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1.
J Med Microbiol ; 73(9)2024 Sep.
Article in English | MEDLINE | ID: mdl-39229883

ABSTRACT

Introduction. The discordance between phenotypic and molecular methods of rifampicin (RIF) drug susceptibility testing (DST) in Mycobacterium tuberculosis poses a significant challenge, potentially resulting in misdiagnosis and inappropriate treatment.Hypothesis/gap statement. A comparison of RIF phenotypic and molecular methods for DST, including whole genome sequencing (WGS), may provide a better understanding of resistance mechanisms.Aim. This study aims to compare RIF DST in M. tuberculosis using two phenotypic and molecular methods including the GeneXpert RIF Assay (GX) and WGS for better understanding.Methodology. The study evaluated two phenotypic liquid medium methods [Lowenstein-Jensen (LJ) and Mycobacterium Growth Indicator Tube (MGIT)], one targeted molecular method (GX), and one WGS method. Moreover, mutational frequency in ponA1 and ponA2 was also screened in the current and previous RIF resistance M. tuberculosis genomic isolates to find their compensatory role.Results. A total of 25 RIF-resistant isolates, including nine from treatment failures and relapse cases with both discordant and concordant DST results on LJ, MGIT and GX, were subjected to WGS. The phenotypic DST results indicated that 11 isolates (44%) were susceptible on LJ and MGIT but resistant on GX. These isolates exhibited multiple mutations in rpoB, including Thr444>Ala, Leu430>Pro, Leu430>Arg, Asp435>Gly, His445>Asn and Asn438>Lys. Conversely, four isolates that were susceptible on GX and MGIT but resistant on LJ were wild type for rpoB in WGS. However, these isolates possessed several novel mutations in the PonA1 gene, including a 10 nt insertion and two nonsynonymous mutations (Ala394>Ser, Pro631>Ser), as well as one nonsynonymous mutation (Pro780>Arg) in PonA2. The discordance rate of RIF DST is higher on MGIT than on LJ and GX when compared to WGS. These discordances in the Delhi/CAS lineages were primarily associated with failure and relapse cases.Conclusion. The WGS of RIF resistance is relatively expensive, but it may be considered for isolates with discordant DST results on MGIT, LJ and GX to ensure accurate diagnosis and appropriate treatment options.


Subject(s)
High-Throughput Nucleotide Sequencing , Microbial Sensitivity Tests , Mycobacterium tuberculosis , Rifampin , Mycobacterium tuberculosis/drug effects , Mycobacterium tuberculosis/genetics , Mycobacterium tuberculosis/isolation & purification , Rifampin/pharmacology , Humans , Whole Genome Sequencing , Mutation , Drug Resistance, Bacterial/genetics , Antitubercular Agents/pharmacology , Bacterial Proteins/genetics , Tuberculosis/microbiology
2.
Clin Case Rep ; 12(8): e9246, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39099886

ABSTRACT

The case underscores the necessity of adaptable airway management strategies in aortic dissection surgeries complicated by carinal shift. Successful lung isolation was achieved using a single-lumen endotracheal tube after failed attempts with traditional methods and bronchial blockers.

3.
Sci Rep ; 14(1): 19147, 2024 Aug 19.
Article in English | MEDLINE | ID: mdl-39160227

ABSTRACT

This research is focused on the development of an eco-friendly low-cost concrete using fly ash (FA) and marble powder waste (MPW) as partial replacements for cement and fine aggregate respectively. The substantial use of cement in concrete makes it expensive and contributes to global warming due to high carbon emissions. Thus, using such waste materials can help reduce the overall carbon footprint. For this purpose, various mix designs of concrete were developed by varying the percentages of FA and MPW. The concrete's fresh and hardened properties were experimentally determined for those mixes. The test results revealed that MPW as a sand substitute increases strength up to 40% and gradually decreases beyond that, but a 60% replacement still has more strength than the control specimen. Similarly, using FA as a cement replacement was found to reduce the strength, but the reduction was not very significant up to 20%. A mixed blend of FA and MPW showed superior results and maximum strength was obtained at F10M40. The optimal mix, with 10% FA and 40% MPW (F10M40), achieved a compressive strength of 4493.46 psi, a 16.21% improvement compared to the control mix proportion. Furthermore, the microstructure of the cementitious material was improved due to the pozzolanic reaction that led to a denser microstructure, as supported by the permeability test and SEM analysis.

