Predictors of outcome after CABG in the South-Asian community: a propensity matched analysis.

BACKGROUND: Ethnicity is not incorporated into standardized pre-operative risk-stratification tools for cardiac surgery. This study compared short-term outcomes following coronary artery bypass graft (CABG) surgery in South Asian and non-Asian patients. METHODS: Consecutive patients undergoing isolated CABG surgery via sternotomy between the years 2011 and 2019 were retrospectively analyzed. Initially, 1957 patients were identified (799 South-Asian, 40.8%). The patient groups were then propensity matched according to 10 relevant pre-operative covariates (age, body mass index, pulmonary disease, renal failure, smoking, diabetes, ventricular function, renal failure): 675 non-Asian patients were matched against 675 Asian patients. RESULTS: Operative mortality was 1.77% and similar between the two groups (p = 0.447). Multivariate regression analysis found predictors of operative mortality to be pre-operative serum creatinine, age, left ventricular (LV) impairment, and extent of coronary disease. The effect of creatinine on mortality was selective for South-Asian patients (p = 0.015). LV impairment was a predictor of mortality in non-Asian patients, however this effect did not exist in South-Asian patients. Predictors of short-term complications (composite of death, stroke, reoperation, hemofiltration, and pneumonia) were age and creatinine (coefficient 0.002, 95% CI 0.0004-0.004, p = 0.019) in the overall cohort. Subgroup analysis found age to remain a selective negative predictor of complications in South-Asian patients. Cox regression analysis found creatinine, age, and LVEF to influence 10-year survival, whilst ethnicity was not a predictor. CONCLUSION: This study highlights the cumulative risk associated with ethnicity and renal disease in predicting short-term outcomes following CABG. This warrants further investigations in larger populations, thus guiding pre-operative risk-stratification.

First-principles calculations to investigate the effects of strain, electric field, and atom impurity on the electronic and magnetic properties of RuX2 (X = S, Se) nanosheets.

An experimental group (Angew. Chem., Int. Ed., 2021, 60, 7013-7017) has recently demonstrated the synthesis of two-dimensional (2D) RuSe2, which was shown to hold promise for hydrogen evolution due to enhanced HER performance. Herein, we studied the effects of external factors (strain, electric field, and atom adsorption) on the electronic and magnetic properties of T'-RuX2 (X = S, Se) sheets using DFT+U calculations. The estimated carrier effective mass results show that electrons are heavier than holes for T'-RuX2 sheets. The band-gap increases when the bi-axial strain increases from -5% to -1% (-5% to 1%) for T'-RuS2(RuSe2) and then decreases beyond these strain points. We found that the T'-RuX2 sheets exhibit a semiconductor to metal transition under a maximum electric field strength of 10 V nm-1. It is revealed that the magnetic moment can be achieved in T'-RuX2via adsorption of Li, Na, and K atoms. The findings show that the AFM state is the preferred magnetic ground state for T'-RuS2 with adsorbed Li and Na, whereas FM is the magnetic ground state for the remaining atm-RuX2 systems. Interestingly, an indirect to direct transition of the band-gap for T'-RuS2 with adsorbed K was found whereas the remaining T'-RuX2 with adsorbed Li, Na and K atoms showed either half-metallic or metallic electronic properties. Our results can extend the application of T'-RuX2 sheets in actuating, optoelectronic and spintronic fields.

Ferromagnetic TM2BC (TM = Cr, Mn) monolayers for spintronic devices with high Curie temperature.

Transition metal boro-carbide (TM2BC) structures crystallize in the layered orthorhombic structure in their bulk phases. In this study, however, we find that TM2BC (TM = Cr, Mn) prefer a tetragonal (t) crystal structure in their monolayer phases due to the occurrence of strong sp2 bonds between the metal and B/C atoms instead of sp3 + sp2 bonds which exist in the orthorhombic phase. The calculated energy difference between the orthorhombic and the tetragonal structures based on density functional theory (DFT) is more than 1 eV per unit cell. In addition, t-Cr2BC and t-Mn2BC monolayers are dynamically and thermally stable with their magnetic metal electronic structures. For further investigations, we combine our DFT calculations with the Monte Carlo simulations and find that both t-TM2BC monolayers show ferromagnetic properties. The calculated Curie temperatures are 846 K and 128 K for t-Cr2BC and t-MnBC sheets, respectively. In addition, we examine the magnetic anisotropy energies (MAE) of t-TM2BC monolayers and find that both structures prefer out-of-plane as the easy axis magnetization direction and the applied electric field can easily modulate the MAE of the monolayers. Our theoretical calculations reveal that t-TM2BC (TM = Cr, Mn) sheets have great potential for the future design of controllable spintronic devices with their tunable MAE properties.

