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1.
J Am Mosq Control Assoc ; 40(2): 81-91, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38811013

ABSTRACT

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


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

ABSTRACT

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

3.
Medicine (Baltimore) ; 103(4): e37040, 2024 Jan 26.
Article in English | MEDLINE | ID: mdl-38277572

ABSTRACT

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


Subject(s)
COVID-19 , Adult , Humans , Cross-Sectional Studies , COVID-19/epidemiology , Fasting/physiology , Weight Loss , Weight Gain , Islam
4.
Microbiol Spectr ; 12(1): e0163123, 2024 Jan 11.
Article in English | MEDLINE | ID: mdl-37982632

ABSTRACT

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


Subject(s)
Mycobacterium tuberculosis , Tuberculosis, Multidrug-Resistant , Tuberculosis , Humans , Rifampin/pharmacology , Rifampin/therapeutic use , Antitubercular Agents/pharmacology , Antitubercular Agents/therapeutic use , Mycobacterium tuberculosis/genetics , Microbial Sensitivity Tests , Tuberculosis/diagnosis , Tuberculosis/drug therapy , Tuberculosis, Multidrug-Resistant/diagnosis , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Multidrug-Resistant/microbiology , Genotype , Phenotype
5.
Environ Monit Assess ; 196(1): 41, 2023 Dec 15.
Article in English | MEDLINE | ID: mdl-38097881

ABSTRACT

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


Subject(s)
Earthquakes , Radiation Monitoring , Radon , Water Pollutants, Radioactive , Radon/analysis , Water/analysis , Pakistan , Water Pollutants, Radioactive/analysis
6.
Medicine (Baltimore) ; 102(47): e36043, 2023 Nov 24.
Article in English | MEDLINE | ID: mdl-38013349

ABSTRACT

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


Subject(s)
Carcinoid Heart Disease , Carcinoid Tumor , Neuroendocrine Tumors , Humans , Carcinoid Heart Disease/diagnosis , Carcinoid Heart Disease/therapy , Neuroendocrine Tumors/diagnosis , Carcinoid Tumor/complications , Heart , Molecular Biology
7.
Medicine (Baltimore) ; 102(41): e35569, 2023 Oct 13.
Article in English | MEDLINE | ID: mdl-37832119

ABSTRACT

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


Subject(s)
Stroke , Humans , Cross-Sectional Studies , Nepal/epidemiology , Stroke/epidemiology , Stroke/etiology , Comorbidity , Risk Factors , Tertiary Care Centers
8.
Medicine (Baltimore) ; 102(35): e34664, 2023 Sep 01.
Article in English | MEDLINE | ID: mdl-37657009

ABSTRACT

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


Subject(s)
Coinfection , Mpox (monkeypox) , Humans , Cross-Sectional Studies , Mpox (monkeypox)/epidemiology , Monkeypox virus , Public Health , Retrospective Studies
9.
EMBO J ; 42(14): e112845, 2023 07 17.
Article in English | MEDLINE | ID: mdl-37272163

ABSTRACT

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


Subject(s)
Autophagy , Microtubule-Associated Proteins , Animals , Humans , Autophagy-Related Protein 8 Family/genetics , Autophagy-Related Protein 8 Family/metabolism , Microtubule-Associated Proteins/genetics , Microtubule-Associated Proteins/metabolism , Autophagosomes/metabolism , Endosomal Sorting Complexes Required for Transport/metabolism , Mammals
10.
Sensors (Basel) ; 23(11)2023 May 25.
Article in English | MEDLINE | ID: mdl-37299808

ABSTRACT

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


Subject(s)
COVID-19 , Humans , Pandemics , Reproducibility of Results , Intelligence , Multimedia
11.
JNMA J Nepal Med Assoc ; 61(261): 469-471, 2023 May 01.
Article in English | MEDLINE | ID: mdl-37203903

ABSTRACT

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


Subject(s)
Melanoma , Rectal Neoplasms , Male , Humans , Middle Aged , Rectal Neoplasms/diagnosis , Rectal Neoplasms/surgery , Melanoma/diagnosis , Melanoma/surgery , Rectum
12.
JNMA J Nepal Med Assoc ; 61(259): 277-279, 2023 Mar 01.
Article in English | MEDLINE | ID: mdl-37203948

ABSTRACT

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


Subject(s)
Carcinoma, Transitional Cell , Hydronephrosis , Lung Neoplasms , Renal Insufficiency , Ureter , Ureteral Neoplasms , Female , Humans , Aged , Carcinoma, Transitional Cell/complications , Carcinoma, Transitional Cell/drug therapy , Carcinoma, Transitional Cell/pathology , Ureter/pathology , Paclitaxel/therapeutic use , Ureteral Neoplasms/complications , Ureteral Neoplasms/drug therapy , Ureteral Neoplasms/pathology , Lung Neoplasms/complications , Lung Neoplasms/drug therapy , Hydronephrosis/etiology
13.
Heliyon ; 9(2): e13687, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36873152

