Efficacy of Computerized Tomography-Guided Core Biopsy in Identifying the Subtypes of Lung Adenocarcinoma: An Observational Perspective From Pakistan.

Background Lung carcinoma is a leading cause of death worldwide. Histological subtype of lung adenocarcinoma is an important indicator of patient's outcome as it is helpful in surgical planning and guidance of prognosis. Objective To determine the diagnostic efficacy of computerized tomography-guided core needle biopsy (CNB) in identifying the histopathological subtype of lung adenocarcinoma. Methods and materials This is a retrospective, descriptive study including clinical data of 73 patients irrespective of their age and gender, who underwent computerized tomography-guided CNB for lung masses at the Department of Pathology, Aznostics - the Diagnostic Centre, Lahore, Pakistan from January 01, 2019 to June 30, 2023. Data collected was analyzed via Google Form (Google Inc., Mountainview, CA) and Statistical Package for Social Sciences (IBM SPSS Statistics for Windows, Version 24, released 2016; IBM Corp., Armonk, New York, United States) and was sent to statistician for descriptive analysis. Categorical data was used for calculating frequency and percentage, while continuous data was computed as mean and standard deviation. Results Seventy-three patients with adenocarcinoma underwent pulmonary biopsy. The mean age of included patients was 64.88 ± 11.39 year with a male predominance of 61.64%. Upper lobe was commonly affected by adenocarcinoma lung in 57.53% patients and 58.90% cases involved the right lung. The most common subtype was acinar with 51.65% followed by solid with 17.58% cases. Computerized tomography-guided CNB showed a diagnostic yield of 75.34% and identified histological subtypes of lung adenocarcinoma in 55 cases. Conclusion Computerized tomography-guided CNB is a useful, yet minimally invasive diagnostic tool to identify the histological subtype of lung adenocarcinoma. It not only helps in planning the surgical and adjuvant management of the patients, but also guides the patient-prognosis.

Printing Parameter Optimization of Additive Manufactured PLA Using Taguchi Design of Experiment.

Three-dimensional printing (3DP), known as additive layer manufacturing (ALM), is a manufacturing process in which a three-dimensional structure is constructed by successive addition of deposited layers. Fused Deposition Modeling (FDM) has evolved as the most frequently utilized ALM process because of its cost-effectiveness and ease of operation. Nevertheless, layer adhesion, delamination, and quality of the finished product remain issues associated with the FDM process parameters. These issues need to be addressed in order to satisfy the requirements commonly imposed by the conventional manufacturing industry. This work is focused on the optimization of the FDM process and post-process parameters for Polylactic acid (PLA) samples in an effort to maximize their tensile strength. Infill density and pattern type, layer height, and print temperature are the process parameters, while annealing temperature is the post-process parameter considered for the investigation. Analysis based on the Taguchi L18 orthogonal array shows that the gyroid infill pattern and annealing cycle at 90 °C results in a maximum ultimate tensile strength (UTM) of 37.15 MPa. Furthermore, the regression model developed for the five variables under study was able to predict the UTS with an accuracy of more than 96%.

Knowledge and awareness of infection control practices among nursing professionals: A cross-sectional survey from South Asia and the Middle East.

BACKGROUND: The proficiency of nursing professionals in the infection prevention and control (IPC) practices is a core component of the strategy to mitigate the challenge of healthcare associated infections. AIM: To test knowledge of nurses working in intensive care units (ICU) in South Asia and Middle East countries on IPC practices. METHODS: An online self-assessment questionnaire based on various aspects of IPC practices was conducted among nurses over three weeks. RESULTS: A total of 1333 nurses from 13 countries completed the survey. The average score was 72.8% and 36% of nurses were proficient (mean score > 80%). 43% and 68.3% of respondents were from government and teaching hospitals, respectively. 79.2% of respondents worked in < 25 bedded ICUs and 46.5% in closed ICUs. Statistically, a significant association was found between the knowledge and expertise of nurses, the country's per-capita income, type of hospitals, accreditation and teaching status of hospitals and type of ICUs. Working in high- and upper-middle-income countries (ß = 4.89, 95%CI: 3.55 to 6.22) was positively associated, and the teaching status of the hospital (ß = -4.58, 95%CI: -6.81 to -2.36) was negatively associated with the knowledge score among respondents. CONCLUSION: There is considerable variation in knowledge among nurses working in ICU. Factors like income status of countries, public vs private and teaching status of hospitals and experience are independently associated with nurses' knowledge of IPC practices.

