Anterior Spinal Artery Syndrome After Bronchial Embolization for Hemoptysis: A Case Report and Literature Review.

Background: Bronchial artery embolization (BAE) is the established first-line treatment for patients presenting with massive haemoptysis, a life-threatening condition that can occur because of numerous underlying diseases. BAE is a relatively safe procedure with control of haemorrhage achieved in 77%-90% of cases and rare occurrence of complications. Spinal cord infarction is one such rare complication, which can have severe implications in terms of morbidity. Case presentations: We present a case of a 70-year-old man who developed paraplegia with loss of pain and temperature sensation as well as sphincteric involvement following BAE for hemoptysis. MRI of the spine was suggestive of an ischaemic event involving anterolateral spinal cord segment T4-T6, so a diagnosis of anterior spinal artery syndrome post BAE was made. The patient was given corticosteroids, dual antiplatelet medications, pregabalin, supportive management and regular physiotherapy. Follow-up of the patient at 3 and 6 months failed to show any significant improvement in neurological function, although the patient did not report problem of significant hemoptysis afterward. Conclusion: Spinal cord infarct is a rare and disabling complication of BAE despite it being a safe procedure with good long-term outcomes. Detailed knowledge about the anatomy of bronchial arteries and spinal arteries with detailed preprocedure investigations may lower the risk of this disabling complication.

Use of hypothermically stored amniotic membrane on diabetic foot ulcers: a multicentre retrospective case series.

OBJECTIVE: The aim of this retrospective case series was to report on the outcomes of diabetic foot ulcers (DFUs) managed with hypothermically stored amniotic membrane (HSAM). METHOD: Deidentified case data of patients who received HSAM were obtained from wound care sites across the US. Data were collected, beginning at the first patient visit to the wound care site (first presentation), at the visit in which the first HSAM application occurred (baseline), and at each subsequent visit over 12 weeks of treatment (follow-up). All patients received standard of care (SoC) between first presentation and baseline. RESULTS: Of the 50 patients in the study, 68% were male. Mean age of the entire cohort was 66.7 years. Of the DFUs, 88% were present for <6 months at first presentation. Mean wound area was 3.5cm2, and mean percentage area reduction was -68.3% from first presentation to baseline. The mean number of HSAM applications was 5.5, and mean number of days between applications was 7.5. A >60% area reduction was attained in 96.0% of DFUs, and 78% attained complete wound closure (CWC) by week 12. The median time to CWC was 55 days. CONCLUSION: The results of this retrospective case series suggest positive outcomes for DFUs managed with HSAM. A reduction in time to CWC may lead to lesser financial burden and improved quality of life for DFU patients. DECLARATION OF INTEREST: The authors have no conflicts of interest.

Liquid phase exfoliation of MoSe2: Effect of solvent on morphology, edge confinement, bandgap and number of layers study.

In this study, a facile and scalable method for synthesizing MoSe2 nanomaterial via a sonication-assisted liquid-phase exfoliation method is proposed. This study shows the successful synthesis of few-layered MoSe2 in various solvents including DI water, ethanol, N-Methyl-2-pyrrolidone (NMP), Dimethylformamide (DMF) and Dimethylsulfoxide (DMSO). The exfoliated nanosheets have remarkably different properties than bulk MoSe2 which were studied using Field emission scanning electron microscopy, Fourier-transform infrared spectroscopy, X-ray diffraction and UV-Vis spectroscopy to investigate their morphology, functional groups, structure and optical properties, respectively. The mean values of the number of layers from an optical extinction spectrum based on the effect of edge and quantum confinement were also calculated. Moreover, the exfoliated material using this method has potential application in energy storage as demonstrated by the electrochemical performance of the bulk and exfoliated materials.•Successful synthesis of the few-layer MoSe2 from bulk MoSe2 using liquid phase exfoliation method in various solvents•The investigation of the effect of solvent on the number of layers and optical properties of MoSe2.

Prevalence of Nocturnal Enuresis Among Children Dwelling in Rural Areas of Sindh.

Introduction Nocturnal enuresis (NE) is usually a condition of childhood and refers to involuntary urinary incontinence during sleep. Due to its impact on a child's mental and social health, it is important to determine the prevalence of this condition among a population. Therefore, the aim of our study is to evaluate its prevalence and associated risk factors among children living in rural areas of Sindh province, Pakistan. Methods Fifteen-hundred children aged between three and 12 years of age who lived in rural areas of Sindh and visited a tertiary care hospital for various complaints were selected at random. Their parents were asked to fill in a questionnaire regarding the symptoms and risk factors of NE. The data were gathered over a period of three months, starting from June 2019 to August 2019. The data were then analyzed to draw associations between the findings. Results Out of the total 1500 participants, 570 (38%) were male and the remaining 930 (62%) were female. Among these, the majority with NE were males (70%) and children between the age of six and seven years (65%). The first and fourth to fifth born were more likely to develop symptoms of NE. There was also a positive association between family history (P=0.003), delayed milestones (0.001), psychological problems (0.005), and urinary tract infection (P=0.001). However, a child suffering from chronic illness, parasitic infection, or anemia did not have a significant relationship with developing NE. Conclusion The total prevalence of NE among rural areas was 40%, which was higher than in urban areas. This could be due to limited awareness among parents and limited healthcare facilities to manage the condition in rural areas. However, it is important to identify the symptoms of NE earlier among children to reduce the impact it leaves on them.

Redox balance and DNA fragmentation in arsenic-exposed occupational workers from different industries of Pakistan.

AbstractOccupational exposure accounts for a contact between workers and different toxicants. Present study was designed to measure the arsenic-induced DNA fragmentation and oxidative stress in exposed workers. Blood, hair, and nail samples were collected from welding, brick kiln, furniture, pesticide, and paint industries (n = 50/industry) of Pakistan along with 200 controls. DNA damage was calculated using DNA fragmentation assay. Antioxidant enzymes (CAT, SOD, GPx) were measured using ELISA. Results revealed that arsenic exposure induced DNA fragmentation in brick kiln, furniture, and welding industries. Enzyme activity was reduced in five industries compared to control. In exposed group, significant depletion of enzymes was observed in furniture, welding, and brick kiln workers. Based on age and time of exposure, significant difference was observed in welding and brick kiln group. Smokers of exposed group showed significantly reduced levels of enzymes compared to controls. Arsenic deposition was observed higher in the hair, nail, and blood samples of exposed group (P < 0.001) compared to control. Likewise, lead and cadmium contents were higher in the blood samples of industrial workers compared to control. This study suggests increased trend of cellular damage and oxidative stress in occupational workers profoundly in welding, furniture, and brick kiln industries. Moreover, this study recognizes the contribution of age, exposure time, and smoking status toward arsenic-induced oxidative stress and DNA fragmentation.