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Aim. Using in silico technologies to search for potential SARS-CoV-2 inhibitors among novel tetracyclic ring systems, which are the common core of Crinipellin.Materials and methods. The study object was new compounds previously synthesized via oxidative dearomatization of Crinipellin A. The method of the flexible molecular docking was applied in the study.Results and discussion. Using the molecular docking, the affinity of five compounds for the receptor-ACE2 SARS-CoV-2 (PDB ID: 7DF4), a spike protein SARS-CoV-2 (PDB ID: 1WNC), a PL protein SARS-CoV-2 (PDB ID: 7CJD) and a reverse transcriptase enzyme SARSCoV-2 (PDB ID: 6YYT) was studied. The results of the molecular docking obtained suggest that 8,8-dimethyl-5-(phenylsulfonyl)-3,3a,4,5,8,9-hexahydroindeno[3a,4-b]furan-2(7H)-one may be a potential SARS-CoV-2 inhibitor; it is the basis for its further experimental pharmacological study.Conclusions. The study constitutes one of the stages of searching for SARS-CoV-2 inhibitors. According to the results obtained, a way to search for potential SARS-COV-2 inhibitors based on Crinipellin A derivatives was proposed. Using the most promising compound with hexahydroindeno[3a,4-b]furan core further studies open up another direction for searching for compounds of SARS-COV-2 inhibitors and will save time and laboratory animals while conducting targeted experimental research.

As a follow-up to an earlier report on the antihyperlipidaemic activity guided fractionation study on the chloroform extract from the sclerotia of the edible mushroom Pleurotus tuber regium, this present study is reporting the isolation of a sesquiterpene enol carboxylic from the active chromatography fraction of the chloroform extract of this edible mushroom. The purity of the compound was confirmed from TLC and Melting point determination. The chemical structure was elucidated using spectroscopic techniques (Mass spectrometry, 1&2D Nuclear magnetic resonance and Infra red spectroscopy). The isolated compound coded as compound P, exhibited molecular mass of 256 with molecular formular of C14H24O4 and from the 1 &2D NMR and IR analyses, the compound P was identified as a sesquiterpene enol carboxylic acid with a sytemic name of 2,3-dihydroxy-10-propylcyclodec-2-ene-1-carboxylic acid.

Background We recently described the tumor immune microenvironment (TIME) in oral squamous cell carcinomas (OSCC) from Sudan by assessing the core of the lesions. However, the invasive tumor front (ITF) is the most active part of OSCC lesions; thus, TIME should also be characterized at the ITF in this patient cohort. Objectives We aimed to evaluate patterns of immune cell infiltration at the ITF in a cohort of OSCC patients from Sudan previously investigated at the tumor center and their association with clinicopathological parameters. Methods This study was performed on a prospective cohort of 22 OSCC patients attending Khartoum Dental Teaching Hospital with a median follow-up of 48 months. Inflammatory infiltrate densities of CD4-, CD8-, FoxP3-, CD20-, CD66b-, M1 (CD80/CD68)-, M2 (CD163/CD68)-, and PD-L1-positive cells were assessed at the ITF by immunohistochemistry, followed by digital quantitative analysis at the stromal and epithelial compartments separately. Histopathological parameters such as the worst pattern of invasion, differentiation, and tumor budding (TB) were also assessed. Correlations between clinicopathological parameters and survival analysis were investigated using SPSS. Results All inflammatory cell subsets investigated were found to be higher in the stromal compartment as compared to the epithelial one, except for the PD-L1+ subset. Stromal infiltration with the CD8+ cell subset was associated with low TB. Kaplan–Meier analyses identified higher epithelial and stromal CD4+ cell subsets. The presence of PD-L1 was found to be associated with unfavorable overall survival. Further, Cox's regression analysis using an age- and tumor-stage-adjusted model identified epithelial PD-L1 expression at the ITF as the only independent prognosticator. Conclusions Epithelial PD-L1 expression at the ITF was found to be an independent prognostic biomarker for OSCC in a cohort of Sudanese patients. publishedVersion