Physiological, Psychosocial and Substance Abuse Effects of Pornography Addiction: A Narrative Review.

Internet pornography provides explicit content in various forms and can progress from habit to addiction. The consumption of online porn has risen due to the general use of current technology. The main reasons people consume it are sexual arousal and sexual enhancement. We planned this review study to identify the reasons for online pornography utilization, the mechanisms involved in its addiction, and its physiological, emotional, behavioral, social, and substance abuse effects. After a detailed literature search using PubMed Central and Google Scholar, four case studies and nine original articles from 2000 to 2022 were included. The main findings of the literature demonstrated that watching porn was most frequently done out of boredom, for sexual gratification, and to pick up new fashion and behavior ideas from these movies. In all facets of the users' lives, negative consequences were seen. Due to the explosion of new technologies, online pornography has risen to an alarming level, which has very injurious effects on societies and individuals. Therefore, it is high time to get rid of this addiction to protect our lives from its harmful effects.

Intervene to Improve: Awareness of Testicular Self-Examination and Testicular Cancer Among Male Patients at a Tertiary Care Hospital in Lahore, Pakistan.

Background and objective Testicular cancer is the commonest of all types of cancer males are affected with. Testicular cancer, when diagnosed early, has one of the best prognoses. However, in Pakistan, early detection is hindered by religious and sociocultural norms, lack of education, and awareness deficit. Testicular self-examination (TSE) can significantly facilitate early detection of the condition and decrease associated mortality rate. This study aimed to acquire the frame of mind regarding testicular cancer (TC) and testicular self-examination (TSE) among the male outdoor patients of Lahore General Hospital, Lahore. Materials and methods After ethical considerations, elaborated literature review and consequent pilot study were done to develop a bilingual questionnaire. Following patient consent, answers to a set of questions were noted down by the authors. A 90-second bilingual, motivational video was displayed and an educational pamphlet on the same topic was also handed over. Afterward, another survey was conducted to grasp the comprehension, satisfaction, and willingness to spread the message. Results About 92% of the subjects had not heard of or performed TSE and 58.3% mentioned lack of education as the reason for not knowing the method. Eighty-two percent patients had never heard of TC. Post-education, 100% patients claimed that their knowledge of the subject improved and 97% were ready to teach other male relatives. Conclusion The results indicate that the population's lack of awareness regarding testicular self-examination and testicular cancer is alarming. Most subjects did not know the age group, risk factors, presentation, and early prevention of testicular cancer.

Significance of Histopathology of Appendectomy Specimens: Analysis From a Teaching Hospital of Pakistan.

Background Histopathology of a tissue specimen plays a crucial role in formulating the final diagnosis of any disease. It confirms whether the histopathological findings are in correspondence with the clinical diagnosis and thus suggests an optimal management plan. Standard surgical practices guide that every human tissue specimen must undergo postoperative tissue analysis unless indicated otherwise. Objective To determine the significance of histopathology in determining the final diagnosis of appendectomy specimens. Materials and methods This retrospective clinical study conducted in May 2022 included 100 patients operated for appendectomy from January 1, 2021, to December 31, 2021, in the emergency room of the Department of General Surgery, Unit-III, Lahore General Hospital, Lahore. Data were retrieved from patients' records and the picture archiving and communication system (PACS). A Google Forms-based pro forma (Google, Mountain View, CA) was generated to include the demographic details, clinical manifestations, and histopathology reports of the patients. Descriptive analysis was completed using a Microsoft Excel spreadsheet (Microsoft Corporation, Redmond, WA). Results Fifty-two patients were females out of the total 100. The mean age at presentation was 23.02 ± 12.02 years. Of the samples, 54% were not sent for histopathology. Among the remaining ones, 27% of cases were proven to be acute appendicitis. Alvarado score was 7-10 in 50% of patients. Other lesions proven by histopathology were appendiceal phlegmon (4%), perforated appendix (4%), mucocele (1%), carcinoid tumor (1%), tuberculosis (1%), and adenocarcinoma (1%). Conclusions Histopathological analysis is the gold standard for the tissue diagnosis of a disease. The high percentage of the samples not sent for histopathology is alarming since the appendix is not only a site for inflammatory pathologies but for neoplastic lesions as well. This practice depicts that the incidence of non-inflammatory pathologies is being ignored by healthcare professionals and there is a dire need to emphasize the significance of acquiring histopathology reports for the specimens of appendectomy in all circumstances.

