Endoscopic treatment for early duodenal papillary carcinoma: long-term outcomes.

BACKGROUND AND AIM: This study aims to determine whether endoscopic papillectomy (EP) is a safe and effective treatment for early duodenal papillary carcinoma with long-term follow-up. METHODS: From June 2012 to September 2022, 48 patients with early duodenal papilloma carcinoma who received endoscopic treatment were included. The histological types, percentage of complete resections, postoperative residuals, adverse events, and recurrences were evaluated. RESULTS: EP was successful in all patients; 46 were lumped, and two were fragmented, with a 95.8% intact removal rate (46/48). The preoperative biopsy pathological positive rate was 70.8% (34/48). The incidence of early postoperative adverse events (within 1 month after EP) were 16.7% (8/48), including four cases of acute pancreatitis, three cases of delayed bleeding, and one case of acute cholangitis. In addition, 4.2% (2/48) of the late adverse events were bile duct stenosis. After 6 months, the postoperative residual rate was 0%. The median time to recurrence was 17.5 months, and the postoperative recurrence rate was 16.7% (8/48) in patients treated with radiofrequency ablation. The median progression-free survival was 18.6 months (95% CI, 12.1-25.1), and the median overall survival was 121.5 months (95% CI, 105.6-120.9). CONCLUSIONS: EP is a safe and efficient alternative therapy for early duodenal papillary carcinoma. Endoscopic follow-up and treatment are essential because of the potential for recurrence.

Cold EMR vs. Hot EMR for the removal of sessile serrated polyps larger than 10 mm: a systematic review and meta-analysis.

BACKGROUND: Endoscopic mucosal resection (EMR) appears to be a promising technique for the removal of sessile serrated polyps (SSPs) ≥ 10 mm. To assess the effectiveness and safety of EMR for removing SSPs ≥ 10 mm, we conducted this systematic review and meta-analysis. METHODS: We conducted a thorough search of Embase, PubMed, Cochrane, and Web of Science databases for relevant studies reporting on EMR of SSPs ≥ 10 mm, up until December 2023. Our primary endpoints of interest were rates of technical success, residual SSPs, and adverse events (AE). RESULTS: Our search identified 426 articles, of which 14 studies with 2262 SSPs were included for analysis. The rates of technical success, AEs, and residual SSPs were 100%, 2.0%, and 3.1%, respectively. Subgroup analysis showed that the technical success rates were the same for polyps 10-19 and 20 mm, and en-bloc and piecemeal resection. Residual SSPs rates were similar in en-bloc and piecemeal resection, but much lower in cold EMR (1.0% vs. 4.2%, P = 0.034). AEs rates were reduced in cold EMR compared to hot EMR (0% vs. 2.9%, P = 0.168), in polyps 10-19 mm compared to 20 mm (0% vs. 4.1%, P = 0.255), and in piecemeal resection compared to en-bloc (0% vs. 0.7%, P = 0.169). CONCLUSIONS: EMR is an effective and safe technique for removing SSPs ≥ 10 mm. The therapeutic effect of cold EMR is superior to that of hot EMR, with a lower incidence of adverse effects. PROSPERO REGISTRATION NUMBER: CRD42023388959.

Efficacy and Safety of Radiofrequency Ablation Plus Stent Versus Stent-alone Treatments for Malignant Biliary Strictures: A Systematic Review and Meta-analysis.

BACKGROUND/AIMS: Malignant biliary strictures (MBS) are very aggressive and cannot be diagnosed in the early stages due to their asymptomatic nature. Stenting the stricture area of the biliary tree is palliative treatment but has poor survival time. Radiofrequency ablation plus stent (RFA+S) have been recently used to improve the survival and stent patency time in patients with MBS. In this systematic review and meta-analysis, we tried to evaluate the efficacy and safety of radiofrequency ablation. MATERIALS AND METHODS: Study search up to December 2021 was performed in different medical databases such as PubMed, Web of Science, and Cochrane library, etc. We selected eligible studies reporting survival time, stent patency time, and adverse events in patients with MBS. We compare the outcomes of RFA+S and stent-alone treatment groups. RESULTS: A total of 15 studies (6 randomized controlled trials and 9 observational studies) with 1815 patients were included for meta-analysis of which 701 patients were in RFA+S group and 1114 patients in the stent-alone group. Pooled mean difference of survival time was 2.88 months (95% CI: 1.78-3.97) and pooled mean difference of stent patency time was 2.11 months (95% CI: 0.91-3.30) and clinical success risk ratio was 1.05 (95% CI: 1.01-1.09). Risk ratios for adverse events are given; Bleeding 0.84 (95% CI: 0.34-2.11), abdominal pain 1.06 (95% CI: 0.79-1.40), pancreatitis 0.93 (95% CI: 0.43-2.01), cholangitis 1.07 (95% CI: 0.72-1.59), and stent dysfunction 0.87 (95% CI: 0.70-1.07). CONCLUSIONS: Radiofrequency ablation is involved in increased survival and stent patency time for MBS patients. With the help of better techniques, adverse events can be limited.