The Effect of Minimally Invasive Surgery and Sternotomy on Physical Activity and Quality of Life.

AIM: The aim of this study was to compare minimally invasive surgery (MI) and median sternotomy (MS) in terms of post-procedure health-related quality of life (HRQoL) and functional outcome. METHOD: We conducted a multicentre prospective cohort study that enrolled patients from January 2015 until February 2017. Combined cardiac procedures were performed with MS and isolated valve procedures with either MS or MI, depending on patient preference and surgeon experience. HRQoL was measured using the five-level version of the EQ-5D (EQ-5D-5L) and physical activity before and after surgery was evaluated using a wearable accelerometer. Activity patterns and intensity recorded by the accelerometer in each period were classified as "sedentary", "light physical activity", "moderate physical activity", and "vigorous physical activity" for each patient. We also conducted a sub-analysis of frail patients in each group, as identified by the Reported Edmonton Frail Scale (>10 points). Patients were followed for 1 year. RESULTS: The study included 100 consecutive patients who underwent MI (n=50) or MS (n=50) during the study period. Patients in the MI group showed a faster recovery of physical activity in the immediate postoperative period and superior HRQoL in the first 3 months (both p<0.001) versus the MS group. Differences between the MI and MS group were indistinguishable over a longer follow-up. A similar correlation was observed in the frailty subanalysis. Overall, the MS group had a higher cumulative incidence of events than the MI group (p<0.001). CONCLUSIONS: Compared to conventional MS, MI was associated with better HRQoL and early functional outcome, even in frail patients.

A tetragonal phase Mn2B2 sheet: a stable room temperature ferromagnet with sizable magnetic anisotropy.

Exploring the magnetic properties of two-dimensional (2D) metal boride (MBene) sheets for spin-based electronics is gaining importance for developing electronic devices. Through combined first-principles calculations and Monte Carlo simulations, we present a new tetragonal Mn2B2 (tetra-Mn2B2) sheet. The tetra-Mn2B2 sheet shows metallic ferromagnetism (2.65 µB per Mn atom) with excellent stability. Moreover, it is demonstrated that the tetra-Mn2B2 sheet holds promise for experimental synthesis within an acceptable range from the results of stability tests of tetra-Mn2B2. We also find that the magnetic anisotropy (MAE) of the 2D tetra-Mn2B2 sheet is significantly increased under an electric field. The Curie temperature (TC) of the tetra-Mn2B2 sheet is calculated as 406 K. This 2D tetra-Mn2B2 with a high Curie temperature can serve as a promising candidate for future magnetoelectronics applications.

First-principles studies on the effects of halogen adsorption on monolayer antimony.

Using first-principles calculations, we carry out systematic studies on the electronic, magnetic and structural properties of halogenated ß-phase antimonene. We consider two different levels of halogen adatom coverage i.e. Θ = 1/8 and Θ = 1/18. It is found that F, Cl and Br adatoms act as acceptors whereas the I adatom acts as a donor. For a high coverage of Θ = 1/8, halogenated ß-phase antimonene exhibits metallic characteristics. With a lower coverage of Θ = 1/18, through the adsorption of F, Cl and Br the semiconducting unstrained antimonene becomes metallic. In contrast, I-adsorbed antimonene remains semiconducting but exhibits magnetic behavior. We further investigate the effects of bi-axial strain on the halogenated ß-phase antimonene. It is found that bi-axial strain can only induce ferromagnetism on the halogenated antimonene at Θ = 1/18. However, the ferromagnetism is suppressed when the applied strain is high. We uncover that the emergence of strain-dependent magnetism is attributed to the presence of localized states in the bandgap resulting from collective effects of bi-axial strain and the adsorption of halogen atoms.

