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Globalization has resulted in more women participating in the workforce, but it has also led to an alarming increase in human rights violations. A persistent issue in the modern workplace is harassment. Workplace harassment takes many forms, including verbal abuse, physical assault, discrimination, and sexual misconduct. It creates hostile and offensive experiences for individuals and groups, despite being illegal in many places. This not only hampers productivity and job satisfaction but also harms employees’ mental and physical health. Organizations have a moral and legal duty to address workplace harassment. Organizations should promote awareness of the legal and ethical consequences of sexual harassment through dialogue, leadership support, and accessible resources. Key strategies to combat workplace harassment include clear policies, training, inclusive culture, strong legal frameworks, victim support, monitoring, and collaboration. Implementing these strategies creates safe and thriving workplaces. This article focuses on workplace harassment, particularly sexual harassment against women. It highlights the prevalence of harassment, its various forms, and the challenges women face in addressing it. The article emphasizes the need for societal and governmental recognition to effectively combat workplace harassment. It also explores global and regional prevalence of workplace harassment, its consequences, and strategies for prevention.

Abstract Low response rate, treatment relapse, and resistance remain key challenges for cancer treatment with immune checkpoint blockade (ICB). Here we report that loss of specific tumor suppressors (TS) induces an inflammatory response and promotes an immune suppressive tumor microenvironment. Importantly, low expression of these TSs is associated with a higher expression of immune checkpoint inhibitory mediators. Here we identify, by using in vivo CRISPR/Cas9 based loss-of-function screening, that NF1, TSC1, and TGF-β RII as TSs regulating immune composition. Loss of each of these three TSs leads to alterations in chromatin accessibility and enhances IL6-JAK3-STAT3/6 inflammatory pathways. This results in an immune suppressive landscape, characterized by increased numbers of LAG3+ CD8 and CD4 T cells. ICB targeting LAG3 and PD-L1 simultaneously inhibits metastatic progression in preclinical triple negative breast cancer (TNBC) mouse models of NF1-, TSC1- or TGF-β RII- deficient tumors. Our study thus reveals a role of TSs in regulating metastasis via non-cell-autonomous modulation of the immune compartment and provides proof-of-principle for ICB targeting LAG3 for patients with NF1-, TSC1- or TGF-β RII-inactivated cancers.

This paper investigates the performance of deep neural network (DNN)-based signal detection in multiple input, multiple output (MIMO), communication systems. MIMO technology plays a critical role in achieving high data rates and improved capacity in modern wireless communication standards like 5G. However, signal detection in MIMO systems presents significant challenges due to channel complexities. This study conducts a comparative analysis of signal detection techniques within both the single input, single output (SISO), and MIMO frameworks. The analysis focuses on the entire transmission chain, encompassing transmitters, channels, and receivers. The effectiveness of three traditional methods—maximum likelihood detection (MLD), minimum mean square error (MMSE), and zero-forcing (ZF)—is meticulously evaluated alongside a novel DNN-based approach. The proposed study presents a novel DNN-based signal detection model. While this model demonstrates superior computational efficiency and symbol error rate (SER) performance compared to more conventional techniques like MLD, MMSE, and ZF in the context of a SISO system, MIMO systems face some challenges in outperforming the conventional techniques specifically in terms of computation times. This complexity of MIMO systems presents challenges that the current DNN design has yet to fully address, indicating the need for further developments in wireless communication technology. The observed performance difference between SISO and MIMO systems underscores the need for further research on the adaptability and limitations of DNN architectures in MIMO contexts. These findings pave the way for future explorations of advanced neural network architectures and algorithms specifically designed for MIMO signal-processing tasks. By overcoming the performance gap observed in this work, such advancements hold significant promise for enhancing the effectiveness of DNN-based signal detection in MIMO communication systems.