ABSTRACT

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

14.
Discov Nano ; 18(1): 15, 2023 02 16.
Article in English | MEDLINE | ID: mdl-36795251

ABSTRACT

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

15.
Int J Fertil Steril ; 17(1): 57-60, 2023 Jan 01.
Article in English | MEDLINE | ID: mdl-36617204

ABSTRACT

BACKGROUND: Idiopathic hypogonadotropic hypogonadism (IHH) is a medical condition where there is a deficiency or insensitivity of gonadotropin-releasing hormone (GnRH) without a known cause. Not only are the sexual characteristics of a person affected by this condition but also are the psychological and physical development, thus necessitating its early recognition and treatment. This research was carried out to identify the laboratory parameters and to present symptoms of the patients with complaints of IHH. MATERIALS AND METHODS: This retrospective, center, single-center, cross-sectional study was carried out in Aga Khan University from December 2000 until December 2020 on the patients that presented to the clinic with IHH. The patients included in the study were those that presented with hypogonadism, a low concentration of sex steroid hormone, and an abnormal gonadotropin level without any expansive pituitary or hypothalamic lesion. RESULTS: Seventy nine patients presenting with IHH were included with their mean age of 24.2 ± 7.5 years. Of these, 64 (81.0%) had genital atrophy, 50 (63.6%) showed an absence of secondary sexual characteristics, 53 (67.1%) complained of infertility, 44 (55.7%) had not shown signs of puberty, 52 (65.8%) had erectile dysfunction, 46 (58.2%) had a decrease in libido, 11(13.9%) had a previous familial history, 24 (30.3%) had gynecomastia, 9 (11.4%) had non-descended testes, and 6 (7.6%) had anosmia. These patients had serum testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels of 26.3 ± 60, 1.3 ± 2.4, and 2.7 ± 5.0 (IU/L), respectively. CONCLUSION: Thus, it can be stated that small genitalia is the most common complaint among patients with IHH, followed by infertility and lack of secondary sexual characteristics. The testosterone level in serum is also found to be low among these patients.

16.
Pak J Med Sci ; 38(8): 2380-2383, 2022.
Article in English | MEDLINE | ID: mdl-36415235

ABSTRACT

Hodgkin's Lymphoma is a cancer affecting the lymphatic system. There are two subtypes of Hodgkin's Lymphoma: Nodular lymphocyte predominant (NLPHL) and classical Hodgkin's Lymphoma which has further four types. It has a bimodal distribution and is more common among males. The most common presentation is painless swelling in the neck, armpit or groin region. Associated Symptoms include night sweats, unintentional weight loss, fever, persistent cough or dyspnea. Involvement of the gastrointestinal tract is a rare occurrence. Diagnosis is based on hematological, radiological and histochemical studies. Here we report a rare presentation of a 47-year-old male who presented with symptoms of loose stools, weight loss and fever. CT scan and abdominal lymph node biopsy findings were consistent with a lymphoproliferative disorder Patient was being managed in the line of malabsorption syndrome with possible underlying malignancy but his condition deterioted before the histological diagnosis was confirmed. Thus, this report highlights the importance having a consideration for Hodgkin's lymphoma in the management of chronic diarrhea.

17.
J Pak Med Assoc ; 72(8): 1652-1655, 2022 Aug.
Article in English | MEDLINE | ID: mdl-36280939

ABSTRACT

Pituitary gonadotroph adenomas are common but very rarely do they secrete biologically active luteinizing hormone (LH) and follicle-stimulating hormone (FSH). There have been case studies reporting high sex hormones (testosterone/estrogen) in the presence of high or normal LH and FSH. Here we report two cases (with their consent) who presented with visual disturbance and headache at a tertiary care hospital (Aga Khan university hospital) Karachi, Pakistan. Brain imaging revealed a pituitary macroadenoma. Further workup was consistent with pituitary gonadotroph adenoma with high FSH (case 1) and normal LH/FSH (case 2) and elevated serum testosterone in both cases. Transsphenoidal resection was performed and the tissue sample histopathology confirmed pituitary adenoma. Postoperatively, improvement in hormonal profile was observed along with a resolution of visual disturbances and headaches. Thus, functional gonadotroph adenoma should be considered in the presence of elevated testosterone/estrogen and normal or elevated follicle-stimulating hormone (FSH)/ luteinizing hormone (LH). Early diagnosis leads to a better outcome.