Constant heat stress reduces skeletal muscle protein deposition in broilers.

BACKGROUND: This experiment was conducted to evaluate the effects of constant heat stress on growth performance and protein metabolism in skeletal muscle of Arbor Acres broilers. RESULTS: Two hundred and seventy 21-day-old Arbor Acres broilers with similar body weight (1298 ± 28 g) were selected for a 3-week trial (29-49 days of age). The broilers were randomly assigned to three groups including the control group, constant heat stress group and pair-fed group. Up-regulation of the rectal temperature and the mRNA expression of heat shock protein 70 in liver indicate that the model for constant heat stress was success. The average daily gain, feed conversion ratio, breast and thigh muscle weight, percentage of breast muscle, crude protein content in breast and thigh muscle in constant heat stress group were significantly lower than in control group and pair-fed group. Serum uric acid content and the glutamic-oxaloacetic transaminase activity were significantly higher, while protein content and glutamic-pyruvate transaminase activity were significantly lower in liver of heat stress group than of the control and pair-fed groups. The expression of insulin-like growth factor 1, phosphatidylinositol 3-kinase and p70S6 kinase associated with protein synthesis were lower in breast muscle but higher in thigh muscle in heat stress group compared to the control or fed-pair groups. In thigh muscles, the expression of muscle ring-finger protein-1 and MAFbx associated with protein degradation were higher in the heat stress group than in the control and pair-fed groups. CONCLUSION: Poor performance of the birds under heat stress may be due to lower synthesis and increased degradation of proteins.

Sebaceous carcinoma in a 54-year-old Black African man after cancer chemotherapy: a case report.

BACKGROUND: Sebaceous carcinoma is a very rare malignant skin adnexal tumor that is occasionally aggressive. We have not seen a case of sebaceous carcinoma in our center in the last 10 years. It is extremely rare in Black Africans. CASE PRESENTATION: We described the case of a 55-year-old man African man who presented to our ophthalmologist with complaints of growth on the right upper eyelid for 8 months. He had surgery and chemotherapy for rectal carcinoma 6 years prior to presentation and received his last dose of chemotherapy 5 years before seeing our ophthalmologist. There was a history of spontaneous unprovoked bleeding from the lesion. He subsequently underwent surgical excision under general anesthesia. Histology of the mass showed an effaced architecture due to proliferating malignant epithelial cells disposed as trabecules, solid nests, and tongues. The microscopic features of widespread multivacuolated cytoplasm of the neoplastic cells led us to conclude that the tumor was a sebaceous carcinoma. The patient is alive and well. CONCLUSION: Sebaceous carcinoma is a rare malignant skin adnexal tumor in Black Africans. It can present as an eyelid mass with spontaneous bleeding. It can follow cancer chemotherapy either because of its association with other tumors in Muir-Torre syndrome or because of mutagenic effects of chemotherapeutic agents.

Microengineered neuronal networks: enhancing brain-machine interfaces.

The brain-machine interface (BMI), a crucial conduit between the human brain and computers, holds transformative potential for various applications in neuroscience. This manuscript explores the role of micro-engineered neuronal networks (MNNs) in advancing BMI technologies and their therapeutic applications. As the interdisciplinary collaboration intensifies, the need for innovative and user-friendly BMI technologies becomes paramount. A comprehensive literature review sourced from reputable databases (PubMed Central, Medline, EBSCOhost, and Google Scholar) aided in the foundation of the manuscript, emphasizing the pivotal role of MNNs. This study aims to synthesize and analyze the diverse facets of MNNs in the context of BMI technologies, contributing insights into neural processes, technological advancements, therapeutic potentials, and ethical considerations surrounding BMIs. MNNs, exemplified by dual-mode neural microelectrodes, offer a controlled platform for understanding complex neural processes. Through case studies, we showcase the pivotal role of MNNs in BMI innovation, addressing challenges, and paving the way for therapeutic applications. The integration of MNNs with BMI technologies marks a revolutionary stride in neuroscience, refining brain-computer interactions and offering therapeutic avenues for neurological disorders. Challenges, ethical considerations, and future trends in BMI research necessitate a balanced approach, leveraging interdisciplinary collaboration to ensure responsible and ethical advancements. Embracing the potential of MNNs is paramount for the betterment of individuals with neurological conditions and the broader community.

