Search

Abstract Background Pulsed‐field ablation (PFA) has emerged as an innovative alternative to radiofrequency (RF) and cryoablation because it selectively targets myocardial tissue. Thus, we aim to estimate the efficacy and safety of PFA versus thermal ablation for atrial fibrillation (AF) ablation. Methods A systematic review and meta‐analysis were retrieved from PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through September 2023. We used RevMan V. 5.4 to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD) with a 95% confidence interval (CI). PROSPERO ID: CRD42023480321 Results We included 17 studies with a total of 2255 patients. PFA was significantly associated with a decreased incidence of AF recurrence (RR: 0.66 with 95% CI [0.51, 0.87], p = .003). However, there was no significant difference between PFA and thermal ablation in arrhythmia recurrence (RR: 0.92 with 95% CI [0.74, 1.46], p = .42). PFA was significantly associated with decreased total procedure time (MD: −15.15 with 95% CI [−20.23, −10.07], p

Abstract Objectives With Artificial Intelligence (AI) profoundly affecting education, ensuring that students in health disciplines are ready to embrace AI is essential for their future workforce integration. This study aims to explore dental students' readiness to use AI, perceptions about AI in health education and healthcare, and their AI‐related educational needs. Material and Methods A cross‐sectional survey was conducted among dental students at the College of Dental Medicine, Qatar University. The survey assessed readiness for AI using the Medical Artificial Intelligence Readiness Scale (MAIRS). Students' perceptions of AI in healthcare and health education and their educational needs were also explored. Results A total of 94 students responded to the survey. AI readiness scores were average (3.3 ± 0.64 out of 5); while participants appeared more ready for the vision and ethics domains of MAIRS, they showed less readiness regarding cognition and ability. Participants scored average on AI perceptions (3.35 ± 0.45 out of 5), with concerns regarding AI risks and disadvantages. They expressed a high need for knowledge and skills related to AI use in healthcare (84%), AI for health‐related research (81.9%), and AI in radiology and imaging procedures (79.8%). Student readiness had a significant correlation with AI perceptions and perceived level of AI knowledge. Conclusions This is the first study in Qatar exploring dental students' AI readiness, perceptions, and educational needs regarding AI applications in education and healthcare. The perceived AI knowledge gaps could inform future curricular AI integration. Advancing AI skills and deepening AI comprehension can empower future dental professionals through anticipated advances in the AI‐driven healthcare landscape.

Abstract Adherence to antihypertensives is crucial for control of blood pressure. This study analyzed factors and interventions that could affect adherence to antihypertensives in the US. PubMed, Scopus, Web of Science, and Embase were searched on January 21, 2022 and December 25, 2023 for studies on the adherence to antihypertensives in the US. Nineteen studies and 23 545 747 patients were included in the analysis, which showed that adherence to antihypertensives was the highest among Whites (OR: 1.47, 95% CI 1.34–1.61 compared to African Americans). Employment status and sex were associated with insignificant differences in adherence rates. In contrast, marital status yielded a significant difference where unmarried patients demonstrated low adherence rates compared to married ones (OR: 0.8, 95% CI 0.67–0.95). On analysis of comorbidities, diabetic patients reported lower adherence to antihypertensives (OR: 0.95, 95% CI 0.92–0.97); furthermore, patients who did not have Alzheimer showed higher adherence rates. Different BMIs did not significantly affect the adherence rates. Patients without insurance reported significantly lower adherence rates than insured patients (OR: 3.93, 95% CI 3.43–4.51). Polypill users had higher adherence rates compared with the free‐dose combination (OR: 1.21, 95% CI 1.2–1.21), while telepharmacy did not prove to be as effective. Lower adherence rates were seen among African Americans, uninsured, or younger patients. Accordingly, interventions such as fixed‐dose combinations should be targeted at susceptible groups. Obesity and overweight did not affect the adherence to antihypertensives.

Abstract Guideline‐directed medical therapy (GDMT) has improved outcomes in patients with heart failure, including the use of renin–angiotensin–aldosterone system inhibitors, which can hinder the excretion of potassium, resulting in hyperkalaemia. New potassium binders (NPBs) can prevent this adverse effect; however, the efficacy and safety of NPB for this indication have not been fully established. We conducted a systematic review and meta‐analysis synthesizing randomized controlled trials (RCTs), which were retrieved by systematically searching PubMed, Web of Science, Scopus, and Cochrane through 26 April 2023. The risk of bias assessment was conducted, following Cochrane's updated Risk of Bias 2 assessment tool. We used the fixed‐effects model to pool dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), with a 95% confidence interval (CI) (PROSPERO ID: CRD42023426113). We included six RCTs with a total of 1432 patients. NPB was significantly associated with successful mineralocorticoid receptor antagonist (MRA) optimization [RR: 1.13 with 95% CI (1.02–1.25), P = 0.02], decreased patients with MRA at less than the target dose [RR: 0.72 with 95% CI (0.57–0.90), P = 0.004], and decreased hyperkalaemic episodes [RR: 0.42 with 95% CI (0.24–0.72), P = 0.002]. However, there was no difference between NPB and placebo regarding angiotensin‐converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB)/angiotensin receptor/neprilysin inhibitor (ANRi) optimization [RR: 1.02 with 95% CI (0.89–1.17), P = 0.76] and serum potassium change [MD: −0.31 with 95% CI (−0.61 to 0.00), P = 0.05], with an acceptable safety profile except for the increased incidence of hypokalaemia with NPB [RR: 1.57 with 95% CI (1.12–2.21), P = 0.009]. NPB has been shown to improve GDMT outcomes by enhancing MRA optimization and reducing hyperkalaemic episodes. However, there are limited data on the effects of NPB on ACEi/ARB/ANRi optimization. Future RCTs should investigate ACEi/ARB/ANRi optimization and conduct head‐to‐head comparisons of NPB (patiromer and sodium zirconium cyclosilicate).

