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The key attention of this work is on the impact of suction/injection on the free convective flow of a viscous fluid passing between two infinite, parallel, vertical and porous plates with non‐Fourier effects. The analysis focuses on a porous channel with boundaries featuring a steady–periodic temperature regime. The governing equations, representing velocity(momentum) and temperature(energy) fields, are well‐stated in dimensional form. Employing a separation technique, the momentum and energy equations are separated into steady and periodic components. On solving, the resulting second‐order ordinary differential equations derived, revealed the expressions for velocity and temperature in dimensionless form. However, the study investigates the influence of various flow parameters used in this work, including suction/injection (s) $(s)$, heat source/sink (H) $(H)$, Strouhal number (St) $({St})$, Prandtl number (Pr) $(Pr)$, and dimensionless relaxation time (γ) $(\gamma)$, on the velocity and temperature distributions. Also not left out is the rate of heat transfer on the flow performance and the skin‐friction coefficient on the plates. The findings are visualized using MATLAB‐generated graphs. An interesting observation found during the course of investigation in that the introduction of suction/injection enhances the flow velocity and fluid temperature within the channel, and they are both seen as declining functions of the Strouhal number, which measures the frequency of periodic heating on the plates. Furthermore, when the suction/injection parameter(s) is being relaxed, this study demonstrates a strong agreement with the findings of Ajibade and Mukhtar. [ABSTRACT FROM AUTHOR]

Anthrax, caused by Bacillus anthracis (B. anthracis), is an important zoonotic disease of livestock that poses a threat to public safety. The present study aimed to determine the seroprevalence of Bacillus anthracis in sheep and cattle in endemic areas (Punjab and Balochistan provinces) of Pakistan by enzyme-linked immunosorbent assay (ELISA). Cross-sectional survey was also done to assess the control measures of the farmers. Out of 401 serum samples from sheep and cattle, a total of 68 (16.9%) samples were seropositive for anti-PA antibodies; seroprevalence of B. anthracis in sheep and cattle was 22.11% (48/217) and 10.86% (20/184), respectively. Seroprevalence was significantly higher (p<0.05) in Baluchistan province (33.3%, 44/132) compared to Punjab province (8.92%, 24/269). Most farmers (65.90%, 29/44) were not disposing carcasses as recommended. Around 77.28%, 17/22 of the veterinary officials reported the non-availability of vaccine against anthrax and 63.63% (14/22) stated the lack of cold chain for the vaccine storage and transportation. We concluded that seroprevalence of B. anthracis in unvaccinated sheep and cattle is evidence that the pathogen is circulating in Baluchistan and Punjab provinces. So must applied an active surveillance and, strengthened veterinary practices vaccination programs to control anthrax outbreaks in endemic areas. [ABSTRACT FROM AUTHOR]

Education plays an important role in human behavior to improve the quality of life, so there must be mature thought for the success of education. To produce a good education there needs to be an educational strategy, therefore an educational strategy is very important. This study aimed to reveal the forms of strategies for teaching speaking skills in terms of behavioral theory in the intensive program and reveal the contribution of implementing speaking skills teaching strategies in intensive programs at the Darussalam Banyuwangi Islamic Religion Institute. In this study, researchers used a qualitative approach and methodology as a case study in the Arabic Language Education Department. Used for collecting teacher and student interview data in the Intensive Program, classroom and outside classroom observations and documentation. Using interactive data analysis. The method of checking the validity of the data is by triangulation of theory and sources. The results of this study in essence are: (1) The strategies for teaching speaking skills in the perspective of behavioral theory in the intensive program are strategies of repetition and memorization, storytelling strategies, strategies for presenting modern topics, and strategies for creating an artificial Arabic environment. (2) The contribution of implementing speaking skills teaching strategies in the intensive program is the high demand for teaching Arabic and the ease of teaching Arabic, and the Institute has become famous for Arabic.

Water stored beneath the Earth's surface, known as groundwater is a major water supply for living things. The increase in human population leading to high urban development and industrial needs in Malaysia has made the use of groundwater more critical. The current issue faced by Malaysia is the limitation of freshwater source from dam resulting in increasing demand to gather the source of fresh water from groundwater; hence, leading to the crucial exploitation of groundwater. Therefore, this study aims to evaluate groundwater storage (GWS) using Gravity Recovery and Climate Experiment (GRACE) and Global Land Data Assimilation System (GLDAS) data in Peninsular Malaysia. GRACE data consist information on the liquid water equivalent thickness covering terrestrial water storage (TWS) of GWS, soil moisture (SM), snow water equivalent (SWE), and surface water (SW). In comparison with GLDAS data, they only consist hydrological products of SM, SWE, and SW. Therefore, the differences between the GRACE and GLDAS data are most likely to reflect the information of GWS. Due to the seasonal monsoon, the changes in GWS can also be seen in specific months. In addition, the data can also be used to identify important areas that need improvement and attention. The output of this study is expected to help authorities monitoring the changes in GWS in recharge and discharge areas for future preservation of groundwater quality. Moreover, the excessive exploitation of groundwater can also be observed for the prevention of land hazard phenomena, such land subsidence. [ABSTRACT FROM AUTHOR]