4.
Clin Case Rep ; 12(8): e9280, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39109303

ABSTRACT

Early recognition and prompt surgical intervention are crucial in managing giant arachnoid cysts causing obstructive hydrocephalus, as illustrated in this case of a 17-year-old male. Timely treatment can alleviate symptoms and prevent neurologic complications, ensuring favorable outcomes in affected patients.

5.
Medicine (Baltimore) ; 103(32): e39312, 2024 Aug 09.
Article in English | MEDLINE | ID: mdl-39121288

ABSTRACT

Evaluating gynecological mass lesions and reviewing their morphological characteristics based on their imaging appearance on magnetic resonance imaging (MRI), and correlating the MRI findings with histopathological findings, was the central theme of our study. This observational cross-sectional study was conducted on 60 female patients with clinically suspected gynecological mass lesions upon physical examination and/or ultrasonography, referred for MRI at a tertiary care hospital over a 1-year period between June 2022 and July 2023. A broad spectrum of differential diagnoses of gynecological masses was observed. In our study, the ratio of benign versus malignant disease was 1.6:1, with 37 benign and 23 malignant masses identified. The most common benign masses were uterine fibroids (n = 14; 23.3%), followed by endometriosis (n = 8; 13.3%), and ovarian dermoid cysts (n = 4; 6.6%). Among the malignant lesions, cervical cancer was the most common (n = 11; 18.3%), followed by endometrial carcinoma (n = 7; 11.6%), ovarian carcinoma (n = 3; 5%), and vaginal carcinoma (n = 2; 3%). Benign lesions mostly appeared hypo- to isointense on T1-weighted imaging and iso- to hyperintense on T2-weighted imaging, while malignant lesions appeared isointense on T1-weighted and hyperintense on T2-weighted imaging. Hemorrhage and fat were well appreciated on MRI and aided in diagnosis. T2 shading was present in 7 out of 8 endometriotic cysts, demonstrating a specificity of 100% and a sensitivity of 83%. For determining parametrial invasion in cervical carcinoma, MRI showed an accuracy of 91%, specificity of 100%, and positive predictive value, negative predictive value, and sensitivity of 100%, 75%, and 88%, respectively. In cases of endometrial carcinoma, MRI demonstrated a sensitivity and specificity of 87% and 91%, respectively, with a positive predictive value of 87% and a negative predictive value of 91% for identifying myometrial invasion greater than 50%. Compared to other modalities, MRI provided substantial information regarding uterine and adnexal masses and surrounding structures, facilitating accurate staging of lesions.


Subject(s)
Magnetic Resonance Imaging , Humans , Female , Magnetic Resonance Imaging/methods , Cross-Sectional Studies , Middle Aged , Adult , Diagnosis, Differential , Aged , Genital Neoplasms, Female/diagnostic imaging , Genital Neoplasms, Female/pathology , Endometriosis/diagnostic imaging , Endometriosis/pathology , Dermoid Cyst/diagnostic imaging , Dermoid Cyst/pathology , Leiomyoma/diagnostic imaging , Leiomyoma/pathology , Ovarian Neoplasms/diagnostic imaging , Ovarian Neoplasms/pathology , Young Adult
6.
J Pak Med Assoc ; 74(6): 1041-1045, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38948968