Emerging cancer disease burden in a rural sub-Saharan African population: northeast Nigeria in focus.

Introduction: Sub-Saharan Africa (SSA) is plagued by myriads of diseases, mostly infectious; but cancer disease burden is rising among non-communicable diseases. Nigeria has a high burden of cancer, however its remote underserved culturally-conserved populations have been understudied, a gap this study sought to fill. Methods: This was a cross-sectional multi-institutional descriptive study of histologically diagnosed cancers over a four-year period (January 2019-December 2022) archived in the Departments of Pathology and Cancer Registries of six tertiary hospitals in the northeast of Nigeria. Data obtained included age at diagnosis, gender, tumor site and available cancer care infrastructure. Population data of the study region and its demographics was obtained from the National Population Commission and used to calculate incident rates for the population studied. Results: A total of 4,681 incident cancer cases from 2,770 females and 1,911 males were identified. The median age at diagnosis for females was 45 years (range 1-95yrs), and 56 years (range 1-99yrs) for males. Observed age-specific incidence rates (ASR) increased steadily for both genders reaching peaks in the age group 80 years and above with the highest ASR seen among males (321/100,000 persons) compared to females (215.5/100,000 persons). Breast, cervical, prostatic, colorectal and skin cancers were the five most common incident cancers. In females, breast, cervical, skin, ovarian and colorectal cancers were the top five malignancies; while prostate, haematolymphoid, skin, colorectal and urinary bladder cancers predominated in men. Conclusion: Remote SSA communities are witnessing rising cancer disease burden. Proactive control programs inclusive of advocacy, vaccination, screening, and improved diagnostics are needed.

Theoretical design of porous dodecagonal germanium carbide (d-GeC) monolayer.

Porous nanosheet materials have recently emerged as attractive candidates to serve as nanofiltration membranes. Through first-principles calculations based on density functional theory (DFT) calculations, we propose a new porous dodecagonal GeC (d-GeC) monolayer. We show that the d-GeC monolayer exhibits excellent energetic, mechanical, dynamic, and thermal stabilities. The d-GeC monolayer shows semiconducting properties with an indirect band gap of 1.73 eV (2.53 eV) PBE(HSE06). We also show that the d-GeC monolayer can serve as a good membrane for molecular and atomic permeation due to its low value of estimated diffusion energy barriers. Our results demonstrate the potential of the d-GeC monolayer for the design of nanofiltration membrane technology.

Epidemiological characteristics and comparative outcome of blast versus gunshot injuries of the extremities in Somalia.

BACKGROUND: War conflicts and terror-related injuries constitute a significant public health problem in Somalia. We aim to characterize and compare the injury characteristics of gunshot and blast injuries of the extremities. METHODS: The data of 333 patients with gunshot and blast injuries of the extremities over three years were retrospectively reviewed. The demographics, injury characteristics, and outcomes were analyzed. RESULTS: Most of the patients had injuries due to gunshot casualties compared with blast victims (n = 222, 66.7% vs. n = 111, 33.3%). Patients with gunshot wounds (GSW) had a more significant proportion of males than those with blast wounds (BW) (95.5% vs. 85.6%, P < 0.001). There were more open extremity fractures in GSW casualties (96.4% vs. 81.1%). The BW victims had significantly higher associated injuries (52.3% vs. 18.5%, P < 0.001). The BW group had a higher injury severity score (ISS ≥ 16 in 55%, P < 0.001). The need for an intensive care unit (ICU) admission was significantly higher in the BW patients (18% vs. 6.3%, P < 0.001); as well as the length of hospital stay (LOS) was higher in the BW group compared with the GW patients (> 2-week hospital stay in 31% vs. 19%, P < 0.04). About a 2.7% mortality rate was observed in BW (P < 0.014). CONCLUSION: Gunshot and explosion injuries comprise the majority of war and terror-related trauma of the extremities. These injury mechanisms differ in the body regions involved, the severity of the injury, duration of hospital stay, need for ICU admission, and mortality. Assessment and management of such devastating casualties require a complex and multidisciplinary approach.