BackgroundTooth extraction procedures often lead to bone resorption, which can have adverse effects on the dimensions of the alveolar ridge. Research has shown that socket preservation techniques using bone graft substitutes can effectively minimize early bone loss in such cases. α–calcium sulfate hemihydrate (α-CSH) has garnered significant attention as a potential bone graft material due to its favorable properties, including osteoconductivity, angiogenic potential, and biocompatibility. Considering these facts, we developed a preliminary protocol for applying α-CSH in addressing alveolar bone loss following tooth extraction. ObjectiveThis research’s general objective is to evaluate the feasibility and initial effectiveness of α-CSH as bone-inducing graft material for socket preservation after tooth extraction. MethodsThis preliminary clinical trial will involve 30 fresh extraction sockets from individuals aged 18-35 years. The participants will be divided into 2 groups: one group will receive α-CSH graft material after tooth extraction for socket preservation, while the other group will not receive any graft material. Throughout the study, the participants will be closely monitored for safety measures, which will include clinical examinations, radiographic imaging, and blood tests. Radiographic imaging will be used extensively to assist the progress of bone formation. ResultsThe study commenced enrollment in August 2022 and is scheduled to conclude post assessments and analyses by the end of 2023. The results of the study are anticipated to be accessible in late 2024. ConclusionsThis clinical study represents the initial investigation in humans to assess the feasibility and efficacy of α-CSH in alveolar bone regeneration. We hypothesize that the inclusion of α-CSH can greatly expedite the process of bone formation within fresh sockets, resulting in a swift restoration of bone height without the disadvantages associated with harvesting autogenous bone graft. Trial RegistrationIndonesia Registry Center INA-D02FAHP; https://tinyurl.com/2jnf6n3s International Registered Report Identifier (IRRID)DERR1-10.2196/49922

Purpose: To statistically analyse sitting posture using anthropometrics data among college students in Malaysia. Design/methodology/approach: This study was conducted among 52 college students consisting of males and females. Data were analysed using a common statistical tool which is the Statistical Package of Sosial Science (SPSS). Findings: Preliminary analysis of data indicated that there are wider differences in standard deviation of eye sitting height compared to the previous study conducted. Research limitations/implications: This study was conducted at only one higher learning institution/college located at East Cost of Malaysia. Practical implications: The larger value of standard deviation discovered as statistical analysis performed using combined data among male and female participants suggested that data should be segregated. Originality/value: Result obtained could be used as a preliminary guideline to design any related item in related to sitting posture. [ABSTRACT FROM AUTHOR]

Fine particulate matter (PM2.5) has been linked to a number of adverse health effects, hence its prediction for epidemiological studies has become very crucial. In this study, a novel ensemble technique was proposed for the prediction of PM2.5 concentration in cities with high traffic noise using traffic noise as an input parameter. Air pollutants concentration (P), meteorological parameters (M) and traffic data (T) simultaneously collected from seven sampling points in North Cyprus were used for conducting the study. The modelling was done in 2 scenarios. In scenario I, PM2.5 was modelled using 4 different input combination without traffic noise as input parameter while in scenario II, traffic noise was added as an input variable for 4 input combinations. The models were evaluated using 4 performance criteria including Nash-Sutcliffe Efficiency (NSE), Root Mean Square Error (RMSE), Correlation Coefficient (CC) and Bias (BIAS). Modelling PM2.5 with combined relevant input parameters of P, M and T could improve the performance of the model developed with only one set of the parameters by up to 12, 17 and 29% for models containing only P, M and T respectively. All the models in scenario II have demonstrated high prediction accuracy than the corresponding model in scenario I by up to 12% in the verification stage. The Support Vector Regression-based Ensemble model (SVR-E) could improve the performance accuracy of single models by up to 17% in the verification stage.

Bacterial skin infections are most prevalent in humans. These skin infections can be easily prevented by the topical application of herbal soaps produced from the medicinal plants. Medicinal plants contain natural bioactive compounds with a variety of biological potential that can be used to incorporate into a basic soap formulation. This study aims to prepare the antibacterial soap using leaf extract of local medicinal plant, Rhinachantus nasutus. The leaf extract was prepared by maceration extraction using methanol as solvent. The antibacterial and antifungal activities of the leaf extract and herbal soap were evaluated using the disc diffusion assay against Bacillus cereus, Bacillus subtilis, Staphylococcus aureus, Escherichia coli, Yersinia enterocolitica, Methicillin-resistant Staphylococcus aureus (MRSA), Aspergillus niger and Candida albicans. The thump impression test was employed to test the effectiveness of the soap as antibacterial and antifungal soap. The results obtained from the current study revealed that the leaf extract of R. nasutus efficiently inhibited the growth of all test microorganisms at a concentration of 25 mg/mL with a diameter of inhibition zone ranging from 1.0 ± 0.1 mm to 2.5 ±0.1 mm, whereas a prepared soap with a similar concentration also inhibited all test microorganisms with an inhibition zone ranging from 0.7±0.1 mm to 1.3±0.1 mm. A thumb impression test result indicated a reduction in microbial development when using herbal soap. Leaf extracts of R.nasutus can be used to produce herbal soaps with remarkable antibacterial activity.

Okra ( Abelmoschus esculentus), is a highly nutritious summer vegetable crop in Malaysia. The greatest challenge in growing okra is the okra seeds germinate slowly and unevenly, which leads to weak seedling growth and vigour. To address this issue, a study was conducted to evaluate the impact of various osmopriming techniques on Okra seed germination and performance growth. This study also aims to find effective solutions for enhancing seed germination. Different osmopriming treatments including Polyethylene glycol (PEG 20%), potassium chloride (KCl 4%), potassium dihydrogen phosphate (KH2PO4 3%), calcium chloride (CaCl2 3%), sodium chloride (NaCl 3%), potassium nitrate (KNO3 2%), and negative control (no treatment) were applied to the seeds. Data on germination rate, leaf number, plant height, chlorophyll content, and stem diameter were collected and analysed using one-way ANOVA. Among the 3 hours of osmopring treatment, KH2PO4 3% exhibited the highest germination rate (10.1886 ± 1.73894). For the 6-hour osmopriming treatment, PEG 20% demonstrated the most promising results, with the highest leaf number (3.6071 ± 0.35295), plant height (20.977±11.92103), and stem diameter (0.950±00.22281). The highest chlorophyll content was observed in the KNO3 2% osmopriming treatment (23.3286 ± 0.64104) for 6 hours. Overall, PEG 20% osmopriming treatment for 6 hours emerged as the most effective in promoting germination percentages and enhancing the growth performance of okra, serving as a positive control in the study.