Radiological risk assessment from the Gamma spectrometry of soil samples in the vicinity of a research centre in Nilore, Pakistan.

Measurements of radionuclides' activities in air, water, and soil give clues about the anthropogenic activities in the region, and imperative to assess the overall radiological risk for individuals. Such an investigation was carried out to characterize the soil activities in the region hosting a research center, and to calculate the associated elements of radiological risk in terms of radiation doses and hazard indices. The soil samples were collected within the radius of 10 km in local area, Nilore, and analysed for activity using a high-purity germanium (HPGe) gamma spectrometric system. In all samples, only the basic nuclides, contributing to terrestrial activity, i.e., 40 K, 232Th, 226Ra, and 137Cs, were observed within the detectable limits of activity. The distribution of the data set and the correlation between the measured activities were studied with the use of the principal component analysis (PCA). The measured average specific activities of 226Ra, 232Th, 40 K, and 137Cs were 40.65 ± 9.84 Bq/kg, 59.31 ± 16.53 Bq/kg, 528.24 ± 131.18 Bq/kg, and 5.16 ± 4.56 Bq/kg respectively. The corresponding dose rate in air was found to be 76.63 ± 18.39 nGy/h, which is slightly higher than the world median value of 51 nGy/h calculated from concentration of terrestrial radionuclides in soil but falls within the world average value range of outdoor external exposure of 18-93 nGy/h obtained through direct measurement, and therefore not harmful for the living species. The standard hazard indices for all soil samples such as radium equivalent activity ([Formula: see text]), external hazard index (Hex), and internal hazard index (Hin) were also found within safe limits for the soil to be used as construction of building material. This investigation led to conclusion that the soil activities are consistent with the usual background level of terrestrial activities, and their associated dose rates are well within the safe limits for public.

Case Report Of A Rare Incidentaloma Of The Adrenal Gland-Schwannoma.

The Schwannoma is a benign growth of the nerve sheath cells most commonly seen in the vestibulocochlear nerve. Its prevalence in the adrenal gland is 1-3%. Here we discuss a case that presented as an incidentaloma of the right adrenal gland in a young male patient who had vague abdominal symptoms and a normal hormonal profile. He underwent an excisional biopsy of the right adrenal gland due to the large size of the lesion (more than 4cm). The histopathology report helped to establish the diagnosis of Schwannoma. Incidentaloma is defined as a lesion of the adrenal gland encountered on any radiological investigation carried out for symptoms that are not associated with adrenal pathologies. After discovering such lesions, it is imperative to perform radiological and hormonal investigations in an organised manner to plan further management of such cases.

Safety and efficacy of side-by-side versus stent-in-stent stenting for malignant hilar biliary obstruction: a systematic review and meta-analysis.

