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The efficiency of the waste water treatment plant at Salah Al-deen governorate was evaluated by measuring certain physical and chemical properties. The results showed that water temperature rates (19.840C), electric conductivity (544.2 Micro Siemens/cm), pH (7.76), biological oxygen demand (40.3 mg/L.) and chloride ion concentration (209.16 mg/ L.) in drained water were accordance the Iraqi standard properties determinants. Turbidity (7.9 naphthalene turbidity unit), total hardness (396.8 mg calcium carbonate /L.), and magnesium hardness (194.3 mg magncium carbonate /L.) were removed efficiently by the station, as the removal capacity of these determinants where (93.404%), (2.935%) and (15.337) respectively. The station was not capable enough to remove the calcium hardness (202.80mg calcium carbonate/L.) and total alkalinity (345.2 mg calcium carbonate/L (. The statistical analysis of the studied factors in the station have no significant differences among the studded sites and have highly significant differences among the studded months.

Learning strategies and methods provide EFL learners opportunity to explore their knowledge, organize, compare and contrast information. To develop their skills, many teachers want their learners to be activated in classroom. Learners EFL are also in trouble to produce effective written texts that comply with the appropriate content, the organization, use those learner voice or precision, vocabulary and other mechanisms. In addition, students adequately improve their academic writing skills with the conventional learning methods like negotiations method.The current study aims at finding out whether using negotiations enhancing students’ ability in learning meaning or not.This study hypothesized that there is no statistically significant difference between the mean scores of the experimental group that is taught by negotiation of meaning and the control group which is taught by ordinary method.It is concluded that negotiation of meaning has a great significant effect on the mean score of the third stage of university learners in learning English by doing negotiations tasks.

The current research aims to know the effect of Entwistle’s model on the acquisition of morphological concepts among second grade intermediate students and their attitudes towards the Arabic language. The researcher follows the experimental design with equal groups of partial control. The researcher chooses second-grade students in the intermediate school at Al-Shaheed Ahmed Al-Fahal Secondary School for Girls. The study randomly chooses Division (A) as an experimental group with (30) female students, and Division (B) as a control group with (30) students. The results show the superiority of the experimental group students who study according to the Entwistle’s model over the students of the control group who study according to the usual method. The researcher presents a number of recommendations and suggestions including the impact of using the Entwistle’s model in acquiring language skills of different types, and the use of the Entwistle’s model in teaching Arabic to middle school students.

The current study included collection of 90 serum samples to assess the relationship between the level of vitamin D3 and some biochemical variables in women with polycystic ovarian syndrome. The samples were collected from external laboratories in Salah al-Din Governorate for the period from 10/29/2021 to 12/25/2021. 60 samples were taken for women with PCOS, and 30 samples were taken from the control group, their ages ranged between (18-40) years for healthy women and patients. Vitamin D3 level and some hormones concentrations (luteinizing hormone, follicle-stimulating hormone, and testosterone) were estimated in the blood serum of the study groups. The results of the current study showed that the level of vitamin D3 decreased significantly (P≤0.05) in women with PCOS compared to healthy women as a control group, the results showed a significant increase (P≤0.05) in the level of studding hormones (luteinizing hormone, follicle-stimulating hormone, and testosterone) in women with PCOS compared to healthy women as a control group.

The current study included the collection of 90 serum samples to assess the relationship between the level of Fetuin-A, and some biochemical variables in women with polycystic ovarian syndrome. The samples were collected from external laboratories in Salah El-Din Governorate for the period from 10/29/2021 to 12/25/2021. 60 samples of women with PCOS and 30 samples representing the control group, their ages ranged between (18-40) years for patients and healthy ones. Fetuin-A level and lipid profile were estimated in the blood serum of groups for both of women with PCOS and healthy women as a control group. The results of the study showed that the level of Fetuin-A was significantly increased at (P≤0.05) in women with PCOS compared to healthy women as a control group, and the results also showed a significant increase (P≤0.05) in the cholesterol level, Triglycerides, low-density lipoproteins, with no significant difference in the level of high-density lipoprotein- and very low-density lipoproteins in women with PCOS compared to healthy women as a control group.

هدفت الدراسة في التعرف إلى دور الدورات التدريبية في إكساب مهارات إستخدام الوسائل التعليمية. إتبعت الدراسة المنهج الوصفي التحليلي. تكون مجتمع الدراسة من معلمي مرحلة الأساس بوحدة الحصاحيصا الإدارية والبالغ عددهم (430) معلما، تم اختيارعينة الدراسة عشوائيا من (94) معلما. تم تحليل البيانات ومعالجتها من خلال برنامج الحزم الإحصائية للعلوم الاجتماعية (SPSS). توصلت الدراسة إلى النتائج التالية : تسهم الدورات التدريبية في إكساب معلمي مرحلة الأساس بوحدة الحصاحيصا مهارة اختيار الوسائل التعليمية بدرجة متوسطة ، للدورات التدريبية دور في اكساب معلمي مرحلة الأساس بوحدة الحصاحيصا لمهارة استخدام الوسائل التعليمية بدرجة متوسطة، تواجه معلمي مرحلة الأساس بوحدة الحصاحيصا صعوبات في استخدام الوسائل التعليمية بدرجة كبيرة، لا توجد فروق دالة احصائياً عند مستوى المعنوية 0.05 بين معلمي مرحلة الأساس بوحدة الحصاحيصا في درجة دور الدورات التدريبية في اكساب مهارات استخدام الوسائل التعليمية تبعاً لمتغير المؤهل التعليمي، لا توجد فروق دالة احصائياً عند مستوى المعنوية 0.05 بين معلمي مرحلة الأساس بوحدة الحصاحيصا في درجة دور الدورات التدريبية في اكساب مهارات استخدام الوسائل التعليمية تبعاً لمتغير الخبرة. توصي الدراسة بالآتي: عقد دورات تدريبية للتدريب على مهارات الوسائل التعليمية، ضرورة إعداد ورش عمل للمعلمين لتوضيح أساليب استخدام الوسائل التعليمية، التركيزعلى دعم الجهود لتحسين الوسائل التعليمية لحل مشكلات الدراسة بعامل الاوبئة التي تجتاح العالم.