Context: For Muslim patients on levothyroxine (L-T4) therapy, the best approach for L-T4 intake during Ramadan fasting remains unclear., Objective: We compared 2 practical approaches for L-T4 intake during Ramadan., Methods: We randomly assigned 69 patients (21 males, 48 females, median age 44 years) with differentiated thyroid cancer (DTC) who underwent thyroidectomy in the past and are on stable LT4 doses to 2 arms. Arm A (33 patients) ingested their pre-Ramadan L-T4 dose at the evening meal and ate immediately. Arm B (36 patients) increased their pre-Ramadan dose by 25 µg if their regular L-T4 dose was ≤150 µg/day or by 50 µg if their pre-Ramadan dose was >150 µg/day and ate immediately., Results: At the beginning of Ramadan (baseline), the median thyrotropin (TSH) level and the numbers of patients in euthyroidism, subclinical hyperthyroidism (Shyper), or subclinical hypothyroidism (Shypo) were comparable between the 2 arms ( P = .69 and P = .65, respectively). At the end of Ramadan, in arm A there were 17 (51.5%), 3 (9.1%), and 13 (39.4%) patients in euthyroidism, Shyper, and Shypo compared with 17 (47.2%), 14 (38.9%), and 5 (13.9%) patients, respectively, in arm B ( P = .005). The mean ± SD TSH levels in arms A and B at the end of Ramadan were 5.6 ± 6.0 mU/L and 1.67 ± 2.6 mU/L, respectively ( P = .0001)., Conclusion: No overt thyroid dysfunction developed but there were more cases of Shypo in arm A and Shyper in arm B. Arm B achieved desirable levels of TSH (normal or slightly suppressed) in 86% of cases and might be a preferable approach, especially for patients who need TSH suppression (eg, DTC)., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)

Introduction: So far, only 11 PTH mutations have been described as causes of familial isolated hypoparathyroidism (FIH). In this report, we describe a family with FIH but with significant elevation of functionally inactive PTH due to a PTH mutation. We also show a positive therapeutic outcome of recombinant human PTH (teriparatide) therapy in one of the siblings who was not well controlled on large doses of calcitriol and calcium replacement therapy., Case Description: The proband is a 34-year-old woman who has a history of chronic severe hypocalcemia (HypoCa) since birth. She and her three brothers (33-year-old male twins, and a 21-year-old male) were diagnosed with pseudohypoparathyroidism type 1b (PHPT 1b) based on the presence of chronic HypoCa (serum Ca 1.6-1.85 mmol/l) since birth associated with significantly elevated plasma PTH levels in the range of 310-564 pg/dl (normal range 10-65) and absence of signs of Albright hereditary osteodystrophy., Molecular Studies: WES showed no pathogenic, likely pathogenic or variants of unknown significance in any known calcium-associated genetic disorder but a bi-allelic variant in the PTH itself ((NM&#95;000315.4:c.128G>A, p.Gly43Glu). This was confirmed by Sanger sequencing in the patient and her affected brothers., Management: Because the patient's HypoCa was not controlled on large doses of calcitriol and calcium carbonate, a trial of teriparatide 20 mcg SC daily was started and resulted in normalization of calcium, decline in PTH levels and significant improvement in her general wellbeing., Conclusion: High PTH in the presence of congenital hypocalcemia is not always due to receptor or post-receptor defect and can be due to a biologically inactive mutated PTH. In such cases, treatment with teriparatide may result in stabilization of biochemical profile and improvement in quality of life., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mukhtar, Alghamdi, Alswailem, Alsagheir and Alzahrani.)

Importance: Hepatocellular carcinoma (HCC) is the leading oncologic cause of death among patients with cirrhosis, but large studies examining mortality trends are lacking., Objective: To evaluate survival among patients with HCC in one of the largest integrated health care systems in the US., Design, Setting, and Participants: This retrospective cohort study included 3441 adult patients who received a diagnosis of HCC between January 1, 2006, and December 31, 2019, with end of follow-up on December 31, 2020. The study period was further categorized as era 1, defined as 2006 to 2012, and era 2, defined as 2013 to 2019. Statistical analysis was conducted from January 2021 to June 2024., Exposures: Patient demographic characteristics and disease factors., Main Outcomes and Measures: All-cause and HCC-specific mortality were used as primary end points, and survival probabilities were estimated using the Kaplan-Meier method. Cox proportional hazards regression analyses were adjusted for age at diagnosis, sex, race and ethnicity, cause of disease, Barcelona Clinic Liver Cancer (BCLC) stage, alpha-fetoprotein level, and treatment type., Results: Of 3441 patients with HCC, 2581 (75.0%) were men, and the median age was 65 years (IQR, 58-73 years). A total of 1195 patients (34.7%) received curative treatment, 1374 (39.9%) received noncurative treatment, and 872 (25.3%) received no treatment. During the study period, 2500 patients (72.7%) experienced all-cause mortality, and 1809 (52.6%) had HCC-specific mortality. In multivariable analysis, being 70 years of age or older (adjusted hazard ratio [AHR], 1.39; 95% CI, 1.22-1.59), male sex (AHR, 1.20; 95% CI, 1.07-1.35), BCLC stage C or D (AHR, 2.40; 95% CI, 2.15-2.67), increasing alpha-fetoprotein level (vs <20 ng/mL; 20-99 ng/mL: AHR, 1.20; 95% CI, 1.04-1.38; ≥1000 ng/mL: AHR, 2.84; 95% CI, 2.45-3.25), noncurative treatment (AHR, 2.51; 95% CI, 2.16-2.90), and no treatment (AHR, 3.15; 95% CI, 2.64-3.76) were associated with higher all-cause mortality, while Asian or Other Pacific Islander race and ethnicity (vs non-Hispanic White; AHR, 0.76; 95% CI, 0.65-0.88) was associated with lower all-cause mortality. Survival improved in diagnosis era 2 (2013-2019; n = 2007) compared with diagnosis era 1 (2006-2012; n = 1434)., Conclusions and Relevance: This large, racially and ethnically diverse cohort study of patients with HCC found improving survival over time, especially among individuals with early-stage HCC receiving potentially curative treatments. This study highlights the importance of surveillance for detection of HCC at early stages, particularly among groups at risk for poorer outcomes.