Funding Acknowledgements Type of funding sources: None. Background Long QT syndrome (LQTS) is an inherited primary arrhythmia syndrome associated with life-threatening ventricular arrhythmia. Objective To report the clinical and genetic characteristics and outcome of LQTS patients in single center inherited arrhythmia clinic. Methods Retrospective review of patients diagnosed LQTS and evaluated by ECG, 12 lead holter, exercise test and genetic testing in inherited arrhythmia clinic from January 212 to January 2022. Results 101 patients (32 families) were included, mean age 24.3± 17 years. Thirteen patients (12.8%) were diagnosed after previous cardiac arrest and six patients (6%) had syncope. Seventy (69.3%) were identified as having LQTS during family screening. 97 patients (97%) were confirmed to have a pathogenic mutation for LQTS genes. Beta blockers were recommended to 74 patients (73%), flecainide to 20 (19.8%). Nine patients (8.9%) received an ICD for secondary prevention and one patient (1%) for primary prevention. During 5.8 ± 2.7 years, dose of beta-blockers increased from propranolol 70 ±42 mg to 105 ±60.3 mg (p= 0.0004), QTC shortening (479 ± 36.9 to 466 ±30.1 msec, p=0.01) in ECG and maximal QTC measured in 12 lead holter (521± 43.9 to 505± 37.8 msec, p=0.01). Maximal heart rates measured in 12 lead holter and exercise test were reduced ( 130± 24.5 to 116 ± 20.2 beats/min p=0.0001 and 152.6±22 to 145± 20.58 beats/min, p=0.043). Seven patients (6.9%) experienced ventricular arrhythmia, five received appropriate ICD shock and two patients that declined beta blockers experienced syncope due to polymorphic ventricular tachycardia and cardiac arrest. The one patient that had the ICD for primary prevention, experienced polymorphic ventricular tachycardia that was successfully treated by the ICD. Conclusions Intensive clinical follow up and an optimal medical therapy in a specialized arrhythmia clinic is associated with a relatively low incidence of sudden cardiac death and a low rate of ICD utilization in LQTS patients.

The study aimed at undertaking preliminary phytochemical studies and antifungal activities of Lawsonia inermis leaf extracts against clinical Candida isolates from female patients attending Dalhatu Araf Specialist Hospital (DASH) Lafia, Nasarawa State. HVS (High Vaginal Swab) samples were collected from 185 subjects and transported to the laboratory for analysis. Microbial culture and isolations were done on Sabouraud dextrose agar (SDA), Blood agar, Potato dextrose agar (PDA) and Sabouraud dextrose broth. Identification of clinical isolates was done following standard guideline for Candida identification including microscopic, cultural and biochemical characteristics (sugar utilization and fermentation). Antifungal susceptibility tests of the plant extracts at different concentrations were carried out against Candida isolates. Distilled water and ketoconazole drug served as negative and positive control respectively. Zones of inhibitions, the minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) of the extracts were determined. Data were analysed on the Minitab 16.0 software for descriptive (mean with standard error) and inferential statistics and Chi Square at 95% confidence limit. In conclusion, L.inermis leaf has been shown to have antifungal properties since it contained quality phytochemicals in sufficient quantity that may be explored in the synthesis of drugs against some species of Candida. This finding is crucial in the management and control of candidiasis in the study.