Objectives: Stenting of the malignant hilar biliary obstruction (MHBO) area for bile drainage is challenging. Bilateral stenting techniques of stent-in-stent (SIS) and stent-by-stent (SBS) have shown promising results. This study evaluates the efficacy of different stenting methods for MHBO. Design: A meta-analysis was performed to determine the efficacy of SIS and SBS stenting strategies for MHBO. Data sources and methods: Medical databases such as PubMed, Web of Science, Embase, and Scopus, were searched up to August 2023. We selected eligible studies reporting the data on technical and clinical success, adverse events, and incidence of re-obstruction (RO) of SBS and SIS groups in MHBO patients. We compared the outcomes of SBS and SIS groups. Results: A total of 9 studies comparing the data of 545 patients (268 in the SBS group and 277 in the SIS stenting group) were analyzed. There was no significant difference (p > 0.05) in the odds ratio (OR) of Re-obstruction (RO) 0.87 (95% confidence interval (95% CI) 0.6-1.25), technical success 0.58 (95% CI 0.16-2.11), clinical success 1.13 (95% CI 0.62-2.07), and adverse events 1.53 (95% CI 0.88-2.64). The mean difference in procedure time was -12.25 min (95% CI -18.39, -6.12), and the hazard ratio of stent patency was 1.22 (95% CI 1.01-1.47), favoring SBS, with high heterogeneity (I 2 = 94%). There was no significant difference in HR for survival 1.05 (95% CI 0.95-1.16) with high heterogeneity (I 2 = 84%). Conclusion: Compared with SIS, SBS showed better stent patency with comparable technical and clinical success and adverse events. Prospero registration: The registration number for this study on PROSPERO is CRD42024523230.

From pill to pain: Alendronate-induced esophageal injury-A case report and review.

Background: Alendronate is used to treat Paget's bone disease, glucocorticoid-induced osteoporosis, and postmenopausal osteoporosis because it suppresses osteoclast activity to stop bone resorption. Case report: We present an exceptional case of esophagitis caused by alendronate. Blood tests and other data were normal when the patient was taken to the hospital, but an endoscopic examination revealed significant esophageal redness, erosion, and ulceration, along with pseudomembrane. The patient was given medicine after receiving a diagnosis of alendronate pill-induced esophagitis based on the pathological findings. Conclusion: This case report is a timely reminder of the importance of thorough pharmacovigilance, patient education, and smart therapeutic decision-making in the context of alendronate use. To properly treat and prevent problems with the esophagus caused by alendronate, additional research is required.

Service failure is bound to happen: Unraveling the impact of dissatisfaction, complaint behavior and re-travel intention in travel and tourism industry.

Service failure is bound to happen, but dissatisfaction has always been undermined by scholars previously. The present study investigates dissatisfaction factors in travel decision-making leading towards re-travel intention with the help of the expectancy disconfirmation theory (EDT) model. Moreover, complaint behavior mediates the relationship between dissatisfaction and re-travel intention concerning the factors involved in it. For the findings, 434 real-time responses were collected through an offline survey following the lifetime value (LTV) approach. Kaiser-Meyer-Olkin (KMO) and Bartlett's tests were conducted to test the sphericity of the variables one by one. Furthermore, structural equation modeling (SEM) was implied to test the measurement and structural models. All the hypotheses supported and accepted the proposed research questions. The findings reveal that the dissatisfaction factors, with their interaction terms (transaction-based and experience-based), help study the variable dissatisfaction and its multifaceted concept in travel and tourism literature. Moreover, complaint behavior is identified as a key mediating factor in the relationship between dissatisfaction and re-travel intention, suggesting that commuters' response to dissatisfaction, including complaints, shapes their future re-travel intentions. The theoretical implications of the study are substantial, as it advances our understanding of commuter behavior in the context of public transport travel and tourism. Practically, the findings offer actionable insights for public transport authorities and service providers. Understanding the specific dissatisfaction factors influencing re-travel intention allows for targeted interventions to improve service quality and customer experience. Recognizing the importance of effective complaint management systems can help organizations better address customer grievances and mitigate the negative effects of dissatisfaction on re-travel intention.

Background radioactivity level estimation and passive shield optimization using adjoint Monte Carlo method.