This work explored the influence of cuminaldehyde on the metabolic activity of four primary human cytochrome P450 (CYP) enzymes. Human liver microsomes (HLM) with and without cuminaldehyde were incubated with specific substrates of different CYP enzymes. The influence of cuminaldehyde on “CYP1A2, CYP2C9, CYP2D6 and CYP3A4” activities was examined. The formation of specific metabolites was analyzed by HPLC analytical methods. It was observed that cuminaldehyde appears to have a negligible influence on CYP1A2 activity. However, CYP2C9 activity was significantly and potently inhibited by cuminaldehyde at all investigated concentrations. It was found that cuminaldehyde (1 µM) inhibited the most CYP2C9 enzyme activity with 64.87 % inhibition followed by CYP3A4 (38.90 %), CYP2D6 (25.76 %) and CYP1A2 (4.99 %). Inhibition of both CYP2D6 and CYP3A4 enzyme activity was observed in response to cuminaldehyde concentrations. Findings of the current investigation indicate that herb-drug interactions are very possible when cuminaldehyde is concurrently taken with medicines predominantly metabolized by CYP2C9 and CYP3A4. Cuminaldehyde should be tested further to examine how it affects CYP2C9 and CYP3A4-metabolized drugs.

The proliferation landscape of the Internet of Things (IoT) has accentuated the critical role of Authentication and Authorization (AA) mechanisms in securing interconnected devices. There is a lack of relevant datasets that can aid in building appropriate machine learning enabled security solutions focusing on authentication and authorization using physical layer characteristics. In this context, our research presents a novel dataset derived from real-world scenarios, utilizing Zigbee Zolertia Z1 nodes to capture physical layer properties in indoor environments. The dataset encompasses crucial parameters such as Received Signal Strength Indicator (RSSI), Link Quality Indicator (LQI), Device Internal Temperature, Device Battery Level, and more, providing a comprehensive foundation for advancing Machine learning enabled AA in IoT ecosystems.

This study aimed to provide an understanding of the influence of eugenol on CYP1A2, 2C9, 2D6, and 3A4 in human liver microsomes (HLM). Specific substrate for CYP1A2, 2C9, 2D6, and 3A4 were incubated in HLM with or without eugenol. The formation of their respective metabolites was assessed with HPLC analytical methods. Eugenol at 1, 10 and 100 µM levels inhibited the activity of CYP1A2 and CYP2C9 by 23.38 %, 23.57 %, 39.80 % and 62.82 %, 63.27 %, 67.70 % respectively. While, CYP2D6 and CYP3A4 activity was decreased by 40.70 %, 45.88 %, 62.68 % and 37.41 %, 42.58 % and 67.86 % at 1, 10 and 100 µM eugenol level respectively. The IC50 value of eugenol for CYP2D6 and CYP3A4 was calculated as 11.09 ± 3.49 µM and 13.48 ± 3.86 µM respectively. Potential herb-drug interactions was noted when eugenol is administered simultaneously with medications metabolized by these enzymes, most notably CYP2C9, CYP2D6 and CYP3A4.

Vascular Dementia is a severe disease that results from dead nerve cells’ accumulation in blood vessels. This affects the blood flow and impairs memory and decision-making abilities. Machine learning and deep learning have been used in detecting this disease. Nevertheless, their accuracy has been inconsistent, explaining why their utilization in diagnosing patients has led to poor performance. We developed several transfer learning architectures that improve classification accuracy and diagnosis performance in assessing vascular dementia. The process first entails the preprocessing of the dataset where a random selection ensures data representation is balanced. We used a dataset containing resting-state fMRI scans to split training, testing, and validation into 80%, 10%, and 10%. We employ different Convolutional Neural Network architectures such as VGG16, VGG19, DenseNet121, and InceptionResNetV2 to enhance classification. To, enhance these, we incorporated Rectified Linear Unit and leaky activation functions for the training phase to counteract problems associated with vanishing gradient common in deep learning tasks. Our methodology ensures effective information flow throughout different layers, which is essential for a divergent information hierarchy in medical information. As such, the specifics show that our approach achieved 84.67% in accuracy in the multi-classification, which is better than the current state-of-the-art research in the same field. Therefore, the result shows that transfer learning-based approaches are suitable when combined with strategic pre-processing and activation functions in improving the diagnosis of vascular dementia using MRI images.