In the search for novel ligands with efficacy against various diseases, particularly parasitic diseases, molecular hybridization of organometallic units into biologically active scaffolds has been hailed as an appealing strategy in medicinal chemistry. The conjugation to organometallic fragments can be achieved by an appropriate linker or by directly coordinating the existing drugs to a metal. The success of Ferroquine (FQ, SR97193), an effective chloroquine-ferrocene conjugate currently undergoing the patient-exploratory phase as a combination therapy with the novel triaminopyrimidine ZY-19489 for malaria, has sparked intense interest in organometallic compound drug discovery. We present the evolution of organometallic antimalarial agents over the last decade, focusing on the parent moiety's class and the type of organometallics involved. Four main organometallic antimalarial compounds have been chosen based on conjugated organic moieties: existing antimalarial drugs, other clinical drugs, hybrid drugs, and promising scaffolds of thiosemicarbazones, benzimidazoles, and chalcones, in particular. The presented insights contribute to the ongoing discourse on organometallic compound drug development for malaria diseases., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Chronic intertrigo of toe-web space is a recalcitrant problem which is often associated with multi-organism infections. For this, a number of topical therapies with preventative measures are used, but many of them are cumbersome and not very effective. Cryotherapy is a good option for treating the toe intertrigo, but its availability is a major concern. Here as an alternative to cryotherapy, trichloroacetic acid (TCA) cautery and Sodium hypochlorite (NaOCl) (a broad spectrum anti-infective agent) solution is advocated as a simple, feasible, and cost-effective treatment of chronic inter digital intertrigo., Competing Interests: There are no conflicts of interest., (© 2024 Published by Scientific Scholar on behalf of Journal of Cutaneous and Aesthetic Surgery.)

Ingrown toenails is a painful foot problem seen in primary care among young men. To provide immediate pain relief, some types of splints are placed in the gutter to separate it from the ingrown lateral nail. There are time-consuming and effort-intensive procedures that use available nail separators and elevators to separate the nail plate. Here, the hub of the syringe is cut obliquely to create a beveled or slant edge to create a custom nail separator which is a useful device for the easy and less painful separation of the ingrown nail plate from its gutter, which is an important stage of nail splinting., Competing Interests: There are no conflicts of interest., (© 2024 Published by Scientific Scholar on behalf of Journal of Cutaneous and Aesthetic Surgery.)

Importance: In the US, hepatocellular carcinoma (HCC) has been the most rapidly increasing cancer since 1980, and metabolic dysfunction-associated steatotic liver disease (MASLD) is expected to soon become the leading cause of HCC., Objective: To develop a prediction model for HCC incidence in a cohort of patients with MASLD., Design, Setting, and Participants: This prognostic study was conducted among patients aged at least 18 years with MASLD, identified using diagnosis of MASLD using International Classification of Diseases, Ninth Revision (ICD-9) or International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnosis codes; natural language processing of radiology imaging report text, which identified patients who had imaging evidence of MASLD but had not been formally diagnosed; or the Dallas Steatosis Index, a risk equation that identifies individuals likely to have MASLD with good precision. Patients were enrolled from Kaiser Permanente Northern California, an integrated health delivery system with more than 4.6 million members, with study entry between January 2009 and December 2018, and follow-up until HCC development, death, or study termination on September 30, 2021. Statistical analysis was performed during February 2023 and January 2024., Exposure: Data were extracted from the electronic health record and included 18 routinely measured factors associated with MASLD., Main Outcome and Measures: The cohort was split (70:30) into derivation and internal validation sets; extreme gradient boosting was used to model HCC incidence. HCC risk was divided into 3 categories, with the cumulative estimated probability of HCC 0.05% or less classified as low risk; 0.05% to 0.09%, medium risk; and 0.1% or greater, high risk., Results: A total of 1 811 461 patients (median age [IQR] at baseline, 52 [41-63] years; 982 300 [54.2%] female) participated in the study. During a median (range) follow-up of 9.3 (5.8-12.4) years, 946 patients developed HCC, for an incidence rate of 0.065 per 1000 person-years. The model achieved an area under the curve of 0.899 (95% CI, 0.882-0.916) in the validation set. At the medium-risk threshold, the model had a sensitivity of 87.5%, specificity of 81.4%, and a number needed to screen of 406. At the high-risk threshold, the model had a sensitivity of 78.4%, a specificity of 90.1%, and a number needed to screen of 241., Conclusions and Relevance: This prognostic study of more than 1.8 million patients with MASLD used electronic health record data to develop a prediction model to discriminate between individuals with and without incident HCC with good precision. This model could serve as a starting point to identify patients with MASLD who may need intervention and/or HCC surveillance.

Lingual hematoma is a rare, life-threatening condition that can obstruct the airway. We report a 73-year-old male with end-stage renal disease (ESRD) who developed lingual hematoma while on rivaroxaban. He presented with odynophagia and significant tongue swelling. Treatment with vitamin K, dexamethasone, tranexamic acid, and prothrombin complex concentrate led to rapid improvement without the need for intubation. This case highlights the importance of prompt medical management to prevent airway obstruction in similar patients., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Jalal Eldin et al.)

