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The present study was conducted to investigate the carcass characteristics and organ development in four different varieties of native Aseel chicken. One day-old Aseel chicks (n=96) of 4 different varieties (24 each) were maintained under standard managemental conditions for a period of 15 weeks. The results showed that the Aseel male had higher live body weight, non-eviscerated weight and dressed weight, than female birds at 12 and 15 weeks of age. The results indicated that males had higher gizzard weight, breast width, and keel length at 12 weeks of age. Whereas, significant (p<0.05) differences were observed in these parameters at 15 weeks of age. Similarly significant (p<0.05) difference was also observed in abdominal fat percentage at 12 weeks of age. Based on the findings of this study it may be stated that Mushki variety of Aseel exhibited better carcass and organ development than other varieties. [ABSTRACT FROM AUTHOR]

The present study was conducted at a commercial hatchery with the objective to evaluate the chick quality (average day-old chick weight, chick to egg ratio, A+ Chicks, A, US and B grade chicks) from fertile eggs of Hubbard broiler breeder strain during four production phases, categorized into 3 egg weights and 3 different storage periods maintained at. For this purpose, eggs during 4 production phases (pre-peak; 25-28, peak; 29-36, post-peak; 37-52 and terminal; 53-56th weeks of age) were categorized into three different weight categories (small, medium and large; subject to change in each production phase), stored for three different durations (1, 4 and 7-days) and replicated 6 times. A total of 93312 fertile eggs; pre-peak: 11664, peak: 23328, post-peak: 46656 and terminal: 11664 eggs in 4 production phases were collected. During each week of the experiment, a total number of 972 eggs per storage period from three egg weight categories replicated 6 times (each replicate containing 54 eggs) were incubated in a commercial hatchery. The data were analyzed by ANOVA technique under randomized complete block design in 4×3×3 factorial arrangement and means were compared by using DMR Test. The results of the present study showed that the egg weight categories and length of storage period significantly (p<0.05) influenced the average chick weight, chick to egg ratio, A+ chick's 'A' grade chick's US chick's and 'B' grade chicks percent. The highest average chick weight, chick to egg ratio, A+ chick's and 'A' grade chick's percent was observed in large egg weight category followed by those in medium and small ones in all the production phases, while, the highest 'US' and 'B' grade chick's percent was observed in small egg weight category in all production phases. Higher average chick weight, chick to egg ratio and US chick percent were observed in one and four day's storage than that of seven days storage in all the production phases. Higher A+ chick percent in one and four days storage was observed than that of seven days in peak and post-peak, while, higher 'A' grade chick percent was recorded in one and four days storage than that of seven days in pre-peak and peak. [ABSTRACT FROM AUTHOR]

The present study was conducted at a commercial hatchery with the objective to evaluate the effects of egg weight and storage period on embryonic mortality (early, mid and late) during incubation of fertile eggs from Cobb broiler breeder strain during 4 production phases(pre-peak; 25-28, peak; 29-36, post-peak; 37-52 and terminal; 53-56th weeks of age), categorized into 3 egg weights (small, medium and large subjected to change in each production phase) and maintained at 3 different storage periods (1, 4- and 7-days)and replicated 6 times. A total 93312 fertile eggs (pre-peak: 11664, peak: 23328, post-peak: 46656 and terminal: 11664) in 4 production phases were incubated in a commercial hatchery. The data were analyzed by ANOVA technique under randomized complete block design in 4x3x3 factorial arrangement and means were compared by using DMR Test. The results of the present study showed that the egg weight categories significantly (p<0.05) affected embryonic mortality in all the production phases. The highest early and late embryonic mortality was observed in small egg weight category followed by that of medium and large egg weight categories. Higher mid embryonic mortality was observed in small and large egg weight categories than in medium ones. Storage period was also significantly (p<0.05) affected embryonic mortality in all production phases. Higher early, mid and late -embryonic mortality was observed in seven days storage than those of four and one day storage. As for as interaction between egg weight categories and storage periods is concerned, the highest (p<0.05) early embryonic mortality was observed in seven days storage with small egg weight category in all production phases, while, the lowest was in one day storage with all the egg weight categories in all the production phases. It may be concluded from the present study that large egg weight category with 1 or 4 days storage period resulted in lower embryonic mortality leading to higher hatchability. [ABSTRACT FROM AUTHOR]