Deletion of chromosome 5q is common in prostate cancer and is linked to aggressive disease. Most previous studies focused on 5q21 where CHD1 is located, but deletion of mapping studies has identified a second deletion hotspot at 5q13. To clarify the prevalence and clinical relevance of 5q13 deletions and to determine the relative importance of 5q13 and 5q21 abnormalities, a tissue microarray containing samples from 12 427 prostate cancers was analyzed by fluorescence in situ hybridization. Deletion of 5q13 and 5q21 was found in 13.5% and 10%, respectively, of 7932 successfully analyzed cancers. Deletion was restricted to 5q13 in 49.4% and to 5q21 in 32.0% of cancers with a 5q deletion. Only 18.6% of 5q-deleted cancers had deletions of both loci. Both 5q13 and 5q21 deletions were significantly linked to advanced tumor stage, high Gleason grade, nodal metastasis and early biochemical recurrence (P < .005 each). Cancers with co-deletion of 5q13 and 5q21 had a worse prognosis than cancers with isolated 5q13 or 5q21 deletion (P = .0080). Comparison with TMPRSS2:ERG fusion status revealed that 5q21 deletions were tightly linked to ERG negativity (P < .0001) while 5q13 deletions were unrelated to the ERG status. In summary, 5q13 deletion and 5q21 deletion are common, but independent genomic alterations with different functional effects lead to aggressive prostate cancer.

River Kopili, regarded as one of the most important Southern bank tributaries of the mighty river Brahmaputra, is facing a tremendous pollution threat from its riparian areas, especially in its upper stretches due to anthropogenic activities. The Central Pollution Control Board (CPCB) in one of its report has placed the Kopili river in 4th rank among the 56 most polluted river of North-East region. The results of the present study showed that water quality index [1] of the river ranges from poor to unsuitable quality of water for drinking in almost all the five sampling stations. The water quality found to be deteriorated during winter season with an average WQI value of 81.88 as compared to pre-monsoon and monsoon season with an average value of 67.13 and 80.12 respectively. According to the water quality index, station 4 and 5 are recorded to be the most polluted stations among the study area. Thus, all the above analysis showed that the riverine ecosystem is moderately polluted, which may degrade further if proper management of the riverine ecosystem is not initiated timely, which is the need of the hour to sustain the environmental integrity of the river Kopili.

Dikhow River is one of the largest tributaries of the Brahmaputra river basin originating from Yezami village near Zunheboto town of Nagaland. It debouches into the mighty river Brahmaputra river at Dikhowmukh, Sivasagar district, Asam covering a length of 255.8 km contributing 0.7% runoff. The geographical area of the Dikhow catchment is approximately 3100 km2, covering 85% of Nagaland, 10% of Assam and 5% of Arunachal Pradesh. The study area of the entire river stretch was divided into 6 stations whose elevation ranged from 90.83 msl to 669.9 msl (3 in Nagaland and 3 in Assam). These stations were selected to study the hydro-biological profile of the river stretch, its pollution status and fish diversity from January 2019 to February 2020. The important physico-chemical water quality parameters of the river in these stations like Dissolved Oxygen (5.2-10.1 mg/L), pH (7.0-8.2), Turbidity (3.8-143.8 NTU), Total Hardness (24.02-121.01 mg/L), Total alkalinity (33-89 mg/L), etc. were found to be ambient for the survival of aquatic fauna in some parts in some period of the year.

The present study was conducted to evaluate the …effect of dietary selenium on growth performance and antioxidant enzymes activity in Cirrhinus mrigala for a period of 45 days. Four numbers of experimental diets were prepared, Tc for Control (0 mg organic selenium/kg of diet), T₁ (2.5 mg organic selenium/kg of diet), T₂ (5.0 mg organic selenium/kg of diet) and T₃ (10 mg organic selenium/kg of diet). The water quality parameters (temperature, DO, pH, conductivity, hardness, ammonia, nitrate and nitrite) were found to be insignificant (p > .05) among all the treatments. Superoxidase dismutase (SOD) was found to be significantly highest in T₂ (6.10 ± 0.07) when compared with the other treatments. Similarly, catalase (CAT) activity in T₁ (13.21 ± 0.13) was significantly (p

The present communication reports an endangered catfish of the family Siluridae, Pterocryptis barakensis (Vishwanath & Sharma) for the first time outside its type locality from Brahmaputra drainage. The specimens were collected from the River Tissa, Longding district, Arunachal Pradesh foothills of Himalayan region of North East India. The current study describes morphometric and molecular characteristics of this endangered species.