The current study proposes a procedure to estimate the activity concentration of natural radionuclides and to optimize passive shielding solutions for HPGe detectors using adjoint Monte Carlo (MC) simulation technique of Geant4 for the first time. The background spectrum is acquired for 1.56 × 106 s using an HPGe detector model (GC3020), set inside a shielding solution, during 2021-2022 to estimate the activity concentration of natural radionuclides inside the shielding. While, a background spectrum for 65,000 s is acquired with shielding removed to estimate the concentration of natural radionuclides in the building materials of the laboratory. The detector design used in the simulations is validated by comparing computed and measured Full Energy Peak Efficiency (FEPE) for point sources 241Am, 152Eu, 137Cs, 133Ba, and 60Co. Adjoint MC simulations are used to compute the activity concentration of natural radionuclides assuming an isotropic distribution. The activity concentration of 40K, 226Ra and 232Th in the building material is found to be 524 ± 140, 83 ± 20 and 65 ± 18 Bqkg-1, respectively. The computed values are found in good agreement with the published data. The natural radioactivity levels of 40K, 226Ra and 232Th measured in lead shielding are 155.7 ± 0.1 mBqkg-1, 24 ± 13 mBqkg-1 and 33 ± 17 mBqkg-1 respectively. The radiological risks arising due to natural radioactivity is assessed by calculating radium equivalent activity (Raeq), indoor radiation hazard index (Hin) and annual effective dose equivalent. All the radiological parameters are found below their permissible limits and building materials may be considered radiologically safe. The optimal lead shield thickness for the detector is determined to be 12 cm, resulting in reduction of background signal by two orders of magnitude compared to an unshielded detector. The adjoint MC simulations in Geant4 are 103-104 times more rapid as compared to normal simulations for shield optimization of HPGe detectors and therefore, are identified as viable computing solution to calculate the activity of the background radiation.

Actions are oriented to delight travelers: A sequential mediation model to explore the relationship between travel quality and re-travel intentions.

The actions are oriented to delight travelers where existing protocols fall short of solving problems in the travel and tourism industry, seeking the retention of commuters by offering travel quality. The present study investigates the travel decision-making process by exploring the nexus between travel quality and re-travel intentions (RTI). The study also analyzes the relational switching cost's (RSC) unique role as a sequential mediator in driving travel quality through the theoretical lens of expectancy disconfirmation theory. Furthermore, the study also explores the role of gender in explaining RTI. 434 real-time responses were collected following the lifetime value (LTV) approach. The structural equation modeling (SEM) was used to test the hypotheses. The study reveals that travel quality significantly influences commuter satisfaction. The results also suggest the indirect effect of RSC on commuter satisfaction (CS) and (RTI). Finally, it is suggested that RTI is higher among female commuters than male commuters. The fundamental contribution of this study is developing and testing the travel decision-making process by extending the EDT model. Additionally, the TRAVQUAL scale contributes to measuring perceived and expected travel quality. Commuter satisfaction and relational switching costs act as sequential mediators, while gender emerges as a moderator, emphasizing the greater significance of re-travel intentions among female commuters post-RSC. These insights contribute valuable perspectives for enhancing travel experiences and decision-making processes in the travel and tourism industry.

The role and implication of autophagy in cholangiocarcinoma.

Cholangiocarcinoma (CCA) is a malignant tumor that originates from the biliary epithelial cells. It is characterized by a difficult diagnosis and limited treatment options. Autophagy is a cellular survival mechanism that maintains nutrient and energy homeostasis and eliminates intracellular pathogens. It is involved in various physiological and pathological processes, including the development of cancer. However, the role, mechanism, and potential therapeutic targets of autophagy in CCA have not been thoroughly studied. In this review, we introduce the classification, characteristics, process, and related regulatory genes of autophagy. We summarize the regulation of autophagy on the progression of CCA and collect the latest research progress on some autophagy modulators with clinical potential in CCA. In conclusion, combining autophagy modulators with immunotherapy, chemotherapy, and targeted therapy has great potential in the treatment of CCA. This combination may be a potential therapeutic target for CCA in the future.

Correlation between prescribing doctor attributes and intestinal cleanliness in colonoscopy: a study of 22522 patients.