This study was conducted to appraise the effects on egg quality and production performance of laying hens when drinking water was supplemented with calcium (Ca) and magnesium (Mg). A total of 384 (64- week-old) Hy-line Brown laying hens were assigned at random to four treatments, which consisted of CON: unsupplemented drinking water; T1: drinking water + 2 mg/L Ca + 250 mg/L Mg; T2: drinking water + 4 mg/L Ca + 510 mg/L Mg /10 L; and T3: drinking water + 5 mg/L Ca and 760 mg/L Mg. The experiment lasted six weeks. Water intake increased linearly in week 1 with the rising levels of Ca and Mg in the drinking water. Increasing the Ca and Mg levels improved eggshell strength (week 2 (P =0.01), week 5 (P =0.01), and week 6 (P = 0.03), and eggshell thickness (week 6) (P =0.02) and reduced the rate at which eggs were broken (week 4) (P =0.01). The supplemental Ca and Mg did not affect egg production, egg weight, Haugh unit, albumen height, eggshell colour, and yolk colour compared with CON. Nor did they influence the Haugh unit and albumen height after storing for 1, 5, 10 and 15 days. In conclusion, adding Ca and Mg to the drinking water increased the thickness and strength of the eggshells. [ABSTRACT FROM AUTHOR]

The behaviour, welfare, and tibia characteristics of fast- and slow-growing chickens were evaluated in free-range and intensive production systems. A total of 720 birds of three strains were subjected to these systems after 21 days of rearing under the same intensive environment. Each treatment was replicated six times with 20 birds in each replicate. Data were collected for welfare aspects, including feather condition, footpad, hock joint and tonic immobility, behavioural features, especially feeding or foraging, sitting, walking, scratching, pecking and dust-bathing, and tibia characteristics, including weight, length, width, medullary canal diameter and robusticity index (4 - 8 weeks). Production system had significant effects on all welfare and behaviour aspects of the birds. However, tibia characteristics were not influenced by production system, except for medullary canal diameter. The strains differed significantly in welfare, tibia characteristics and behaviour. For example, the slow-growing strains had better feather condition, footpad d hock joint scores. Significant interactions of strain and production system were noted for all characteristics. It was recommended that Rhode Island Red chickens could be raised under either production system without compromising their welfare or causing adverse effects on leg health. [ABSTRACT FROM AUTHOR]

Objectives: Hepatitis B virus (HBV) infection is a global health problem with about 2 billion infected persons. Pakistan is one of the endemic areas for viral hepatitis B. Prevention is merely a safe approach rather than curing against high incidence of viral hepatitis. Therefore, the aim of the present study was to assess the knowledge and awareness of HBV infection, its prevention and transmission, perception of HBV vaccine and vaccination status among young females of Karachi, Pakistan. Methods: This cross sectional study was conducted from Oct till Dec 2014 by adopting a pre-validated questionnaire distributed to female individuals in Karachi, Pakistan. Descriptive statistics were used to demonstrate students' demographic information and their response to the questionnaire items. Kruskal Wallis H test was executed to evaluate the association of age and educational status of the respondents with their response. A p-value <0.05 was considered as significant. Results: Out of 550 survey questionnaires, only 434 were returned back in useable form. Hence the response rate was 78.9%. More than 90% had knowledge of HBV infection and 85.94% knew that HBV infection can be prevented by vaccination. However, only 17% had received HBV vaccination during childhood. 67.05% and 54.60% knew that HBV can be transmitted from mother to infant and an infected mother may transmit hepatitis B to her newborn baby through breast milk respectively. Only 24% had been tested for HBV in adulthood. General excuses for not having their HBV status tested, were lack of motivation (36.76%) and lack of time to check (21.54%). Conclusion: It indicates that majority of respondents showed some awareness of HBV and its related consequences. Yet, there are some misapprehensions regarding the attitudes that imitate a fallacy perception of the disease. It identifies a more standardized approach coupled with the well-structured health education programs pointing out such misconceptions. [ABSTRACT FROM AUTHOR]

This manuscript is a consensus document of an expert panel on the Evaluation and Treatment of Gastrointestinal Bleeding in Patients Taking Anticoagulants Presenting to the Emergency Department, sponsored by the American College of Emergency Physicians., (© 2024. The Author(s).)