BackgroundSkeletal muscle is the main site for insulin-dependent glucose disposal. The hyperinsulinemic euglycemic clamp (HIEC) is the gold standard for the assessment of insulin sensitivity (IS). We have previously shown that insulin sensitivity, measured by HIEC, varied widely among a group of 60 young healthy men with normoglycemia. The aim of this study was to correlate the proteomic profile of skeletal muscles to insulin sensitivity.MethodsMuscle biopsies from 16 subjects having the highest (M ≥ 13; n = 8, HIS) and lowest (M ¾ 6, n = 8, LIS) IS were obtained at baseline and during insulin infusion after stabilization of the blood glucose level and glucose infusion rate at the end of the HIEC. The samples were processed using a quantitative proteomic analysis approach.ResultsAt baseline, 924 proteins were identified in the HIS and LIS groups. Among the 924 proteins detected in both groups, three were suppressed and three were increased significantly in the LIS subjects compared with the HIS subjects. Following insulin infusion, 835 proteins were detected in both groups. Among the 835 proteins, two showed differential responsiveness to insulin; ATP5F1 protein was decreased, and MYLK2 was higher in the LIS group compared with that in the HIS group. Our data suggest that alteration in mitochondrial proteins and an increased number of proteins involved in fast-twitch fiber correlate to insulin sensitivity in healthy young Arab men.ConclusionsThese results suggest a change in a small number of differentially expressed proteins. A possible reason for this small change could be our study cohorts representing a homogeneous and healthy population. Additionally, we show differences in protein levels from skeletal muscle in low and high insulin sensitivity groups. Therefore, these differences may represent early events for the development of insulin resistance, pre-diabetes, and type 2 diabetes.

Background: Over the years, the scope of practice for the pharmacy profession has considerably broadened and several practice areas can now be chosen by young pharmacy graduates. However, not much is known about the career preferences of Nigerian pharmacy students.Objectives: To explore factors influencing the choice of a pharmacy degree, career preferences and perceptions of pharmacy practice areas in final year pharmacy students at selected universities in Northern Nigeria.Methods: A cross sectional study using a structured paper-based questionnaire to collect data from consenting students of six Northern Nigerian universities, was conducted from May to August 2021. Descriptive statistics were used to report the results obtained.Results: A total of 226 questionnaires were retrieved. Many of the respondents were male (57.5%) and studying for the Bachelor of Pharmacy degree (88%). Pharmacy was the first-choice course of study for almost 70% of the respondents, and the most common factors influencing their choice were personal interest (59.7%) and good job prospects (50.4%). Majority of respondents perceived that community pharmacy practice would provide them with the most financially rewarding career (32.7%), best work environment (33%) and best job opportunities (20%). Most of them also perceived themselves as having a heavy workload if they worked in hospital pharmacy (47.8%) and the best work schedule if they worked in academia (28.9%). Respondents’ top four career choices were community pharmacy, hospital pharmacy, public health pharmacy and industrial pharmacy.Conclusion: This study identified factors influencing the choice of a pharmacy degree and career preferences of respondents. Structured career counselling for young pharmacists is recommended.

A series of 3-substituted guinazolinone derivatives have been synthesized in good to excellent yields and high selectivity by one-pot reaction using anthranilic acid, amine and orthoester in ethanol under mild conditions, respectively. The reaction was efficiently promoted by Bi(OTf)3 and the catalyst could be recovered easily after the reactions and reused without evident loss of reactivity. Docking studies have shown that the tested molecules have an affinity for anticancer targets. The data obtained can be used in planning experimental screening for antitumor activity.

MATLAB was used to compute the effective thermal conduction of different samples of hard isotropic low porosity composites. The computational algorithms intended to use the Effective Medium Theory (EMT) Model to estimate the effective thermal conductivity (keff) of homogeneous composites. It estimates keff of a homogeneous mixture of components with known volume fractions and components’ conductivities. Starting with preliminary indicators to check the homogeneity conditions, we follow two approaches one for the measured samples and the other for a hypothetical sample with a certain specific desired property. One approach is to use preliminary indicators of surface homogeneity of the measured samples either via electron and/or via optical transmission microfilm scanning. The other approach is used for both measured and hypothetical samples by assuming a layered structure of parallel and series of slabs to compute upper and lower bounds of conduction. We used MATLAB to implement a fine precision computing algorithm to investigate the composite samples. The results predicted by the EMT model were examined for validation. The deviation of keff from the experiment for the homogenous samples is between 3 to 28% depending on the uniformity of distribution of phases within the composite matrix.