ABSTRACT

OBJECTIVE: To assess the diagnostic features of acromegaly, and analyse its management outcomes over a 15-year period in a tertiary care setting. METHODS: The descriptive, cohort, retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of adult patients of either gender diagnosed with acromegaly based on biochemical and radiological evidence between January 2005 and December 2019. Data was retrieved from the medical records. Data was analysed using SPSS 19. RESULTS: Of the 84 subjects, 54(64.3%) were males and 30(35.7%) were female. The overall mean age was 38.69±13.52 years. The patients presented 5.43±4.3 years after the onset of symptoms, with somatic growth features, such as enlarged hands and feet which was the most common complaint 81(96.4%). Of all the patients, 73(86.9%) underwent trans-sphenoidal surgery for the removal of the pituitary adenoma, while 11(13.1%) opted out of the surgical option. Further, 9(12.3%) patients showed biochemical and radiological remission 6 months post-surgery. Out of the remaining 64(87.7%) patients, 38(59.4%) received radiosurgery or radiotherapy, 15(23.4%) underwent repeat trans-sphenoidal surgery, and 11(17.2%) chose medical treatment. CONCLUSIONS: Majority of patients failed to achieve remission after trans-sphenoidal surgery, which is the first line of treatment. Radiotherapy/repeat surgery was generally the options taken by those with persistent disease.


Subject(s)
Acromegaly , Tertiary Care Centers , Humans , Female , Male , Acromegaly/therapy , Acromegaly/diagnosis , Acromegaly/epidemiology , Pakistan/epidemiology , Adult , Retrospective Studies , Middle Aged , Adenoma/therapy , Adenoma/diagnosis , Adenoma/surgery , Adenoma/epidemiology , Pituitary Neoplasms/therapy , Pituitary Neoplasms/diagnosis , Pituitary Neoplasms/surgery , Treatment Outcome , Young Adult , Radiosurgery/methods
7.
J Am Mosq Control Assoc ; 40(2): 81-91, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38811013

ABSTRACT

Land use and land cover (LULC) gradients are associated with differences in mosquito species composition and the entomological risk of mosquito-borne disease. Here, we present results from a season-long study of mosquito species richness and abundance with samples collected at 9 locations from 2 plots with contrasting LULC, an urban farm and a forest preserve, in Bloomington, IN, a city in the midwestern USA. With a total sampling effort of 234 trap-nights, we collected 703 mosquitoes from 9 genera and 21 species. On the farm, we collected 15 species (285 mosquitoes). In the preserve, we collected 19 species (418 mosquitoes). Thirteen species were common in both study plots, 2 were exclusive to the farm, and 6 were exclusive to the forest preserve. In both plots, we collected Aedes albopictus and Ae. japonicus. In the farm, the most common mosquito species were Culex restuans/Cx. pipiens and Coquillettidia perturbans. In the preserve, Ae. japonicus and Ae. triseriatus were the 2 most common mosquito species. Time series analysis suggests that weather factors differentially affected mosquito species richness and mosquito abundance in the plots. Temperature, relative humidity (RH), and precipitation were positively associated with richness and abundance at the farm, while increases in the SD of RH decreased both richness and abundance at the preserve. Our results highlight the importance that LULC has for mosquito species diversity and abundance and confirm the presence of Ae. albopictus and Ae. japonicus in southwestern Indiana.


Subject(s)
Biodiversity , Culicidae , Population Density , Animals , Culicidae/physiology , Culicidae/classification , Indiana , Cities , Animal Distribution
8.
Ann Med Surg (Lond) ; 86(2): 930-942, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38333295