Introduction Irrigation of the root canal system is a vital step in endodontic treatment aimed at disinfecting the canal. The efficacy of irrigation can be improved by various irrigation agitation methods. One such novel method of interest is the manual dynamic agitation (MDA) technique. However, the effect of MDA on postoperative pain as compared to needle irrigation (NI) with sodium hypochlorite has been scarcely explored. This study aimed to compare the effects of NI and MDA techniques on postoperative pain in teeth with symptomatic irreversible pulpitis. Materials and methods This quasi-experimental study was conducted at the Department of Operative and Paediatric Dentistry, Fauji Foundation Dental Hospital, over four months after gaining ethical approval. One hundred and sixty-eight participants diagnosed with symptomatic irreversible pulpitis were enrolled in the study through the purposive sampling technique. The participants were divided into two groups based on the irrigation technique used: Group A (NI) and Group B (MDA). Postoperative pain was recorded after six hours, 24 hours, 48 hours, and seven days using the 0-100mm visual analog scale (VAS). The VAS scores were compared using an independent sample t-test. Results Out of 168 participants, 48.2% were in Group A and 51.2% in Group B. The study found that VAS pain scores for Group B (MDA) were significantly lower at six hours, 24 hours, 48 hours, and seven days as compared to Group A (NI), with a p -value less than 0.001. Conclusion This study shows that the MDA technique leads to decreased postoperative pain both immediately after endodontic treatment and a week later as compared to the NI technique. Hence, the use of MDA can aid in controlling postendodontic pain and, therefore, ensure smoother recovery and increased patient satisfaction., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethical Review Board of Foundation University College of Dentistry issued approval FF/FUCD/632/ERC 023. Based on the information submitted by researcher(s), this research project does not raise any ethical issue/is compliant with the Ethical principles of Medical research outlined in WMA declaration of Helsinki made at 64th WMA General assembly, Fortaleza, Brazil, in October 2013. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. 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, Abbas et al.)

Acute airway obstruction is a life-threatening complication of benign goitre mostly occurring in cases of known progressing goitres. The index presentation of goitre with decompensated type two respiratory failure is an exceedingly rare and a diagnostically challenging presentation. We discuss the case of a woman in her 50 s, who had been diagnosed with asthma by her general practitioner, but during admission was found to have a large goitre with retrosternal extension causing critical tracheal compression. She presented with acute decompensated type two respiratory failure. We explore the diagnostic confounding posed by the patient's background of asthma and describe the initial management of the patient with non-invasive ventilation by the emergency department. The diagnosis of upper airway obstruction was not apparent which is an interesting anomaly in this case. She underwent an emergency hemithyroidectomy and recovered with a resolution of her respiratory symptoms. Histology confirmed benign multinodular hyperplasia., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose To assess early subclinical coronary artery disease (CAD) burden and its relation to myocardial function in asymptomatic persons living with HIV (PLWH) who are at low risk for cardiovascular disease (CVD). Materials and Methods In this prospective, HIPAA-compliant study (ClinicalTrials.gov NCT01656564 and NCT01399385) conducted from April 2010 to May 2013, 74 adult PLWH without known CVD and 25 matched healthy controls underwent coronary MRI to measure coronary vessel wall thickness (VWT) and echocardiography to assess left ventricular function. Univariable and multivariable linear regression analyses were used to evaluate statistical associations. Results For PLWH, the mean age was 49 years ± 11 (SD), and the median Framingham risk score was 3.2 (IQR, 0.5-6.6); for matched healthy controls, the mean age was 46 years ± 8 and Framingham risk score was 2.3 (IQR, 0.6-6.1). PLWH demonstrated significantly greater coronary artery VWT than did controls (1.47 mm ± 0.22 vs 1.34 mm ± 0.18; P = .006) and a higher left ventricular mass index (LVMI) (77 ± 16 vs 70 ± 13; P = .04). Compared with controls, PLWH showed altered association between coronary artery VWT and both E/A (ratio of left ventricular-filling peak blood flow velocity in early diastole [E wave] to that in late diastole [A wave]) ( P = .03) and LVMI ( P = .04). In the PLWH subgroup analysis, coronary artery VWT increase was associated with lower E/A ( P < .001) and higher LVMI ( P = .03), indicating restricted diastolic function. In addition, didanosine exposure was associated with increased coronary artery VWT and decreased E/A ratio. Conclusion Asymptomatic low-CVD-risk PLWH demonstrated increased coronary artery VWT in association with impaired diastolic function, which may be amenable to follow-up studies of coronary pathogenesis to identify potential effects on the myocardium and risk modification strategies. Keywords: Coronary Vessel Wall Thickness, Diastolic Function, HIV, MRI, Echocardiography, Atherosclerosis Clinical trial registration nos. NCT01656564 and NCT01399385 Supplemental material is available for this article. © RSNA, 2024.

Background: Klippel-Feil syndrome is a rare congenital bone disorder characterized by an abnormal fusion of two or more cervical spine vertebrae. Individuals with Klippel-Feil syndrome exhibit diverse clinical manifestations, including skeletal irregularities, visual and hearing impairments, orofacial anomalies, and anomalies in various internal organs, such as the heart, kidneys, genitourinary system, and nervous system., Case Presentation: This case report describes a 12-year-old Pashtun female patient who presented with acute bilateral visual loss. The patient had Klippel-Feil syndrome, with the typical clinical triad symptoms of Klippel-Feil syndrome, along with Sprengel's deformity. She also exhibited generalized hypoalgesia, which had previously resulted in widespread burn-related injuries. Upon examination, bilateral optic disc swelling was observed, but intracranial pressure was found to be normal. Extensive investigations yielded normal results, except for hypocalcemia and low vitamin D levels, while parathyroid function remained within the normal range. Visual acuity improved following 2 months of calcium and vitamin D supplementation, suggesting that the visual loss and optic nerve swelling were attributed to hypocalcemia. Given the normal parathyroid function, it is possible that hypocalcemia resulted from low vitamin D levels, which can occur after severe burn scarring. Furthermore, the patient received a provisional diagnosis of congenital insensitivity to pain on the basis of the detailed medical history and the findings of severe and widespread loss of the ability to perceive painful stimuli, as well as impaired temperature sensation. However, due to limitations in genetic testing, confirmation of the congenital insensitivity to pain diagnosis could not be obtained., Conclusion: This case highlights a rare presentation of transient binocular vision loss and pain insensitivity in a patient with Klippel-Feil syndrome, emphasizing the importance of considering unusual associations in symptom interpretation., (© 2024. The Author(s).)