Intestinal colonization against Vibrio cholerae: host and microbial resistance mechanisms.

Vibrio cholerae is a non-invasive enteric pathogen known to cause a major public health problem called cholera. The pathogen inhabits the aquatic environment while outside the human host, it is transmitted into the host easily through ingesting contaminated food and water containing the vibrios, thus causing diarrhoea and vomiting. V. cholerae must resist several layers of colonization resistance mechanisms derived from the host or the gut commensals to successfully survive, grow, and colonize the distal intestinal epithelium, thus causing an infection. The colonization resistance mechanisms derived from the host are not specific to V. cholerae but to all invading pathogens. However, some of the gut commensal-derived colonization resistance may be more specific to the pathogen, making it more challenging to overcome. Consequently, the pathogen has evolved well-coordinated mechanisms that sense and utilize the anti-colonization factors to modulate events that promote its survival and colonization in the gut. This review is aimed at discussing how V. cholerae interacts and resists both host- and microbe-specific colonization resistance mechanisms to cause infection.

Intestinal obstruction due to giant liver cyst: A case report.

BACKGROUND: Congenital hepatic cysts are relatively rare but are now diagnosed earlier and more frequently with a routine prenatal ultrasound. Solitary liver cysts are divided into simple and solitary intrahepatic biliary cysts, depending on the biliary connection. While some solitary liver cysts are symptomatic in childhood, even in newborns, they are often found incidentally in adults. CASE SUMMARY: A 3-mo-old female infant was admitted to Mogadishu Somali Training and Research Hospital with recurrent vomiting, respiratory problems, and abdominal bloating complaints. On examination, the abdomen was greatly distended and extremely tight. She had repeated vomiting for 3 d, no stool output, and decreased urine. The abdominal ultrasonography detected a solitary cystic lesion measuring 10 cm × 10 cm × 14 cm, extending from the liver or right kidney to the pelvis. In the magnetic resonance imaging examination of the patient, a solitary cystic structure of 10 cm × 10 cm × 14 cm in the right abdomen was observed, extending to the pelvis and possibly originating from the liver. The patient was operated via fenestration after her fluid and electrolytes improved. Oral nutrition was initiated on the 2nd postoperative day, and the drain was removed on the 5th postoperative day. The patient visited the outpatient clinic control 1 mo later with no clinical complaints. CONCLUSION: Congenital liver cysts are usually followed without complications. They rarely reach gigantic dimensions and may cause respiratory distress, intestinal obstruction and recurrent vomiting. Surgery can provide quite successful outcomes in the treatment of giant sized simple liver cysts.

A strangulated umbilical hernia with perforated Meckel diverticulum: Case report.

INTRODUCTION AND IMPORTANCE: Meckel's diverticulum (MD) is one of the most common gastrointestinal anomalies and affects 2-3 % of the population. Strangulated umbilical hernia with a perforated Meckel diverticulum is an extremely rare event. CASE PRESENTATION: We reported here a case of one year old boy of a strangulated umbilical hernia with perforated MD that operated at the Mogadishu hospital. A wedge resection of the MD and anastomosis was performed. CLINICAL DISCUSSION: MD is one of the most common gastrointestinal anomalies and affects 2-3 % of the population. About 60 % of cases come to medical attention before the age of ten, with the remainder of patients presenting in adolescence and adulthood. It is more difficult to diagnose in males, especially in adulthood. CONCLUSION: Being aware of the likelihood that there could be a perforated Meckel's diverticulum in a sac of strangulated umbilical hernia has notable importance and may lead to innovative treatment and postoperative rehabilitation modalities.

Risk factors, classification, and operative choices of femur fractures at a Tertiary Hospital: first report from Somalia.