Background: Imidacloprid (IMI) belongs to the class of neuro active insecticides, used to control pest and insects in agricultural crops. Reports suggest that IMI has highly toxic consequences on bees, humans and non-targeted aquatic animals. Hence the present study aims to investigate the toxicity effects of commercial-grade Imidacloprid (IMI) (Premise, 30.5%, a.i) using histological and transcriptional changes in heat shock protein 70 (HSP70) and cytochrome P4501A(CYP1A) genes in liver and gills of non-targeted aquatic animal, Cyprinus carpio. Methods: Three different sublethal concentrations of IMI (T1=26.04 mg/L, T2= 20.38 mg/L, T3=17.36 mg/L) were selected and common carp fingerlings were exposed for 28 days where histological alterations and expression study of HSP70 and CYP1A in gills and liver of exposed fishes being studied on 7, 14, 21 and 28 days interval using standard procedure. Result: Marked histological alteration like hydropic degeneration and cellular infiltration in liver; telangiectasis in secondary lamellae, epithelial lifting and oedema in gills were recorded. Moreover, significant upregulation of HSP70 and CYP1A gene in the gills and liver in a dose and time dependent manner was observed (P less than 0.05). As a result of the current investigation, it is obvious that IMI could be a possible toxicant that affects fish at the tissue and gene level in dosage and time dependent ways, potentially influencing other physiological processes in the long term.

OBJECTIVE To evaluate the clinical and radiological outcomes of the Ilizarov fixator in the proximal and distal fractures of the tibia. MATERIALS AND METHODOLOGY This retrospective study reviewed 59 patients having high-energy intra-articular proximal and distal tibia fractures associated with severe soft-tissue injury, who were managed surgically with an Ilizarov fixator. The functional outcome was evaluated by using the American Orthopaedic Foot and Ankle Society scoring system (AOFAS) and the Association for the Study and Application of the Method of Ilizarov (ASAMI) Italy scoring system for tibial plateau and plafond fractures respectively. RESULTS The most common mode of injury was road traffic accidents. According to the Gustilo open fracture classification, there were 16 patients with grade-I and nine with grade II open fractures. The remaining had closed fractures. According to the Schatzker classification of plateau fractures, 20 were graded as type V and 15 as type VI. According to the AO classification of plafond fractures, 12 fractures were graded as Type-43C1, 5 as Type-43C2, and 7 as Type-43C3. There was delayed union in 11 proximal and four distal fractures, all of which achieved union without additional bone grafting. In proximal fractures, according to AOFAS, out of 35, 26 had an acceptable while nine had a fair result. In distal fractures, according to ASAMI, out of 24, 16 had an acceptable while five had fair results. There were 192/448 wires in 58 patients with pin site infection; all were superficial and settled. Posttraumatic joint arthrosis was noted in nineteen. CONCLUSIONS The postoperative clinical and radiological outcome indicated that primary Ilizarov external fixator is a reliable minimal invasive surgery and definitive fixation method for high-energy intra-articular proximal and distal tibial fractures with compromised soft-tissue. It also offers early stabilisation and painless joint motion without a high rate of complications.

Study Design:Prospective observational cohort study.Objectives:To analyze clinical and economic results in patients with degenerative disc disease in the lumbar area for patients who received combined anterior and posterior fusion or total disc replacement (TDR).Methods:The study included 75 patients, 38 in the fusion group and 37 in the TDR group, who received either anterior/posterior fusion or TDR for lumbar disc disease from January 2005 to December 2008 with a minimum follow-up of 24 months. We collected data with regard to clinical parameters, demographics, visual analogue scale scores, Oswestry Disability Index scores, SF-36 and SF-6D data, surgery time, amount of blood loss, transfusion of blood products, number of levels, duration of hospital stay, and complications. For cost analysis, general infrastructure, theatre costs, as well as implant costs were examined, leading to primary hospital costs. Furthermore, average revision costs were examined, based on the actual data. Statistical analysis was performed using t tests for normal contribution and Mann-Whitney test for skew distributed values. The significance level was set to .05.Results:There was a higher surgery time, more blood loss, and longer hospital stay for the fusion group, compared with the TDR group. In addition, the hospital costs for the primary procedure and revision were 35% higher in the fusion group. The clinical data in terms of SF-36 and SF-6D showed no difference between these 2 groups.Conclusions:TDR is a good alternative to anterior and posterior lumbar fusion in terms of short follow-up analysis for clinical data and cost analysis. General advice cannot be given due to missing data for long-term costs in terms of surgical treatment of adjacent level or further fusion techniques.

The human body is a flexible structure which naturally resists external forces. When these forces exceed the safe limits, deformation in a structure is produced. The present study is carried out on the arm of an industrial worker to determine the risk of musculoskeletal disorder. It has been observed that during machine operations, vibrations are mostly experienced by arms which cause degradation of internal human structure. Worker can suffer from the Hand-Arm Vibration Syndrome (HAVS) with direct exposure to vibrations. In order to examine the effect of these disturbances, a 3-D model of human arm is created in SolidWorks followed by analysis in ANSYS to obtain the response of the human arm. In addition, the magnitude of vibrations being transmitted to the human arm is measured using experimental setup. These obtained values are further used to limit the timeframe of the use of devices available at the workplace using vibration exposure calculator. In accordance to the Health and Safety Executive standards, if vibration exposure points exceed the value of 400, a person is under the huge risk of HAVS. It has been shown from the analytical and experimental study that the degradation of the internal human structure is exponential due to continuous vibrations experienced by the human body and it increases the likelihood of musculoskeletal disorders. In severe cases, if magnitude of vibrations matches the resonance frequency of internal human structure, it may lead towards fracture.