Inaccurate sizing of left atrial appendage (LAA) occlusion devices is associated with increased stroke risk. We compared the LAA size to implant the Watchman device assessed by computed tomography (CT) to transesophageal echocardiography (TEE).Databases were searched to identify studies comparing LAA anatomical measurements and procedural outcomes across imaging modalities for the Watchman device implantation.Seven studies were included in the analysis (242 patients on TEE, and 232 on CT). The LAA orifice was larger when sized with CT compared to TEE (CT mean vs TEE SMD 0.30 mm, 95%CI 0.09-0.51 mm, P 0.01; and CT max vs TEE SMD 0.69 mm, 95%CI 0.51-0.87 mm, P 0.001). Additionally, CT, including CT-based 3-dimensional models, had higher odds of predicting correct device size compared to TEE (OR 1.64; 95%CI 1.05-2.56; P = 0.03). CT resulted in a lower fluoroscopy time vs TEE (SMD -0.78 min, 95% CI -1.39 to -0.18, P = 0.012). No significant differences were found in device clinical outcomes.Compared to TEE, CT resulted in larger LAA orifice measurements, improved odds of predicting correct device size, and reduced fluoroscopy time in patients undergoing LAA occlusion with the Watchman device. There were no significant differences in other procedural outcomes.

The relative merits of the drug-coated balloon (DCB) versus uncoated balloon (UCB) angioplasty in endovascular intervention for patients with symptomatic lower extremity peripheral arterial disease (PAD) remains controversial.Online databases were queried with various combinations of keywords to identify relevant articles. Net adverse events (NAEs) and its components were compared using a random effect model to calculate unadjusted odds ratios (ORs).A total of 26 studies comprising 26,845 patients (UCB: 17,770 and DCB: 9075) were included. On pooled analysis, DCB was associated with significantly lower odds of NAE (OR: 0.47, 95% confidence interval [CI]: 0.36-0.61), vessel restenosis (OR: 0.46, 95% CI: 0.37-0.57), major amputation (OR: 0.68, 95% CI: 0.47-99), need for repeat target lesion (OR: 0.38, 95% CI: 0.31-0.47) and target vessel revascularization (OR: 0.62, 95% CI: 0.47-0.81) compared with UCB. Similarly, the primary patency rate was significantly higher in patients undergoing DCB angioplasty (OR: 1.44, 95% CI: 1.19-1.75), while the odds for all-cause mortality (OR: 0.96, 95% CI: 0.85-1.09) were not significantly different between the two groups. A subgroup analysis based on follow-up duration (6 months vs. 1 vs. 2 years) followed the findings of the pooled analysis with few exceptions.The use of DCB in lower extremity PAD intervention is associated with higher primary patency, lower restenosis, lower amputation rate, and decreased need for repeat revascularization with similar all-cause mortality as compared to UCB.

Alteration of redox status is one of the molecular pathways commonly associated with pesticide toxicity. Antioxidants, including those obtained from plant phenolics, have been shown to mitigate pesticide-induced cellular injury. The present study was aimed at evaluating the effect of daflon-500(®), a flavonoid compound on sub-chronic chlorpyriphos-evoked changes in antioxidant and biochemical parameters in the hypophysis and testes of adult male rats. Twenty-five male albino rats were randomly divided into 5 groups of 5 animals each. Group I (DW) received distilled water (2 ml/kg); group II (SO) was dosed with soya oil (2 ml/kg); Group III (DAF) received daflon-500(®) at 1000 mg/kg ~ 1/5th of LD50 (≥ 5000 mg/kg); group IV (CP) was administered chlorpyriphos at 7.74 mg/kg ~ 1/10th of LD(50) (77.4 mg/kg) while group V (DAF + CP) was previously treated with daflon-500(®) (1000 mg/kg) and then exposed to CP (7.74 mg/kg), 30 min later. Daily oral regimen administration was done for 60 days after which the animals were sacrificed by cervical venesection after light chloroform anesthesia. The hypophysis and testicular tissues were harvested, and their homogenates were analyzed for malondialdehyde, catalase and superoxide dismutase, and acetylcholinesterase levels. A significant increase in the hypophysis and testicular MDA concentrations, coupled with a decrease in the SOD, CAT, and AChE activities were observed in the CP group. The levels of these oxidative and biochemical parameters were alleviated in the group pretreated with Daflon-500(®). Results of this study demonstrated that pre-treatment with Daflon-500(®) mitigated CP-induced alterations in oxidative and biochemical parameters apparently due to the antioxidant effect of the flavonoid compound.