Abstract Purpose This study aimed to compare two different double‐level knee osteotomy (DLO) fixation techniques. The primary outcome reported the radiological coronal plane correction and its accuracy. The secondary outcomes reported the correction outliers, the clinical outcomes, the 5‐year postoperative satisfaction and the complications. Methods A retrospective review of a single surgeon osteotomy database identified 52 cases of DLO between 2011 and 2019, of which 24 cases met the inclusion criteria. Patients were categorised into two groups: the nail‐plate (NP) group fixed with a magnetic extendable intramedullary tibial nail and femoral conventional plate, and the double‐plate (DP) group fixed with conventional plates (tibia and femur). Radiographic parameters were recorded, including the mechanical femorotibial angle (mFTA), medial proximal tibial angle (MPTA), mechanical lateral distal femoral angle (mLDFA), joint line convergence angle (JLCA) and weight‐bearing line ratio (Mikulicz %). Surgical accuracy was calculated as the difference between the achieved and the planned correction. Outliers were defined as those with a greater than 10% difference from the planned correction. Simple knee value scores and visual analogue scale for pain were recorded preoperatively and postoperatively at 2 and 5 years. Five‐year patient satisfaction was recorded. Results A total of 24 patients were included: the NP group (n = 12) and the DP group (n = 12). Significant coronal plane corrections were achieved in the NP group for the mean mFTA (preoperative 167.9° ± 3.4° to postoperative 182.1° ± 1.4°), the mean MPTA (preoperative 83.5° ± 2.9° to postoperative 91.3° ± 2.8°) and the mean mLDFA (preoperative 89.8° ± 3.4° to postoperative 85.9° ± 4.4°). Similarly, significant coronal plane corrections were achieved in the DP group for the mean mFTA (preoperative 168.6° ± 4.4° to postoperative 182.2° ± 2°), the mean MPTA (preoperative 84.2° ± 2° to postoperative 88.3° ± 4.1°) and the mean mLDFA (preoperative 90.7° ± 2.9° to postoperative 83.9° ± 1.7°) (all p

Key Clinical Message Extensive studies are required to understand the behavior as well as prognosis of SS in the colorectal region. IHC staining is essential for the accurate diagnosis when a lesion is encountered at an unusual site.

Abstract Different dosing strategies exist to initiate warfarin, most commonly fixed warfarin dosing (FWD), clinical warfarin dosing (CWD), and genetic‐guided warfarin dosing (GWD). Landmark trials have shown GWD to be superior when compared to FWD in the EU‐PACT trial or CWD in the GIFT trial. COAG trial did not show differences between GWD and CWD. We aim to compare the anticoagulation quality outcomes of CWD and FWD. This is a prospective cohort study with a retrospective comparator. Recruited subjects in the CWD (prospective) arm were initiated on warfarin according to the clinical dosing component of the algorithm published in www.warfarindosing.org. The primary efficacy outcome was the percentage time in the therapeutic range (PTTR) from day 3 to 6 till day 28 to 35. The study enrolled 122 and 123 patients in the CWD and FWD, respectively. The PTTR did not differ statistically between CWD and FWD (62.2 ± 26.2% vs. 58 ± 25.4%, p = 0.2). There was also no difference between both arms in the percentage of visits with extreme subtherapeutic international normalized ratio (INR) (4; 7.7 ± 14.7% vs. 7.5 ± 12.4%, p = 0.92). We conclude that CWD did not improve the anticoagulation quality parameters compared to the FWD method.

Abstract Background and Aim Though emergency medical services (EMS) respond to all types of emergency calls, they do not always result in the patient being transported to the hospital. This study aimed to explore the determinants influencing emergency call‐response‐based conveyance decisions in a Middle Eastern ambulance service. Methods This retrospective quantitative analysis of 93,712 emergency calls to the Hamad Medical Corporation Ambulance Service (HMCAS) between January 1 and May 31, 2023, obtained from the HMCAS electronic system, was analyzed to determine pertinent variables. Sociodemographic, emergency dispatch‐related, clinical, and miscellaneous predictors were analyzed. Descriptive, bivariate, ridge logistic regression, and combination analyses were evaluated. Results 23.95% (N = 21,194) and 76.05% (N = 67,285) resulted in patient nontransport and transportation, respectively. Sociodemographic analysis revealed that males predominantly activated EMS resources, and 60% of males (n = 12,687) were not transported, whilst 65% of females (n = 44,053) were transported. South Asians represented a significant proportion of the transported patients (36%, n = 24,007). “Home” emerged as the primary emergency location (56%, n = 37,725). Bivariate analysis revealed significant associations across several variables, though multicollinearity was identified as a challenge. Ridge regression analysis underscored the role of certain predictors, such as missing provisional diagnoses, in transportation decisions. The upset plot shows that hypertension and diabetes mellitus were the most common combinations in both groups. Conclusions This study highlights the nuanced complexities governing conveyance decisions. By unveiling patterns such as male predominance, which reflects Qatar's expatriate population, and specific temporal EMS activity peaks, this study accentuates the importance of holistic patient assessment that transcends medical histories.

Abstract Modular Multilevel Converters (MMCs) are promising candidates for high‐voltage high‐power applications. The main challenge of the MMCs is the zero‐frequency operation. To achieve a successful DC–DC conversion process with balanced capacitors’ voltages with limited voltage ripple, this paper suggests the employment of the conventional two‐leg half‐bridge submodule‐based MMC structure in conjunction with a single bidirectional high‐voltage (HV) valve across the low‐voltage side. In the suggested structure, the HV valve is controlled on and off to ensure energy equalization for the MMC arms. In addition, soft‐switching for the HV valve is proposed to reduce the switching losses. Detailed illustration and design of the proposed concept are presented. Simulation and experimentation results are elucidated to show the effectiveness of the proposed DC–DC hybrid MMC. The results showed efficient performance of the suggested converter.

Abstract Mineral oil is the most frequent insulating liquid used in oil‐immersed transformers for electrical insulation and heat dissipation. However, oil‐based nanofluids are becoming more popular in scientific research as they have proved to have better dielectric and thermal characteristics. When applying these nanofluids into actual transformers, they would be exposed to thermal and electrical stresses. Thus, The aim of the authors is to investigate the generation pattern of dissolved gases in nanofluids under thermal and electrical faults and to assess the applicability of traditional Dissolved Gas Analysis (DGA) techniques if oil‐based nanofluids are used in transformers. Oil‐based nanofluid samples were prepared using a magnetic stirrer and an ultrasonic homogeniser and then subjected to simulated thermal and electrical faults in the laboratory using properly sealed test cells. Three types of metal oxides, Silicon dioxide, Titanium dioxide, and Aluminium oxide nanoparticles, have been used to prepare nanofluids with 0.02 g/L and 0.04 g/L concentrations. The gases released and dissolved into oil due to the simulated faults were analysed and compared to traditional mineral oil as a benchmark. The dielectric dissipation factor was obtained and analysed for all samples. According to the findings, the presence and concentration of nanoparticles were shown to influence the amount of gases produced. As a result, this research is crucial in guaranteeing that traditional DGA techniques can be employed in transformers that use oil‐based nanofluids.

