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The sixth most common malignant disease is renal cell carcinoma (RCC), which accounts for almost 90% of all cases. The probability of recovery can be greatly increased by early detection of kidney tumors. Imaging techniques are the most sought out non-invasive diagnostic techniques in recent times. In this review, the current method of image processing involves rapid identification of the tumor from CT scans by a combination of pre-processing, segmentation, feature extraction and classification methods. Machine learning (ML) techniques such as support vector machines (SVM), random forests (RF), artificial neural networks (ANN), convolutional neural networks (CNN), and Deep learning models can be used to analyze abdominal CT images for renal cancer detection. On the other hand, a probabilistic neural network (PNN) can also be used as a feedforward neural network that uses a probabilistic methodology by accurately classifying the class probability estimates. Various types of RCCs were defined in the histological study and diagnosed using various imaging methods such as ultrasound, MRI, CT, PET and angiography in the radiological part. Machine learning algorithms are used to identify tumors, extract relevant data from medical images, and help interpret imaging results. When these algorithms are integrated with medical imaging data such as computed tomography (CT) images, renal cancer detection models become more accurate. By being trained on labeled data sets, these algorithms can identify renal cancer. A detailed review has been done and after comparing the accuracy of several algorithms, CNN is considered to be the most suitable algorithm for identification of RCC., {"references":["1.\tBray, F., Ferlay, J., Soerjomataram, I., Siegel, R.L., Torre, L.A. and Jemal, A., 2018. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 68(6), pp.394-424.","2.\tUdager, A.M. and Mehra, R., 2016. Morphologic, molecular, and taxonomic evolution of renal cell carcinoma: a conceptual perspective with emphasis on updates to the 2016 World Health Organization Classification. Archives of pathology & laboratory medicine, 140(10), pp.1026-1037.","3.\tRao A, Wiggins C, Lauer RC. Survival outcomes for advanced kidney cancer patients in the era of targeted therapies. Ann Transl Med. 2018 May;6(9):165. doi: 10.21037/atm.2018.04.44. PMID: 29911113; PMCID: PMC5985277.","4.\tDeja S, Litarski A, Mielko KA, Pudełko-Malik N, Wojtowicz W, Zabek A, Szydełko T, Młynarz P. Gender-Specific Metabolomics Approach to Kidney Cancer. Metabolites. 2021 Nov 10;11(11):767. doi: 10.3390/metabo11110767. PMID: 34822425; PMCID: PMC8624667.","5.\tGharaibeh, M., Alzu'bi, D., Abdullah, M., Hmeidi, I., Al Nasar, M.R., Abualigah, L. and Gandomi, A.H., 2022. Radiology imaging scans for early diagnosis of kidney tumors: a review of data analytics-based machine learning and deep learning approaches. Big Data and Cognitive Computing, 6(1), p.29.","6.\tAurna, N.F., Yousuf, M.A., Taher, K.A., Azad, A.K.M. and Moni, M.A., 2022. A classification of MRI brain tumor based on two stage feature level ensemble of deep CNN models. Computers in Biology and Medicine, 146, p.105539.","7.\tBarragán-Montero, A., Javaid, U., Valdés, G., Nguyen, D., Desbordes, P., Macq, B., Willems, S., Vandewinckele, L., Holmström, M., Löfman, F. and Michiels, S., 2021. Artificial intelligence and machine learning for medical imaging: A technology review. Physica Medica, 83, pp.242-256.","8.\tCastiglioni, I., Rundo, L., Codari, M., Di Leo, G., Salvatore, C., Interlenghi, M., Gallivanone, F., Cozzi, A., D'Amico, N.C. and Sardanelli, F., 2021. AI applications to medical images: From machine learning to deep learning. Physica Medica, 83, pp.9-24.","9.\tBehura, A., 2021. The cluster analysis and feature selection: Perspective of machine learning and image processing. Data Analytics in Bioinformatics: A Machine Learning Perspective, pp.249-280.","10.\tUhm, K.H., Jung, S.W., Choi, M.H., Shin, H.K., Yoo, J.I., Oh, S.W., Kim, J.Y., Kim, H.G., Lee, Y.J., Youn, S.Y. and Hong, S.H., 2021. Deep learning for end-to-end kidney cancer diagnosis on multi-phase abdominal computed tomography. NPJ precision oncology, 5(1), p.54."]}

Primary squamous cell carcinoma of pancreas is a rare malignant neoplasm. It has been reported as case reports only, hence clinical information is limited. Here, we present a case of primary squamous cell carcinoma of pancreas in a 47-year-old female with a background history of chronic pancreatitis. Patient was treated with systemic chemotherapy; however, she did not respond to the treatment protocol. Follow-up CT scan showed increase in the size and extension of the lesion. It is an aggressive tumor and does not respond well to chemotherapy or radiotherapy.