ABSTRACT

Lewy body dementia (LBD) is situated at the convergence of neurodegenerative disorders, posing an intricate and diverse clinical dilemma. The accumulation of abnormal protein in the brain, namely, the Lewy body causes disturbances in typical neural functioning, leading to a range of cognitive, motor, and mental symptoms that have a substantial influence on the overall well-being and quality of life of affected individuals. There is no definitive cure for the disease; however, several nonpharmacological and pharmacological modalities have been tried with questionable efficacies. The aim of this study is to figure out the role of different interventional strategies in the disease. Donepezil, rivastigmine, memantine, and galantamine were the commonly used drugs for LBD. Together with that, levodopa, antipsychotics, armodafinil, piracetam, and traditional medications like yokukansan were also used, when indicated. Talking about nonpharmacological measures, exercise, physical therapy, multicomponent therapy, occupational therapy, psychobehavioral modification, transcranial stimulation, and deep brain stimulation have been used with variable efficacies. Talking about recent advances in the treatment of LBD, various disease-modifying therapies like ambroxol, neflamapimod, irsenontrine, nilotinib, bosutinib, vodobatinib, clenbuterol, terazosin, elayta, fosgonimeton, and anle138b are emerging out. However, there drugs are still in the different phases of clinical trials and are not commonly used in clinical practice. With the different pharmacological and nonpharmacological modalities we have for treatment of LBD, all of them offer symptomatic relief only. Being a degenerative disease, definite cure of the disease can only be possible with regenerative measures.

9.
Medicine (Baltimore) ; 103(4): e37040, 2024 Jan 26.
Article in English | MEDLINE | ID: mdl-38277572

ABSTRACT

Ramadan intermittent fasting (RIF) presents unique challenges and opportunities for public health and clinical practice, especially in populations with a high prevalence of non-communicable diseases. This study aims to investigate the impact of RIF on weight change among Indian Muslims and explore the associated demographic, dietary, and behavioral factors. A cross-sectional survey was conducted with a sample of Indian Muslim adults who observed RIF. Participants were asked to report their demographic information, family and personal health history, and dietary and lifestyle behaviors before and during Ramadan month. The primary outcome was body weight change, with secondary outcomes including changes in dietary patterns, physical activity, and other health-related lifestyle behaviors. The study found that during Ramadan, nearly half of the participants (48.5%) self-reported a retained initial weight, while a significant fraction (30.9%) self-reported a modest weight reduction between 0.5 to 2.5 kg at the end of Ramadan. Additionally, self-reported eating practices demonstrated moderately altered by about half (48.4%) of the study participants, with 32.2% reporting minor changes and 8.2% indicating substantial changes. An urban residence was associated with a higher likelihood of weight gain, where urban residents showed 3 times the odds of increased weight compared to rural inhabitants. Employment status emerged as a significant determinant for weight fluctuation, influencing both weight gain and loss. During Ramadan, there was a significant rise in snacking frequency, increasing from 21.7% to 32.6% in comparison with pre-Ramadan. The consumption of large quantities of food more frequently grew from 14.9% to 36%, and the incidence of eating despite not being hungry went up from 17.4% to 33.2%. The study demonstrates that RIF is associated with variable changes in body weight among adult Indian Muslims, influenced by urbanization, employment status, and dietary changes. The findings suggest that clinicians should provide tailored advice about body weight regulation during Ramadan and consider integrating community-based health initiatives within religious settings to improve health outcomes.


Subject(s)
COVID-19 , Adult , Humans , Cross-Sectional Studies , COVID-19/epidemiology , Fasting/physiology , Weight Loss , Weight Gain , Islam
10.
Microbiol Spectr ; 12(1): e0163123, 2024 Jan 11.
Article in English | MEDLINE | ID: mdl-37982632

ABSTRACT

IMPORTANCE: An accurate diagnosis of drug resistance in clinical isolates is an important step for better treatment outcomes. The current study observed a higher discordance rate of rifampicin resistance on Mycobacteria Growth Indicator Tube (MGIT) drug susceptibility testing (DST) than Lowenstein-Jenson (LJ) DST when compared with the rpoB sequencing. We detected a few novel mutations and their combination in rifampicin resistance isolates that were missed by MGIT DST and may be useful for the better management of tuberculosis (TB) treatment outcomes. Few novel deletions in clinical isolates necessitate the importance of rpoB sequencing in large data sets in geographic-specific locations, especially high-burden countries. We explored the discordance rate on MGIT and LJ, which is important for the clinical management of rifampicin resistance to avoid the mistreatment of drug-resistant TB. Furthermore, MGIT-sensitive isolates may be subjected to molecular methods of diagnosis for further confirmation and treatment options.