Background: People living with HIV have an increased risk of cardiovascular disease (CVD). Although coronary endothelial function (CEF) is an early direct indicator of CVD, only a few studies have been able to interrogate CEF directly. Most studies have examined vascular endothelial function through indirect assessment of brachial flow-mediated dilatation (FMD). However, peripheral arteries are significantly larger and manifest atherogenesis differently from the coronary arteries, and so produce conflicting results. Additionally, none of these studies focused on young adults who acquired HIV perinatally or in early childhood., Objective: The present study investigates CEF in a unique population of young adults with lifelong HIV using direct magnetic resonance imaging (MRI) of coronary FMD (corFMD) with an in-house developed MRI-integrated isometric handgrip exercise system with continuous feedback and monitoring mechanisms (fmIHE)., Methods: Young adults who acquired HIV perinatally or in early childhood (n = 23) and group-matched healthy participants (n = 12) completed corFMD-MRI with fmIHE. CorFMD was measured as the coronary cross-sectional area response to the fmIHE., Results: In univariable and multivariable regression analysis, HIV status was a significant risk modifier. CD8+ T-cell count and smoking pack-years and their interaction with HIV status were independently associated with impaired coronary artery response to fmIHE. In people living with HIV, corFMD was significantly inversely correlated with CD8+ T-cells and smoking pack-years. In a multivariable regression analysis adjusted for age and body mass index, CD8+ T-cells and smoking and their interaction with HIV status remained significant independent predictors of coronary endothelial dysfunction., Discussion: In this unique population of young adults, HIV status was a significant risk modifier, and immune activation and smoking were associated with decreased CEF, directly measured from the coronary vascular response to fmIHE., Conclusions: Management of CVD risk factors such as smoking and developing strategies that target immune activation in people living with HIV are warranted., (Published 2023. This article is a U.S. Government work and is in the public domain in the USA.)

Background: It has been unknown whether there exist any relations of C-Reactive Protein (CRP) level with hyperlipidaemia in polycystic ovarian syndromes patients. To determine Association of CRP with Hyperlipidaemia in patients with polycystic ovarian syndrome., Methods: This was a cross sectional descriptive study conducted among 50 each polycystic ovarian syndrome and normal women. After taking a written consent from participants predesigned questionnaire was filled including information regarding demography and medical history. A 3 to 5 ml blood was taken from patients and controls and transferred to laboratory for determination of CRP level and lipid profile. The test results were collected, compiled, entered and analyzed using SPSS Version 20 for determination of any kind of association of CRP with Hyperlipidaemia in patients with polycystic ovarian syndrome., Results: The mean age of study participants was 29.72±4.00 for cases and 29.04±3.99 for control. The cases and control were with the same age range, however there was a significant difference p=0.00 in BMI of the cases and control. There was no significant association observed between CRP and lipid profile parameters among polycystic ovarian syndrome patients., Conclusions: There exist no association between increasing CRP level and hyperlipidaemia in polycystic ovarian syndrome patients however CRP and lipid profile parameters showed high values among these patients.