Bacteria employ numerous resistance mechanisms against structurally distinct drugs by the process of multidrug resistance. A study was planned to discover the antibacterial potential of a graphene oxide nanosheet (GO), a graphene oxide–zinc oxide nanocomposite (GO/ZnO), a graphene oxide-chitosan nanocomposite (GO–CS), a zinc oxide decorated graphene oxide–chitosan nanocomposite (GO–CS/ZnO), and zinc oxide nanoparticles (ZnO) alone and in a blend with antibiotics against a PS-2 isolate of Pseudomonas aeruginosa. These nanocomposites reduced the MIC of tetracycline (TET) from 16 folds to 64 folds against a multidrug-resistant clinical isolate. Efflux pumps were interfered, as evident by an ethidium bromide synergy study with nanocomposites, as well as inhibiting biofilm synthesis. These nanoparticles/nanocomposites also decreased the mutant prevention concentration (MPC) of TET. To the best of our knowledge, this is the first report on nanomaterials as a synergistic agent via inhibition of efflux and biofilm synthesis.

The polymerization of 1,4-benzenediboronic acid (BDBA) on mica to form a covalent organic framework (COF-1) reveals a dramatic increase in crystallinity when physically confined by exfoliated graphene. COF-1 domains formed under graphene confinement are highly geometric in shape and on the order of square micrometers in size, while outside of the exfoliated flakes, the COF-1 does not exhibit long-range mesoscale structural order, according to atomic force microscopy imaging. Micro-Fourier transform infrared spectroscopy confirms the presence of COF-1 both outside and underneath the exfoliated graphene flakes, and density functional theory calculations predict that higher mobility and self-assembly are not causes of this higher degree of crystallinity for the confined COF-1 domains. The most likely origin of the confined COF-1's substantial increase in crystallinity is from enhanced dynamic covalent crystallization due to the water confined beneath the graphene flake.

Objectives: The performance of shear wave elastography (SWE) for peripheral nerve pathology, predominantly compressive neuropathy, has been studied with the median nerve, sciatic nerve, and tibial nerve. However, studies for ulnar nerve are limited in literature. The aim of the study was to study the performance of SWE for ulnar nerve in arm by analyzing the correlation of elasticity value by two transducers of the same ultrasound system. Material and Methods: This was a prospective observational study. Elasticity of ulnar nerve was measured in the mid-arm and supracondylar region in longitudinal and transverse planes with two different transducers of the same ultrasound system. The reliability of measurement was assessed by interclass correlation of values obtained. Results: Ninety-two ulnar nerve measurement sets were analyzed. The ages of the patients ranged from 14 years to 76 years, with a median age of 50. The SWE values obtained by two probes showed a weak interclass correlation coefficient value Conclusion: Quantitative SWE measurements of the ulnar nerve in the arm by two transducers showed a weak interclass correlation. It should be used with caution as a diagnostic tool with a universally acceptable cut off values.

Background: Emergency Department of National Trauma Center Nepal Center is the only specialized trauma care hospital in Nepal, in operation since 2012. Traumatic injury is one of the major causes for mortality worldwide. This study aims to see the epidemiology, pattern of injuries and outcome of the patients presenting to the emergency room.Methods: After getting ethical approval, we included all patients presenting to the Emergency Department with at least one injury, between Jan 2018 to Dec 2020. Informations on age, gender, mechanism of injury and outcome was abstracted for all patients presenting to the emergency department. Data were extracted from hospital database with the permission of hospital authority.Results: Total of 49991 patients presented to emergency department with different types of injuries. Among them 7792 (14.0%) needed hospital admission. Fall and road crashes comprised almost 80% of admitted cases. Mortality was 2.1% of admitted patients, mostly with head injuries followed by multiple injuries. Conclusions: Among the patient visiting the trauma center during the study period most common mechanism of the injury were fall and road crash with head and neck injury. Majority of the patients were only managed in the ward without surgery.Keywords: Emergency care; triage; trauma care system; unintentional injury