Present dynamic performance reputation and technical innovations in Internet of Things (IoT) technologies have endowed ultra-inexpensive, energy effcient, smart, and tiny IoT gadgets. IoT gadgets can be easily implanted inside, attached to, or placed around the chronic patient body, and they can be employed in several healthcare monitoring systems such as mobile, wearable, and implantable healthcare monitoring for chronic diseases. Healthcare monitoring for chronic diseases is one of the major applications of IoT and is also a typical challenging area. The rapidly rising proportion of patients with chronic diseases brought enormous pressure on governments and healthcare providers and required up-to-date long-term healthcare service and continuous monitoring. In this survey paper, we extensively review numerous industrial and non-commercial contemporary healthcare monitoring systems (HMS) and applications. We present a design layout of IoT-based HMS for chronic diseases. We presented societal and technological challenges associated with the design of IoT-based HMS and their solutions. To accomplish this, more than 80 different healthcare monitoring systems have been characterized and classied. Moreover, we describe contemporary healthcare monitoring networks and communication technologies. This review also presents the dynamic capabilities of key IoT technologies for chronic diseases healthcare monitoring to show dedicated research pathways to IoT researchers. Last, we deeply analyze different healthcare monitoring systems and describe open issues that will help researchers and healthcare system designers design future systems.

As professionals in the healthcare industry, there is a duty deeply ingrained within us to be better today than what we were yesterday. This means that each day we have the opportunity to rise up to bigger challenges, whether it is to pass an Endotracheal tube into an unconscious patient with severe neck edema, or to increase the vaccine coverage to more rural areas. Understandably it is the decisions made at a national level which have the potential to be more impactful…

Objectives: To report and analyze the pattern of maxillofacial injuries in trauma victims and to define the role of a maxillofacial surgeon in an emergency trauma care team. Materials and methods: Trauma patients reported and reporting to the casualty of a tertiaryhospital with facial injuries and other suspected concomitant injuries in the body were included in this study. The complete medical and radiographic records of each patient were reviewed and data was collected in a standard proforma in this 5-year clinical study (3 year of retrospective and 2 year of prospective study). The complete data related to the facial injuries and associated systemic trauma was recorded and statistical analysis conducted. Results: A total of 18,369 patients with trauma were admitted to the hospital from May 2018 to April 2023. Out of these, 11,277 (61.4%) were males and 7,092 (38.6%) were females. Seventy percent of the reported cases with trauma were in the age group of 14–40 years. The incidence of trauma during the monsoon season was highest (n = 7,927, 43%). The commonest etiological factor leading to trauma was road traffic accident (n = 4,510, 40%). Among facial injuries, the mandibular fractures (n = 1,821, 41%) were predominant. Conclusions: The management of polytrauma patients should be undertaken by a team of specialists which should include a maxillofacial surgeon as facial injuries were common. This data is essential in developing and assessing the preventative strategies aimed at decreasing the frequency of facial and other injuries.

The standard solid-state reaction method is used to synthesize Aluminium (Al) substituted lithium-nickel-manganese ferrites. The synthesized samples were sintered at a temperature of 1200⁰C for 5h. The confirmation of single-phase cubic spinel structure is revealed by Reitveld refinement analysis. The average grain size is determined to be within the range of 1.72 to 0.91 μm based on the analysis of surface morphology. The densities showed a slight declination with Al contents because the Al3+ ion has less molecular weight than the Fe3+ ion and porosity increased gradually. The real part of initial permeability (μiʹ) is gradually decreased with Al substitution. The lowest value of magnetic loss (tanδM) and the highest value of μiʹ is obtained for the mother material (μiʹ=68.5). The maximum value of relative quality factor (RQF) is found for x=0.20 sample and is approximately 1600. The sample of x=0.00 comprises the large value of saturation magnetization (=89.7 emu/g). Through the analysis of frequency-dependent dielectric constants and AC conductivity, it can be seen that the synthesized ferrites exhibit a high level of resistivity. The dielectric characteristics of the Al-substituted samples are improved, and the maximum dielectric constant (ɛ') of 3200 is observed for the x=0.40 sample at 102Hz. The Nyquist plot indicates that grain boundary contribution is significant to the conductivity mechanism of the compositions and that the materials exhibit non-Debye-type relaxation of conductivity. The studied samples showed ferroelectric properties with lossy behavior.