A traumatic femur fracture is a significant cause of morbidity, affecting one to three million individuals annually. The present is the first study investigated the epidemiological characteristics, risk factors, classification, mechanisms of injury, and early management of femoral fractures in Somalia. This retrospective epidemiological study included all patients with a femur fracture who were admitted for four years between November 2018 and December 2022 to the orthopedic and trauma surgery department. We reviewed patient demographic characteristics, including age and gender, the mechanism of injury, injury characteristics, and the type of fixation performed. We reviewed the radiographs and classified the fracture using the AO/OTA classification system. During the study period, a total of 402 patients were treated for femur fractures; 256 (64%) were males, and 144 (36%) were females. The mean patient age was 47.7 ± 8.5 years. Regarding the anatomical location of femur fractures, the proximal (31A, 31B) was the most common, accounting for 50% of the patients. Femur neck fracture (31B) was the most common in the proximal femur fractures. Gunshot 82 (59.42%) was the leading cause of femur shaft fractures. Most patients with femur shaft fractures were males; 150 (86.20%) and 152 (64.47%) were young patients between 19 and 40 years old. Almost half of the patients (86) with femur shaft fractures had open fractures. The distribution of the mechanism of injury significantly differed according to age (p < 0.001). Younger patients (< 40 years) were predominantly injured due to gunshot injuries compared to elderly cases (> 60 years), where falls from standing height were the primary mechanism of injuries. There was a statistically significant difference between the mechanism of injury and gender categories (p < 0.001). Male patients were injured mainly by gunshots in about 40%, while 80% of fractures in female patients were due to falls from standing height. Female fractures occurred primarily in the proximal, while the males had an equal fracture rate for proximal and shaft fractures. Femur fracture causes significant morbidity and mortality. The study findings revealed that the most common femur fracture type was femur neck fracture, and low-energy injuries were the most common mode of injury in the elderly. Proximal femur fractures occur in older age and mainly in females. Gunshots were the most common cause of femur shaft fractures in Somalia, a country that has struggled with wars for over 30 years.

Progress and experiences of implementing an integrated disease surveillance and response system in Somalia; 2016-2023.

Introduction: In 2021, a regional strategy for integrated disease surveillance was adopted by member states of the World Health Organization Eastern Mediterranean Region. But before then, member states including Somalia had made progress in integration of their disease surveillance systems. We report on the progress and experiences of implementing an integrated disease surveillance and response system in Somalia between 2016 and 2023. Methods: We reviewed 20 operational documents and identified key integrated disease surveillance and response system (IDSRS) actions/processes implemented between 2016 and 2023. We verified these through an anonymized online survey. The survey respondents also assessed Somalia's IDSRS implementation progress using a standard IDS monitoring framework Finally, we interviewed 8 key informants to explore factors to which the current IDSRS implementation progress is attributed. Results: Between 2016 and 2023, 7 key IDSRS actions/processes were implemented including: establishment of high-level commitment; development of a 3-year operational plan; development of a coordination mechanism; configuring the District Health Information Software to support implementation among others. IDSRS implementation progress ranged from 15% for financing to 78% for tools. Reasons for the progress were summarized under 6 thematic areas; understanding frustrations with the current surveillance system; the opportunity occasioned by COVID-19; mainstreaming IDSRS in strategic documents; establishment of an oversight mechanism; staggering implementation of key activities over a reasonable length of time and being flexible about pre-determined timelines. Discussion: From 2016 to 2023, Somalia registered significant progress towards implementation of IDSRS. The 15 years of EWARN implementation in Somalia (since 2008) provided a strong foundation for IDSRS implementation. If implemented comprehensively, IDSRS will accelerate country progress toward establishment of IHR core capacities. Sustainable funding is the major challenge towards IDSRS implementation in Somalia. Government and its partners need to exploit feasible options for sustainable investment in integrated disease surveillance and response.

Exploring room-temperature ferromagnetism in WXBC (X = W, Mn, Fe) monolayers.