Multi-Objective Welding-Parameter Optimization Using Overlaid Contour Plots and the Butterfly Optimization Algorithm.

Distortion and residual stress are two unwelcome byproducts of welding. The former diminishes the dimensional accuracy while the latter unfavorably affects the fatigue resistance of the components being joined. The present study is a multi-objective optimization aimed at minimizing both the welding-induced residual stress as well as distortion. Current, voltage, and welding speed were the welding parameters selected. It was observed that the parameters that minimize distortion were substantially different from those that minimized the residual stress. That is, enhancing dimensional accuracy by minimizing distortion results in an intensification of residual stresses. A compromise between the two objectives was therefore necessary. The contour plots produced from the response surfaces of the two objectives were overlaid to find a region with feasible parameters for both. This feasible region was used as the domain wherein to apply the novel butterfly optimization algorithm (BOA). This is the first instance of the application of the BOA to a multi-objective welding problem. Weld simulation and a confirmatory experiment based on the optimum weld parameters thus obtained corroborate the efficacy of the framework.

Development and Characterization of Silver-Doped Multi-Walled Carbon Nanotube Membranes for Water Purification Applications.

A unique approach was utilized to develop multi-walled carbon nanotube (MWCNT) silver (Ag) membranes. MWCNTs were impregnated with 1 wt% Ag loading, which resulted in a homogeneous dispersion of Ag in MWCNTs. MWCNTs impregnated with Ag were then uniaxially compacted at two different pressures of 80 MPa and 120 MPa to form a compact membrane. Compacted membranes were then sintered at two different temperatures of 800 °C and 900 °C to bind Ag particles with MWCNTs as Ag particles also act as a welding agent for CNTs. The powder mixture was characterized by FESEM, thermogravimetric analysis, and XRD, while the developed samples were characterized by calculating the porosity of membrane samples, contact angle, water flux and a diametral compression test. The developed membranes showed overall large water flux, while maximum porosity was found to decrease as the compaction load and sintering temperature increased. The mechanical strength of the membranes was found to increase as the compaction load increased. The hydrophilicity of the membranes remained unchanged after the addition of Ag particles. The developed membranes would be useful for removing a variety of contaminants from water.

Incidence of sickle cell disease patients with pulmonary embolism admitted to the intensive care unit in Bahrain.

OBJECTIVES: To describe the incidence of pulmonary embolism (PE) in sickle cell disease (SCD) patients admitted to the intensive care unit (ICU). METHODS: A retrospective descriptive analysis was conducted with 124 SCD patients diagnosed with PE or suspected PE admitted to the ICU of Salmaniya Medical Complex, Manama, Bahrain between May 2017 and April 2018. A data collection form was used to obtain information on the history and demographics of PE patients. RESULTS: A total of 124 patients diagnosed with SCD were admitted to the ICU during the study period. Male patients slightly outnumbered (n=75; 56.4%) female patients, and the average age was in the mid- thirties (mean=37.4 years). The main diagnosis leading to ICU admission was vaso-occlusive crisis. The average hemoglobin level was 8.6 mg/dl, hemoglobin S% was 55.8%, and the length of stay in the ICU was 5.3 days. A total of 5 patients were diagnosed with PE with an incidence rate of 3.8%. All PE patients were females, which resulted in a significant relationship between gender and the likelihood of developing PE. No statistical relationship existed between the likelihood of developing PE and patient age, hemoglobin, hemoglobin S%, length of stay in ICU, and mortality. CONCLUSION: The demographic characteristics of the population included a male predominance, age in the mid-thirties, and vaso-occlusive crisis diagnosis upon admission to the ICU. The incidence of PE was significantly related to female gender. No significant relationship existed between the likelihood of developing PE and age, hemoglobin, hemoglobin S%, length of ICU stay, or mortality.