Abstract The emergence of drone-based innovative cyber security solutions integrated with the Internet of Things (IoT) has revolutionized navigational technologies with robust data communication services across multiple platforms. This advancement leverages machine learning and deep learning methods for future progress. In recent years, there has been a significant increase in the utilization of IoT-enabled drone data management technology. Industries ranging from industrial applications to agricultural advancements, as well as the implementation of smart cities for intelligent and efficient monitoring. However, these latest trends and drone-enabled IoT technology developments have also opened doors to malicious exploitation of existing IoT infrastructures. This raises concerns regarding the vulnerability of drone networks and security risks due to inherent design flaws and the lack of cybersecurity solutions and standards. The main objective of this study is to examine the latest privacy and security challenges impacting the network of drones (NoD). The research underscores the significance of establishing a secure and fortified drone network to mitigate interception and intrusion risks. The proposed system effectively detects cyber-attacks in drone networks by leveraging deep learning and machine learning techniques. Furthermore, the model's performance was evaluated using well-known drones’ CICIDS2017, and KDDCup 99 datasets. We have tested the multiple hyperparameter parameters for optimal performance and classify data instances and maximum efficacy in the NoD framework. The model achieved exceptional efficiency and robustness in NoD, specifically while applying B-LSTM and LSTM. The system attains precision values of 89.10% and 90.16%, accuracy rates up to 91.00–91.36%, recall values of 81.13% and 90.11%, and F-measure values of 88.11% and 90.19% for the respective evaluation metrics.

Abstract Tungsten disulfide (WS2) nanotubes exhibit various unique properties depending on their structures, such as their diameter and wall number. The development of techniques to prepare WS2 nanotubes with the desired structure is crucial for understanding their basic properties. Notably, the synthesis and characterization of multi-walled WS2 nanotubes with small diameters are challenging. This study reports the synthesis and characterization of small-diameter WS2 nanotubes with an average inner diameter of 6 nm. The optical absorption and photoluminescence (PL) spectra of the as-prepared nanotubes indicate that a decrease in the nanotube diameter induces a red-shift in the PL, suggesting that the band gap narrowed due to a curvature effect, as suggested by theoretical calculations.

Abstract Background Many physicians use point-of-care ultrasound (PoCUS) in their clinical practice to improve their diagnostic capabilities, accuracy, and timeliness. Over the last two decades, the use of PoCUS in the emergency room has dramatically increased. This study aimed to determine emergency physicians’ retention of knowledge and skills after a brief training workshop on a focused ultrasound-guided approach to a patient presenting with undifferentiated shock, shortness of breath, and cardiac arrest in the emergency department of a tertiary care hospital. The secondary aim was to deliver the PoCUS-guided algorithmic approach to manage a patient presenting with undifferentiated shock, respiratory distress, and cardiac arrest in the emergency department. Methods A quasi-experimental study was conducted with a single-day Point of Care Ultrasonographic Life Support in Emergency (PULSE) training workshop in October 2021 at the Aga Khan University Hospital, Karachi, Pakistan. A total of 32 participants attended the course, including twenty-one junior residents (PGY 1 and 2) and medical officers with experience of fewer than two years working in different emergency departments of urban tertiary care hospitals across Karachi, Pakistan. Pre- and post-assessment tools comprised a written examination, evaluating participants' knowledge and skills in ultrasound image acquisition and interpretation. Cronbach's alpha was used to calculate the validity of the tool. Results obtained before and after the training session were compared by the McNemar’s test. A p value of ≤ 0.05 was considered significant. Results There was a significant improvement in response to each question pre to post-test after completion of the course (Table 1). The significant change can be seen in questions 7, 8, 13, and 15, with a percentage change of 33.3, 80.9, 42.9, and 47.7. There was a significant improvement in the understanding and knowledge of participants after the training. The scores in the post-test were high compared to the pre-test in each category, i.e., respiratory distress (p