Two-dimensional (2D) transition metal boron-carbide is a novel material that has unique properties suitable for advanced spintronics and storage applications. Through first-principles calculations based on density functional theory (DFT) calculations, we report a new class of stable 2D ceramic WXBC (X = W, Mn, Fe) monolayers. We find that all WXBC monolayers prefer a ferromagnetic ground state with metallic electronic property. DFT calculations proved that WXBC monolayers exhibit good energetic, mechanical, and dynamic stabilities. More importantly, these monolayers exhibit large magnetic anisotropy energy (MAE) of 1213 µeV, 247 µeV and 20 µeV per magnetic atom for W2BC, WMnBC, and WFeBC, respectively. An out-of-plane easy axis (EA) magnetization direction is found for W2BC whereas the EA for WMnBC and WFeBC are in-plane. By performing Monte Carlo (MC) simulations based on the 2D Heisenberg model, we predict Curie temperatures (T C) of 155 K for the W2BC monolayer. The Berezinskii-Kosterlitz-Thouless transition (BKT) temperature values of WMnBC and WFeBC are as high as 374.69 K and 417.39 K. For further investigations, the adsorption properties of Li, Na, and K atoms on WXBC (atm-WXBC) systems are examined. It is revealed that the initial ferromagnetic metallic properties of bare WXBC monolayers are maintained for all atm-WXBC systems. The obtained strong chemisorption energies are high enough to make adsorbed Li, Na, and K immobile on WXBC surfaces. All these findings demonstrate the unique potential of WXBC monolayers as multifunctional candidates for advanced magnetic device and storage applications.

Waardenburg-Shah syndrome rare and challenging case report from Somalia.

INTRODUCTION AND IMPORTANCE: Waardenburg-Shah disorder could be an uncommon autosomal recessive inherited ailment characterized by aganglionic megacolon with a high mortality rate. Babies born with Waardenburg syndrome may have typical features of hair, skin and eye pigmentary abnormalities, and hearing loss. Here we present a case with typical presentation of Waardenburg Shah syndrome. CASE PRESENTATION: This is a case of neonatal intestinal obstruction caused by a rare syndrome known as Waardenburg-Shah syndrome, with clinical manifestations of abdominal distension, bilious vomiting, and a history of delayed meconium passage with a family history of variant forms of this syndrome. The patients underwent first laparotomy, which found no atresia.post op colongarphy revealed a narrowed colon. Then reoperated, and a biopsy was taken and opened ileostomy. The pathology result showed gangilion negative. The patient was lost due to uncontrollable sepsis at the age of 2 months. CLINICAL DISCUSSION: Waardenurg syndrome is a congenital audito-pigmentary syndrome first described in 1951.Waardenurg syndrome is classified into four types, WS1 to WS4, and they share the common presence of congenital sensoneural hearing loss and pigmentary defects. The diagnosis of WS has major and minor criteria. The definitive management of this disorder involves surgical removal of aganglionic segment of the bowel and connecting functioning gangilioic bowel to the anus. CONCLUSION: Shah-Waardenburg syndrome TYPE-4 is a relatively unusual syndrome characterized by a higher prevalence of whole colonic aganglionosis with or without small bowel involvement, resulting in substantial morbidity and mortality in the neonatal age range.

A case of empyema necessitans in an adolescent with mycobacterium tuberculosis.

Introduction and importance: An empyema is a buildup of pus in the pleural space and is most commonly associated with pneumonia. Streptococcus pneumonia is the most common cause of pneumonia, although staphylococcus aureus is common in developing countries. empyema necsitans is An extravasation of purulent material outside the pleural space involving the chest wall. Case presentation: Here we present a 15-year-old girl presented with swelling on the right thorax wall. I was told that the swelling had been there for 1 year with moderate discomfort upon lifting objects, with no other complaints. Her medical history was unremarkable until the mass appeared. There was no history of fever, cough, or weight loss, and there was no family history of tuberculosis. Clinical discussion: Empyema necessitatis can be quite harmful. It has the potential to cause bone and soft tissue erosion. This may be asymptomatic at first and proceed at a slow and steady pace. Tuberculous EN can be treated with both surgical and medical treatments. This case applies to both surgical intervention and medical treatment with antituberculosis. Conclusion: Empyema necessitans is uncommon consequence of pleural space infection. pulmonary mycobacterium tuberculosis, Actinomyces, and nontuberculous organisms such Staphylococcus aureus are the most prevalent causes.