Plants with medicinal value produce certain chemical elements known as phytochemicals that have antibacterial activity. The study was aimed at determining the antibacterial activity of Vernonia amygdalina against bacterial isolates using agar well diffusion method. In addition, the phytochemicals analysis of the extracts was also determined. The phytochemical analysis showed the presence of saponins, steroids, terpenoids, tannins, alkaloids, and flavonoids. The result of Vernonia amygdalina showed that the average zones of inhibitions observed against these bacterial ranges from 6-22mm. The highest zone is also exhibited against E. coli with average diameter of zone of inhibition of 22mm. At 100mg/ml concentration for Samonella, the zone of inhibition was recorded to be 21mm while at 12.5mg/ml there was no inhibition. At 25mg/ml and 12.5mg/ml, against Pseudomonas there was no inhibition. In other to further confirm the activity of these plant extracts, the minimum inhibitory concentration and minimum bactericidal concentration was determined and the result showed that the extract exerted good antibacterial activity on all the test organisms at different concentration. The result of minimum inhibitory concentration ranges from 10 to 12.5mg/ml and that of MBC ranges from 5 to 20mg/ml. It is worthy to note that MBC values is greater than that of minimum inhibitory concentration. The study provides insight into the antibacterial activities of the plant extracts and its use in the treatment of bacterial infections.

Background Tumor immune infiltrate has been explored in oral squamous cell carcinoma (OSCC), but studies on simultaneous characterization of multiple immune cell subtypes separately in stromal and intraepithelial tumor compartments are limited. Objectives We aimed to investigate the immune cell infiltrate in OSCC by using immunohistochemistry (IHC) for a panel of inflammatory cells in stromal and epithelial tumor compartments for a better characterization of the tumors. Methods Thirty-six OSCC lesions and nine normal oral mucosa (NOM) samples from patients attending Khartoum Dental Teaching Hospital, Sudan were investigated for presence of tumor infiltrating lymphocytes, tumor-associated macrophages, tumor-associated neutrophils, and PD-L1 positive cells in the inflammatory infiltrate by single and double IHC. Digital quantitative analysis (Aperio Technologies Inc.) was performed separately for stromal and epithelial compartments. Results OSCC cases displayed a higher inflammatory infiltrate in the associated stroma, but not in the epithelial compartment when compared to NOM. The immunosuppressive type of inflammatory infiltrate, that is, T regulatory cells (FoxP3+ cells) was identified to be significantly higher in the epithelial compartment of tumors with advanced clinical state. An immunoscore developed by combining intraepithelial FoxP3+ and CD4+ cells was found significantly higher in lesions from elderly patients, localized at toombak dipping-related sites, poorly differentiated OSCCs, or with loco-regional lymph node spreading. Conclusions Despite heavy immune cell infiltration in tumor-associated stroma, the majority of OSCCs in this cohort displayed a low intraepithelial immune infiltration. An immunoscore based on combined CD4 and FoxP3 intraepithelial expression may serve as an indicator of advanced tumor progression and should be further investigated for its use as potential prognostic biomarker in OSCC. publishedVersion

Colour removal from dye-bearing effluent is a serious challenge due to the difficulty in treating such wastewater by conventional treatment methods. The present investigation explores the decolourization of contaminated wastewater using acid-activated sawdust as an adsorbent. The physicochemical properties of wastewater samples labelled A, B, and C vizaverage temperature; pH; electrical conductivity; and total dissolved solids were determined using standard methods to be 302.63; 6.1; 284.47 µS/cm;35116.66 mg/L respectively. Colour removal efficiency of the adsorbent was studied under variable conditions (contact time, rate of agitation,loading). Experimental results demonstrated that the sawdust adsorbent has a significant capacity for colour removal from tannery effluent. There was significant variation in the absorbance of the treated samples. Adsorbent dose, stirring rate, and contact time were found to be directly proportional to colour removal while pH variation of the samples show that the effluents became less alkaline (slightly acidic) after decolourization.