The edible part of the prickly pear fruit is most commonly consumed, while the peel is often discarded, leading to the loss of valuable bioactive components, such as phenolic compounds. This research aims to assess the antioxidant activity, total phenolic content, and quantities of phenolic and flavonoid contents of fruit peel of Opuntia ficus-indica, Opuntia robusta, and Opuntia dillenii. Ten phenolic compounds were identified, with isorhamnetin being the most abundant flavonoid measuring 7184.09 μg/g, while sinapic acid was identified as the major phenolic acid measuring 1806.36 μg/g. Opuntia robusta exhibited the highest total phenolic content, total flavonoids, and total phenolic acids measuring 5583.19 mg GAE 100 g−1, 21041.03 μg/g, and 3265.17 μg/g, respectively. Opuntia robusta and Opuntia dillenii demonstrated the higher antioxidant capacity in scavenging 2,2-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid) compared to Opuntia ficus-indica, whereas Opuntia dillenii and Opuntia ficus-indica exhibited the highest concentration of antioxidants capable of reducing the Fe3+ complex of ferric ions (TPTZ)3+ to the ferrous complex Fe (TPTZ)2+. In contrast, the 2,2-diphenyl-1-picrylhydrazyl (DPPH) and total antioxidant capacity (TAC) assays showed no significant difference between the examined species. Compared to the local species Opuntia ficus-indica, the two newly introduced Dactylopius opuntiae-resistant species are richer in phenolic compounds and exhibit greater antioxidant activity.

In today’s data-driven world, we are constantly exposed to a vast amount of information. This information is stored in various information systems and is used for analysis and management purposes. One important approach to handle these data is through the process of clustering or categorization. Clustering algorithms are powerful tools used in data analysis and machine learning to group similar data points together based on their inherent characteristics. These algorithms aim to identify patterns and structures within a dataset, allowing for the discovery of hidden relationships and insights. By partitioning data into distinct clusters, clustering algorithms enable efficient data exploration, classification, and anomaly detection. In this study, we propose a novel centroid-based clustering algorithm, namely, the morphological accuracy clustering algorithm (MAC algorithm). The proposed algorithm uses a morphological accuracy measure to define the centroid of the cluster. The empirical results demonstrate that the proposed algorithm achieves a stable clustering outcome in fewer iterations compared to several existing centroid-based clustering algorithms. Additionally, the clusters generated by these existing algorithms are highly susceptible to the initial centroid selection made by the user.

Prickly pear serves as a significant source of income for farmers worldwide, with production taking place in temperate, subtropical, and cold regions. The objective of the present investigation is to explore the morphological parameters of Opuntia robusta and Opuntia dillenii which are resistant to the white cochineal (Dactylopius opuntiae), as well as the local prickly pear that is currently threatened with extinction. This investigation aims to evaluate the feasibility of replacing the endangered local prickly pear with the recently introduced species O. robusta and O. dillenii. This analysis is based on a comprehensive assessment of 26 qualitative and 25 quantitative traits pertaining to cladodes and fruits. In terms of species differentiation and the selection of discriminative features, this study demonstrates the effectiveness of various statistical methods, as well as the analysis carried out according to the descriptors recommended by the International Union for the Protection of New Varieties of Plants (UPOV). Of the 51 parameters evaluated, 13 qualitative and 23 quantitative characters are significant in differentiating the species under study. This underscores the importance of quantitative traits in distinguishing different prickly pear species. Furthermore, color is identified as a crucial characteristic for discriminating between the studied samples. O. robusta is characterized by its high fruit weight, large size, greater pulp content, and high pulp-to-peel ratio, all of which are desirable traits for fresh consumption. Additionally, O. robusta has the highest number of fully developed seeds, making it an attractive option for use in the cosmetic industry. This characteristic renders the O. robusta a potential substitute for the endangered ecotype . However, O. robusta is distinguished by its short stalk, which poses a challenge for fruit harvesting and leaves it susceptible to physical damage and quality loss. Conversely, O. dillenii displays a low pulp content, which serves as a critical indicator of fruit quality. The only desirable agronomic trait of this species is its elevated seed content, which has the potential for utilization in oil production for the cosmetic industry.

Key Clinical Messages Diagnosis of rare even can be missed due to less familiarity with the disorder. In patients with muscle weakness, infectious causes are prioritized. Electrolyte profile not only identifies the problem, but also prevents unnecessary workup. Abstract In underdeveloped countries, diagnosis of rare disorders is usually delayed due to less familiarity of the clinicians to such disorders. As a result, infectious and inflammatory causes for an ailment are prioritized as compared to non‐infectious etiologies. Hypokalemic periodic paralysis (PP) is a rare disorder, characterized by episodic muscle weakness that can rarely be associated with life‐threatening cardiac arrhythmia. A teenage Afghan boy presented to the emergency department with an acute flaccid paralysis, that started 1 h after intense exercise The weakness involved both, the upper and lower extremities. Laboratory investigations, led to the impression of hypokalemic PP, precipitated by intense exercise. Accordingly, intravenous potassium chloride infusion diluted with normal saline led to the complete resolution of paralysis as well as correction of electrocardiographic changes. The list of differential diagnosis for flaccid muscle paralysis is wide, which generally requires a extensive investigations, but in hypokalemic PP, a cardinal electrolytes profile can lead towards early diagnosis. High degree of clinical suspicion with appropriate history taking and physical examination helps with the immediate identification and management of this disorder.

Key Clinical Message Poncet's disease is an acute onset reactive polyarthritis associated with tuberculosis infection. Although uncommon, the diagnosis should be considered among patients presenting with symmetrical polyarthritis in tuberculosis‐endemic regions. Abstract This is a case report of Poncet's disease presenting as bilateral knee and wrist pain associated with swelling. Joint x‐rays and immunological assays were normal. A chest x‐ray and Gene‐Xpert diagnosed tuberculosis. A complete resolution of symptoms was attained following the completion of antituberculous therapy regimen.

