A Comparison of the Epidemiological Characteristics Between Influenza and COVID-19 Patients: A Retrospective, Observational Cohort Study.

Background and objective It is crucial to make early differentiation between coronavirus disease 2019 (COVID-19) and seasonal influenza infections at the time of a patient's presentation to the emergency department (ED). In light of this, this study aimed to identify key epidemiological, initial laboratory, and radiological differences that would enable early recognition during co-circulation. Methods This was a retrospective, observational cohort study. All adult patients presenting to our ED at the Watford General Hospital, UK, with a laboratory-confirmed diagnosis of COVID-19 (2019/20) or influenza (2018/19) infection were included in this study. Demographic, laboratory, and radiological data were collected. Binary logistic regression was employed to determine features associated with COVID-19 infection rather than influenza. Results Chest radiographs suggestive of viral pneumonitis and older age (≥80 years) were associated with increased odds of having COVID-19 [odds ratio (OR): 47.00, 95% confidence interval (CI): 21.63-102.13 and OR: 64.85, 95% CI: 19.96-210.69 respectively]. Low eosinophils (<0.02 x 109/L) were found to increase the odds of COVID-19 (OR: 2.12, 95% CI: 1.44-3.10, p<0.001). Conclusions Gaining awareness about the epidemiological, biological, and radiologic presentation of influenza-like illness can be useful for clinicians in ED to differentiate between COVID-19 and influenza. This study showed that older age, eosinopenia, and radiographic evidence of viral pneumonitis significantly increase the odds of having COVID-19 compared to influenza. Further research is needed to determine if these findings are affected by acquired or natural immunity.

Pseudoaneurysm - A Late and Rare Occurrence Following Shoulder Arthroscopy.

Introduction: The incidence of vascular injuries from arthroscopic surgeries has been reported to be 0.005%. Pseudoaneurysms account for 11% of those injuries. Case Report: In this case report, we discuss a 76-year-old female who presented with a pulsatile swelling in the right shoulder after 10 years following arthroscopic rotator cuff repair. Imaging confirmed the diagnosis of a posterior circumflex artery pseudoaneurysm. The patient was successfully embolised using a transradial approach with thrombosis of the pseudoaneurysm. Conclusion: Vascular injuries following arthroscopic shoulder surgery are rare. However, a pseudoaneurysm should be considered in patients who present with swelling at the surgical site, regardless of the post-operative interval.

Sudden perceived absence of foetal movement - a unique presentation of a vertebral haemangioma in pregnancy.

OBJECTIVE: Symptomatic vertebral haemangiomas that present during pregnancy are extremely uncommon with few cases reported in literature. Epidural haemangiomas are rarer still with few documented. METHODS: In this report, we describe the case of a 22-year-old pregnant patient who presented with apparent loss of foetal movement at 38 weeks' gestation. Clinical review demonstrated the foetus was well but neurological examination revealed lower limb paresthesia, paresis and evident uterine hypoesthesia. An MRI scan illustrated a haemangioma in the T1 vertebral body with an epidural component causing cord compression. RESULTS: The management of spinal haemangiomas that present during pregnancy is a complex clinical scenario, which requires careful multidisciplinary consideration to determine if surgical intervention is appropriate. In this case, the patient had an emergency caesarean section followed by posterior decompression and laminectomy of the T1 vertebra with excellent post-operative recovery. CONCLUSION: Gestational increase in the size of vertebral haemangiomas is well documented. We discuss a rare case in which a young pregnant patient presents with an atypical symptom of a vertebral haemangioma (uterine hypoesthesia). This case highlights the importance of prompt imaging in these scenarios and a cohesive multidisciplinary approach in order to provide optimal treatment for the patient.

Future implications of COVID-19 through Mathematical modeling.

COVID-19 is a pandemic respiratory illness. The disease spreads from human to human and is caused by a novel coronavirus SARS-CoV-2. In this study, we formulate a mathematical model of COVID-19 and discuss the disease free state and endemic equilibrium of the model. Based on the sensitivity indexes of the parameters, control strategies are designed. The strategies reduce the densities of the infected classes but do not satisfy the criteria/threshold condition of the global stability of disease free equilibrium. On the other hand, the endemic equilibrium of the disease is globally asymptotically stable. Therefore it is concluded that the disease cannot be eradicated with present resources and the human population needs to learn how to live with corona. For validation of the results, numerical simulations are obtained using fourth order Runge-Kutta method.