Healthcare professionals are standing against the widespread use of e-cigarettes among the population, especially young adults. E-cigarettes are generally introduced, especially via social media platforms, as a safer alternative to conventional cigarette smoking. The aim of this study was to measure the prevalence of e-cigarette use among healthcare professions students at the University of Jordan, as well as to explore their knowledge and attitudes toward the use of e-cigarettes. An anonymous Google-Form®-based cross-sectional questionnaire was presented to potential participants at the University of Jordan. Students’ responses were analyzed using SPSS® 23.0 software. A total of 679 online surveys were completed. About 37.4% of students reported using e-cigarettes at least once in their lifetime and about 20% of students were current e-cigarette users. The multivariate analysis showed that the factors associated with E-cigarette smoking are being male, having mothers, siblings, or friends using e-cigarettes, having easy access to e-cigarettes, and having social media as the main source of knowledge regarding e-cigarettes. The relatively high acceptance level and use of e-cigarettes among health professions students should be an alarming sign to decision-makers to give more attention to legislation that controls tobacco products including e-cigarette selling and advertising.

Introduction Atrial Fibrillation (AF) is the most common sustained arrhythmia. Thrombus formation in the left atrial appendage (LAA) increases the risk for stroke and systemic embolism in AF patients. The proposed mechanisms for thrombus formation in the LAA are stasis, endothelial dysfunction and local hypercoagulability. The aim of this study was to compare thrombin generation potential in various heart chambers among AF patients. Material and methods A prospective cross-sectional study of 47 patients with AF undergoing pulmonary vein isolation (PVI). Blood samples from the femoral vein (FV), right atrium (RA), left atrium (LA) and LAA were collected during the PVI procedures. The Samples were collected before heparin administration. Thrombin generation was assessed by the calibrated automated thrombogram (CAT). Results A total of 47 patients (36.2% female, mean age 58.7±13, 59.6% with CHADS-VASc ≥2) were enrolled into the study. The mean endogenous thrombin potentials (ETP) were 1580±558, 1433±540, 1141±611 and 1487±760 in the FV, RA, LA and LAA, respectively (P A post-hoc pairwise comparison demonstrated elevated thrombin generation in the LAA compared to the LA (P=0.014). Furthermore, LA thrombin generation levels were significantly lower from the FV and RA (P Conclusion In patients with AF, the LAA has increased thrombotic potential compared to the LA. These findings might explain why the LAA is more predisposed to thrombus formation than the LA. Funding Acknowledgement Type of funding sources: None.

In order to search for innovative nootropic agents, new 1-benzyl-4- (4- (R)-5-sulfonylidene-4,5-dihydro-1H-1,2,4-triazol-3-yl) pyrrolidine-2-ones was synthesized by reacting benzylamine with itaconic acid to 1-benzyl-5-oxopyrrolidine-3-carboxylic acid, which was then subjected to hydrazinolysis followed by the addition of substituted isothiacyanate followed by cyclization of intermediate thiosemicarbazides. The structure and purity of the obtained substances were confirmed by elemental analysis

We established a unique immortal cell line designated, FOH-SA, by serial passage of fetal ovine heart cells. In a novel phenomenon in cell biology, we demonstrated that the immortalization of the line supervened as a result of spontaneous cellular and nuclear fusion of two morphologically distinct cardiocytes in passage 29. Fused cells gave progeny cells which grew into multicellular filaments. Trypsinization of the filamentous multicellular growth gave the immortal heart cell line.Comparative single nucleotide polymorphism (SNP) genotyping of the cell line before and after cell fusion revealed a large scale genetic conversion resulting in 96% homozygosity in SNPs genotypes in the progeny cells. Partial sequencing of the mitochondrial (mt) genome of the cell line revealed the occurrence of large mutational events in the control region, the tRNA-Phe and 12S rRNA genes of the mt genome of progeny cells. The cell line was found permissive to sheep pox, peste des petits ruminants (PPR), lumpy skin disease (LSD), rift valley fever (RVF), and camel pox viruses.This study would resolve the over half a century mystery of how the African Green Monkey cell line (VERO) had evolved. We authenticated the cell line at the European Collection of Authenticated Cell Cultures (ECACC) and deposited it at the American Type Culture Collection (ATCC) for the purpose of patenting under the Budapest Treaty.