BACKGROUND: The first national severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serosurvey in India, done in May-June, 2020, among adults aged 18 years or older from 21 states, found a SARS-CoV-2 IgG antibody seroprevalence of 0·73% (95% CI 0·34-1·13). We aimed to assess the more recent nationwide seroprevalence in the general population in India. METHODS: We did a second household serosurvey among individuals aged 10 years or older in the same 700 villages or wards within 70 districts in India that were included in the first serosurvey. Individuals aged younger than 10 years and households that did not respond at the time of survey were excluded. Participants were interviewed to collect information on sociodemographics, symptoms suggestive of COVID-19, exposure history to laboratory-confirmed COVID-19 cases, and history of COVID-19 illness. 3-5 mL of venous blood was collected from each participant and blood samples were tested using the Abbott SARS-CoV-2 IgG assay. Seroprevalence was estimated after applying the sampling weights and adjusting for clustering and assay characteristics. We randomly selected one adult serum sample from each household to compare the seroprevalence among adults between the two serosurveys. FINDINGS: Between Aug 18 and Sept 20, 2020, we enrolled and collected serum samples from 29 082 individuals from 15 613 households. The weighted and adjusted seroprevalence of SARS-CoV-2 IgG antibodies in individuals aged 10 years or older was 6·6% (95% CI 5·8-7·4). Among 15 084 randomly selected adults (one per household), the weighted and adjusted seroprevalence was 7·1% (6·2-8·2). Seroprevalence was similar across age groups, sexes, and occupations. Seroprevalence was highest in urban slum areas followed by urban non-slum and rural areas. We estimated a cumulative 74·3 million infections in the country by Aug 18, 2020, with 26-32 infections for every reported COVID-19 case. INTERPRETATION: Approximately one in 15 individuals aged 10 years or older in India had SARS-CoV-2 infection by Aug 18, 2020. The adult seroprevalence increased approximately tenfold between May and August, 2020. Lower infection-to-case ratio in August than in May reflects a substantial increase in testing across the country. FUNDING: Indian Council of Medical Research.

The COVID-19 outbreak caused by the SARS Corona virus 2 (SARS-CoV-2), that appeared in Wuhan, China in December 2019 evolved into a pandemic and caused a devastating effect in all aspect of life. The aim of this study is to determine the impact of Covid-19 on the management of spine patients requiring surgery and to observe the functioning of a trauma center in a pandemic situation.A retrospective study was performed at National Trauma Center, Kathmandu, Nepal from January 1 2019 to February 28 2020(Pre-Covid period) and March 1 2020 to April 30 2021(Covid Period) . All patients undergoing spine surgery were included and details regarding demographics, diagnosis, surgical procedures were obtained and compared between pre- covid and covid period and also between complete lockdown period and partial lockdown period of the covid duration.The mean age of the patients undergoing surgery in the Pre covid period was (40.4 ± 14.51) years and covid period was (38.9 ± 14.00) years. The number of spine surgeries performed during the pre covid period was 295 whereas the number decreased to 197 in the covid period. The total number of non traumatic spine surgery in the pre covid period was 22.03% of the total spine surgery cases where as it decreased to 11.68% in the covid period. Similarly out of the total cases instrumented surgery was 91.86% in the pre covid period whereas it was 97.97% in the covid period. While analyzing the spine surgery done in the COVID period we found that most of the cases of surgery done in the complete restriction period was of traumatic spine only (97.77%) where as in the limited restriction period non traumatic spine surgery was also increased with traumatic spine surgery accounting for 85.52% of the total spine surgery cases.The COVID pandemic has had a direct impact on traumatic and non-traumatic spine surgeries performed in this center.