Key clinical message Lesions that are suspected for malignancy need be managed by a multidisciplinary team. Utilization of radiological as well as pathological diagnostic modalities ensures correct diagnosis and thus timely intervention. Abstract Introduction Proteus mirabilis is a Gram‐negative rod. It is a highly motile bacterium that belongs to the Enterobacteriaceae. Lung infection and pneumonia caused by p. mirabilis is extremely rare and occurs in patients with chronic debilitation or chronic lung disease. Case Presentation A 65‐year‐Old Woman presented with dry cough, dyspnoea on exertion, and chest pain of 4 months' duration. She received multiple medications including antibiotics but without any resolution of her symptoms. Computed Tomography scan of the chest was performed reported a tumor in the upper lobe of the left lung with multiple associated pulmonary nodules. The impression was that of metastatic lung disease with superimposed acute infection. Accordingly, the patient was reevaluated and a diagnostic bronchoscopy with multiple endobronchial biopsies and broncho‐alveolar lavage was done. The gram stain showed Gram‐Negative Bacilli and the bacteria identified P. mirabilis. Conclusion Mass lesions suspected for malignancy should be managed with involvement of multiple medical disciplines, to ensure correct and timely diagnosis. This is to avoid miss‐management.

Abstract Background Dyslipidemia is recognized as one of the risk factors of cardiovascular diseases (CVDs), type 2 diabetes mellitus (T2DM), and non‐alcoholic fatty liver disease (NAFLD). Objective The study aimed to investigate the association between selected single nucleotide polymorphisms (SNPs) with dyslipidemia and increased susceptibility risks of CVD, NAFLD, and/or T2DM in dyslipidemia patients in comparison with healthy control individuals from the Qatar genome project. Methods A community‐based cross‐sectional study was conducted among 2933 adults (859 dyslipidemia patients and 2074 healthy control individuals) from April to December 2021 to investigate the association between 331 selected SNPs with dyslipidemia and increased susceptibility risks of CVD, NAFLD and/or T2DM, and covariates. Results The genotypic frequencies of six SNPs were found to be significantly different in dyslipidemia patients subjects compared to the control group among males and females. In males, three SNPs were found to be significant, the rs11172113 in over‐dominant model, the rs646776 in recessive and over‐dominant models, and the rs1111875 in dominant model. On the other hand, two SNPs were found to be significant in females, including rs2954029 in recessive model, and rs1801251 in dominant and recessive models. The rs17514846 SNP was found for dominant and over‐dominant models among males and only the dominant model for females. We found that the six SNPs linked to gender type had an influence in relation to disease susceptibility. When controlling for the four covariates (gender, obesity, hypertension, and diabetes), the difference between dyslipidemia and the control group remained significant for the six variants. Finally, males were three times more likely to have dyslipidemia in comparison with females, hypertension was two times more likely to be present in the dyslipidemia group, and diabetes was six times more likely to be in the dyslipidemia group. Conclusion The current investigation provides evidence of association for a common SNP to coronary heart disease and suggests a sex‐dependent effect and encourage potential therapeutic applications.

Abstract Clonal evolution in acute leukemias is one of the most important factors that leads to therapeutic failure and disease relapse. Delay in therapeutic intervention is one of the reasons that leads toward clonal evolution. In this report, we present a case of acute lymphoblastic leukemia in which therapeutic delay resulted in clonal evolution that was detected by conventional karyotyping and was responsible for non‐responsiveness of the disease to conventional chemotherapy. A 17‐year‐old boy presented with generalized body aches, rapidly progressive pallor and lethargy. Bone marrow analysis was consistent with the diagnosis of B‐cell ALL. Karyotypic analysis revealed 46, XY male karyotype. The patient left the hospital due to financial reasons and after 40 days came back to the hospital. Repeated bone marrow analysis including cytogenetic studies revealed presence of three different clones of blast cells: one clone showed 46, XY with del(9p) and t (11;14), second clone showed 46, XY with del(7q) and del(9p), and the third clone showed 46, XY normal karyotype. The patient did not respond to chemotherapy and died within 1 week of induction chemotherapy (HyperCVAD‐A). Timely diagnosis and institution of chemotherapy in acute leukemias patients is the key to prevent clonal evolution and thus resistance of the disease to therapeutic interventions.

Key Clinical Message Sclerotherapy is a convenient modality for the treatment of venous malformation. Ethanol as a sclerosing agent is easily available and cheap. Sclerotherapy for venous malformations has both functional as well as aesthetic outcome.

Abstract In this work, a novel three‐phase unidirectional off‐board Electric Vehicles (EVs) fast charger is proposed. Each phase of the proposed converter consists of a two‐stage converter. The first stage is an AC–DC front‐end converter with power factor correction (PFC) control. The front‐end AC–DC converter is based on an isolated boost converter, which has a boosting capability and provides galvanic isolation. In this stage, parallel‐in parallel‐out isolated boost converter modules are employed in each phase. This enables sharing the current among modules to avoid implementing one module with a high current rating to meet the fast‐charging requirements. The multimodule option provides fault‐ride through capability for the proposed charger. The DC outputs of involved phases, that is, three isolated DC voltages, are fed to three cascaded DC–DC unidirectional buck converters. The charging terminals are used to charge the EV battery through a filter inductor with a charging current controller's aid. A detailed illustration of the suggested closed‐loop controllers is presented to ensure a successful operation for the proposed architecture. A simulation case study for a 25‐kW charger is presented. Finally, a 1‐kW prototype is implemented for experimental validation.

Abstract Background Acute promyelocytic leukaemia results from reciprocal translocation between the long arms of chromosomes 15 and 17. This translocation leads to the formation of chimeric gene, which is both the diagnostic marker as well as the therapeutic target of the disease. Additional chromosomal abnormalities are randomly encountered either at diagnosis or during therapy. Here, we present a case of acute promyelocytic leukaemia that had a rare cytogenetic profile at diagnosis. Case presentation Our patient was a 14‐year‐old boy, who presented with characteristic clinical and morphological features of acute promyelocytic leukaemia. Karyotypic analysis revealed trisomy of chromosome 8 with deletion of 9p in addition to t(15;17). The patient passed away within the first 8 h of presentation while receiving conventional chemotherapy and haemodynamic resuscitation. Conclusion Our patient presented with a rare cytogenetic profile and rapidly progressive disease. According to our extensive literature search, this was the first case of acute promyelocytic leukaemia having pathognomonic t(15;17) along with trisomy 8 and 9q deletion.