Subject(s)
Mycobacterium tuberculosis , Tuberculosis, Multidrug-Resistant , Tuberculosis , Humans , Rifampin/pharmacology , Rifampin/therapeutic use , Antitubercular Agents/pharmacology , Antitubercular Agents/therapeutic use , Mycobacterium tuberculosis/genetics , Microbial Sensitivity Tests , Tuberculosis/diagnosis , Tuberculosis/drug therapy , Tuberculosis, Multidrug-Resistant/diagnosis , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Multidrug-Resistant/microbiology , Genotype , Phenotype
11.
Environ Monit Assess ; 196(1): 41, 2023 Dec 15.
Article in English | MEDLINE | ID: mdl-38097881

ABSTRACT

Radon and its progenies found in water indicate the existence of seismically active faults in the region. However, exposure to high levels of radon can also result in radiation-related health risks. This study focuses on radon-based active tectonic studies along the Muzaffarabad Fault in the core of the Hazara-Kashmir Syntaxis (HKS), NW Himalayas, Pakistan. In this study, spring water samples were collected along roadside of Jhelum Valley and in close proximity to the Muzaffarabad Fault in Pakistan using Radon Thoron Monitor (RTM1688-2). The results of the study showed that the radon concentrations in the water samples ranged from 1.895 to 17.097 Bq/l. The study found that the highest radon concentration was observed in the samples collected closest to the fault, while the lowest concentration was observed in the samples collected further away. The statistical analysis between the radon concentration and the distance from the fault showed a strong inverse relationship (R2=0.73). The study also found that 68% of the sampling sites had radon concentrations that exceeded the maximum contamination level (MCL) set by the US Environmental Protection Agency (EPA). The higher radon concentrations in the springs water suggest the probability of earthquake, which in turn poses potential health risks for the local population. The findings suggest that the measurement of radon concentration in water can be used as a tool for identifying seismically active faults in the region.


Subject(s)
Earthquakes , Radiation Monitoring , Radon , Water Pollutants, Radioactive , Radon/analysis , Water/analysis , Pakistan , Water Pollutants, Radioactive/analysis
12.
Medicine (Baltimore) ; 102(47): e36043, 2023 Nov 24.
Article in English | MEDLINE | ID: mdl-38013349

ABSTRACT

Carcinoid tumors (CT) are among the least studied tumors. It is a relatively rare and slow-growing tumor with good survival in its primary form. However, metastatic carcinoid tumor comes up with many different complications contributing to increased morbidity and mortality. Metastatic form of the disease has a wide spectrum of clinical manifestations and multisystem involvement including cardiovascular manifestations, neurological manifestations, and psychiatric manifestations and so on. In this review, we are centered towards the cardiovascular manifestations of the disease, which, by far, is one of the commonest causes of death in these patients. Being a neuroendocrine tumor, cardiovascular manifestations are mainly because of biologically active substances, produced by the tumor cells, remodeling the heart. Development of targeted therapies against carcinoid heart diseases is currently limited by lack of understanding of pathophysiology of the disease processes. In this review, we aim to figure out the spectrum of carcinoid heart diseases, along with the molecular biology of the changes going on, which, in turn, will not only pave a way to the development of targeted therapies but will also extend opportunities for molecular screening of the tumor and diagnosis at an early stage, thereby, reducing the morbidity and mortality.


Subject(s)
Carcinoid Heart Disease , Carcinoid Tumor , Neuroendocrine Tumors , Humans , Carcinoid Heart Disease/diagnosis , Carcinoid Heart Disease/therapy , Neuroendocrine Tumors/diagnosis , Carcinoid Tumor/complications , Heart , Molecular Biology
13.
Medicine (Baltimore) ; 102(41): e35569, 2023 Oct 13.
Article in English | MEDLINE | ID: mdl-37832119