Threshold conditions for global stability of disease free state of COVID-19.

This article focus the elimination and control of the infection caused by COVID-19. Mathematical model of the disease is formulated. With help of sensitivity analysis of the reproduction number the most sensitive parameters regarding transmission of infection are found. Consequently strategies for the control of infection are proposed. Threshold condition for global stability of the disease free state is investigated. Finally, using Matlab numerical simulations are produced for validation of theocratical results.

Threshold condition and non pharmaceutical interventions's control strategies for elimination of COVID-19.

In this work we focus on the eradication of the COVID-19 infection with the help of almost Non Pharmaceutical Interventions(NPIs), using mathematical modelling. First the basic reproduction number R 0 is investigated. Then, on the basis of sensitivity test of R 0 , the most active/sensitive parameters are presented in detail. Non Pharmaceutical Interventions(NPIs) are applied to control the sensitive parameters. The major NPIs are, stay home (isolation), sanitizers (wash hands), Treatment of side effects of infection, like throat infection etc and face mask. These NPIs helps in mitigation and reducing the size of outbreak of the disease. Threshold condition for global stability of the disease free state is investigated.The NPI's are used in different ratios to formulate a strategy. The results of these strategies are validated using Matlab software.

Short-term and Midterm Results of Fenestrated Anaconda Endograft in Patients with Previous Endovascular Aneurysm Repair.

PURPOSE: To review short-term and midterm results of the fenestrated Anaconda stent graft in management of patients with pre-existing endovascular aortic stent graft and persistent type 1a endoleak. MATERIALS AND METHODS: This single-center retrospective study assessed all consecutive patients with type 1a endoleak and pre-existing endovascular aneurysm repair (EVAR) treated with fenestrated Anaconda stent grafts. Ten patients (9 males; mean age 78 y) with mean follow-up of 22.4 months ± 13 were included. Average aneurysm size was 80.1 mm (range, 62-101 mm). Mean time for conversion to fenestrated EVAR following original EVAR was 53.7 months (range, 22-101 months; median 54 months). Technical and clinical success; anatomic features, including aortic tortuosity, side vessel angulation, and stenosis; complications; and reinterventions were recorded. RESULTS: The technical success rate was 90%. There was no open conversion and no 30-day mortality, leading to a clinical success rate of 100%. Five of 10 patients demonstrated an aortic tortuosity index of grade 2 or 3. Additional hostile anatomy that made side vessel catheterization challenging was observed in 15 vessels (45%) with a stenosis of ≥ 50% (related to atherosclerotic disease or struts of indwelling prosthesis) and 21 vessels (66%) with ≤ 70° angulation. Two reinterventions, renal artery stent angioplasty and renal artery covered stent extension, were observed at 2 and 13 months. CONCLUSIONS: Use of the fenestrated Anaconda endograft in patients with type 1a endoleaks following previous EVAR is safe, feasible, and offers some technical features that facilitate overcoming certain anatomic difficulties.

Imaging of Pancreatic-Neuroendocrine Tumours: An Outline of Conventional Radiological Techniques.

INTRODUCTION: Pancreatic Neuroendocrine Tumours (p-NETs) are an important disease entity and comprise of peptide-secreting tumours often with a functional syndrome. Accounting for a small percentage of all pancreatic tumours, they have a good overall survival rate when diagnosed early, with surgery being curative. The role of nuclear medicine in the diagnosis and treatment of these tumours is evident. However, the vast majority of patients will require extensive imaging in the form of conventional radiological techniques. It is important for clinicians to have a fundamental understanding of the p-NET appearances to aid prompt identification and to help direct management through neoplastic staging. METHODS: This article will review the advantages and disadvantages of conventional radiological techniques in the context of p-NETs and highlight features that these tumours exhibit. CONCLUSION: Pancreatic neuroendocrine tumours are a unique collection of neoplasms that have markedly disparate clinical features but similar imaging characteristics. Most p-NETs are small and welldefined with homogenous enhancement following contrast administration, although larger and less welldifferentiated tumours can demonstrate areas of necrosis and cystic architecture with heterogeneous enhancement characteristics. Prognosis is generally favourable for these tumours with various treatment options available. However, conventional radiological techniques will remain the foundation for the initial diagnosis and staging of these tumours, and a grasp of these modalities is extremely important for physicians.