Demand Side Management (DSM) plays a significant role in the smart grid to minimize Electricity Cost (EC). Home Energy Management Systems (HEMSs) have recently been studied and proposed explicitly for HEM. In this paper, we propose a novel nature-inspired hybrid Genetic Flower Pollination Algorithm (GFPA) to minimize cost with an affordable delay in appliance scheduling. Our proposed GFPA algorithm combines elements of the Genetic Algorithm (GA) and Flower Pollination Algorithm (FPA) to create a hybrid approach. To assess the effectiveness of the proposed algorithm, we consider a scalable town consisting of 1, 10, 30, and 50 homes, respectively. The proposed solution finds an optimal scheduling pattern that simultaneously minimizes EC and Peak to Average Ratio (PAR) while maximizing User Comfort (UC). We assume that all homes are homogeneous in terms of appliances and power consumption patterns. Simulation results show that our proposed scheme GFPA performs better when applying Critical Peak Pricing (CPP) signal using different Operational Time Intervals (OTIs) and compared with unscheduled, GA, and FPA-based solutions in terms of reducing cost since they achieve on average 98%, 36%, 23%, and 22%, respectively. Similarly, PAR averages 98%, 36%, 59%, and 55%, respectively. While, UC comparing to GA and FPA, are around 88%, 48%, and 63%, respectively. Our proposed scheme achieves better results by applying Real Time Pricing (RTP) signals and different OTIs. As these schemes, i.e., unscheduled, GA, FPA, and GFPA, achieve cost on average 92%, 50%, 29%, and 28%, respectively. While PAR on average 94%, 39%, 62%, and 56%, and UC for GA, FPA, and GFPA on average 98%, 52%, and 49%, respectively. Overall, our proposed GFPA algorithm offers a more effective solution for minimizing EC with an affordable delay in appliance scheduling while considering PAR and UC.

Mn-substituted Cu and Zn co-doped spinel-typed nano-crystalline ferrites having nominal composition Ni0.50-xMnxCu0.15Zn0·35Fe2O4 (x = 0.00–0.25 in 0.05 increments) have been prepared through the citric acid assisted sol-gel auto-combustion technique. From the XRD measurements, it was found that several intense peaks ensured the cubic spinel-based ferrite structure beyond the formation of any impurity peaks. The crystallite sizes varied from 20 to 28 nm for ash-burnt powders following the coalescence process that decreased the lattice defects and strain. With an increase in Mn concentration, the hopping length (LA) of the tetrahedral A-site increases, while the hopping length (LB) of the octahedral B-site decreases with enhanced lattice constant. The sintered samples' average grain sizes, as measured using the Field Emission Scanning Micrographs (FESEM), differed from around 1.40 to 5.30 μm. Incorporating Mn-ion accelerates grain growth and crystallite size with increased bulk density and reduced porosity due to heat treatment. For increasing sintering temperature along with Mn concentration, porosity drops from 42% to 3%, resulting in enhancing the magnetic induction of the prepared ferrites. The 25% Mn substituted composition displays the maximum initial permeability (μi′ = 315), which is ∼7 times larger than the pristine composition. Due to the reduction of Ni content, the relative quality factor rises but the magnetic loss tangent reduces. An increased trends of μi′ are accompanied by decreased resonant frequency, obeying Snoek's law. According to the experimental findings, the high spin Mn substitution in the composition causes the saturation magnetization to increase while the coercivity and Néel temperature drop with increasing grain size. Hence, the locally prepared low-cost Nano-crystalline Ni–Mn–Cu–Zn ferrites bearing excellent properties can be a good candidate for promising future applications in nanotechnology.

Named Data Networking (NDN) has emerged as a promising network architecture for content delivery in edge infrastructures, primarily due to its name-based routing and integrated in-network caching. Despite these advantages, sub-optimal performance often results from the decentralized decision-making processes of caching devices. This article introduces a paradigm shift by implementing a Software Defined Networking (SDN) controller to optimize the placement of highly popular content in NDN nodes. The optimization process considers critical networking factors, including network congestion, security, topology modification, and flowrules alterations, which are essential for shaping content caching strategies. The article presents a novel content caching framework, Popularity-aware Caching in Popular Programmable NDN nodes (PaCPn). Employing a multi-variant vector autoregression (VAR) model driven by an SDN controller, PaCPn periodically updates content popularity based on time-series data, including ‘request rates’ and ‘past popularity’. It also introduces a controller-driven heuristic algorithm that evaluates the proximity of caching points to consumers, considering factors such as ‘distance cost,’ ‘delivery time,’ and the specific ‘status of the requested content’. PaCPn utilizes customized DATA named packets to ensure the source stores content with a valid residual freshness period while preventing intermediate nodes from caching it. The experimental results demonstrate significant improvements achieved by the proposed technique PaCPn compared to existing schemes. Specifically, the technique enhances cache hit rates by 20% across various metrics, including cache size, Zipf parameter, and exchanged traffic within edge infrastructure. Moreover, it reduces content retrieval delays by 28%, considering metrics such as cache capacity, the number of consumers, and network throughput. This research advances NDN content caching and offers potential optimizations for edge infrastructures.