OBJECTIVE: This study aimed to analyze the correlation between different attributes of doctors who prescribe colonoscopies and the cleanliness of the intestine to guide the development of colonoscopy application protocols. METHODS: Data on colonoscopy cases conducted in the gastroenterology department of Hangzhou First People's Hospital between April 2018 and March 2021 were collected. The gender, age, professional attributes of the prescribing doctors, and Boston Bowel Preparation Scale (BBPS) score were recorded. In addition, the correlation between the prescribing doctors' characteristics and the intestine's cleanliness was analyzed. RESULTS: The study included 22,522 patients with a mean BBPS score of 6.83 ± 1.94. There were 16,459 male and 6,063 female doctors with similar BBPS scores (p = 0.212). The study found no significant difference in BBPS scores between 19,338 internist and 3,184 non-internist (p = 0.154). However, BBPS scores differed significantly between 18,168 gastroenterologists and 4,354 non-gastroenterologists (p = 0.016) and between 19,990 intestinal-related specialties(gastroenterology and gastrointestinal surgery) and 2,532 non-intestinal-related specialties (p = 0.000). In addition, BBPS scores were significantly different between 18,126 prescribing endoscopiests and 4,396 non-endoscopiests (p = 0.014). However, there was no significant difference in BBPS scores among doctors of different ages (p = 0.190). The study found significant differences in BBPS scores between male and female patients and those under or over 40 years (p = 0.000). CONCLUSION: To improve colonoscopy preparation quality, priority should be given to doctors in gastroenterology, intestinal-related specialties, and endoscopiests. Their expertise may result in better education and improved bowel cleanliness.

Efficacy and safety of endoscopic drainage versus percutaneous drainage for pancreatic fluid collection; a systematic review and meta-analysis.

BACKGROUND/AIMS: Pancreatic fluid collections (PFC) are debris or fluid of the pancreas that needs to be drained out. This may result from surgery or necrotizing pancreatitis. This meta-analysis compared the outcomes of PFC through endoscopic and percutaneous interventions. METHODS: A medical database was searched up to June 2022, comparing the outcomes of endoscopic drainage (ED) and percutaneous drainage (PD) for the PFC. Eligible studies reporting clinical and technical success and adverse events were selected. RESULTS: Seventeen studies with 1170 patients were included for meta-analysis, of which 543 patients underwent ED and 627 underwent PD. The odd ratio (OR) of technical success was 0.81 (95% confidence interval (CI) 0.31, 2.1) and clinical success was in the favor of the ED group at OR 2.23 (95% CI 1.45, 3.41). Adverse events OR 0.62 (95% CI 0.27, 1.39) and stent migration OR 0.61 (95% CI 0.10, 3.88) were the same in both groups, but hospital stay pooled mean difference of 15.02 days (95% CI 9.86, 20.18), mortality OR 0.24 (95% CI 0.09, 0.67), and re-interventions OR 0.25 (95% CI 0.16, 0.40) favored ED. CONCLUSIONS: ED is safe and efficient for PFC with higher clinical success, lower mortality rate, hospital stay, and re-interventions compared with PD.

Endoscopic versus minimally invasive surgical approach for infected necrotizing pancreatitis: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND/AIMS: Acute pancreatitis is a common condition of the digestive system, but sometimes it develops into severe cases. In about 10-20% of patients, necrosis of the pancreas or its periphery occurs. Although most have aseptic necrosis, 30% of cases will develop infectious necrotizing pancreatitis. Infected necrotizing pancreatitis (INP) requires a critical treatment approach. Minimally invasive surgical approach (MIS) and endoscopy are the management methods. This meta-analysis compares the outcomes of MIS and endoscopic treatments. METHODS: We searched a medical database until December 2022 to compare the results of endoscopic and MIS procedures for INP. We selected eligible randomized controlled trials (RCTs) that reported treatment complications for the meta-analysis. RESULTS: Five RCTs comparing a total of 284 patients were included in the meta-analysis. Among them, 139 patients underwent MIS, while 145 underwent endoscopic procedures. The results showed significant differences (p < 0.05) in the risk ratios (RRs) for major complications (RR: 0.69, 95% confidence interval (CI): 0.49-0.97), new onset of organ failure (RR: 0.29, 95% CI: 0.11-0.82), surgical site infection (RR: 0.26, 95% CI: 0.07-0.92), fistula or perforation (RR: 0.27, 95% CI: 0.12-0.64), and pancreatic fistula (RR: 0.14, 95% CI: 0.05-0.45). The hospital stay was significantly shorter for the endoscopic group compared to the MIS group, with a mean difference of 6.74 days (95% CI: -12.94 to -0.54). There were no significant differences (p > 0.05) in the RR for death, bleeding, incisional hernia, percutaneous drainage, pancreatic endocrine deficiency, pancreatic exocrine deficiency, or the need for enzyme use. CONCLUSIONS: Endoscopic management of INP performs better compared to surgical treatment due to its lower complication rate and higher patient life quality.