Breast cancer is a lethal disease in females worldwide and needs effective treatment. Targeting cancer cells with selective and safe treatment seems like the best choice, as most chemotherapeutic drugs act unselectively. Papaverine showed promising antitumor activity with a high safety profile and increased blood flow through vasodilation. At the same time, it was widely noticed that virotherapy using the Newcastle disease virus proved to be safe and selective against a broad range of cancer cells. Furthermore, combination therapy is favorable, as it attacks cancer cells with multiple mechanisms and enhances virus entrance into the tumor mass, overcoming cancer cells’ resistance to therapy. Therefore, we aimed at assessing the novel combination of the AMHA1 strain of Newcastle disease virus (NDV) and nonnarcotic opium alkaloid (papaverine) against breast cancer models in vitro and in vivo. Methods. In vitro experiments used two human breast cancer cell lines and one normal cell line and were treated with NDV, papaverine, and a combination. The study included a cell viability MTT assay, morphological analysis, and apoptosis detection. Animal experiments used the AN3 mouse mammary adenocarcinoma tumor model. Evaluation of the antitumor activity included growth inhibition measurement; the immunohistochemistry assay measured caspase protein expression. Finally, a semiquantitative microarray assay was used to screen changes in apoptotic proteins. In vitro, results showed that the combination therapy induces synergistic cytotoxicity and apoptosis against cancer cells with a negligible cytotoxic effect on normal cells. In vivo, combination treatment induced a significant antitumor effect with an obvious regression in tumor size and a remarkable and significant expression of caspase-3, caspase-8, and caspase-9 compared to monotherapies. Microarray analysis shows higher apoptosis protein levels in the combination therapy group. In conclusion, this study demonstrated the role of papaverine in enhancing the antitumor activity of NDV, suggesting a promising strategy for breast cancer therapy through nonchemotherapeutic drugs.

Abstract A teenage Afghan girl presented with seizure. Clinical features and laboratory investigations revealed elevated serum parathormone, high phosphate levels with low serum calcium. In third‐world countries, diagnosis of rare disorders, such as Albright hereditary osteodystrophy (AHO), can usually be delayed due to scarcity of standard medical and diagnostic services.

It is shown that naturally occurring under‐extrusion results in mechanically weak prints while over‐extrusion causes excess use of material with little strength gain. Herein, a deep‐learning‐based computer vision system to correct under‐ and over‐extrusion issues commonly found in 3D printing technology such as the fused deposition modeling (FDM) is developed. The adaptive correction system is created to acquire recurring images of print‐in‐progress, allowing pretrained convolutional neural network (CNN) models to classify the printing condition. Then the classification data allow the adaptive system to make subsequent changes of printing parameters in a simple feedback loop to correct printing extrusion in an average of four to eight printed layers. The result shows that the system can improve the strength consistency of the prints by reducing yield strength variance by a factor of six through in situ correction. This system strengthens weaker prints by up to 200% and can save up to 40% material amount in extreme over‐extruded cases. In the future, the deep‐learning approach demonstrated in this design can be expanded to correct different parameters and its corresponding defects in the other 3D printing technologies with the same methods.

Abstract New options for treatment escalation in critically ill COVID‐19 patients are unmet need. Five critically ill patients were treated using a low‐dose protocol thrombolytic therapy in the form of intravenous alteplase infusion over 15 min (0.6 mg/kg). This therapeutic intervention yielded an immediate favorable outcome on follow up and all five patients were extubated and transferred to the ward. This report suggests that bedside echocardiography can be a beneficial tool in the urgent assessment of the right ventricle—to—pulmonary vascular coupling in mechanically ventilated COVID‐19 patients, and thrombolytic therapy may be beneficial in hemodynamically unstable patients who show echocardiographic criteria of right ventricular strain.

Abstract Epilepsia partialis continua is a rare epileptic syndrome presenting with simple, partial, repetitive motor seizures. It can be a result of structural central nervous system lesion or due to metabolic causes. We report a case of a 65‐year‐old male patient diagnosed with EPC secondary to diabetic ketoacidosis.

Abstract Chronic myelogenous leukemia is a myeloproliferative neoplasm characterized by the BCR‐ABL1 fusion gene and the development of the Philadelphia chromosome, which leads to an increase in granulocytes and bone marrow myeloid precursors in the blood, it can lead to many possible complications depending on the disease stage at the time of diagnosis. The Morel‐Lavallée lesion (MLL) is a closed traumatic soft‐tissue degloving injury, that results from the separation of the hypodermis from the underlying fascia, with resultant hemo‐lymphatic fluid collection between the tissue layers. We report a case of a 48‐year‐old male patient, with no chronic illnesses, who presented with 2 weeks history of posterior chest wall pain and swelling. Initial investigation showed a white blood cell count of 364.4 × 103/μl. Bone marrow pathology report findings were consistent with chronic myeloid leukemia (CML), and the BCR‐ABL test came positive. CT chest with contrast showed a large chest wall lesion, suggestive of a Morel‐Lavallee lesion. Ultrasound‐guided aspiration of the lesion yielded 20 mm of fluid from the thick hematoma. Histopathology of the fluid showed Necrotic debris with mixed inflammation. Patient's condition improved, and he was discharged on Dasatinib with follow‐up in hematology and surgery clinics.

Abstract One of the main challenges that impact transportation systems electrification is their batteries' charging process. This work presents the development of a three‐phase ultra‐fast Electric Vehicle (EV) charger based on the SEPIC converter. Since SEPIC operating in Discontinuous Conduction Mode (DCM) is usually recommended for low‐power applications, this work proposes a scheme for its employment in high‐power EV chargers. This is achieved through three single‐phase modules of interleaved SEPIC converters. The presented scheme ensures reducing the stresses on the semiconductor devices since the power is divided over the interleaved modules. The design addresses DCM operation in terms of both capacitor voltage and inductor current (DCVM and DICM, respectively). This paper examines the analysis of the proposed converter and the small‐signal modelling. Also, the converter efficiency is assessed. A Constant Current (CC) charging approach is deployed for charging the EV battery. The validation of the designs is explored through simulation results using MATLAB/Simulink platform. A 4 kW experimental prototype for the interleaved SEPIC DC–DC converter is built to verify the claimed contributions with 92% efficiency.