Introduction: Rhodococcus is an extremely rare, gram positive, aerobic, coccobacillary organism, usually found in the soil or in dairy and livestock animals. It is most commonly affecting the immunocompromised. Only 15 % of cases have been reported in immunocompetent hosts. Case report: We bring forth the unusual case of a 45-year-old gem minor who had already undergone pericardial window due to pericardial effusion. He presented to us with recurrent pericardial effusion and anterior mediastinal mass diagnosed on Computed Tomography Pulmonary Angiogram scan. He was diagnosed with Rhodococcus as being the causative organism of the condition on pericardial fluid cultures. This is an extremely rare manifestation of Rhodococcus infection, which has not yet been reported in literature to the best of our knowledge. Discussion: The first human case of Rhodococcus was reported in a young male upon steroidal therapy for autoimmune hepatitis who developed pneumonia in 1967. Rhodococci infections are usually common in immunocompromised hosts, and only 19 cases have been reported in immunocompetent hosts till now. The usual signs of presentation are cough, pleuritic chest pain, and fever; however, it varies according to the site of infection. The most common manifestation is pneumonia, although other presentations include osteomyelitis, brain abscess, wound infections, etc. Result: The diagnosis and treatment of Rhodococci is very difficult due to the rarity of presentation. Despite that, surgical intervention should be considered as the preferred modality for diagnostic purposes and in infections resistant to medical management.

Aims: The atrioventricular block (AVB) is a conduction system problem that results from the impairment in the transmission of an impulse from the atria to the ventricle, the disease has many etiologies. This article aimed to evaluate the efficacy and safety of dual and single-chamber pacemakers in patients with SSS and AVB. Methods: An electronic search of PubMed (Medline), EMBASE, and Google Scholar was performed from 2000 till August 15th, 2022. Retrieved articles were exported to Endnote Reference Library Software, where duplicate studies were removed from the list, and only articles meeting the eligibility criteria of this study were selected. RevMan 5.4 and STATA 16 software were used for the analysis. The modified Cochrane Collaboration's risk of bias and New-castle Ottawa scale were used for quality assessment of RCTs and observational studies respectively. Results: This study is composed of 8953 patients with sick-sinus syndrome and atrioventricular block. A total of thirteen outcomes are included in this meta-analysis, out of which atrial fibrillation significantly favored dual chamber [OR = 1.29; 95 % CI = 1.05–1.59; P = 0.01 I2 = 29 %] and overall complications [OR = 0.48; 95 % CI = 0.29–0.77; p = 0.03 I2 = 0 %] and pneumothorax [OR = 0.31; 95 % CI = 0.10–0.93; p = 0.04, I2 = 0 %] were satisfied by single-chamber pacing. Conclusion: This study concluded that neither single-chamber nor dual-chamber pacemakers are superior to each other, but they are unique in their own ways as the results of this study manifest remarkable reduction in atrial fibrillation rates and pneumothorax using dual-chamber and single-chamber pacemakers respectively.

A simple and inexpensive spray pyrolysis deposition (SPD) approach was used to produce TiO2 and Cr (2–8) at.%-doped TiO2 thin films. To explore the morphological features of the films, FE-SEM micrographs were used and found that 6 and 8 at.% TiO2:Cr films had fibrous patterns with diameters of 0.45 and 0.78 μm, respectively, while the remainder of the films were agglomerated particles. From X-ray diffraction investigation, it was found that the TiO2 thin films had an anatase crystal phase (tetragonal) up to 6 at.% Cr doping, while an anatase-rutile mixed crystalline phase was identified for 8 at.% Cr doping. The crystallite size of the pristine TiO2 film was 35 nm, while for TiO2:Cr films, it ranges from 35 to 46 nm. The Fizeau fringes technique was employed to measure the thickness of the TiO2 film and 165 nm was found for pristine TiO2 and 164–180 nm for TiO2:Cr films. UV–visible spectroscopy was used to study optical properties such as absorbance, refractive index, optical band gap, dielectric constant, and optical conductivity. As the Cr concentration increases, the optical band gap decreases from 3.40 eV to 2.70 eV. Using the four-point probe method, it was found that the resistivity changes with temperature and is also affected by the Cr content.