Safety and efficacy of lumen-apposing metal stents and double-pigtail plastic stents for endoscopic ultrasound-guided drainage of walled-off necrosis; a systematic review and meta-analysis.

BACKGROUND: Patients with walled-off necrosis (WON) are still challenging to treat safely and effectively. Recently, double-pigtail plastic stents (DPS), bi-flanged metallic stents (BFMS), and lumen-apposing metal stents (LAMS) have been employed with endoscopic ultrasound-guided (EUS-guided) drainage. However, there is little solid evidence to support the effectiveness and safety of using stents. This study aims to compare the outcomes of the LAMS and the PS. METHOD: Till July 2022, a thorough database search was done, and studies that met the criteria were chosen. By using the RevMan software, the technical and clinical success and other secondary outcomes were calculated. Subgroup analysis was performed between the LAMS and the BFMS. RESULTS: Fifteen studies (two randomized controlled trials and thirteen observational) with 687 patients receiving metal stents and 771 patients receiving plastic stents were selected for final analysis. There was no significant risk of bias or publication bias. The odds ratios (OR) for technical and clinical success were 0.36 (95% confidence interval (95% CI) 0.08, 1.52) and 2.26 (95%CI 1.62, 3.15), respectively. The OR for overall adverse events was 0.74 (95% CI 0.41, 1.34). In subgroup analysis, the LAMS and the BFMS showed the same outcomes. CONCLUSION: Compared to DPS, LAMS had better clinical outcomes and fewer side effects when treating patients with WON.

What is the best endoscopic treatment option for the walled-off necrosis (WON)?A brief comparison of lumen-apposing metal stents (LAMS), bi-flanged metallic stents (BFMS) and double-pigtail plastic stents (DPS) for the treatment of WON patients.How can we limit the adverse events and provide better treatment.

Graphene Oxide-Grafted Hybrid Diblock Copolymer Brush (GO-graft-PEG6k-block-P(MA-POSS)) as Nanofillers for Enhanced Lithium Ion Conductivity of PEO-Based Nanocomposite Solid Polymer Electrolytes.

Nanocomposite solid polymer electrolytes (NSPEs) with PEO as the matrix and (i) GO or (ii) GO-graft-PEG6k or (iii) GO-graft-PEG6k-block-P(MA-POSS) as nanofillers have been fabricated to elucidate the impact of the filler morphology on the lithium ion conductivity. GO-graft-PEG6k was obtained by grafting PEG6k onto GO via esterification. GO-graft-PEG6k-block-P(MA-POSS) was prepared via surface-initiated atom transfer radical polymerization. Fourier-transform infrared spectroscopy revealed enhanced salt dissociation and complexation between the filler and PEO host that could be attributed to Lewis acid-base interactions. Electrochemical impedance spectroscopy revealed the improved ion conductivity of the fabricated NSPEs as compared with the pristine PEO-LiClO4. As an example, at 50 °C, the ion conductivity increased to 4.01 × 10-5 and 6.31 × 10-5 S cm-1 with 0.3% GO and 0.3% GO-graft-PEG6k, respectively, from 2.36 × 10-5 S cm-1 of PEO-LiClO4, suggesting that the filler with brush-like architecture (GO-graft-PEG6k) is more efficient in enhancing the ion conductivity. Further increase in filler content resulted in lowering of the ion conductivity that could be ascribed to aggregation of the filler. The most dramatic impact on conductivity was observed with the incorporation of brush-like GO-graft-PEG6k-block-P(MA-POSS) as a nanofiller (3.0 × 10-4 S cm-1 at 50 °C with 1.0 wt % filler content). The increase in ion conductivity in the current systems, as opposed to the conventional view, could not be correlated with the content of the amorphous phase of the matrix. The conduction mechanism is still unclear; nevertheless, it could be assumed that in addition to the ion conduction through the PEO matrix, the filler forms additional low-energy ion conducting channels at its interface with the matrix. The pendent POSS nanocages of GO-graft-PEG6k-block-P(MAPOSS) might probably increase the free volume at the interface with the matrix that is associated with higher chain and ion mobility, thus further enhancing the ion conductivity as compared with GO and GO-graft-PEG6k. The faster ion dynamics in 1.0 wt % GO-graft-PEG6k-block-P(MAPOSS) NSPEs has also been verified by the dielectric relaxation studies. Thus, integration of both the PEG and POSS nanocages into GO-grafted brush-like architecture offers a new tool for tuning the lithium ion conductivity for potential Li ion battery applications.