Background and Aims: Studies show decreased rates of poor outcomes after hepatitis C virus (HCV) cure. However, there are no data comparing risk of poor outcomes to that of HCV never infected; results that could have implications for those who may not need ongoing specialty follow-up after cure., Methods: Retrospective cohort study conducted among Kaiser Permanente Northern California adults ages 18 and up between 2002 and 2019. Three cohorts were identified: 1) chronic HCV, 2) HCV cured, and 3) every chronic HCV and HCV-cured individual was matched by age, sex and race-ethnicity to 3 HCV negative controls. Outcomes of interest were cirrhosis, decompensated cirrhosis, hepatocellular carcinoma (HCC) and all-cause mortality. A low-risk group of HCV cured individuals without significant liver disease and/or concomitant liver disease cofactor(s) were identified., Results: We identified 21,184 chronic HCV, 11,950 HCV cure, and 99,402 control individuals. Five-year cumulative incidence of cirrhosis, decompensated cirrhosis, HCC and all-cause mortality was 10% vs 3.6% vs 0.8%, 12% vs 2.6% vs 0.6%, 3.9% vs 1.6% vs 0.07%, and 14% vs 2.8% vs 2.2% for chronic HCV, HCV cure, and control individuals, respectively (log-rank P < .01 for all). Compared to controls, HCV cured low-risk individuals had numerically similar 5-year cumulative incidence of cirrhosis, decompensated cirrhosis, HCC and all-cause mortality (1.2% vs 0.8%, P < .01; 0.9% vs 0.6%, P < .01; 0.5% vs 0.1%, P < .01; 1.7% vs 2.2%, P < .01)., Conclusion: HCV cure provides significant health benefits but does not universally return risk of poor outcomes to that of the general population. A simple stratification at the time of HCV cure could identify low-risk individuals who can potentially be discharged from specialty clinics/HCC surveillance., (© 2024 The Authors.)

Plane viral warts on the face can be difficult to treat at times. Various treatment approaches for facial viral warts have had variable degrees of effectiveness. In contrast, the majority of existing treatments are more costly, painful, and difficult to manage. In approximately 15.6% of instances, retinoic acid (0.05%) is also ineffective. It is very difficult to cure warts on the face at a young age. In pyogenic granuloma, table salt (NaCl) is useful as a sclerosing agent, and its hypertonic solution (15%) is effective in prolabial mucoceles. The aim of treating viral warts is to necrose infected cells and sclerose or thrombose their feeding capillaries at the wart's base., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Cutaneous and Aesthetic Surgery.)

The aim of the current study was to map the genetic diversity in the haemagglutinin (HA) glycoprotein of influenza A viruses (IAVs) of the H9N2 subtype. Twenty-five H9N2 IAVs were isolated from broiler chickens from March to July 2019. The HA gene was amplified, and phylogenetic analysis was performed to determine the evolutionary relationship. Important antigenic amino acid residues of HA attributed to immune escape and zoonotic potential were compared among H9N2 IAVs. Phylogenetic analysis revealed that sublineage B2 under the G1 lineage in Pakistan was found to be diversified, and newly sequenced H9N2 isolates were nested into two clades (A and B). Mutations linked to the antigenic variation and potential immune escape were observed as G72E (1/25, 4%), A180T (3/25, 12%), and A180V (1/25, 4%). A twofold significant reduction ( P < 0.01) in log 2 hemagglutination inhibition titers was observed with H9N2 IAV naturally harboring amino acid V180 instead of A180 in HA protein. Moreover, in the last 20 years, complete substitution at residues (T127D, D135N, and L150N) and partial substitution at residues (72, 74, 131, 148, 180, 183, 188, 216, 217, and 249, mature H9 HA numbering) associated with changes in antigenicity were observed. The presence of L216 in all H9N2 IAV isolates and T/V180 in four isolates in the receptor-binding site reveals the potential of these viruses to cross the species barrier to infect human or mammals. The current study observed the circulation of antigenically diverse H9N2 IAV variants that possess potential mutations that can escape the host immune system.

Viral infectious illnesses represent a severe hazard to human health due to their widespread incidence worldwide. Among these ailments, the dengue virus (DENV) infection stands out. World Health Organization (WHO) estimates that DENV infection affects ~400 million people each year, with potentially fatal symptoms showing up in 1% of the cases. In several instances, academic and pharmaceutical researchers have conducted several pilot and clinical studies on a variety of topics, including viral epidemiology, structure and function analyses, infection source and route, therapeutic targets, vaccinations, and therapeutic drugs. Amongst Takeda, TAK-003, Sanofi, Dengvaxia®, and Butantan/NIH/Merck, Dengvaxia® (CYD-TDV) is the only licensed vaccination yet; however, the potential inhibitors are under development. The biology and evolution of DENVs are briefly discussed in this review, which also compiles the most recent studies on prospective antiviral targets and antiviral candidates. In conclusion, the triumphs and failures have influenced the development of anti-DENV medications, and the findings in this review article will stimulate more investigation., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Irrigation of food crops with untreated wastewater leads to the accumulation of heavy metals in their edible parts. Exposure to toxic elements through consumption of contaminated vegetables even at very low concentration is becoming a serious problem for human health in many countries. This issue of heavy metals contamination needs great attention especially in Pakistan where irrigation by wastewater has become a common practice in urban and periurban areas. The present study was conducted to assess the contamination of different heavy metals including nickel (Ni), cadmium (Cd), lead (Pb) and chromium (Cr) in vegetables irrigated with wastewater in different districts of Punjab (Pakistan) like, Faisalabad, Lahore, Gujranwala, Sargodha, Sahiwal, Multan, Rawalpindi and Bahawalpur during years 2016-2019. The maximum contamination factor (Ni, 1.39; Cd, 5.86; Pb, 3.99; Cr, 2.24), pollution load index (2.92) and degree of contamination (13.48) were observed in wastewater irrigated agricultural soils of district Gujranwala as compared to other districts. Mean metal concentration in vegetables grown with untreated wastewater and transfer factor varied with plant type, frequency of irrigation and soils types/series of different districts of Punjab. The highest metal contamination was observed in Gujranwala where 44% vegetable samples were contaminated with Ni, 87% with Cd, 97% with Pb and 88% with Cr. Radar analysis and hierarchical cluster analysis showed that mustard leaves, spinach and lettuce were more contaminated vegetables compared to other vegetables. This study contributes to the evidence-based conclusion that cultivation of vegetable with untreated wastewater should be prohibited and required treatment of wastewater is needed., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Context: The American Thyroid Association risk stratification (ATA) and the American Joint Committee on Cancer Tumor Node Metastases (TNM) predict recurrence and mortality of differentiated thyroid cancer (DTC). BRAF V600E and TERT promoter mutations have been shown to correlate with the histopathological features and outcome of DTC. Our objectives were to study the correlation of these molecular markers with these clinicopathological-staging systems., Patients and Methods: We studied 296 unselected patients, 214 females and 82 males with a median age of 36 years (IQR 23.3-49.0). BRAF V600E and TERT promoter mutations were tested by PCR-based Sanger sequencing. Data were extracted from medical records and analysed using Chi-Square and Fisher Exact tests and Kaplan Meier analysis., Results: Of 296 patients tested, 137 (46.3%) had BRAF V600E -positive tumors and 72 (24.3%) were positive for TERT promoter mutations. The BRAF V600E mutation did not correlate with the ATA and TNM staging, being non-significantly different in various stages of these systems and did not predict the development of persistent disease (PD) ( P 0.12). Unlike BRAF V600E , TERT promoter mutations were more frequent in the ATA high-risk than in intermediate- or low-risk tumors (P 0.006) and in TNM stages III and IV than lower stages ( P < 0.0001). TERT promoter mutations also predicted the outcome, being present in 37.2% of patients with PD compared to only 15.4% in those without evidence of disease ( P < 0.0001). The same pattern was also seen when BRAF V600E and TERT promoter mutations were combined., Conclusion: TERT promoter mutations alone or in combination with BRAF V600E mutation, but not BRAF V600E mutation alone, correlated well with the ATA and TNM staging and predicted development of PD, especially in higher stages of these systems., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Mukhtar, Alhamoudi, Alswailem, Alhindi, Murugan, Alghamdi and Alzahrani.)