Thin films of pristine titanium dioxide (TiO2) and doped with different concentrations (0–8) at.% of nickel (Ni) were synthesized onto transparent glass substrates using the spray pyrolysis deposition technique. Field emission scanning electron microscopy revealed the porous and agglomerated surface morphology of the films. X-ray diffractometer demonstrated the anatase crystal structure with a nominal increment of (101) peak. The shifting of peak position revealed the expansion of the unit cell volume from 134.64 to 137.54 (Å)3 whereas crystallite size increased from 34 to 63 nm. Using the Fizeau fringes technique, the thickness of the films was determined between 165 and 190 nm. UV–Vis measurements were employed to examine the optical characteristics of the films. The red shift was observed for 2 at.% Ni content (3.38 eV) while the blue shift was observed for (4–8) at.% Ni content. The wavelength-dependent refractive index and dielectric constant showed anomalous dispersion in the absorption band, representing the transparency of the films. The 4-point probe measurement showed a decreasing trend of resistivity with increasing temperature, whereas the resistivity increased with Ni content. Activation energy indicated a higher amount of adsorbed oxygen in the films due to the high amount of Ni content.

Dasatinib (DAS) is a narrow therapeutic index drug and novel oral multitarget inhibitor of tyrosine kinase and approved for the first-line therapy for chronic myelogenous leukemia (CML) and Philadelphia chromosome (Ph + ) acute lymphoblastic leukemia (ALL). DAS, a known potent substrate of cytochrome (CYP) 3A, P-glycoprotein (Pgp) and breast cancer resistance protein (BCRP) and is subject to auto-induction. The dietary supplementation of sinapic acid (SA) or concomitant use of SA containing herbs/foods may alter the pharmacokinetics as well as pharmacodynamics of DAS, that may probably lead to potential interactions. Protein expression in rat hepatic and intestinal tissues, as well as the in vivo pharmacokinetics of DAS and the roles of CYP3 A2 and drug transporters Pgp-MDR1 and BCPR/ABCG2, suggested a likely interaction mechanism. The single dose of DAS (25 mg/kg) was given orally to rats with or without SA pretreatment (20 mg/kg p.o. per day for 7 days, n = 6). The plasma concentration of DAS was estimated by using Ultra-High-Performance Liquid Chromatography Mass spectrometry (UHPLC-MS/MS). The in vivo pharmacokinetics and protein expression study demonstrate that SA pretreatment has potential to alter the DAS pharmacokinetics. The increase in Cmax, AUC and AUMC proposes increase in bioavailability and rate of absorption via modulation of CYP3 A2, PgP-MDR1 and BCPR/ABCG2 protein expression. Thus, the concomitant use of SA alone or with DAS may cause serious life-threatening drug interactions.

The objective of this study was to investigate the effects of cinnamon on the pharmacodynamic (PD) & pharmacokinetic (PK) of amlodipine in hypertensive rats. The hypertensive control group of Wistar rats received L-NAME (40 mg/kg, daily, orally) only. The cinnamon group of rats was treated with cinnamon (200 mg/kg, daily, orally) along with L-NAME. Following 14 days treatment period, blood pressures of rats were monitored at designated intervals over 24 h utilizing a tail-cuff system for measuring blood pressure. To assess the oral PK; amlodipine was administered as a single oral dose of 1 mg/kg to rats and blood samples were collected at specified intervals over 24 h and analysed by UPLC-LC MS/MS.Synergistic decreased in rat’s blood pressure was observed in presence of cinnamon + amlodipine. Simultaneous administration of cinnamon ameliorates the Cmax and AUC0-t of amlodipine, the Cmax and AUC0-t was 11.04 ± 1.01 ng/ml and 113.76 ± 5.62 ng h/ml for the cinnamon + amlodipine group as compared to 4.12 ± 0.49 ng/ml and 48.59 ± 4.28 ng h/ml for the amlodipine alone group. The study demonstrates that the use of cinnamon considerably decreases the blood pressure levels and enhances the PK parameters of amlodipine in hypertensive rats.