ABSTRACT

cerebrovascular accident (CVA) has contributed to a significant increase in the morbidity and mortality rates in lower middle-income counties like Nepal. Despite being a common noncommunicable disease in Nepal, little attention has been paid to it, in terms of formulating national health plans and policies by the concerned authorities. This was a descriptive cross-sectional study in patients diagnosed with cerebrovascular accidents at a tertiary care hospital in Eastern Nepal. We analyzed 128 diagnosed cases of cerebrovascular accidents from February 26, 2023 to June 26, 2023 after taking ethical clearance from the Institutional Review Committee (Reference no. IRC-PA-283/2078-79). Data were analyzed by Statistical Package for the Social Sciences version 23. The objective of this study was to explore the age and sex distribution of CVA, its association with medical co-morbidities, and known risk factors like Type-2-Diabetes Mellitus, hypertension, thyroid disorders, smoking and alcohol. Together with calculating the distribution of ischemic CVA and hemorrhagic CVA we had also staged the disease based on the National Institute of Health Stroke Scale.


Subject(s)
Stroke , Humans , Cross-Sectional Studies , Nepal/epidemiology , Stroke/epidemiology , Stroke/etiology , Comorbidity , Risk Factors , Tertiary Care Centers
14.
Medicine (Baltimore) ; 102(35): e34664, 2023 Sep 01.
Article in English | MEDLINE | ID: mdl-37657009

ABSTRACT

BACKGROUND: The last few decades have witnessed an appalling rise in several emerging and re-emerging viral and zoonotic outbreaks. Amongst those emerging zoonosis, one of the diseases which is gaining popularity these days and has been declared as public health emergency of international concern by the world health organization, is human monkeypox virus (HMPX). Proper understanding of the clinical spectrum of the disease is of paramount importance for early diagnosis and treatment. In this review, we aimed to study and quantify the neurological manifestations of HMPX virus infection. METHODS: Any study, released prior to April 13, 2023, that reported neurological manifestations in patients infected by HMPX virus were reviewed systematically on PubMed, Scopus, Google Scholar, and Cochrane Library using the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis) statement. RESULTS: Our systematic review included data from 22 eligible studies: 10 cohort studies, 3 cross sectional studies, one retrospective study, 5 case series, and 2 case reports. The most commonly reported neurological manifestations of HMPX were headache (48.84%), myalgia (27.50%), fatigue (17.73%), and photophobia (4.43%). Uncommonly, HMPX can also present with visual deficit (0.57%), seizure (0.34%), encephalitis (0.8%), dizziness (0.34%), encephalomyelitis (0.23%), coma (0.11%), and transverse myelitis (0.11%). DISCUSSIONS: Monkeypox virus usually presents with self-limiting painful rash, lymphadenitis, and fever, complications like secondary skin infection, eye problems and pneumonia can be life threatening, carrying a case fatality rate of 1% to 10%. Neurological manifestations are not uncommon and can further add-on to morbidity and mortality.


Subject(s)
Coinfection , Mpox (monkeypox) , Humans , Cross-Sectional Studies , Mpox (monkeypox)/epidemiology , Monkeypox virus , Public Health , Retrospective Studies
15.
EMBO J ; 42(14): e112845, 2023 07 17.
Article in English | MEDLINE | ID: mdl-37272163

ABSTRACT

The canonical autophagy pathway in mammalian cells sequesters diverse cytoplasmic cargo within the double membrane autophagosomes that eventually convert into degradative compartments via fusion with endolysosomal intermediates. Here, we report that autophagosomal membranes show permeability in cells lacking principal ATG8 proteins (mATG8s) and are unable to mature into autolysosomes. Using a combination of methods including a novel in vitro assay to measure membrane sealing, we uncovered a previously unappreciated function of mATG8s to maintain autophagosomal membranes in a sealed state. The mATG8 proteins GABARAP and LC3A bind to key ESCRT-I components contributing, along with other ESCRTs, to the integrity and imperviousness of autophagic membranes. Autophagic organelles in cells lacking mATG8s are permeant, are arrested as amphisomes, and do not progress to functional autolysosomes. Thus, autophagosomal organelles need to be maintained in a sealed state in order to become lytic autolysosomes.