Background: The purpose of the study was to assess the epidemiology, risk factors and outcomes of native vertebral osteomyelitis (NVO) in patients with Staphylococcus aureus bacteremia (SAB)., Methods: A retrospective institutional review was conducted at Mayo Clinic, Minnesota. Patients aged ≥18 years with SAB who developed NVO from January 1, 2006 to December 31, 2020 were included and 3-month follow-up data were abstracted. Data pertaining to patient demographics, risk factors and outcomes were recorded using REDCap. A 1:2 nested case-control analysis was performed, and controls were matched according to age, sex and year of SAB diagnosis., Results: A total of 103 patients had NVO. A majority (60.2%) of patients was male, with a median age of 62.0 years. Thirty-one (30.1%) cases were caused by methicillin-resistant S. aureus (MRSA). The lumbar spine was most commonly (57.6%) and the most commonly reported comorbid conditions included diabetes mellitus (36.9%) and coronary artery disease (27.2%). Mortality at three-month follow-up was 18.6%. Nested case-control analysis revealed that injection drug use (IDU) and tobacco consumption were significant risk factors associated with NVO, while chronic hemodialysis and chronic liver disease (CLD) were associated with a decreased risk of NVO., Conclusions: Atherosclerotic vascular disease was prominent in our contemporary cohort with NVO in the setting of SAB. Diabetes mellitus, tobacco consumption, older age and male sex likely contributed to this profile. Because IDU was associated with NVO, an increased number of cases should be anticipated among patients with IDU given the ongoing opioid epidemic in the United States., Competing Interests: Declaration of Competing Interest Larry M. Baddour, M.D. reports Boston Scientific, consultant duties; UpToDate, royalty payments (authorship duties); Botanix Pharmaceuticals, consulting duties; Roivant Sciences Inc., consultant duties. M. Rizwan Sohail, M.D. reports receiving funds from TYRX Inc. and Medtronic for prior research unrelated to this study administered according to a sponsored research agreement between Mayo Clinic and study sponsor that prospectively defined the scope of the research effort and corresponding budget; and honoraria/consulting fees from Medtronic Inc., Philips, and Aziyo Biologics, Inc. Research Grant: Medtronic (significant - $40K), Honoraria: Medtronic (significant $20K), and Aziyo Biologics (modest $5K). The other authors report no financial support or conflict of interest., (Copyright © 2021 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)

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The present trial explained the effect of alternative production systems on growth, morphometric and carcass traits of four different chicken genotypes. The second generation of two genotypes RNN (Rhode Island Red × Naked Neck) and BNN (Black Australorp × Naked Neck) obtained by two self-crosses (RNN × RNN = RR and BNN × BNN = BB) and two reciprocal crosses (RNN × BNN = RB and BNN × RNN = BR) were evaluated in three alternative production systems (conventional cages, enriched cages, and aviary). At the 6th week of age after sexing, a total of 600 birds, comprising 150 from each crossbred with a total of 300 pullets and 300 cockerels were divided into conventional cages, enriched cages, and aviary systems having 200 birds in each.Birds were organized into 3×4 factorial arrangements under Completely Randomized Design (3 production systems × 4 genotypes × 2 sexes × 25 birds = 600 birds). Regarding genotypes, RB and BR males showed higher (p < 0.01) carcass yield, drumstick weight, breast weight, and thigh weight than BB and RR genotypes. Females of BR genotype showed higher (p < 0.01) breast weight, thigh weight and drumstick weight. As far as production systems are concerned, higher (p < 0.01) liver weight, heart weight, breast weight, intestinal weight, drumstick weight, and thigh weight were observed in the males reared in enriched cages compared with conventional cages and aviary system. Females reared in enriched cages showed higher (p < 0.01) heart weight, breast weight, intestinal weight, drumstick weight, and thigh weight when compared with those reared in conventional cages and aviary. It is concluded that chickens (both sexes) of BR and RB genotypes had better morphological measurements and carcass traits than those of RR and BB genotype chickens. Among alternative production systems, chickens reared in enriched cages had better traits than those of reared in conventional cages and aviary during the growing phase.

Purpose: To assess the relationship between high vancomycin minimum inhibitory concentrations (MIC), in patients with methicillin-resistant Staphylococcus aureus bacteremia (MRSAB), and both mortality and complicated bacteremia., Methods: Embase, Medline, EBM, Scopus and Web of Science were searched for studies published from January 1st 2014 to February 29th 2020. "High" vancomycin MIC cut off was defined as ≥ 1.5 mg/L. Three referees independently reviewed studies that compared outcomes in patients with MRSAB stratified by vancomycin MIC. Subgroup analyses were performed for rates of mortality and complicated bacteremia., Results: A total of 13 studies with 2089 patients were included. Overall, mortality was 27.7% and 23.3% in the high and low vancomycin MIC group, respectively. No significant difference was found between vancomycin MIC groups for overall mortality, in-hospital mortality, late mortality, persistent bacteremia, severe sepsis or septic shock, acute renal failure, septic emboli or endocarditis, and osteomyelitis or septic arthritis. Early mortality was significantly associated with low vancomycin MIC. Mortality in studies using broth microdilution method (BMD) and need for mechanical ventilation were significantly associated with high vancomycin MIC., Conclusion: Overall mortality and complicated bacteremia were not significantly associated with high vancomycin MICs in a patient with MRSAB. Randomized controlled trials to assess the utility of vancomycin MIC values in predicting mortality and other adverse clinical outcomes are warranted., (© 2021. Springer-Verlag GmbH, DE part of Springer Nature.)