Summary Pseudomonas aeruginosa produces phenazine‐1‐carboxylic acid (PCA) and pyocyanin (PYO), which aid its anaerobic survival by mediating electron transfer to distant oxygen. These natural secondary metabolites are being explored in biotechnology to mediate electron transfer to the anode of bioelectrochemical systems. A major challenge is that only a small fraction of electrons from microbial substrate conversion is recovered. It remained unclear whether phenazines can re‐enter the cell and thus, if the electrons accessed by the phenazines arise mainly from cytoplasmic or periplasmic pathways. Here, we prove that the periplasmic glucose dehydrogenase (Gcd) of P. aeruginosa and P. putida is involved in the reduction of natural phenazines. PYO displayed a 60‐fold faster enzymatic reduction than PCA; PCA was, however, more stable for long‐term electron shuttling to the anode. Evaluation of a Gcd knockout and overexpression strain showed that up to 9% of the anodic current can be designated to this enzymatic reaction. We further assessed phenazine uptake with the aid of two molecular biosensors, which experimentally confirm the phenazines’ ability to re‐enter the cytoplasm. These findings significantly advance the understanding of the (electro) physiology of phenazines for future tailoring of phenazine electron discharge in biotechnological applications.

Abstract Medium‐/High Voltage DC grids are interesting for the integration of renewable energy sources. DC‐DC conversion systems are highly needed for the development of DC grids. Recently, Modular Multilevel Converter (MMC) is the most promising technology for medium‐/high‐voltage applications, but employing the conventional MMC with DC output voltage leads to diversion in the Submodule (SM) capacitor voltages, that is energy drift. This paper proposes a modified modular multilevel DC‐DC converter with self‐energy equalization, which ensures successful DC‐DC conversion with balanced capacitors voltages. In the modified topology, clamping Insulated Gate Bipolar Transistors (IGBTs) are employed in each arm to enable parallel‐connection of the capacitors in the same arm. During the operation (equalization period), the parallel‐connected upper capacitors are connected to the parallel‐connected lower capacitors in each leg through a small limiting inductor to transfer energy between the arms to ensure balanced capacitor voltages. The proposed configuration, along with the operational concepts, mathematical analysis, and design, are presented. Finally, simulation and experimental results are presented for validation.

Cytokine storm is one of the causative deaths in a patient with severe acute respiratory syndrome. This study aimed at evaluating the prophylaxis effect of quercetin complexes with zinc and buffered ascorbic acid upon cytokine storm induction in mice and identifying the complex’s acute toxicity. Mice were randomly divided into three groups: group A, control group, received 0.9% normal saline; group B received 100 mg/kg of the complex one hour before lipopolysaccharide (LPS) administration; and group C received the LPS IP 5 mg/kg. Then, levels of interleukin 1 and interleukin 6 were measured in the serum, and lung and kidney tissues were investigated for any changes that may have happened. Thirty mice were used to investigate the acute toxicity; mice were distributed into six groups: one control group and five treated groups; then several serial dilutions from the complex have been prepared for different concentrations from 5 g/kg to 0.312 g/kg. The animals were observed for 14 days. The LD50 was deduced by the straight-line equation calculated from the dose-response curve. The results in this study showed that group A had no significant tissue change. LPS group C showed tissue damage in the lung and kidney, which significantly prevented by the pretreated complex in group B. Moreover, the complex’s acute toxicity value (LD50) was 655 mg/kg. In conclusion, the complex has significantly ameliorated LPS-induced acute lung and kidney injury, largely through suppression of inflammation; the large lethal dose value may make the complex have a promising therapeutic effect in the prevention of cytokine storm.

Aim. To assess incidence and characteristics of post-laparoendoscopic single-site donor nephrectomy (LESS DN) testicular pain. Materials and Methods. A prospective comparative study of all male donors post-left LESS DN (group A) vs. postopen nephrectomies (group B) was performed at our center. Patients’ demographics, perioperative data, and postoperative consultation reports were reviewed. Testicular pain, swelling, numbness, urinary symptoms, and sexual dysfunction were evaluated. Patients with a history of scrotal pathology or surgical procedure were excluded. Pain and tenderness were scored on a standard 10-point scale. Results. From September 2017 to December 2020, 85 and 35 male patients of groups A and B met the evaluation criteria. Ipsilateral testicular pain developed in 11 patients (15.3%) and 2 patients (9.5%) in groups A and B, respectively. In most instances, the pain was mild to moderate in severity, started after 6 ± 2.1 and 4 ± 1.1 days postoperatively in groups A and B, respectively. Six patients in group A were evaluated with transscrotal ultrasonography that showed no abnormalities. All patients in both groups responded well to medical treatment. Conclusions. Post-LESS DN ipsilateral testicular pain is usually mild and self-limited. Preoperative patient education and discussion of the possibility of development of testicular pain and its management should be an integral component of laparoscopic donor nephrectomy informed consent.

Tracking of moving objects in video sequences is an important research problem because of its many industrial, biomedical, and security applications. Significant progress has been made on this topic in the last few decades. However, the ability to track objects accurately in video sequences that have challenging conditions and unexpected events, e.g. background motion and shadows; objects with different sizes and contrasts; a sudden change in illumination; partial object camouflage; and low signal‐to‐noise ratio, remains an important research problem. To address such difficulties, the authors developed a robust multiscale visual tracker that represents a captured video frame as different subbands in the wavelet domain. It then applies N independent particle filters to a small subset of these subbands, where the choice of this subset of wavelet subbands changes with each captured frame. Finally, it fuses the outputs of these N independent particle filters to obtain final position tracks of multiple moving objects in the video sequence. To demonstrate the robustness of their multiscale visual tracker, they applied it to four example videos that exhibit different challenges. Compared to a standard full‐resolution particle filter‐based tracker and a single wavelet subband (LL)2‐based tracker, their multiscale tracker demonstrates significantly better tracking performance.

Background Patient selection and outcomes for percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) have changed over the past decade. However, there is limited information on outcomes for both revascularization strategies in the same population. The study evaluated temporal changes in risk profile, procedural characteristics, and clinical outcomes for PCI‐ and CABG‐treated patients. Methods and Results We analyzed all PCI and isolated CABG between 2005 and 2017 in nonfederal hospitals in Washington State. Descriptive analysis was performed to evaluate temporal changes in risk profile and, risk‐adjusted in‐hospital mortality. Over the study period, 178 474 PCI and 36 592 CABG procedures were performed. PCI and CABG volume decreased by 2.9% and 22.6%, respectively. Compared with 2005–2009, patients receiving either form of revascularization between 2014 and 2017 had a higher prevalence of comorbidities including diabetes mellitus and hypertension and dialysis. Presentation with ST‐segment–elevation myocardial infarction (17% versus 20%) and cardiogenic shock (2.4% versus 3.4%) increased for patients with PCI compared with CABG. Conversely, clinical acuity decreased for patients receiving CABG over the study period. From 2005 to 2017, mean National Cardiovascular Data Registry CathPCI mortality score increased for patients treated with PCI (20.1 versus 22.4, P