Subject(s)
Autophagy , Microtubule-Associated Proteins , Animals , Humans , Autophagy-Related Protein 8 Family/genetics , Autophagy-Related Protein 8 Family/metabolism , Microtubule-Associated Proteins/genetics , Microtubule-Associated Proteins/metabolism , Autophagosomes/metabolism , Endosomal Sorting Complexes Required for Transport/metabolism , Mammals
16.
Sensors (Basel) ; 23(11)2023 May 25.
Article in English | MEDLINE | ID: mdl-37299808

ABSTRACT

Fifth-generation (5G) networks offer high-speed data transmission with low latency, increased base station volume, improved quality of service (QoS), and massive multiple-input-multiple-output (M-MIMO) channels compared to 4G long-term evolution (LTE) networks. However, the COVID-19 pandemic has disrupted the achievement of mobility and handover (HO) in 5G networks due to significant changes in intelligent devices and high-definition (HD) multimedia applications. Consequently, the current cellular network faces challenges in propagating high-capacity data with improved speed, QoS, latency, and efficient HO and mobility management. This comprehensive survey paper specifically focuses on HO and mobility management issues within 5G heterogeneous networks (HetNets). The paper thoroughly examines the existing literature and investigates key performance indicators (KPIs) and solutions for HO and mobility-related challenges while considering applied standards. Additionally, it evaluates the performance of current models in addressing HO and mobility management issues, taking into account factors such as energy efficiency, reliability, latency, and scalability. Finally, this paper identifies significant challenges associated with HO and mobility management in existing research models and provides detailed evaluations of their solutions along with recommendations for future research.


Subject(s)
COVID-19 , Humans , Pandemics , Reproducibility of Results , Intelligence , Multimedia
17.
JNMA J Nepal Med Assoc ; 61(261): 469-471, 2023 May 01.
Article in English | MEDLINE | ID: mdl-37203903

ABSTRACT

Primary anorectal melanoma is an extremely rare and aggressive mucosal melanocytic malignancy of the anorectal region. Because of the rarity of the tumor and vague clinical presentations, diagnosis at an early stage is a challenge for clinicians. In our context, where the hemorrhoid is a diagnosis of cultural familiarity for any sort of rectal pathology, these patients often present to us at a very advanced stage of the disease. Here, we present a case of a 55-year-old male patient with stage 2 anorectal melanoma who is on adjuvant chemotherapy following abdominoperineal resection with a permanent colostomy. Five cycles of dacarbazine and carboplatin have been given and the patient is doing well with the treatment. Abdominoperineal resection with excision of the tumor remains the mainstay of treatment; however, poor patient compliance with permanent colostomy is a major limiting factor of abdominoperineal resection. Even with the best interventions and care, the survival rate is not very good. Keywords: abdominoperineal resection; adjuvant chemotherapy; case reports; melanoma.


Subject(s)
Melanoma , Rectal Neoplasms , Male , Humans , Middle Aged , Rectal Neoplasms/diagnosis , Rectal Neoplasms/surgery , Melanoma/diagnosis , Melanoma/surgery , Rectum
18.
JNMA J Nepal Med Assoc ; 61(259): 277-279, 2023 Mar 01.
Article in English | MEDLINE | ID: mdl-37203948

ABSTRACT

Ureteric carcinoma is the rarest of all urothelial malignancies, and little attention has been given to it. Palliation in these groups of patients is a dilemma in the clinics. Use of chemotherapeutic agents in ureteric carcinoma is a double edged sword, as these patients had already impaired renal function due to post-renal failure and nephrotoxic nature of most of the chemotherapeutic agents can further deteriorate the renal function, making the management approach, a relatively visionary task. Here, we present a case of a 77-year-old female with metastatic ureteric carcinoma locally complicated with hydroureteronephrosis, coming to us with gross haematuria, lower abdominal pain along with cough. Apart from age factor of the lady, presence of hydroureteronephrosis and pulmonary metastases was another challenge for us. Paclitaxel remains the mainstay of our treatment. Keywords: carcinoma; case reports; metastasis; paclitaxel.