A novel method to estimate the dead layer of HPGe detector for Monte Carlo FEPE computation.

In this study, a novel method to determine the surface and lateral dead layers of p-type HPGe detector is proposed to compute the full energy peak efficiency (FEPE). The method employed standard radioactive point sources 241Am, 133Ba and FEPE measurement at low energies to estimate the thickness of frontal and lateral dead layers. The method is simple to apply, requires only two standard radioactive sources to estimate the optimum thickness of frontal and lateral dead layers. The proposed method is validated by measuring the efficiency of various point sources and a volume source in the energy range from 59 to 1408 keV. The measured efficiencies agree to simulation with relative deviation less than 4.0% at each energy. The proposed detector model enables to calibrate the detector for environmental radioactivity measurement without standard volume sources.

Analysis of antidiabetic, antiulcer and analgesic potential of traditional ethnomedicinal plant Emex spinosa (L.) Campd. from Azad Jammu and Kashmir.

In this research antidiabetic, analgesic and antiulcer potential of traditional ethnomedicinal plant: Emex spinosa (L.) Campd. (Family Polygonaceae) was evaluated by extracting its phytoconstituents using methanol (MeOH) solvent through maceration protocol. The quantitative phytochemical analysis of the extract revealed flavonoids were highest in leaf extract (15.63±0.93 mg/mL) and with (11.5±0.57 mg/mL) in stem. Alkaloids and tanins were also present in the samples in various conc. while saponins were absent. To confirm pharmaceutical potential of plant against ulcer, diabetes and analgesic infirmities, a model experimental animal wistar albino rats (Rattus norvegicus) were used. In antiulcer study, using hot plate method the maximum results were observed with 250 mg/kg in the 2.5 hours of study. The leaf extract showed a 40.41±2.73 latency time and the fruit with a 36.77±2.41, and the stem with a 27.85±3.09, which was comparable to the standard drug Aspirin, i.e., 47.5±0.57. For analysis of antiulcer potential of the plants parts doses of 250 and 500 mg/kg was applied to check the reclamation of ethanol-induced acute ulcer and of Aspirin-induced chronic ulcer of stomach. In order to confirm efficacy of the drug potential of plant following parameters like microscopic evaluation, gastric volume, total acidity, mucosa weight, ulcer index, pH and histopathology of stomach were analyzed. In antidiabetic analysis, in an acute study after a single dose of 500 mg/kg extract after 2hrs the blood glucose levels were 367±51.09958NS, 416±59.79548NS, 437.5±61.96437NS mg/dL for leaf, stem and fruit, respectively. After4hrs 351.75±88.27644NS mg/dl, 448.25±25.64948NS mg/dl, 445.25±27.07205NS mg/dl and after 6hrs 354.5±92.70428NS, 442±24.60691NS, a440±33.16625NS mg/dl, respectively. The analgesic activity was explored by applying hot plate, tail flick and formalin paw licking method. In hot plate method the maximum results were observed with 250mg/kg in the 2.5 hours of study. The leaf extract showed a 40.41±2.73 latency time and the fruit with a 36.77±2.41 and the stem with a 27.85±3.09, which was comparable to the standard drug Aspirin, i.e., 47.5±0.57. The respective plant extracts at 250mg/kg showed a gradual rise in latency time when compared to the control. It was concluded that all three components of E. spinosa perform proved to be significant as potential source of herbal medicines to cure different prevalently occurring diseases. Furthermore, it was confirmed through results analysis that plant t can be used to discover novel drug using dedicated high throughput techniques and ethnopharmacological approaches.

Ethnobotanical and conservation studies of tree flora of Shiwalik mountainous range of District Bhimber Azad Jammu and Kashmir, Pakistan.