Resume Alors que l’orthodontiste concentre de grands efforts sur le diagnostic et le traitement des patients, il porte moins d’attention a l’evolution post-therapeutique et le risque de recidives souvent causees par la croissance tardive des arcades et des bases osseuses. L’objectif de ce travail est donc de determiner les changements de la croissance qui peuvent affecter les dimensions craniofaciales chez les sujets entre les âges de 13 et 17 ans. Une etude longitudinale retrospective incluant 50 patients (31 filles et 19 garcons), dont la fin du traitement orthodontique a coincide avec la fin de la periode postpubertaire (13–14 ans), a permis de comparer les analyses cephalometriques pour chaque patient, entre T1 (fin de traitement orthodontique) et T2 (fin de contention). L’etude a montre des changements des dimensions craniofaciales postpubertaires dans les sens vertical et sagittal. Les filles et les garcons ne presentent pas le meme potentiel de croissance apres l’âge de 13 ans. Le phenomene de croissance residuelle est plus important chez les garcons que chez les filles avec, d’une part, une augmentation des dimensions craniofaciales postpubertaires qui atteint essentiellement la mandibule et d’une facon moindre le maxillaire dans le sens sagittal et, d’autre part, une diminution de la dimension verticale.

Key points Spasticity is a disorder of muscle tone that is associated with lesions of the motor system. This condition involves an overactive spinal reflex loop that resists the passive lengthening of muscles. Previously, we established that application of anodal trans-spinal direct current stimulation (a-tsDCS) for short periods of time to anaesthetized mice sustaining a spinal cord injury leads to an instantaneous reduction of spasticity. However, the long-term effects of repeated a-tsDCS and its mechanism of action remained unknown. In the present study, a-tsDCS was performed for 7 days and this was found to cause long-term reduction in spasticity, increased rate-dependent depression in spinal reflexes, and improved ground and skill locomotion. Pharmacological, molecular and cellular evidence further suggest that a novel mechanism involving Na-K-Cl cotransporter isoform 1 mediates the observed long-term effects of repeated a-tsDCS. Abstract Spasticity can cause pain, fatigue and sleep disturbances; restrict daily activities such as walking, sitting and bathing; and complicate rehabilitation efforts. Thus, spasticity negatively influences an individual's quality of life and novel therapeutic interventions are needed. We previously demonstrated in anaesthetized mice that a short period of trans-spinal subthreshold direct current stimulation (tsDCS) reduces spasticity. In the present study, the long-term effects of repeated tsDCS to attenuate abnormal muscle tone in awake female mice with spinal cord injuries were investigated. A motorized system was used to test velocity-dependent ankle resistance and associated electromyographical activity. Analysis of ground and skill locomotion was also performed, with electrophysiological, molecular and cellular studies being conducted to reveal a potential underlying mechanism of action. A 4 week reduction in spasticity was associated with an increase in rate-dependent depression of spinal reflexes, and ground and skill locomotion were improved following 7 days of anodal-tsDCS (a-tsDCS). Secondary molecular, cellular and pharmacological experiments further demonstrated that the expression of K-Cl co-transporter isoform 2 (KCC2) was not changed in animals with spasticity. However, Na-K-Cl cotransporter isoform 1 (NKCC1) was significantly up-regulated in mice that exhibited spasticity. When mice were treated with a-tsDCS, down regulation of NKCC1 was detected, and this level did not significantly differ from that in the non-injured control mice. Thus, long lasting reduction of spasticity by a-tsDCS via downregulation of NKCC1 may constitute a novel therapy for spasticity following spinal cord injury.

Objective Burnout is exceptionally pervasive among medical professionals, especially surgeons, and is considered the main indicator of surgeons' fulfillment with career choice. Our objectives are to discover the extent of orthopedic specialist burnout in Pakistan and to explore the clinical impact of burnout. The efficacy of surgeons may be enhanced by implementing burnout prevention and treatment plans. Data collection This observational study was conducted from April 2018 to May 2018 in various tertiary care hospitals in Pakistan and includes post-graduate trainees and consultants. Those who agreed to be part of this study were asked to complete a self-structured questionnaire about demographics and burnout. The questionnaire had 28 questions based on a standard questionnaire from the American Public Welfare Association. Results In our study, 15% (n=15) of respondents had advance burnout, 22% (n=22) had early burnout, and 43% (n=49) had a fair chance of burnout. All 15 participants suffering from advance burnout were consultants. Of participants suffering from early burnout, 36.3% (n=8) were consultants, and 63.7% (n=14) were post-graduate trainees. Conclusion Compared to other countries, the burnout rate is higher among Pakistani orthopedic surgeons. Special care and attention should be paid towards the stress and workload of surgeons.