Background: African trypanosomiasis is a protozoan disease with huge socio-economic burden to sub-Saharan African exceeding US$4.6 annual loss. To mitigate the incidence of trypanosomal drug resistance, efforts are geared towards discovery of molecules, especially from natural products, with potential to inhibit important molecular target (trypanosome alternative oxidase, TAO) in trypanosomes that are critical to their survival. Method: Crude methanol extract of Anogeissus leiocarpa was subjected to in vitro bioassay-guided antitrypanosomal assay to identify the most active extract with trypanocidal activity. The most active extract was run on a column chromatography yielding five fractions, F1-F5. The fractions were assayed for inhibitory effect on TAO. The most promising TAO inhibitor was subjected to antitrypanosomal evaluation by trypanosome count, drug incubation infectivity test (DIIT) and in vivo studies. Gas chromatography-mass spectrometry (GC-MS) was used to identify and quantify phytochemical constituents of the potential TAO-inhibiting fraction. Results: Ethyl acetate extract (EtOAc) significantly (p

The decision-making process behind the selection of a gas turbine engine (GT) is crucial and must be made in accordance with economic, environmental, and technical requirements. This paper presents the relevant economic, exergoeconomic and exergoenvironmental analyses for four GT engines with different compressor configurations. The GT engine configurations are identified according to the type of compressor: axial, axial-centrifugal, two-stage centrifugal, and centrifugal-centrifugal. The performances of the four GT engines were validated against manufacturer supplied data using specialized software. The economic analysis, a detailed life cycle costing considering the cost to be paid per unit net power obtained from the GT, and subsequent shortest payback period showed that the GT with centrifugal-centrifugal compressor was most economically feasible. This was followed, in order, by the GT-axial, GT-axial-centrifugal, and finally the GT-two-stage centrifugal configuration, where the cost of ownership for a 20 year plan ranges between 8000 USD/kW to about 12,000 USD/kW at different operational scenarios during the life cycle costing. Exergoeconomic assessment provided useful information to enhance the cost-effectiveness of all four systems by evaluating each component separately. The axial-centrifugal configuration registered the lowest CO2 emissions (about 0.7 kg/kWh); all environmental indicators confirmed it is the most environmentally friendly option.

Several researchers employed N2 to augment CH4 recovery efficiency and CO2 sequestration during the Enhanced Gas Recovery (EGR) process in consolidated rocks. To our knowledge, there has been limited data backing the reason why CO2 experienced a more extended breakthrough during the EGR process in the presence of N2 gas. This study inves-tigated CO2 and N2 behaviour during the core flooding experiment by CO2 injection in Bentheimer core plug. N2 was used as the continuous phase during the core flooding process, while CO2 was the dispersed phase. The experiment was designed with varying injection rates at 30 and 40 0C temperature points. The experimental findings showed that the dispersion and diffusion coefficient, CO2 storage, concentration profile and breakthroughs were highly influenced by temperature change, especially at lower injection rates. However, at high injections, those properties are less sensitive to change in temperature, with most of the curves overlapping in the concentration profile. The highest and most negligible dispersion and diffusion coefficients were recorded at the highest and lowest injection rates respec-tively. These results agree with those reported by several researchers for sandstone rocks. Thus, higher temperatures have a more substantial effect on dispersion and diffusion coefficient, which eventually led to higher mixing between CO2 and N2. The breakthrough time decreases with an increase in reservoir temperature, confirming the diffusion and dispersion coefficients are temperature dependent. The experiment at 30 0C recorded an extended breakthrough time over that at 40 0C. The maximum breakthrough time at 0.52 PV was recorded at 30 0C at the lowest injection rate. The concentration profile highlighted the trend between the displacing and displaced gas during the core flooding experiment. From the range of injections and temperatures tested, the CO2 PV stored decreases as the rate of injection increases from 0.4 – 1.2 ml/min. However, the CO2 stored was more promising at higher rates, corresponding with high differential pressure, due to flow resistance within the tortuous flow channels in the porous medium.