The present study was carried out to explore and document traditional ethnobotanical knowledge of indigenous rural communities of Shiwalik mountainous range regarding tree flora of the area, District Bhimber of Azad Jammu and Kashmir, Pakistan. The local people of the area primarily depend on wild flora for life sustenance and cure of different infirmities. In this research, data was collected through visual appraisal and participatory rural approach using questionnaire method by applying semi-structured and structured-interview protocols (S4 Table). To validate and explore novelty of research work, various quantitative ethnobotanical indices like informant consensus factor, use value index, fidelity level, relative frequency of citation, relative importance of plants, rank order of priority, Jaccard index and priority ranking were used. The highest ICF was found for jaundice with 0.91 value followed by ICF values of 0.89, 0.86 and 0.85 for wounds, skin diseases and stomach pains, respectively. Fidelity level predicted that Azadirachta indica (Indian lilac tree) ranked first (100%) for its prevalent use in ethnomedicines. Highest use value index (0.61) was found for Azadirachta indica while the highest relative frequency of citation (55) was measured for Melia azedarach. The relative order of priority index was the highest for Azadirachta indica and Acacia arabica L. (ROP = 100) depicting their prevalent use in ethnomedicines. For EB study, the highest relative importance (50.8) was found for Azadirachta indica with good number of agro-uses and its seeds and bark are sold or marketed in local markets to prepare herbal therapeutics by indigenous practioners. The Jaccard index depicted that many traditional ethnomedicinal uses of prescribed trees were novel in recipe form or first time reported such as Senegalia modesta (Phulai) resin was used to prepare 'Panjoori' a local tonic prepared from cow or buffalo butter mixing with seeds of Papaver somnifera (Kashkhash) and Prunus amygdalus (Badaam). The wood of many trees like Pinus roxburghii (pine), Dalbergia sissoo (rosewood), Senegalia modesta (Phulai), Acacia. Arabica (kikar), Bombax cieba (cotton tree) is commercially sold as timber in markets (S3 Table). The research proved that population explosion and climate changes have triggered severe biotic and abiotic pressure on tree flora of the study area of Bhimber, AJK. The research describes that plants like Terminalia belerica (belerica), Terminalia arjuna (arjun tree), Cassia fistula (Indian laburnum), Butea monosperma (bastard teak), Phyllanthus emblica (Indian gooseberry), Morus laevigata (Shah toot), Bauhinia variegata (orchid tree) and Flacourtia indica (Indian plum/ kakoo) are threatened species and their population is highly reduced and if reclamation measures for their conservation are not taken, it may lead towards their complete loss from the area. This research recommends sustainable ethnobotanical use of tree flora, their growth and conservation for green and ecofriendly environment for safe and secure future of human generation.

Study of impacts of brickkiln emanations on soil quality of agriculture lands in selected areas of District Bhimber, Azad Jammu and Kashmir, Pakistan.

The pollution is hot issue of current era in world and the current study was carried to explore impacts of brickkilns' emanations on physiochemical properties of agricultural lands from District Bhimber of Azad Jammu and Kashmir (AJK) Pakistan. In this research, various edaphic characteristics: pH, soil organic matter, organic carbon, water holding capacity, cation exchange capacity and heavy metal contamination in soils nearby of brickkilns were determined. The pH of soil ranged from 5.55 to 7.50, soil organic matter was 0.35-0.90% and organic carbon content was 0.65-1.40%. The water holding capacity ranged from 2.10 to 3.20 mgL-1 and carbon exchange capacity was 1250 to 4202 meq/100g. The contamination profile of heavy metal depicted that Pb showed highest conc. 0.065 mg/g followed by Co (0.053 mg/g) and Ni with 0.52 mg/g in the soil. Pb and Cr had high conc. in soil samples around brickkilns due to burning of coal and rubber tyres as fuel. The conc. of sulphate and nitrate ranged from 0.90±0.50 mol L-1 to 4.25±0.65 mol L-1 and 2.30±0.50 mol L-1 to 6.55±0.25 mol L-1, respectively. The fertility of agriculture lands was depicted that edaphic properties were directly related while nutritive features were inversely commensurate to distance from brickkilns. The research proved that emanations of brickkilns causes severe impact on quality of agriculture land, plant growth and its yield. Hence, reclamation measures should be taken to mitigate and/or eradicate nuisance of brickkilns emanations by using environmental friendly strategies.