Objective. To perform a proof of concept microbiome evaluation and PD-L1 expression profiling in clear-cell renal cell carcinoma (cc-RCC) with associated tumor thrombus (TT). Methods. After IRB approval, six patients underwent radical nephrectomy (RN) with venous tumor thrombectomy (VTT). We collected fresh tissue specimens from normal adjacent, tumor, and thrombus tissues. We utilized RNA sequencing to obtain PD-L1 expression profiles and perform microbiome analysis. Statistical assessment was performed using Student’s t-test, chi-square, and spearman rank correlations using SPSS v25. Results. We noted the tumor thrombus to be mostly devoid of diverse microbiota. A large proportion of Staphylococcus epidermidus was detected and unknown if this is a surgical or postsurgical contaminant; however, it was noted more in the thrombus than other tissues. Microbiome diversity profiles were most abundant in the primary tumor compared to the thrombus or normal adjacent tissue. Differential expression of PD-L1 was examined in the tumor thrombus to the normal background tissue and noted three of the six subjects had a threshold above 2-fold. These three similar subjects had foreign microbiota that are typical residents of the oral microbiome. Conclusion. Renal tumors have more diverse microbiomes than normal adjacent tissue. Identification of resident oral microbiome profiles in clear-cell renal cancer with tumor thrombus provides a potential biomarker for thrombus response to PD-L1 inhibition.

Carbamazepine is an antiepileptic drug that can cause seizures in overdose. In certain patient populations, this may be misdiagnosed as a seizure disorder. We describe a case of a 20-month-old female who presented with fever and seizure-like activity who was initially thought to have complex febrile seizures. Further historical information prompted carbamazepine level to be checked, which was found to be 29 mcg/ml (therapeutic range of 4–12 mcg/ml). Her carbamazepine levels downtrended with multidose activated charcoal. Her condition improved, and she was discharged without evidence of permanent neurologic sequelae. This case illustrates that xenobiotic exposure should often be considered, even if historical clues are not present, as they can often present as other conditions leading to misdiagnosis and delayed treatment.

Background. Cardiovascular complications are the most serious threat to diabetic patients. Associated metabolic and microvascular changes are the main cause of cardiac function affection, and the earliest cardiac change is diastolic dysfunction. Assessment of LA function changes is a key to determine early heart damage of diabetic patients. Objectives. To evaluate the effect of diabetes mellitus on left atrial volumes and functions by using real-time 3-dimensional echocardiography in normotensive patients free from cardiovascular disease. Methods. The study included 110 individuals, 50 controls and 60 patients with diabetes mellitus, 30 patients with type 1 diabetes mellitus and 30 patients with type 2 diabetes mellitus. 2-dimensional echocardiography was used to assess the LA maximum volume and LA phasic volumes, and LA maximum volume indexed to body surface area were measured by 3D echocardiography. LA functions (LA total stroke volume, LA active stroke volume, and LA active emptying fraction) were obtained from RT3D volumetric analysis. Results. The results of the analysis revealed that type 2 diabetes mellitus showed enlarged Vmax, Vmin, and LAVi with an increased LA total stroke volume and decreased active emptying fraction, while type 1 diabetics showed only decreased in active emptying fraction. The LA maximum volume indexed to body surface area (LAVi) was significantly higher in type 2 diabetic patients as compared to normal controls which was 23.55±3.37 ml/m2 versus 20.30. Conclusion. Patients with type 2 diabetes mellitus have an increased LA volume with impaired compliance and contractility, while patients with type 1 diabetes mellitus have only impaired contractility compared to nondiabetic subjects.

This paper proposes a new high-voltage pulse generator (PG) fed from a low-voltage DC supply V(s), which charges one arm of N series-connected full-bridge (FB) modular multilevel converter (MMC) sub-module (SM) capacitors sequentially, through a resistive-inductive branch. By utilising FB-SMs, the proposed PG is able to generate bipolar rectangular pulses of peak NV(s) and unipolar rectangular pulses of either polarity, at high repetition rates. Asymmetrical pulses are also possible. The proposed topology is assessed via simulation and scaled-down experimentation, which establish the viability of the topology for water treatment applications.

Plasmablastic lymphoma (PBL) is an aggressive malignancy that usually occurs in the setting of immunosuppression. The immunohistochemical profile of PBL is that of terminally differentiated B lymphocytes. CD138, CD38, and MUM1 are usually immunopositive. However, pan B-cell markers such as CD20 and PAX-5 are usually negative. MYC rearrangement is the most commonly encountered genetic alteration, with immunoglobulin (IG), especially immunoglobulin heavy (IGH) chain, being the most frequent partner. We report a case of PBL in a 48-year-old human immunodeficiency virus- (HIV-) positive male who was admitted to the hospital with signs and symptoms suspicious for tumor lysis syndrome. Bone marrow examination revealed hypercellular marrow with trilineage hypoplasia and sheets of intermediate to large neoplastic cells with basophilic vacuolated cytoplasm comprising the majority of cellular elements of the bone marrow. The neoplastic cells were negative for conventional B-cell, T-cell, plasma cell, and myeloid markers, while flow cytometric analysis revealed an abnormal CD45-dim population that was partially weakly positive for CD71 and CD79b. The diagnosis was initially thought to be a high-grade primitive hematopoietic neoplasm, possibly an acute undifferentiated leukemia. BOB-1, however, was immunopositive in the neoplastic cells, confirming its B-cell origin. MYC was positive by immunohistochemistry and break-apart FISH, as were CD45, MUM-1, and EMA immunostains. There was immunoglobulin kappa (IGK) light chain gene rearrangement by polymerase chain reaction (PCR). Additionally, Epstein–Barr virus- (EBV–) encoded small RNAs (EBER) were positive by in situ hybridization (ISH). The tumor proliferation index by Ki-67 immunostaining approached 95%. Although the tumor cells were negative for CD38 and CD138, the diagnosis of PBL was still rendered. We recommend using a broad spectrum of B-cell markers, including BOB-1 and OCT-2, in such challenging cases of B-cell lymphomas with no expression of conventional B-cell markers. We also emphasize that the negative CD38 and CD138 should not exclude PBL from the differential diagnosis.