There are several bacteria called superbugs that are resistant to multiple antibiotics which can be life threatening specially for critically ill and hospitalized patients. This article provides up-to-date treatment strategies employed against some major superbugs, like methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, vancomycin-resistant Enterococcus, multidrug-resistant Pseudomonas aeruginosa, and multidrug-resistant Escherichia coli. The pathogen-directed therapeutics decrease the toxicity of bacteria by altering their virulence factors by specific processes. On the other hand, the host-directed therapeutics limits these superbugs by modulating immune cells, enhancing host cell functions, and modifying disease pathology. Several new antibiotics against the global priority superbugs are coming to the market or are in the clinical development phase. Medicinal plants possessing potent secondary metabolites can play a key role in the treatment against these superbugs. Nanotechnology has also emerged as a promising option for combatting them. There is urgent need to continuously figure out the best possible treatment strategy against these superbugs as resistance can also be developed against the new and upcoming antibiotics in future. Rational use of antibiotics and maintenance of proper hygiene must be practiced among patients.

In this paper, the experimental analysis of two types of corrugated plate solar collector (CPSC) using water as working fluid has been done. Two similar designs and dimensions of CPSC but different materials of absorber plates have been investigated, the collector1 is copper and collector 2 is aluminium. The performance of energy, exergy and total heat loss coefficient of CPSC were analysed and compared. Thermal performance of CPSC depends on many parameters such as outlet collector temperature, absorber plate temperature, temperature difference, inlet collector temperature, atmospheric temperature, mass flow rate (MFR), solar radiation, wind speed and absorber plate material. The three MFR values of 0.0167 kg/s, 0.025 kg/s and 0.033 kg/s were considered in this experimental setup. The thermal performances of these two types of solar collectors were investigated. Also, a comparison between the performance of these two types of solar collector at various MFR was done. Experimental results show that the use of copper-based CPSC could improve the thermal efficiency compared to the use of aluminium based CPSC. The maximum energy and exergy of copper and aluminium based CPSC was found at MFR 0.033 kg/s. Results show that as the water MFR is increased from 0.0167 kg/s to 0.033 kg/s, the thermal efficiency of collector made of copper and aluminium increases.

The compound 4-hydroxy-α-tetralone (1) has been reported to possess potent anti-tubercular, anti-diabetic and anti-leishmanial activities. In our earlier studies the compound 1 and its various semi-synthetic derivatives showed potent bioenhancing activity in combination with nalidixic acid (NAL) and tetracycline (TET) reducing the minimum inhibitory concentration (MIC) of antibiotics up to 8 folds by inhibition of ABC efflux pump. However, in gram negative bacteria, resistance nodulation division (RND) family are considered as major efflux pump responsible for multidrug resistance (MDR). Hence, the current study was carried out to access the in-silico docking potential of compound 1 and its cinnamoyl (1a), 3, 4, 5-trimethoxybenzoyl (1b) derivatives against RND efflux pump target proteins AcrA, AcrB, TolC of E. coli. The docking study showed that the test compounds have good binding affinity with target proteins. The derivative 1a showed highest interaction with AcrA followed by AcrB showing binding energies -8.7 and -8.2 kcal/mol respectively. The low molecular weight ≤500, high hydrogen bonding, high log p value (>1) with hydroxy, methoxy and aromatic group of ligands make these compounds as effective efflux pump inhibitor. In drug likeliness studies, these compounds pass the safety criteria with enhanced bioavailability and absorption, less acute oral toxicity, less hepatotoxicity. This study promises that the compound 1 and its derivatives (1a & 1b) might be RND efflux pump inhibitors providing the initial platform for development of safer and cost-effective antibacterial drug to manage MDR infections.

The early management, diagnosis, and treatment of emerging and re-emerging infections and the rising burden of non-communicable diseases (NCDs) are necessary. The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-Cas system has recently acquired popularity as a diagnostic tool due to its ability to target specific genes. It uses Cas enzymes and a guide RNA (gRNA) to cleave target DNA or RNA. The discovery of collateral cleavage in CRISPR-Cas effectors such as Cas12a and Cas13a was intensively repurposed for the development of instrument-free, sensitive, precise and rapid point-of-care diagnostics. CRISPR/Cas demonstrated proficiency in detecting non-nucleic acid targets including protein, analyte, and hormones other than nucleic acid. CRISPR/Cas effectors can provide multiple detections simultaneously. The present review highlights the technical challenges of integrating CRISPR/Cas technology into the onsite assessment of clinical and other specimens, along with current improvements in CRISPR bio-sensing for nucleic acid and non-nucleic acid targets. It also highlights the current applications of CRISPR/Cas technologies.