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Background: Few studies have highlighted multiple psychosocial and physical outcomes in patients with COVID-19 infection after recovery. However, the data from developing countries is limited., Aim: To evaluate psychological morbidity, post-traumatic stress disorder (PTSD), fatigue, and perceived stigma among patients with COVID-19 after recovery from the acute phase of COVID-19 infection., Methods: In a cross-sectional online survey, 206 adult patients (age>18 years), recovered from COVID-19 infection completed the Patient Health Questionnaire-4 (PHQ-4), the Impact of Events Scale-Revised (IES-R), Fatigue Severity Scale (FSS), 4 items self-designed questionnaire evaluating cognitive deficits and self-designed questionnaire to evaluate perceived stigma. Additionally, they completed the information about demographic and clinical information., Results: The prevalence of anxiety, depressive symptoms, and PTSD in the study sample was 24.8 %, 23.8 %, and 30 % respectively. About three-fifths of the participants (61.2 %) had at least one fatigue symptom as per the FSS with the mean FSS score being 32.10 ± 15.28. About one-fourth of the participants (23.7 %) reported "feeling confused and always feeling mentally foggy", and 38 % of patients reported experiencing at least one cognitive problem. The level of felt stigma related to self was seen in 31.1 %, 20 % reported stigma related to family, and 50 % reported stigma in relation to neighbors and society. Those reporting higher PTSD scores had higher anxiety and depressive scores, reported more fatigue and stigma, and had a higher level of cognitive deficits. A higher fatigue score was also associated with higher anxiety, depression, and cognitive deficits., Conclusions: Our study reveals that a significant proportion of patients after recovery from COVID-19 experience psychological morbidities, fatigue, cognitive problems, and stigma. Efforts should be made to take care of these issues in routine post-COVID follow-up care., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Pancreatic cancer is one of the most lethal cancers with high metastatic potential and strong chemoresistance. The capability of a tumor to grow and propagate is dependent on a small subset of cells within a tumor, termed cancer stem cells. Cancer stem cells exhibit great tumorigenicity and are closely correlated with drug resistance and tumor recurrence. The aim of our study was to illustrate electrochemotherapy as an effective treatment for pancreatic cancer along with the expression change in stemness genes (Nanog, Sox2 and Oct3/4) in pancreatic cancer cells post electrochemotherapy with bleomycin, cisplatin and oxaliplatin. Our results showed the enhanced expression of Nanog and decreased expression level of Oct3/4 after electrochemotherpy. We thus propose that these stemness markerS may have important roles in the initiation and/or recurrence of pancreatic cancer, and consequently may serve as important molecular diagnostics and/or therapeutic targets for the development of novel treatment strategies in pancreatic cancer patients. In conclusion, targeting these stemness factors could potentially improve electrochemotherapy as a treatment and preventing recurrence., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Novel microcidal silver films for burn dressings have been produced by magnetron sputtering. The nanostructure and dissolution characteristics of these films exhibiting antimicrobial behavior were studied as a function of the process conditions, namely, gas composition, gas pressure and input power, using transmission electron microscopy (TEM), high-resolution scanning electron microscopy, X-ray photoelectron spectroscopy (XPS) and resistivity. TEM revealed that bioactive films were nanocrystalline, with a grain size of the order of 15nm and the presence of twins. Surface morphology studies before and after dissolution suggested that bioactive films released silver at therapeutic levels in the form of nanoparticles or grains. Chemical species identification with XPS showed that the biologically active films were metallic in nature. The importance of oxygen in the sputtering environment, the resultant nanostructure and presence of twins are discussed to explain the unique antimicrobial properties of these silver films.

Objective: To determine whether the sub-Tenon's parabulbar approach for local anesthesia is a safe and effective choice for posterior segment surgery., Design: Prospective, noncomparative case series., Participants: Two hundred seventy-six consecutive patients underwent posterior segment surgery at the University of Texas Medical Branch., Intervention: Two hundred patients received sub-Tenon's parabulbar anesthesia containing an 11 -ml mixture of 5-ml 2% lidocaine (Xylocaine), 5-ml 0.5% bupivacaine (Marcaine), and 1 ml of 150 hyaluronidase (Wydase) units as primary anesthesia. The method did not involve a separate transcutaneous lid nerve or subconjunctival injection., Main Outcome Measures: The proportion of cases receiving supplementation (significant intravenous anesthesia, intraoperative local anesthesia, or both) was estimated. Its relationship to duration of surgery and surgical procedures deemed painful was assessed. Surgery lasting 3 hours or more was considered a long duration. Both scleral buckle and cryotherapy were considered painful procedures. The proportion of cases receiving additional local anesthesia preoperatively was also evaluated. Complications associated with sub-Tenon's parabulbar injection were monitored., Results: There were 101 instances of patients receiving additional anesthesia. Nineteen received additional preoperative sub-Tenon's anesthesia, 12 received intraoperative local anesthesia supplementation, and 70 received intravenous medication. Of these 70, 19 required what the authors defined as a significant amount of intravenous medication, three of whom also received intraoperative local anesthesia supplementation. Consequently, 28 of 200 patients (14%; 95% confidence interval: 9.5, 19.6) received supplementation (significant intravenous anesthesia, intraoperative local anesthesia, or both). The proportion of cases receiving supplementation was directly related to duration of surgery. Patients involved in longer cases (51.7% vs. 7.6%; P < 0.001) and those involved in more painful procedures (48.2% vs. 8.7%; P < 0.001) were more likely to receive supplementation. Adjusting for surgery duration, a greater proportion of patients undergoing painful procedures required supplementation (31.3% vs. 0.5% for surgery < 3 hours, P = 0.003; 72.7% vs. 38.9% for surgery > or = 3 hours, P = 0.13). No associated ocular or systemic complications were observed., Conclusions: The results of this large study demonstrate that a single injection of sub-Tenon's anesthesia is relatively safe and effective for achieving local anesthesia during vitrectomies, with or without other intraocular procedures, lasting less than 3 hours. Other types of posterior segment surgery may require supplementation if they are more painful procedures, such as scleral buckle or cryotherapy, or last longer than 3 hours.

Isolated rupture of the parietal pericardium with herniation of the heart may occur following closed injury of the chest. Such a case is presented here. Clinical suspicion should be aroused by the presence of low cardiac output with localizing signs of cardiac displacement. X-ray films of the chest may reveal important clues and provide an indication for cardiac angiography, which may be diagnostic.