Background Invasive measures of microvascular resistance in the culprit coronary artery have potential for risk stratification in acute ST‐segment–elevation myocardial infarction. We aimed to investigate the pathological and prognostic significance of coronary thermodilution waveforms using a diagnostic guidewire. Methods and Results Coronary thermodilution was measured at the end of percutaneous coronary intervention, (PCI) and contrast‐enhanced cardiac magnetic resonance imaging (MRI) was intended on day 2 and 6 months later to assess left ventricular (LV) function and pathology. All‐cause death or first heart failure hospitalization was a pre‐specified outcome (median follow‐up duration 1469 days). Thermodilution recordings underwent core laboratory assessment. A total of 278 patients with acute ST‐segment elevation myocardial infarction EMI (72% male, 59±11 years) had coronary thermodilution measurements classified as narrow unimodal (n=143 [51%]), wide unimodal (n=100 [36%]), or bimodal (n=35 [13%]). Microvascular obstruction and myocardial hemorrhage were associated with the thermodilution waveform pattern (P=0.007 and 0.011, respectively), and both pathologies were more prevalent in patients with a bimodal morphology. On multivariate analysis with baseline characteristics, thermodilution waveform status was a multivariable associate of microvascular obstruction (odds ratio [95% confidence interval]=5.29 [1.73, 16.22];, P=0.004) and myocardial hemorrhage (3.45 [1.16, 10.26]; P=0.026), but the relationship was not significant when index of microvascular resistance (IMR) >40 or change in index of microvascular resistance (5 per unit) was included. However, a bimodal thermodilution waveform was independently associated with all‐cause death and hospitalization for heart failure (odds ratio [95% confidence interval]=2.70 [1.10, 6.63]; P=0.031), independent of index of microvascular resistance>40, ST‐segment resolution, and TIMI (Thrombolysis in Myocardial Infarction) Myocardial Perfusion Grade. Conclusions The thermodilution waveform in the culprit coronary artery is a biomarker of prognosis and may be useful for risk stratification immediately after reperfusion therapy.

Dasatinib is an oral second-generation multitarget tyrosine-kinase inhibitor (TKI) that is efficacious in treating imatinib-resistant chronic myeloid leukemia (CML) or intolerant cases. Noncutaneous adverse effects with dasatinib are well known in the literature, most commonly cytopenias and fluid retention, while pigmentary abnormalities have rarely been reported. We report the case of a 12-year-old male known case of CML, who presented to dermatology clinic approximately 2 years after initiating dasatinib treatment, with new-onset hypopigmentation of his upper limb, upper chest, and both knees of six months’ duration.

BackgroundThe impact of percutaneous coronary intervention (PCI) on chronic total occlusion in patients with well‐developed collaterals is not clear. Methods and ResultsA total of 640 chronic total occlusion patients with collateral flow grade ≥2 were divided into 2 groups; chronic total occlusion patients either treated with PCI (the PCI group; n=305) or optimal medical therapy (the optimal medical therapy group; n=335). To adjust for potential confounders, a propensity score matching analysis was performed. Major clinical outcomes were compared between the 2 groups up to 5 years. In the entire population, the PCI group had a lower hazard of myocardial infarction (hazard ratio [HR], 0.177; P=0.039; 95% confidence interval [CI], 0.03–0.91) and the composite of total death or myocardial infarction (HR, 0.298; P=0.017; 95% CI, 0.11–0.80); however, it showed higher hazard of target lesion revascularization (HR, 3.942; P=0.003; 95% CI, 1.58–9.81) and target vessel revascularization (HR, 4.218; P=0.001; 95% CI, 1.85–9.60). After propensity score matching, a total of 158 matched pairs were generated. Although the PCI group showed a higher hazard of target lesion revascularization (HR, 2.868; P=0.027; 95% CI, 1.13–7.31) and target vessel revascularization (HR=2.62; P=0.022; 95% CI, 1.15–5.97), it still exhibited a lower incidence of the composite of total death or myocardial infarction (HR, 0.263; P=0.017; 95% CI, 0.087–0.790). The mean ejection fraction was improved from 47.8% to 51.6% (P

A Fishnet-Mushroom-like metamaterial electromagnetic behaviour is represented in S-parameters numerically and experimentally for X-band frequencies arena. The design has introduced a dielectric substrate as a host with metallic parts. The proposed design is predicted to provide the electromagnetic band gap characterization with desired reiterative characteristic parameters, negative permittivity, and negative permeability exhibiting a double negative left-handed region, which is identified with the X-band regime with good agreement between the simulated and the measured results.

A novel metamaterial, which exhibits a wideband double negative behavior in X-band, is proposed, designed, and investigated in this paper. The metamaterial is composed of modified S-shaped split-ring resonators (S-SRR). The periodic structure is designed and simulated using CST MWs. Next, the experiments are carried out, and it is shown that the simulation and the experimental results agree well and the designed structure has a wide bandwidth in X-band. An absorber application of this metamaterial is also provided, and the structure can be used as an absorber with absorption rate of over 80% for the polarization angles between 0° and 40°.

BackgroundThe time course and relationships of myocardial hemorrhage and edema in patients after acute ST‐segment elevation myocardial infarction (STEMI) are uncertain. Methods and ResultsPatients with ST‐segment elevation myocardial infarction treated by primary percutaneous coronary intervention underwent cardiac magnetic resonance imaging on 4 occasions: at 4 to 12 hours, 3 days, 10 days, and 7 months after reperfusion. Myocardial edema (native T2) and hemorrhage (T2*) were measured in regions of interest in remote and injured myocardium. Myocardial hemorrhage was taken to represent a hypointense infarct core with a T2* value

Plasmodium falciparum malaria is the most common infection in Yemen. The present study aims to investigate changes in hematological and hepatic function indices of P. falciparum infected individuals. This study included 67 suspected falciparum malarial patients attended in clinics and rural Abs Hospital (Tehama, Hajjah), Yemen, from October 2013 to April 2014. The diagnosis of malaria was confirmed by thick and thin film with Giemsa staining of malaria parasite. Hematological parameters and serum levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), and bilirubin (total and direct) as test indicators of liver function were studied. Patients with parasitaemia tended to have significantly lower hemoglobin, hematocrit, white blood cell count, lymphocytes, and platelets, compared with healthy normal subjects. Neutrophils levels were significantly higher in cases of falciparum malaria in comparison to healthy normal subjects. Serums AST, ALT, ALP, and bilirubin (total and direct) in falciparum malaria patients were significantly higher (p