Deletion of 12p is a recurrent alteration in prostate cancer, but the prevalence and clinical consequences of this alteration have not been studied in detail. Dual labeling fluorescence in situ hybridization using probes for 12p13 (CDKN1B; p27) and centromere 12 as a reference was used to successfully analyze more than 3700 prostate cancers with clinical follow-up data assembled in a tissue microarray format. CDKN1B was selected as a probe because it is located in the center of the deletion, which spans > 10 Mb and includes > 50 genes in 80% of cancers with 12p deletion. Deletion of 12p was found in 13.7% of cancers and included 13.5% heterozygous and 0.2% homozygous deletions. 12p deletion were linked to advanced tumor stage (p < 0.0001), high Gleason grade (p < 0.0001), rapid tumor cell proliferation (p < 0.0001), lymph node metastasis (p = 0.0004), and biochemical recurrence (p = 0.0027). Multivariate analysis including pT stage (p < 0.0001), Gleason grade (p < 0.0001), pN status (p = 0.0001), preoperative PSA levels (p = 0.0001), and resection margin status (p = 0.0001) revealed an independent prognostic value of 12p deletion (p = 0.0014). Deletion of 12p was unrelated to the ERG fusion status. Deletion of 12p was only marginally linked to reduced p27 expression, which by itself was unrelated to clinical outcome. This argues against p27 as the key target gene of 12p deletions. In summary, the results of our study demonstrate that 12p deletion is frequent in prostate cancer and provides independent prognostic information. 12p deletion analysis alone, or in combination with other prognostic parameters may thus have clinical utility.

New experimental data are reported for water based nanofluids to enhance the heat transfer performance of a car radiator. ZnO nanoparticles have been added into base fluid in different volumetric concentrations (0.01%, 0.08%, 0.2% and 0.3%). The effect of these volumetric concentrations on the heat transfer performance for car radiator is determined experimentally. Fluid flow rate has been varied in a range of 7–11 LPM (liter per minute) (corresponding Reynolds number range was 17,500–27,600). Nanofluids showed heat transfer enhancement compared to the base fluid for all concentrations tested. The best heat transfer enhancement up to 46% was found compared to base fluid at 0.2% volumetric concentration. A further increase in volumetric concentration to 0.3% has shown a decrease in heat transfer enhancement compared to 0.2% volumetric concentration. Fluid inlet temperature was kept in a range of 45–55 °C. An increase in fluid inlet temperature from 45 °C to 55 °C showed increase in heat transfer rate up to 4%.

The proximity of the femoral nerve to the femoral artery renders it vulnerable to injury during transfemoral percutaneous catheterization (TPC) procedures.To determine the incidence of femoral nerve injury in patients undergoing cardiac catheterization in a nationally representative inpatient database.We analyzed data released annually from the Nationwide Inpatient Sample. We pooled data from 2002 to 2010 and, using the ICD-9-CM procedure codes, identified patients who underwent TPC. We subsequently identified occurrences of femoral nerve injury in this cohort. Baseline characteristics, comorbid conditions, in-hospital complications, and discharge outcomes-including mortality, mild disability, and moderate-to-severe disability-were compared between patients with femoral neuralgia and those without.Of the 15,894,201 patients who underwent percutaneous catheterization procedures, 597 (3.8 per 100,000 procedures) developed femoral nerve injury. The incidence of femoral nerve injury was higher in women: 57% versus 39%,Femoral nerve injury is a rare complication of percutaneous catheterization procedures that may increase the likelihood of moderate-to-severe disability at patient's discharge.

Deletion of 12p is a recurrent alteration in prostate cancer, but the prevalence and clinical consequences of this alteration have not been studied in detail. Dual labeling fluorescence in situ hybridization using probes for 12p13 (CDKN1B; p27) and centromere 12 as a reference was used to successfully analyze more than 3700 prostate cancers with clinical follow-up data assembled in a tissue microarray format. CDKN1B was selected as a probe because it is located in the center of the deletion, which spans > 10 Mb and includes > 50 genes in 80% of cancers with 12p deletion. Deletion of 12p was found in 13.7% of cancers and included 13.5% heterozygous and 0.2% homozygous deletions. 12p deletion were linked to advanced tumor stage (p < 0.0001), high Gleason grade (p < 0.0001), rapid tumor cell proliferation (p < 0.0001), lymph node metastasis (p = 0.0004), and biochemical recurrence (p = 0.0027). Multivariate analysis including pT stage (p < 0.0001), Gleason grade (p < 0.0001), pN status (p = 0.0001), preoperative PSA levels (p = 0.0001), and resection margin status (p = 0.0001) revealed an independent prognostic value of 12p deletion (p = 0.0014). Deletion of 12p was unrelated to the ERG fusion status. Deletion of 12p was only marginally linked to reduced p27 expression, which by itself was unrelated to clinical outcome. This argues against p27 as the key target gene of 12p deletions. In summary, the results of our study demonstrate that 12p deletion is frequent in prostate cancer and provides independent prognostic information. 12p deletion analysis alone, or in combination with other prognostic parameters may thus have clinical utility.

The risk of catheter-based angiograms alone (non-therapeutic angiogram that does not lead to therapeutic intervention) in acute ischemic stroke patients who are considered for endovascular treatment is not well studied.We compared the rates of neurological deterioration within 24 h; symptomatic intracranial hemorrhage (ICH) within 30 h; acute kidney injury (AKI) and major non-ICH within five days; and functional independence (defined by modified Rankin scale of 0-2) at three months among subjects who underwent a non-therapeutic catheter-based angiogram with subjects who did not undergo catheter-based angiogram in a multicenter clinical trial. Logistic regression analyses was performed to adjust for age, baseline Alberta stroke program early CT score (ASPECTS) strata (0-7 and 8-10), and baseline National Institutes of Health Stroke Scale (NIHSS) score strata (≤9, 10-19, and ≥20).Compared with subjects who did not undergo any catheter-based angiogram (Non-therapeutic catheter-based angiograms in acute ischemic stroke patients who are being considered for endovascular treatment do not adversely affect patient outcomes.