The purpose of this study is to determine the role of high (≥ 1.5 mg/L) vancomycin minimum inhibitory concentration (VMIC) in predicting clinical outcomes in patients with methicillin-resistant Staphylococcus aureus bacteraemia (MRSAB). A retrospective study was conducted at Mayo Clinic, Minnesota. Patients ≥ 18 years with a 3-month follow-up were included. Outcomes were defined as 30-day all-cause in-hospital mortality, median duration of bacteraemia, metastatic infectious complications, and relapse of MRSAB. A total of 475 patients with MRSAB were identified, and 93 (19.6%) of them had high VMIC isolates. Sixty-four percent of patients were male with a mean age of 69.0 years. Active solid organ malignancy and skin and soft tissue infection as source of MRSAB were associated with high VMIC, while septic arthritis as a complication was significantly associated with low VMIC on multivariate analysis. Eighty-one (17.1%) patients died within 30 days of hospitalization, with no significant difference in mortality rates between the two groups. In-hospital mortality, median duration of bacteraemia, and metastatic infectious complications were not significantly associated with high VMIC MRSAB.

Objective: The aim of this study was to investigate automated feature detection, segmentation, and quantification of common findings in periapical radiographs (PRs) by using deep learning (DL)-based computer vision techniques., Study Design: Caries, alveolar bone recession, and interradicular radiolucencies were labeled on 206 digital PRs by 3 specialists (2 oral pathologists and 1 endodontist). The PRs were divided into "Training and Validation" and "Test" data sets consisting of 176 and 30 PRs, respectively. Multiple transformations of image data were used as input to deep neural networks during training. Outcomes of existing and purpose-built DL architectures were compared to identify the most suitable architecture for automated analysis., Results: The U-Net architecture and its variant significantly outperformed Xnet and SegNet in all metrics. The overall best performing architecture on the validation data set was "U-Net+Densenet121" (mean intersection over union [mIoU] = 0.501; Dice coefficient = 0.569). Performance of all architectures degraded on the "Test" data set; "U-Net" delivered the best performance (mIoU = 0.402; Dice coefficient = 0.453). Interradicular radiolucencies were the most difficult to segment., Conclusions: DL has potential for automated analysis of PRs but warrants further research. Among existing off-the-shelf architectures, U-Net and its variants delivered the best performance. Further performance gains can be obtained via purpose-built architectures and a larger multicentric cohort., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objectives This research aims to analyse the relationship between urine mercury levels and neurological problems. Methods This research is an observational study with a cross-sectional approach. There are 44 goldsmiths in the gold jewellery small scale industry involved in this study. Urine mercury levels were measured using an atomic absorption spectrophotometer. Neurological problems were assessed by a medician. Data collected includes age, time of exposure, work duration, smoking behaviour and nutrition status of the goldsmiths which were obtained by interview. Results The results showed that the concentration of mercury in the goldsmith's urine was around 0.93-64.59 μg/L. The analysis showed that there were 63% of goldsmiths experiencing neurological problems, such as tremors (9.1%) and knee pass reflex (6.8%). The bivariate analysis showed that there is no significant relationship between the concentration of mercury (p=0.133), age (p=0.155), time of exposure (p=0.702), time of working (p=0.354), smoking behaviour (p=0.169) and nutrition status (p=0.541) with neurological problems. Conclusions The goldsmiths who had high levels of mercury in urine samples were diagnosed with at least one of the neurological symptoms. It is recommended that the goldsmith use personal protective equipment during work such as mask, glasses and gloves.

Background: Chemical induced nephrotoxicity is one of the main causes of acute kidney injury. The objective of this study was to determine the antioxidant effect of vitamin E against carbon tetrachloride induced tubulointerstitial and glomerular damage in the kidney of albino mice., Methods: The study had been conducted on albino mice. The duration of study was for five weeks. A total of 35 animals were randomly divided into five groups A, B, C, D and E .The group A served as control group, group B was administered only with carbon tetrachloride (no vitamin E) and groups C, D and E received test drug (vitamin E) in doses of 1, 10 and 50mg/kg body weight respectively along with CCl4. The animals were dissected and kidneys were excised for microscopic study for possible histo-morphological effects., Results: It was observed that carbon tetrachloride treated experimental groups developed tubulo-interstitial and glomerular changes as compared to control group A. The results suggested that these changes were significantly reduced in vitamin E treated groups especially in dose of 50 mg/kg body weight., Conclusions: This study reveals that tubulointerstitial and glomerular damage caused by carbon tetrachloride can be reduced by vitamin E in dose of 50 mg/kg body weight.