Introduction Sigmoid volvulus in pregnancy is a rare cause of intestinal obstruction with high maternal and fetal morbidity and mortality if not diagnosed and managed early. Case presentation A 29-year-old female (Chagga by tribe) presented with clinical features of intestinal obstruction 24 weeks into her second pregnancy. She had symptoms for one week. An emergency laparotomy was performed whereby gangrenous sigmoid volvulus was found; thus, it was resected and Hartmann’s colostomy was raised. Unfortunately, she experienced intrauterine fetal death post-operatively. She was discharged clinically stable. Conclusion Early diagnosis and management can prevent adverse effects such as bowel ischemia and preterm labor. Because classic clinical and radiological features may not be evident, high degree of suspicion is warranted.

Intussusception is a common pediatric emergency, although a prolapsed intussusception is a rare entity, often misdiagnosed as a rectal prolapse. We report a 10-month-old female baby who presented with a three week history of a mass protruding per anus and vomiting, and a 2 week history of bloody diarrhoea. A clinical diagnosis of a prolapsed intussusception was made and no imaging studies were ordered to avoid a delay in management. The patient underwent an emergency laparotomy, where a dual reduction was done and the bowels were found to be ischemic hence a right hemicolectomy was performed with end-to-end ileo-transverse anastomosis. Unfortunately, 2 weeks post laparotomy, the patient presented with a high output enterocutaneous fistula. Another emergency laparotomy was performed, with findings of intestinal adhesions and an anastomotic leak. Adhesiolysis was done along with re-freshening of the ileo-transverse anastomosis. Intussusceptions presenting in the form of a prolapse through the anus is a rare condition indicating a serious sign and is often mistaken for a rectal prolapse. A digital rectal examination can help differentiate the two from each other. Surgery is the mainstay treatment for a prolapse intussusception, and should not be delayed.

Heart failure (HF) is a complex clinical syndrome with symptoms and signs that result from any structural or functional impairment of ventricular filling or ejection of blood. Limited data is available regarding the in-hospital outcomes of TAVR compared to SAVR in the octogenarian population with HF.The National Inpatient Sample (NIS) database was used to compare TAVR versus SAVR among octogenarians with HF. The primary outcome was in-hospital mortality. The secondary outcome included acute kidney injury (AKI), cerebrovascular accident (CVA), post-procedural stroke, major bleeding, blood transfusions, sudden cardiac arrest (SCA), cardiogenic shock (CS), and mechanical circulatory support (MCS).A total of 74,995 octogenarian patients with HF (TAVR-HF n = 64,890 (86.5%); SAVR n = 10,105 (13.5%)) were included. The median age of patients in TAVR-HF and SAVR-HF was 86 (83-89) and 82 (81-84) respectively. TAVR-HF had lower percentage in-hospital mortality (1.8% vs. 6.9%;p 0.001), CVA (2.5% vs. 3.6%; p = 0.009), SCA (9.9% vs. 20.2%; p 0.001), AKI (17.4% vs. 40.8%); p 0.001), major transfusion (26.4% vs 67.3%; p 0.001), CS (1.8% vs 9.8%; p 0.001), and MCS (0.8% vs 7.3%; p 0.001) when compared to SAVR-HF. Additionally, post-procedural stroke and major bleeding showed no significant difference. The median unmatched total charges for TAVR-HF and SAVR-HF were 194,561$ and 246,100$ respectively.In this nationwide observational analysis, TAVR is associated with an improved safety profile for octogenarians with heart failure (both preserved and reduced ejection fraction) compared to SAVR.