Summary Although orthodontists focus intensively on the diagnosis and treatment of their patients, they pay less attention to post-treatment development and the risk of relapse often caused by the late growth of the arches and bony base. The aim of this study, therefore, was to determine the growth changes, which can affect craniofacial dimensions in subjects aged between 13 and 17 years. A retrospective longitudinal study including 50 patients (31 girls and 19 boys) whose end of orthodontic treatment coincided with the end of the post-pubertal period (13–14 years) involved a comparison of the cephalometric analyses for each patient between T1 (end of orthodontic treatment) and T2 (end of retention). The study evidenced changes in the post-pubertal craniofacial dimensions in the vertical and sagittal dimensions. Girls and boys do not have the same potential for growth at the age of 13 years. The residual growth phenomenon is more present in boys than in girls with, on the one hand, an increase in the post-pubertal craniofacial dimensions affecting the mandible more particularly and, to a lesser degree, the maxillary sagittal dimension associated with a decrease in the vertical dimension.

There are little published data on the natural history and evolution of thoracolumbar kyphotic deformity in achondroplasia. Furthermore, there are few published reports indicating the probability of symptoms and at what kyphotic angle progressive deformity might occur. The lack of knowledge of the fundamental natural history does not allow firm guidelines for the management of this problem. In this respect the role of bracing remains uncertain both in terms of altering the prognosis for further vertebral wedging and overall sagittal profile. This report describes three illustrative cases of thoracolumbar kyphosis (TLK) that occurred in achondroplastic infants. The long-term outcomes are presented to illustrate the diverse clinical behaviour of TLK in this patient group.

The rare combination of sickle cell trait with hereditary spherocytosis in a Sudanese family is reported. The splenic hypofunction and fibrosis as a result of sickling has ameliorated the clinical course of the 35 year old father. The symptoms of a six years old son seem to be getting milder with age too. The family is managed conservatively and splenectomy was not required.

Purpose To investigate the relationship between preoperative and postoperative spinopelvic alignment and occurrence of DJK/DJF. Study design/setting This was a retrospective observational cohort study. Patient sample The sample included 40 patients who underwent posterior correction of SK from January 2006 to December 2014. Outcome measures Correlation analysis between the preoperative and postoperative spinopelvic alignment parameters and development of DJK over the course of the study period were studied. Methods Whole spine X-rays obtained before surgery, 3 months after surgery and at the latest follow-up were analyzed. The following parameters were measured: maximum of thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lower instrumented vertebra (LIV) and LIV plumb line. Development of DJK was considered as the primary end point of the study. The patient population was split into a control and DJK group, with 34 patients and 6 patients, respectively. Statistic analysis was performed using unpaired t test for normal contribution and Mann–Whitney test for skew distributed values. The significance level was set to 0.05. Results DJK occurred in 15% (n = 6) over the study period. There was a significantly lower postoperative TK for the group with DJK (42.4 ± 5.3 vs 49.8 ± 6.7, p = 0.015). LIV plumb line showed higher negative values in the DJK group (−43.6 ± 25.1 vs −2.2 ± 17.8, p = 0.0435). Furthermore, postoperative LL changes were lower for the DJK group (33.84 ± 13.86% vs 31.77 ± 14.05, p < 0.0001.) The age of the patients who developed DJK was also significantly lower than that of the control group (16.8 ± 1.7 vs 19.6 ± 4.9, p = 0.0024.) Conclusions SK patients who developed DJK appeared to have a significantly higher degree of TK correction and more negative LIV plumb line. In addition, there may be a higher risk for DJK in patients undergoing corrective surgery at a younger age.

Lumbar catheter placement under fluoroscopic guidance may reduce the rate of technical failures and associated complications seen with insertion guided by manually palpable landmarks.We reviewed our experience with 43 attempted lumbar catheter placements using paramedian approach under fluoroscopic guidance and ascertained rates of technical success, and clinical events.Among the 43 patients, 18, 1, and 1 patients were on aspirin (with dipyrimadole in 2), clopidogrel, and combination of both, respectively. Lumbar catheter placement was successful in 42 of 43 attempted placements. Floroscopic guidance was critical in three patients; one patient had severe cerebrospinal fluid (CSF) depletion (empty thecal sac phenomenon) following pituitary surgery leading to no cerebrospinal fluid return despite correct placement confirmation under fluoroscopy. Two patients had spinal needle placement at the junction between epidural and cerebrospinal fluid spaces (junctional position) leading to cerebrospinal fluid return but inability to introduce the lumbar catheter. After confirmation of position by the injection of contrast or radiographic landmarks the needle was advanced by indenting the subcutaneous tissue or reinserting at a spinal level above the first insertion. The lumbar catheter remained in position over a mean period (±standard deviation) of 4.1(±2.3) days. Improvement in hydrocephalus was seen in two patients with intracranial mass lesions. One patient developed cerebrospinal fluid leakage through the insertion track following removal of catheter and required skin suturing at the site of insertion.We observed a high technical success rate with low rate of complications even in patients with intracranial mass lesions, those on ongoing antiplatelet medications or in whom insertion would not be possible guided by manually palpable landmarks.