Competing Interests: There are no conflicts of interest.

Chronic candidiasis with bacterial infection is common infection in the toe web which is is not inspected and treated well in early stage, and it is now the cause of cellulitis in the leg in a number of cases. To examine the narrow space of the toe web and to treat and to reduce the complication, we described the use a disposable syringe barrel., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Cutaneous and Aesthetic Surgery.)

Anthrax, a severe zoonotic disease, is infrequently reported in anthrax-endemic regions of Pakistan. Despite clinical reports indicating its presence, particularly cutaneous anthrax, there is insufficient laboratory evidence regarding disease occurrence and environmental persistence. The present study aimed to confirm Bacillus anthracis presence, accountable for animal mortality and human infection, while exploring environmental transmission factors. Between March 2019 and July 2021, a total of 19 outbreaks were documented. Of these, 11 affected sheep/goats in Zhob district and 8 affected cattle/sheep in Bajour Agency. Clinical signs suggestive of Bacillus anthracis outbreak were observed in 11 animals. Blood and swab samples were collected for confirmation. The study followed a One Health approach, analyzing animal, environmental (soil/plant), and human samples. Of the 19 outbreaks, 11 were confirmed positive for anthrax based on growth characteristics, colony morphology, and PCR. Soil and plant root samples from the outbreak areas were collected and analyzed microscopically and molecularly. Cutaneous anthrax was observed in six humans, and swab samples were taken from the lesions. Human serum samples ( n = 156) were tested for IgG antibodies against PA toxin and quantitative analysis of anthrax toxin receptor 1 (ANTXR1). Bacillus anthracis was detected in 65 out of 570 (11.40%) soil samples and 19 out of 190 (10%) plant root samples from the outbreak areas. Four out of six human samples from cutaneous anthrax lesions tested positive for Bacillus anthracis . Human anthrax seroprevalence was found to be 11% and 9% in two districts, with the highest rates among butchers and meat consumers. The highest ANTXR1 levels were observed in butchers, followed by meat consumers, farm employees, meat vendors, veterinarians, and farm owners. These findings highlight the persistence of anthrax in the region and emphasize the potential public health risks.

Sugarcane is the world's largest cultivated crop by biomass and is the main source of sugar and biofuel. Sucrose phosphate synthase (SPS) enzymes are directly involved in the synthesis of sucrose. Here, we analyzed and compared one of the important gene families involved in sucrose metabolism in a high and low sucrose sugarcane cultivar. A comprehensive in silico analysis of the SoSPS family displayed their phylogenetic relationship, gene and protein structure, miRNA targets, protein interaction network (PPI), gene ontology and collinearity. This was followed by a spatial expression analysis in two different sugarcane varieties. The phylogenetic reconstruction distributed AtSPS, ZmSPS, OsSPS, SoSPS and SbSPS into three main groups (A, B, C). The regulatory region of SoSPS genes carries ABRE , ARE , G-box, and MYC as the most dominant cis-regulatory elements. The PPI analysis predicted a total of 14 unique proteins interacting with SPS. The predominant expression of SPS in chloroplast clearly indicates that they are the most active in the organelle which is the hub of photosynthesis. Similarly, gene ontology attributed SPS to sucrose phosphate synthase and glucosyl transferase molecular functions, as well as sucrose biosynthetic and disaccharide biological processes. Overall, the expression of SPS in CPF252 (high sucrose variety) was higher in leaf and culm as compared to that of CPF 251 (low sucrose variety). In brief, this study adds to the present literature about sugarcane, sucrose metabolism and role of SPS in sucrose metabolism thereby opening up further avenues of research in crop improvement., Competing Interests: Jiban Shrestha is an Academic Editor for PeerJ., (©2023 Niazi et al.)