Distal revascularization and interval ligation (DRIL) is considered a useful option to relieve haemodialysis access-related steal syndrome. The results of this procedure are not known in the local setup. This is a case series of patients who underwent DRIL between January 2005 and December 2015. A total of ten patients (9 females) were included in the study. All the patients presented with grade 3 steal syndrome. Seven patients had rest pain while three had tissue loss. Polytetrafluoroethylene was used in all patients as the brachio-brachial bypass graft. All patients had smooth recovery except one patient who had postoperative brachio-brachial graft thrombosis and required thrombectomy. In all the cases, access was preserved. Steal symptoms resolved completely in all patients except for two, who had partial relief of rest pain and neurological symptoms. DRIL is a safe and effective procedure for resolution of steal syndrome and in preserving access at the same time.

Purpose: To demonstrate the association between coronary vessel wall thickness (VWT) measured at MRI and coronary artery disease (CAD) risk in asymptomatic groups at low and intermediate risk on the basis of Framingham score., Materials and Methods: A total of 131 asymptomatic adults were prospectively enrolled. All participants underwent CT angiography for scoring CAD, and coronary VWT was measured at 3.0-T MRI. Nonlinear single and multivariable regression analyses with consideration for interaction with sex were performed to investigate the association of traditional atherosclerotic risk factors and VWT with CT angiography-based CAD scores., Results: The analysis included 62 women and 62 men with low or intermediate Framingham score of less than 20%. Age (mean age, 45.0 years ± 14.5 [standard deviation]) and body mass index were not different between the groups. Age, sex, and VWT were individually significantly associated with all CT angiography-based CAD scores ( P < .05). Additionally, sex was a significant effect modifier of the associations with all CAD scores. In men, age was the only statistically significant independent risk factor of CAD; in women, VWT was the only statistically significant independent surrogate associated with increased CAD scores ( P < .05)., Conclusion: In asymptomatic women, VWT MRI was the primary independent surrogate of CAD, whereas age was the strongest risk factor in men. This study suggests that VWT may be used as a CAD surrogate in women at low or intermediate risk of CAD. Further longitudinal studies are required to determine the potential implication and use of this MRI technique for the preventative management of CAD in women.© RSNA, 2019., (2019 by the Radiological Society of North America, Inc.)

Objectives: We aim to assess the antibacterial effectiveness of probiotic cleaning in a dental clinic at the University Dental Hospital Sharjah (UDHS), UAE., Materials and Methods: The current cleaning protocol of UDHS was evaluated by the surface swabbing of three dental clinics routinely cleaned using regular chemical disinfectants. Then, a new probiotic cleaning solution containing Bacillus subtilis was applied for 3 weeks in a selected clinic. Bacteria were grown onto selective culture media for colony counting from surfaces cleaned with probiotic solution compared to those obtained from the same surfaces cleaned with the regular chemical solutions. Isolates identity was confirmed by biochemical tests or polymerase chain reaction., Results: There was a significant reduction of the bacterial counts of various bacterial species ( Staphylococci , Streptococci , and Gram-negative rods) from almost all the surfaces in the dental clinic after the application of the probiotic solution compared to the same surfaces cleaned with the regular chemical solutions. However, the antibiotic resistance rates were not significantly reduced within the short period of 3 weeks of using the new probiotic cleaning product., Conclusions: This study demonstrated that the use of probiotic cleaning is effective in reducing microbial growth in dental settings. This approach may be tested further to examine the long-term effect and to evaluate the opportunity of applying this novel biotechnology as part of the infection control routine in dental settings instead of the chemical disinfectants which are known to cause serious health problems. This is the first study testing the application of probiotic-based solution in dental settings., Competing Interests: There are no conflicts of interest.

Objective: To assess ten-year and lifetime estimated cardiovascular disease risks in non-atherosclerotic subjects., Methods: This cross-sectional study was carried out at the National Institute of Cardiovascular Disease, Karachi, from July 2014 to March 2015, and comprised male and female subjects with multi-ethnic background, aged 20-79 years and having non-atherosclerotic disease. SPSS 22 was used for data analysis., Results: Of the 437 participants, 174(39.8%) were men and 263(60.2%) were women. The overall mean age was 42.65±11.45 years. The mean age of men was 43.3±12.1 years and that of women was 42.2±10.8 years. Moreover, ten-year and lifetime risk assessment rates were higher in men (50[28.2%] and 86[49.4%] respectively) compared to women (28[10.6%] and 84[31.9%], respectively)., Conclusions: Urdu-speaking Pakistanis were found to be at higher risk from atherosclerotic cardiovascular disease.

In a developing country like Pakistan, laparoscopic surgeries are not considered favourable by many, possibly because of high costs or a lack of expertise. It is an established fact that laparoscopic surgery offers better surgical treatments with a shorter hospital stay and fewer complications. The current retrospective study was conducted at a tertiary care hospital in Karachi and comprised of laparoscopy cases performed by a single surgeon from March 2012 to September of 2014. A total of 100laparoscopic surgeries were performed; mostly appendectomies 49(49%) and undescended testes (UDTs) 34(34%). Overall, there were 70(70%) male patients. The mean age of the patients was 7.1 years and standard deviation (SD) of 2. Four (4%) patients had cellulitis. Laparoscopy paediatric surgery offered advantages of fewer wound-associated complications, less incisional pain, a shorter recovery time, and improved cosmesis.