Sudden cardiac death is the dominant reason of sudden unexpected death in epilepsy (SUDEP). Anecdotal reports have documented cardiac arrest during video electroencephalographic (EEG) monitoring. We performed this study to determine the rate of cardiac arrest and need for cardiac resuscitation during video EEG monitoring.We used inpatient data from the Centers for Medicare and Medicaid Services (CMS)'s Linkable 2008-2010 Medicare Data Entrepreneur's Synthetic Public Use File. Using the International Classification of Diseases 9th revision (ICD-9) primary diagnosis codes, we identified patients with epilepsy. We used the primary or secondary ICD-9 procedure codes to identify patients who underwent video EEG during admission. For primary endpoints, we identified patients who suffered cardiac arrest and those who underwent cardiorespiratory resuscitation (CPR).A total of 6,087 patients (mean age 76±12 years; 3,354 women) were included; 5,597 patients had a primary diagnosis of epilepsy and no video EEG, 240 patients had a primary diagnosis of epilepsy and underwent video EEG, and 250 patients underwent a video EEG without any diagnosis of epilepsy. A total of 12 patients (0.2%, 95% CI: 0.7-0.8) suffered a cardiac arrest during their admission. Three patients (0.1%) underwent CPR during their admission. There was no in-hospital mortality. None of the patients in those undergoing video EEG suffered cardiac arrest or underwent CPR.While the risk of cardiac arrest during video EEG monitoring may exist, the rate of such events was negligible in our study comprising of elderly Medicare patients.

Anecdotal reports suggesting that survival rates among hospitalized patients with Ebola virus disease in Guinea are higher than the 29.2% rate observed in the current epidemic in West Africa.Survival after symptom onset was determined using Kaplan Meier survival methods among patients with confirmed Ebola virus disease treated in Conakry, Guinea from March 25, 2014, to August 5, 2014. We analyzed the relationship between survival and patient factors, including demographics and clinical features.Of the 70 patients analyzed [mean age ± standard deviation (SD), 34 ± 14.1; 44 were men], 42 were discharged alive with a survival rate among hospitalized patients of 60% (95% confidence interval, 41.5-78.5%). The survival rate was 28 (71.8%) among 39 patients under 34 years of age, and 14 (46.7%) among 30 patients aged 35 years or greater (p = 0.034). The rates of myalgia (3 of 42 versus 7 of 28, p = 0.036) and hiccups (1 of 42 versus 5 of 28, p = 0.023) were significantly lower among patients who survived.Our results provide insights into a cohort of hospitalized patients with Ebola virus disease in whom survival is prominently higher than seen in other cohorts of hospitalized patients.

This paper deals with the causal relation between military spending and economic growth of a state. There are three schools of thought on this issue: military spending promotes economic growth; it retards economic growth; and there exists no causal relations between the two. Pakistan's military spending – being indispensable because of the existing threat perception – has been considered as a burden on the national economy. This paper argues that military spending as part of the budgetary expenditure does not all go in the drain. Its role in the economic development of Pakistan – if less in economic growth – cannot be neglected. However, their indirect impact on the economic growth of Pakistan has been substantial. Technological advancement, provision of security, military's social uplift projects which positively affect the 'health' of the economy, military's ancillary institutions like Fauji Foundation, Bahria Foundation, Shaheen Foundation, Army Welfare Trust (AWT) are performing their role directly in the economic growth of the state. Importantly, Arms trade internationally has been contributing trillions of dollars in various states economies. This paper suggests that defence industrial capacity and efficiency can be improved in order to increase the output, which in turn, would help the state's economy by earning millions of dollars through arms sale at the international arena and by ensuring the continued supply of necessary equipment to its armed forces, especially in the times of crises – which in turn, may not only ensure the security of the Pakistan, but also reducing the political leverage being held by great powers on Pakistan. To achieve the target, as a first step, efficient planning be done so as to make the defence industry self-sufficient, and in the long-run to strengthen it to support the overall military spending. This way, it would not only contribute to the economic development, but also in the economic growth of Pakistan., Cet article traite de la relation causale entre les dépenses militaires et la croissance économique d'un État. Il existe trois écoles de pensée sur cette question: les dépenses militaires favorisent la croissance économique; il retarde la croissance économique; et il n'existe aucune relation causale entre les deux. Les dépenses militaires du Pakistan - indispensables en raison de la perception actuelle de la menace - ont été considérées comme un fardeau pour l'économie nationale. Cet article soutient que les dépenses militaires dans le cadre des dépenses budgétaires ne vont pas toutes à l'égout. Son rôle dans le développement économique du Pakistan - s'il est moindre dans la croissance économique - ne peut être négligé. Cependant, leur impact indirect sur la croissance économique du Pakistan a été considérable. Les progrès technologiques, la fourniture de la sécurité, les projets de renforcement social de l'armée qui affectent positivement la `` santé '' de l'économie, les institutions auxiliaires de l'armée comme la Fondation Fauji, la Fondation Bahria, la Fondation Shaheen, l'Army Welfare Trust (AWT) jouent directement leur rôle dans la croissance économique de l'État. Surtout, le commerce international des armes a apporté des milliards de dollars dans les économies de divers États. Ce document suggère que la capacité et l'efficacité de l'industrie de la défense peuvent être améliorées afin d'augmenter la production, ce qui à son tour aiderait l'économie de l'État en gagnant des millions de dollars grâce à la vente d'armes sur la scène internationale et en assurant l'approvisionnement continu des équipements nécessaires pour ses forces armées, en particulier en temps de crise - qui à son tour peuvent non seulement assurer la sécurité du Pakistan, mais aussi réduire l'influence politique détenue par les grandes puissances sur le Pakistan. Pour atteindre cet objectif, dans un premier temps, une planification efficace doit être effectuée afin de rendre l'industrie de la défense autosuffisante et, à long terme, de la renforcer pour soutenir les dépenses militaires globales. De cette façon, cela contribuerait non seulement au développement économique, mais aussi au croissance économique du Pakistan.