The first aim of study was to quantify the viral load in the wastewater samples by RT-qPCR testing in Lahore population to estimate the number of patients affected and predict the next resurgence of COVID-19 wave in the city. The second aim of the study was to determine the hotspot areas of Lahore which remained positive more often for virus with high viral load. In this study, n = 420 sewage samples were collected on an average of two weeks intervals from 30 different sewage water disposal stations (14 sampling events) from Sept 2020 to March 2021. RNA was extracted and quantified by RT-qPCR without concentrating the virus in samples. Number of positive disposal sites (7-93%), viral load from sewage samples (10 0.296 to 10 3.034 ), and estimated patients (660-17,030) ranged from low to high according to the surge and restrain of 2 nd and 3 rd COVID-19 waves in the country. The viral load and estimated patients were reported high in January 2021 and March 2021 which were similar to the peak of 2 nd and 3 rd waves in Pakistan. Site 18 (Niaz Baig village DS) showed the highest viral load among all sites. Findings of the present study helped to estimate the number of patients and track the resurgence in COVID-19 waves in Lahore particularly, and in Punjab generally. Furthermore, it emphasizes the role of wastewater-based epidemiology to help policymakers strengthen the quarantine measures along with immunization to overcome enteric viral diseases. Local and national stake holders should work in collaboration to improve the environmental hygiene to control the disease., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Acute liver failure (ALF) is a rare, acute, potentially reversible condition resulting in severe liver impairment and rapid clinical deterioration in patients without preexisting liver disease. Due to the rarity of this condition, published studies are limited by the use of retrospective or prospective cohorts and lack of randomized controlled trials. Current guidelines represent the suggested approach to the identification, treatment, and management of ALF and represent the official practice recommendations of the American College of Gastroenterology. The scientific evidence was reviewed using the Grading of Recommendations, Assessment, Development and Evaluation process to develop recommendations. When no robust evidence was available, expert opinions were summarized using Key Concepts. Considering the variety of clinical presentations of ALF, individualization of care should be applied in specific clinical scenarios., (Copyright © 2023 by The American College of Gastroenterology.)

The emergence of SARS-CoV-2 variants has posed a challenge to disease control efforts worldwide. This study explored the genomic diversity and phylogenetic relationship of SARS-CoV-2 variants reported in Pakistan. Our objective was to understand the transmission dynamics of different lineages within the country. We retrieved and analyzed spike protein sequences from Pakistan and compared them with reference sequences reported worldwide. Our analysis revealed the clustering of Pakistan-origin isolates in nine different clades representing different regions worldwide, suggesting the transmission of multiple lineages within the country. We found 96 PANGO lineages of SARS-CoV-2 in Pakistan, and 64 of these corresponded to 4 WHO-designated variants: Alpha, Beta, Delta, and Omicron. The most dominant variants in Pakistan were Alpha (B.1.1.7), Beta (B.1.351), Delta (B.1.617.2, AY.108), and Omicron (BA.2.75, BA.5.2), and the N-terminal domain and receptor binding regions were the most hypervariable regions of the spike gene. Compared to the reference strain, characteristic substitutions were found in dominant variants. Our findings emphasize the importance of continuously monitoring and assessing nucleotide and residue substitutions over time to understand virus evolutionary trends better and devise effective disease control interventions.

Intralesional therapy is a common treatment for keloid. However, because of some follicular openings and comedones on the surface of the keloid on the hairy chest and acne keloidalis, there is a risk of drug leakage, and sometimes ejection of drugs like a jet spray leads to therapy being ineffective. The authors describe a novel and effective method for preventing drug loss from follicular openings during intralesional therapy. To prevent drug loss during intralesional injection, cyanoacrylate glue is applied to the follicular and comedone openings on the keloid's surface., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Cutaneous and Aesthetic Surgery.)

Vaccines are one of the efficient means available so far for preventing and controlling the infection rate of COVID-19. Several researchers have focused on the whole virus's (SARS-CoV-2) inactivated vaccines which are economically efficient to produce. In Pakistan, multiple variants of SARS-CoV-2 have been reported since the start of the pandemic in February 2020. Due to the continuous evolution of the virus and economic recessions, the present study was designed to develop an indigenous inactivated SARS-CoV-2 vaccine that might help not only to prevent the COVID-19 in Pakistan, it will also save the country's economic resources. The SARS-CoV-2 were isolated and characterized using the Vero-E6 cell culture system. The seed selection was carried out using cross-neutralization assay and phylogenetic analysis. The selected isolate of SARS-CoV-2 (hCoV-19/Pakistan/UHSPK3-UVAS268/2021) was inactivated using beta-propiolactone followed by vaccine formulation using Alum adjuvant, keeping the S protein concentration as 5 μg/dose. The vaccine efficacy was evaluated by in vivo immunogenicity testing in laboratory animals and in in vitro microneutralization test. The phylogenetic analysis revealed that all the SARS-CoV-2 isolates reported from Pakistan nested into different clades, representing multiple introductions of the virus into Pakistan. The antisera raised against various isolates from different waves in Pakistan showed a varied level of neutralization titers. However, the antisera produced against a variant (hCoV-19/Pakistan/UHSPK3-UVAS268/2021; fourth wave) efficiently neutralized (1:64-1:512) all the tested SARS-CoV-2 isolates. The inactivated whole virus vaccine of SARS-CoV-2 was safe and it also elicited a protective immune response in rabbits and rhesus macaques on the 35th-day post-vaccination. The activity of neutralizing antibodies of vaccinated animals was found at 1:256-1:1024 at 35 days post-vaccination, indicating the effectiveness of the double-dose regime of the indigenous SARS-CoV-2 vaccine.