Present study was planned to search for neuropharmacological properties of methanolic extracts of different parts of Melia azedarach Linn. because conventional medicine shows adverse effects. Recently natural products are studied worldwide, as safer alternatives, which are not duly supported with scientifically proved data. Melia azedarach (Bakayan, China berry tree) is medium sized tree belonging to family Meliaceae. Traditional use of plant is as anthelmintic, antilithic and diuretic. Topical application of oil for cramps and rheumatism is beneficial. Methanolic extract of flowers (BFM), twigs (BTM) and roots (BKB) were the test drugs to study different activities on NMRI mice. This is the first report regarding CNS activity of Melia flowers. Significant anxiolytic activity (p=0.000) of extract of flowers (BFM) and of roots (BKB) (p=0.002) was determined by "elevated plus maze" and "Light and dark activity box". Antidepressant activity was seen by BFM (p=0.000) in "forced swim test". Diazepam and Imipramine were used as positive controls respectively. In conclusion flower extract have shown very powerful anxiolytic and anti-depressant activity and cytotoxic potential of twigs cannot be ruled out.

The aim of this study was to evaluate antiviral activity of chloroformic leaves extracts of three plants: Azadirachta indica, Moringa oleifera and Morus alba against Foot and Mouth disease virus using MTT assay (3-(4, 5-Dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide). Antiviral and cytotoxic activity of each extract was evaluated as cell survival percentage and results were expressed as Means ± S.D. The concentrations which resulted in cell survival percentages of greater than 50% are considered to be effective antiviral concentrations. From the tested plant extracts, Moringa oleifera showed potent antiviral activity (p<0.05) while Azadirachta indica showed significant antiviral activity in the range of 1-50μ/ml & 12-100μ/ml respectively. In contrast no antiviral activity was observed by Morus alba as all the tested concentration resulted in significant reduction (p<0.05) in cell survival percentage.

Background. Eclampsia is a reliable indicator of poor birth preparedness and complications readiness. We determined perceptions about eclampsia, birth preparedness, and complications readiness among antenatal clients in Kano, Nigeria. Materials and Method. A cross-sectional design was used to study 250 randomly selected antenatal clients. Data was analyzed using SPSS 16.0. Result. The mean age of the respondents was 26.1 ± 6.4 years. The majority perceived that eclampsia is preventable through good ANC (76.4%) and hospital delivery (70.8%). Overall, 66.8% had good perception about eclampsia. Having at least secondary school education and multigravidity were associated with good perception about eclampsia on multivariate analysis. About a third (39.6%) of the mothers was less prepared. On binary logistic regression, good perception about eclampsia and multigravidity were associated with being very prepared for birth. Up to 37.6% were not ready for complications. Half (50.4%) knew at least three danger signs of pregnancy, and 30.0% donated blood or identified suitable blood donor. On multivariate analysis, having at least secondary school education, being very prepared for birth, and multigravidity emerged as the only predictors of the respondents' readiness for complications. Conclusion and Recommendations. Health workers should emphasize the practicability of birth preparedness and complications readiness during ANC and in the communities, routinely review plans, and support clients meet-up challenging areas. The importance of girl-child education to at least secondary school should be buttressed.

Anxiety and depression leads to a number of morbid states. Search of new agents which are low-priced and safe alternative is necessary. Khamira Gaozaban Ambri Jadwar Ood Salib wala (KGJ), is a product of Hamdard Laboratories (Waqf) Pakistan. They claim that it is anxiolytic, anti-convulsant and nervine tonic. However this claim is not scientifically proven. Some components are proved to be anxiolytic but combination may alter the individual properties of drugs. Therefore we designed present study to prove these properties of KGJ scientifically. Thirty male Sprague Dawley rats were divided into five groups of six animals in each group. The groups were saline group, control group (receiving Diazepam I mg/kg) and three test groups receiving 86, 170 and 360 mg/kg doses of Khamira orally. Assessments of different doses of KGJ in comparison to diazepam were carried out on anxiety paradigms namely "Elevated Plus Maze", "Light And Dark Activity Box" and "Open Field" paradigms. KGJ produced anxiolytic effects in all the behavioral methods, which were not significantly different from the effects produced by diazepam. Basal levels of corticosterone not altered by diazepam were decreased by 86 mg/kg dose of KGJ. Same dose of KGJ also decreased blood glucose levels. In conclusion, these results suggest anxiolytic potential of KGJ with non-sedative property.