Combined application of citric acid and 5-aminolevulinic acid improved biomass, photosynthesis and gas exchange attributes of sunflower (Helianthus annuus L.) grown on chromium contaminated soil.

Phytoremediation is an important technique to remove heavy metals from contaminated soils due to its efficiency and cost-effectiveness. The present study was conducted to assess the synergistic role of 5-aminolevulinic acid (ALA) and citric acid (CA) in improving the phyto-extraction of chromium (Cr) by sunflower. Sunflower plants were grown in soil, spiked with different concentrations of Cr (0, 5, 10, 20 mg kg-1). Various concentrations of 5-ALA (0, 10, 20 mg L-1) and CA (0, 2.5, 5 mM) were applied exogenously at juvenile stage. A significant decrease was observed in biomass and agronomic traits of sunflower under Cr stress alone. Further, Cr toxicity significantly decreased the plant growth, soluble proteins and photosynthetic pigments. However, exogenously applied ALA and CA significantly improved the plants' physiological as well as agronomic attributes by lowering the production of reactive oxygen species and reducing electrolyte leakage. Moreover, Cr uptake was increased with increasing concentration of Cr in spiked soil, which was further enhanced by combined application of ALA and CA.

Control strategies and sensitivity analysis of anthroponotic visceral leishmaniasis model.

This study proposes a mathematical model of Anthroponotic visceral leishmaniasis epidemic with saturated infection rate and recommends different control strategies to manage the spread of this disease in the community. To do this, first, a model formulation is presented to support these strategies, with quantifications of transmission and intervention parameters. To understand the nature of the initial transmission of the disease, the reproduction number [Formula: see text] is obtained by using the next-generation method. On the basis of sensitivity analysis of the reproduction number [Formula: see text], four different control strategies are proposed for managing disease transmission. For quantification of the prevalence period of the disease, a numerical simulation for each strategy is performed and a detailed summary is presented. Disease-free state is obtained with the help of control strategies. The threshold condition for globally asymptotic stability of the disease-free state is found, and it is ascertained that the state is globally stable. On the basis of sensitivity analysis of the reproduction number, it is shown that the disease can be eradicated by using the proposed strategies.

Sensitivity Analysis and Optimal Control of Anthroponotic Cutaneous Leishmania.

This paper is focused on the transmission dynamics and optimal control of Anthroponotic Cutaneous Leishmania. The threshold condition R0 for initial transmission of infection is obtained by next generation method. Biological sense of the threshold condition is investigated and discussed in detail. The sensitivity analysis of the reproduction number is presented and the most sensitive parameters are high lighted. On the basis of sensitivity analysis, some control strategies are introduced in the model. These strategies positively reduce the effect of the parameters with high sensitivity indices, on the initial transmission. Finally, an optimal control strategy is presented by taking into account the cost associated with control strategies. It is also shown that an optimal control exists for the proposed control problem. The goal of optimal control problem is to minimize, the cost associated with control strategies and the chances of infectious humans, exposed humans and vector population to become infected. Numerical simulations are carried out with the help of Runge-Kutta fourth order procedure.

Germination behaviour of seeds from herbicide treated plants of Chenopodium album L.

The carry-over effect of sub-lethal herbicides was investigated on the germination of seeds collected from surviving Chenopodium album plants, which had received 1/8, 1/8 twice, 1/8 three times, 1/4, 1/2, 1/1 doses of either pre-emergence ioxynil or post-emergence bentazone in a previous onion (Allium cepa) crop. Seeds were also collected from surviving C. album plants, which had received 1/4, 1/2, 1/1 of either pre-emergence pendimethalin, propachlor and linuron, or 1/8, 1/8 twice, 1/8 three times, 1/4, 1/2, 1/1 of post-emergence ioxynil or linuron in a previous leek (Allium porrum) crop. Seeds of surviving plants were collected and tested for germination at temperature of 5, 10, 15, 20 and 25 degrees C. The effect of different temperatures on the total number of germinated seeds was significant. Germination was minimum at low temperatures (5 degrees C or 10 degrees C). Herbicides did not show any effect on germination of C. album and resulted in the same final germination percentage as seeds collected from the unsprayed control plots.