Subject(s)
Carcinoma, Transitional Cell , Hydronephrosis , Lung Neoplasms , Renal Insufficiency , Ureter , Ureteral Neoplasms , Female , Humans , Aged , Carcinoma, Transitional Cell/complications , Carcinoma, Transitional Cell/drug therapy , Carcinoma, Transitional Cell/pathology , Ureter/pathology , Paclitaxel/therapeutic use , Ureteral Neoplasms/complications , Ureteral Neoplasms/drug therapy , Ureteral Neoplasms/pathology , Lung Neoplasms/complications , Lung Neoplasms/drug therapy , Hydronephrosis/etiology
19.
Heliyon ; 9(2): e13687, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36873152

ABSTRACT

Perovskite materials play a vital role in the field of material science via experimental as well as theoretical calculations. Radium semiconductor materials are considered the backbone of medical fields. These materials are considered in high technological fields to be used as controlling the decay ability. In this study, radium-based cubic fluoro-perovskite XRaF3 (where X = Rb and Na) are calculated using a DFT (density functional theory). These compounds are cubic nature with 221 space groups that construct on CASTEP (Cambridge-serial-total-energy-package) software with ultra-soft PPPW (pseudo-potential plane-wave) and GGA (Generalized-Gradient-approximation)-PBE (Perdew-Burke-Ernzerhof) exchange-correlation functional. The structural, optical, electronic, and mechanical properties of the compounds are calculated. According to the structural properties, NaRaF3 and RbRaF3 have a direct bandgap with 3.10eV and 4.187eV of NaRaF3 and RbRaF3, respectively. Total density of states (DOS) and partial density of states (PDOS) provide confirmation to the degree of electrons localized in distinct bands. NaRaF3 material is semiconductors and RbRaF3 is insulator, according to electronic results. The imaginary element dispersion of the dielectric function reveals its wide variety of energy transparency. In both compounds, the optical transitions are examined by fitting the damping ratio for the notional dielectric function scaling to the appropriate peaks. The absorption and the conductivity of NaRaF3 compound is better than the RbRaF3 compound which make it suitable for the solar cell applications increasing the efficiency and work function. We observed that both compounds are mechanically stable with cubic structure. The criteria for the mechanical stability of compounds are also met by the estimated elastic results. These compounds have potential application in field of solar cell and medical. Objectives: The band gap, absorption and the conductivity are necessary conditions for potential applications. Here, literature was reviewed to check computational translational insight into the relationships between absorption and conductivity for solar cell and medical applications of novel RbRaF3 and NaRaF3 compounds.

20.
Discov Nano ; 18(1): 15, 2023 02 16.
Article in English | MEDLINE | ID: mdl-36795251

ABSTRACT

Perovskites are the key enabler materials for the solar cell applications in the achievement of high performance and low production costs. In this article, the structural, mechanical, electronic, and optical properties of rubidium-based cubic nature perovskite LiHfO3 and LiZnO3 are investigated. These properties are investigated using density-functional theory with the aid of CASTEP software by introducing ultrasoft pseudo-potential plane-wave (USPPPW) and GG-approximation-PB-Ernzerhof exchange-correlation functionals. It is investigated that the proposed compounds exhibit stable cubic phase and meet the criteria of mechanical stability by the estimated elastic properties. Also, according to Pugh's criterion, it is noted that LiHfO3 is ductile and LiZnO3 is brittle. Furthermore, the electronic band structure investigation of LiHfO3 and LiZnO3 shows that they have indirect bandgap (BG). Moreover, the BG analysis of the proposed materials shows that these are easily accessible. Also, the results for partial density of states (DOS) and total DOS confirm the degree of a localized electron in the distinct band. In addition, the optical transitions in the compounds are examined by fitting the damping ratio for the notional dielectric functions scaling to the appropriate peaks. At absolute zero temperature, the materials are observed as semiconductors. Therefore, it is evident from the analysis that the proposed compounds are excellent candidates for solar cells and protective rays applications.

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