Subject(s)
Adenoma , Gonadotrophs , Pituitary Neoplasms , Humans , Male , Pituitary Neoplasms/complications , Pituitary Neoplasms/diagnosis , Pituitary Neoplasms/surgery , Gonadotrophs/pathology , Adenoma/complications , Adenoma/diagnosis , Adenoma/surgery , Follicle Stimulating Hormone , Luteinizing Hormone , Testosterone , Vision Disorders , Headache/complications , Estrogens
18.
J Pak Med Assoc ; 72(9): 1858-1861, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36280993

ABSTRACT

Primary Thyroid Lymphoma (PTL) is a rare disease, mostly affecting middle-to-old aged females. It has a strong association with pre-existing thyroiditis, which increases the risk of its development. The disease has been studied in detail in the Western populations. However, there is lack of data for south Asians, especially in Pakistani population. This study was carried out to learn more about the disease characteristics in our area. This was a retrospective study where we reviewed four diagnosed and/or treated cases of primary thyroid Lymphoma at tertiary care hospital of Pakistan (Aga Khan University Hospital), Karachi, Pakistan. Each patient's medical record was reviewed and studied. The participants' average age was 62.8±10.12 years,, with two males and two females. The histology of all of the patients was compatible with the Diffuse B cell Lymphoma subtype. One patient died as a result of complications, one patient was lost to follow up, and the remaining two patients are doing well with no active complaints and are being followed up on a regular basis.


Subject(s)
Lymphoma , Thyroid Neoplasms , Aged , Female , Humans , Male , Middle Aged , Developing Countries , Lymphoma/epidemiology , Lymphoma/therapy , Retrospective Studies , Thyroid Neoplasms/epidemiology , Thyroid Neoplasms/therapy
19.
Sensors (Basel) ; 22(20)2022 Oct 21.
Article in English | MEDLINE | ID: mdl-36298429

ABSTRACT

Vehicular Named Data Networking (VNDN) is one of the potential and future networking architectures that allow Connected and Autonomous Vehicles (CAV) to exchange data by simply disseminating the content over the network. VNDN only supports a pull-based data forwarding model, where the content information is forwarded upon request. However, in critical situations, it is essential to design a push-based data forwarding model in order to broadcast the critical data packets without any requests. One of the challenges of push-based data forwarding in VNDN is the broadcasting effect, which occurs when every vehicle broadcasts critical information over the network. For instance, in emergency situations such as accidents, road hazards, and bad weather conditions, the producer generates a critical data packet and broadcasts it to all the nearby vehicles. Subsequently, all vehicles broadcast the same critical data packet to each other, which leads to a broadcast storm on the network. Therefore, this paper proposes a Fuzzy Logic-based Push Data Forwarding (FLPDF) scheme to mitigate the broadcast storm effect. The novelty of this paper is the suggestion and application of a fuzzy logic approach to mitigate the critical data broadcast storm effect in VNDN. In the proposed scheme, vehicles are grouped into clusters using the K-means clustering algorithm, and then Cluster Heads (CHs) are selected using a fuzzy logic approach. A CH is uniquely responsible for broadcasting the critical data packets to all other vehicles in a cluster. A Gateway (GW) has the role of forwarding the critical data packets to the nearest clusters via their GWs. The simulation results show that the proposed scheme outperforms the naive method in terms of transmitted data packets and efficiency. The proposed scheme generates five times fewer data packets and achieves six times higher efficiency than the naive scheme.

20.
Indian J Endocrinol Metab ; 26(2): 137-140, 2022.
Article in English | MEDLINE | ID: mdl-35873927

ABSTRACT

Background and Objective: Differentiated thyroid carcinoma (DTC) is a slow-growing tumour with 20% of the cases having distant metastasis. Its prognosis can vary by its histological characteristics, extension and spread. The data on metastatic DTC patients in Pakistan is scarce; therefore, the purpose of our study was to assess the clinicopathological characteristics and treatment outcomes of metastatic DTC in our population. Methods: This retrospective, single-centre study was carried out on 117 patients with metastatic DTC with their age at diagnosis, gender, tumour size and extent and spread of the tumour, and its histologic characteristic recorded. The treatment they received and the outcome in terms of status, at last, follow-up were also recorded. Results: The mean age of diagnosis was found to be 46.6 ± 17.2 years with an almost equal male to female ratio. The most common site of metastasis was the lung followed by bone. Papillary carcinoma was the most common subtype with 89.7% of the cases followed by follicular carcinoma occurring in 7.7%. The overall survival in years was found to be 5.6 ± 2.6 years. Ninety-six per cent had complete surgical resection followed by radioactive iodine (RAI) in 91.5%. Conclusion: Our study shows that the most significant factors in predicting the outcome in metastatic DTC are age, an extrathyroidal extension of the primary tumour and distant metastasis. However, further multicentric studies done on a much larger population will be needed to further support and strengthen our results.

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