Introduction: The perpetual appearance of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2), and its new variants devastated the public health and social fabric around the world. Understanding the genomic patterns and connecting them to phenotypic attributes is of great interest to devise a treatment strategy to control this pandemic. Materials and Methods: In this regard, computational methods to understand the evolution, dynamics and mutational spectrum of SARS-CoV-2 and its new variants are significantly important. Thus, herein, we used computational methods to screen the genomes of SARS-CoV-2 isolated from Pakistan and connect them to the phenotypic attributes of spike protein; we used stability-function correlation methods, protein-protein docking, and molecular dynamics simulation. Results: Using the Global initiative on sharing all influenza data (GISAID) a total of 21 unique mutations were identified, among which five were reported as stabilizing while 16 were destabilizing revealed through mCSM, DynaMut 2.0, and I-Mutant servers. Protein-protein docking with Angiotensin-converting enzyme 2 (ACE2) and monoclonal antibody (4A8) revealed that mutation G446V in the receptor-binding domain; R102S and G181V in the N-terminal domain (NTD) significantly affected the binding and thus increased the infectivity. The interaction pattern also revealed significant variations in the hydrogen bonding, salt bridges and non-bonded contact networks. The structural-dynamic features of these mutations revealed the global dynamic trend and the finding energy calculation further established that the G446V mutation increases the binding affinity towards ACE2 while R102S and G181V help in evading the host immune response. The other mutations reported supplement these processes indirectly. The binding free energy results revealed that wild type-RBD has a TBE of -60.55 kcal/mol while G446V-RBD reported a TBE of -73.49 kcal/mol. On the other hand, wild type-NTD reported -67.77 kcal/mol of TBE, R102S-NTD reported -51.25 kcal/mol of TBE while G181V-NTD reported a TBE of -63.68 kcal/mol. Conclusions: In conclusion, the current findings revealed basis for higher infectivity and immune evasion associated with the aforementioned mutations and structure-based drug discovery against such variants., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Hanifa, Salman, Fatima, Mukhtar, Almajhdi, Zaman, Suleman, Ali, Waheed and Khan.)

Context: The American Thyroid Association (ATA) risk stratification system predicts risk of recurrence of differentiated thyroid cancer (DTC). Although the majority of patients achieve an excellent response, patients with intermediate- or high-risk DTC are at a significant risk of developing incomplete responses. We undertook this work to understand the factors associated with development of biochemically or structurally incomplete response in these two risk subgroups of DTC., Patients and Methods: We retrospectively reviewed 287 consecutive patients with intermediate- (213 patients) or high-risk (74 patients) DTC. All patients underwent total thyroidectomy with (223 patients) or without (64 patients) lymph node dissection and 94% of them received at least one dose of I-131ablation/therapy. Univariate and multivariate analysis and Kaplan Meier analysis were used to compare patients who achieved an excellent response with those who continued to have biochemically or structurally incomplete responses., Results: In univariate and multivariate analyses, age (P 0.002, Odds ratio 4.8, 95% CI: 1.8-12.9), tumor size (P 0.027, Odds ratio 1.30, 95% CI: 1.03-1.64) and distant metastases (P &lt; 0.0001, Odds ratio 44.6, 95% CI: 10.7-184.5) were significantly associated with the risk of developing biochemically or structurally incomplete statuses. Patients ≥ 55 years, tumors &gt; 2.5 cm and presence of distant metastasis were associated with higher risk of incomplete response and death from DTC. However, when this analysis was performed on intermediate and high-risk groups separately, only age was consistently associated with risk of biochemically or structurally incomplete response in either and both groups., Conclusion: Age is a strong predictor of biochemically and structurally incomplete responses in patients with intermediate and high-risk DTC., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Iodine complexes have known antimicrobial properties along with reported in-vitro antiviral activity for several viruses. Renessans is one such product with iodine complexes and ascorbic acid. The present study was designed to determine its efficacy for SARS-CoV-2 in Rhesus macaque . Rhesus macaque were assigned to: A) prophylactic group (n = 3), (B) treatment group (n = 3), (C) infection control group (n = 4), and (D) negative control group (n = 4). Groups A, B, and C were challenged with 2 × 10 6 TCID of SARS-CoV-2. The prophylactic group (A) was administered Renessans from 5 days before infection till 8 days postinfection (DPI). The treatment group (B) was administered Renessans from 3 till 8 DPI. Group C was administered water-insoluble fractions only. Nasal swabs from all monkeys of groups A, B, and C remained positive for SARS-CoV-2 till 2 and 7 DPI, while the swabs became negative for groups A and B at 14 DPI. Likewise, fecal matter of monkeys in group A returned negative results during the experiment, while that of group B had significantly decreased viral load (10 1.5 genome copies/mL) compared to group C (10 3 genome copies/mL). Hence, it is concluded that Renessans has in-vivo SARS-CoV-2 activity and may result in early clearance of SARS-CoV-2., Competing Interests: The authors declare no conflict of interest.

Context: COVID-19 is a new viral infection affecting mainly the respiratory system with involvement of many other organs. Thyroid dysfunction has been described in COVID-19 but data are still unclear and conflicting on its frequency, severity and relationship with the outcome., Patients and Methods: We assessed thyroid function tests (TFT) in 50 patients admitted to our institution with confirmed COVID-19 infection. We excluded patients known to have thyroid diseases or taking drugs that may affect thyroid function. Serum free thyroxine (FT4), thyrotropin (TSH) and triiodothyronine (T3) were measured once or more during the first 10 days after admission. In about 50 % of the cases, a follow up TFT was obtained during the first year after discharge (at a median follow up of 6 months)., Results: We included 50 patients, 29 males (58 %) and 21 females (42 %). The median age was 47 years (range 25-89). Overall, TFTs were completely normal in all patients except for minor transient abnormalities in 5 patients (10 %) as follows: three patients had a mild transient elevated TSH, one had a mild transient suppressed TSH and one patient had a mildly low FT4 with normal TSH. There were no differences between the follow up TFTs obtained after discharge and TFTs obtained during admission in the acute phase., Conclusion: In this study, thyroid dysfunction during acute COVID-19 infection was rare, mild and transient. However, the study might not be powered enough to detect an association between thyroid dysfunction and the severity of illness and further studies are needed to assess this issue. Late-onset thyroid dysfunction does not seem to occur in COVID-19 infection during the next year after discharge., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Author(s).)