started globally. However, vaccine hesitancy was seen, especially among women of reproductive age, having concerns that the vaccine might affect their menstrual cycle. This study investigated the link between COVID-19 vaccination and menstrual abnormalities. It is essential for us to understand the effects of vaccines on menstruation as menstrual distress can have effects on everyday life, and mental and reproductive health. Methods A cross-sectional study was performed using self-administered online forms to collect data from all over Karachi. The sample included 384 females aged 18 years and above. The data were collected from November 2021 to February 2022. Results Majority of the participants were aged 21 years and had a normal body mass index (BMI). Most were moderately stressed (n=245) with 146 reporting menstrual changes post-vaccination. The difference between the post-vaccine menstruation affected (n=146) and the unaffected cohort (n=238) was significant. Other factors which likely contributed to the post-vaccine menstrual changes included Perceived Stress Scale (PSS) score, strenuous physical activity, and the pre-vaccine menstrual flow. Conclusions Among the women vaccinated for COVID-19, strenuous physical activity and high perceived stress levels affected the menstrual cycle. There is no denying that existing data are inadequate, which is one of the grounds for vaccination apprehension, particularly among menstruating women. To minimize this hesitation, the spread of disinformation about the vaccine's influence on the menstrual cycle must be avoided. In future research and clinical trials, menstruation-related side effects should also be investigated when developing vaccines.

Ferritin heavy chain (FTH1) exerts significant antigrowth effects in breast cancer cells by inhibiting the expression of c-MYC.

Overexpression of ferritin heavy chain (FTH1) often associates with good prognosis in breast cancer (BCa), particularly in the triple-negative subtype (triple-negative breast cancer). However, the mechanism by which FTH1 exerts its possible tumor suppressor effects in BCa is not known. Here, we examined the bearing of FTH1 silencing or overexpression on several aspects of BCa cell growth in vitro. FTH1 silencing promoted cell growth and mammosphere formation, increased c-MYC expression, and reduced cell sensitivity to chemotherapy. In contrast, FTH1 overexpression inhibited cell growth, decreased c-MYC expression, and sensitized cancer cells to chemotherapy; silencing of c-MYC recapitulated the effects of FTH1 overexpression. These findings show for the first time that FTH1 suppresses tumor growth by inhibiting the expression of key oncogenes, such as c-MYC.