Running Title: Sympathetic Block for Ventricular Tachycardia Storm.We present the case of a patient with ventricular tachycardia storm refractory to medical therapy and multiple catheter ablations, successfully managed by percutaneous left inferior cervical sympathetic ganglion block.A 70-year-old man with a history of ischemic cardiomyopathy and previous placement of implantable defibrillator developed intractable ventricular tachycardia recalcitrant to intravenous amiodarone, lidocaine, and multiple catheter ablations with radiofrequency energy and direct current. The patient received numerous defibrillator shocks that did not result in sustained restoration of sinus rhythm. A percutaneous inferior cervical sympathetic ganglion block was performed under fluoroscopic guidance, with the administration of bupivacaine by infiltration of the tissue between the left internal carotid artery and the cervical vertebral bodies.Two and a half hours after the procedure, ventricular tachycardia converted to sinus rhythm. One month after discharge from the hospital, the patient remained free from sustained ventricular tachycardia and did not report discharges from his implantable defibrillator.Percutaneous cervical sympathetic ganglion blockade appears to be an effective intervention in the treatment of ventricular tachycardia storm. Additional data are required before incorporating this technique into the management algorithm of incessant ventricular tachycardia.

Prostate cancer is characterized by structural rearrangements, most frequently including translocations between androgen-dependent genes and members of the ETS family of transcription factor like TMPRSS2:ERG. In a recent whole genome sequencing study we identified 140 gene fusions that were unrelated to ETS genes in 11 prostate cancers. The aim of the present study was to estimate the prevalence of non-ETS gene fusions. We randomly selected 27 of these rearrangements and analyzed them by fluorescence in situ hybridization (FISH) in a tissue microarray format containing 500 prostate cancers. Using break-apart FISH probes for one fusion partner each, we found rearrangements of 13 (48%) of the 27 analyzed genes in 300-400 analyzable cancers per gene. Recurrent breakage, often accompanied by partial deletion of the genes, was found for NCKAP5, SH3BGR and TTC3 in 3 (0.8%) tumors each, as well as for ARNTL2 and ENOX1 in 2 (0.5%) cancers each. One rearranged tumor sample was observed for each of VCL, ZNF578, IMMP2L, SLC16A12, PANK1, GPHN, LRP1 and ZHX2. Balanced rearrangements, indicating possible gene fusion, were found for ZNF578, SH3BGR, LPR12 and ZHX2 in individual cancers only. The results of the present study confirm that rearrangements involving non-ETS genes occur in prostate cancer, but demonstrate that they are highly individual and typically non-recurrent.

Splenic function in 35 Saudi children homozygous for sickle cell disease (age range 3-9 years) was studied using radioactive colloid scans. Two different patterns emerged. Splenic dysfunction was demonstrated in more than 80% of children who were originally from the south-western part of the country. They were found to have low HbF levels. In contrast normal or nearly normal splenic function was found in all patients from the Eastern Province in whom HbF levels were high. These different patterns of splenic function may contribute to the severe and mild forms of sickle cell disease seen in Saudi Arabia.

Location-aided routing (LAR) is a mechanism which attempts to reduce the control message overhead of Ad-hoc on-demand distance vector (AODV) routing protocol by flooding only the portion of the network that is likely to contain the route to destination. LAR takes advantage of Global Positioning System (GPS) coordinates to identify a possible location of the destination node. Based on this information, LAR defines a portion of the network which will be subject to the limited flooding, thus reducing the total number of the control packet traveling through the network during the route discovery process. GeoAODV is a variation of the AODV protocol which like LAR also employs GPS coordinates to limit the search area used during the route discovery process. However, unlike LAR, GeoAODV does not make the assumption that every node in the network knows the traveling speed and location of the corresponding destination node. Instead, GeoAODV tries to dynamically learn and distribute location information among the nodes in the network. This paper examines and compares through simulation the performance of AODV, LAR, and GeoAODV protocols under different environmental settings.

Forty children homozygotes for sickle-cell disease (SCD) aged 2-5 years were enrolled in a study to assess the efficacy of pneumococcal vaccine combined with penicillin prophylaxis in preventing pneumococcal infection. The vaccine was given initially and then every 2 years as a booster. In addition to pneumococcal vaccine, 24 children were prescribed penicillin-V orally twice daily while the remaining 16 were given benzathine penicillin intramuscularly every 4 weeks in the clinic. The study period lasted for 4 years during which the clinic attendance rate of both groups was 90% and 92% respectively. The compliance with oral penicillin intake was checked by random urine testing for penicillin. The test was positive in 128 out of 320 urine samples (40%). The parenteral penicillin was given at every clinic visit and the rate of compliance was 92%. Twelve episodes of bacterial sepsis were documented: 10 of them were caused by Gram-negative organisms. The pneumococcus caused a fatal episode of septicaemia and meningitis in a child who did not comply with penicillin prophylaxis. In a retrospective search, 15 episodes of bacterial sepsis have been documented in 22 children receiving no prophylaxis for 2 years. Eight of those episodes were caused by the pneumococcus. The combination of pneumococcal vaccine with penicillin prophylaxis was effective in preventing pneumococcal sepsis in children with SCD followed up for 153 patients years.