Antibiotic resistance is a growing concern all over the world. The current study sought to identify antimicrobial resistance (AMR) patterns and antibiotic-resistant genes in Escherichia coli (E. coli) isolated from seemingly healthy ducks and neighboring tap water sources at three separate live bird markets (LBMs) in Chattogram, Bangladesh. A total of ninety cloacal swab samples of Khaki Campbell ducks and fifteen water samples from nearby tap water sources were collected from three LBMs. Several cultural and molecular tests were conducted to determine E. coli contamination. The disk diffusion technique was used to evaluate the antibiotic sensitivity of E. coli isolates to 12 different antibiotics. For each isolate, a Multiple Antibiotic Resistance (MAR) index was calculated. The resistance genes were detected using a polymerase chain reaction (PCR) assay. The overall prevalence of E. coli in feces and tap water samples was 64.4% (58/90, 95% CI 54.1-73.6) and 100% (15/15, 95% CI 76.1-100), respectively. Both fecal and water isolates showed 100% resistance to ampicillin, tetracycline, and nalidixic acid. Resistance to other antibiotics was also found to be high. Multidrug- resistance (MDR) was unveiled in all fecal (58/58) and water (15/15) isolates. MAR index ranged from 0.33 to 0.67 in all recovered isolates. Both fecal and water E. coli isolates harbored blaTEM, tetA, sul1, and sul2 genes. The resistance genes in MDR E. coli in live bird markets might transmit from ducks to humans and they, therefore local authorities should consider this issue a major public health risk.

The goal of this work was to improve the aqueous solubility and dissolution rate of eprosartan mesylate by preparing inclusion complex of drug with β-cyclodextrin (β-CD) by microwave technique. In order to determine the solubility of eprosartan, phase solubility was determined and dissolution study was also conducted. Further, analytical techniques for instance, particle size distribution, differential scanning calorimetry, powder X-ray diffraction, scanning electron microscopy, Fourier-transform infrared spectroscopy, and nuclear magnetic resonance spectroscopy were used for the characterization of inclusion complex. In addition, the binding pattern of eprosartan with the β-CD was investigated by molecular modeling study. Phase solubility study revealed that approximately 4.48 folds improvement in the solubility of drug was noted with β-CD (10 mM). The estimated stability constant (Kc) values for eprosartan:β-CD binary mixture was found to be 280.78 M–1. The prepared inclusion complex of drug with β-CD presented better drug release profile (62.96 ± 2.01% in 1 h) as compared to their physical mixture (41.41 ± 1.77% in 1 h) or drug per se (29.97 ± 3.13%). The inclusion complex demonstrated different features and properties from pure drug, and we inferred that this could be due to the inclusion of drug into cyclodextrin cavity that confirmed by different analytical method. Molecular modeling study demonstrated a good affinity of eprosartan to entangle to β-CD. The outcomes have shown that guest molecule has many significant interactions with the host molecule. These observations are very interesting and may be a valuable approach to improve the solubility and in turn the bioavailability of eprosartan.

AbstractThe World Health Organization stated on 11 March 2020 that a coronavirus illness had been discovered in Wuhan, China in December 2019. Effective vaccinations are eagerly awaited as the global outbreak of COVID-19 continues. The aim is to evaluate the safety, effectiveness, and immunogenicity of Pfizer/AstraZeneca/Modera/Cansino vaccines against COVID-19. An electronic search on different databases yielded 12,907 articles. A total of 20 randomized and non-randomized, published, and ongoing trials were selected. Cochrane RoB version 2.0 was used to assess the authenticity of the studies. Of these 20 trials, three were conducted on Pfizer, three on AstraZeneca, three on Moderna, and two on the Cansino vaccine. These trials have reported promising results for the safety, efficacy, and immunogenicity of the respective vaccines. None of the trials have reported the efficacy and severe adverse outcomes for the Cansino vaccine, hindering its reliability as a safe vaccine against covid-19. Furthermore, the results of these trials have established Pfizer to be the most efficacious vaccine against covid-19, having an efficacy of 94.6%. A few severe adverse events were reported by the included trials. However, further systematic reviews are required to understand the respective vaccine profiles on Immuno-suppressive, organ transplants, and patients with other comorbidities.

Background: Tension neck syndrome (TNS) is a prevalent condition worldwide. Soft tissue mobilization and strengthening exercises are used in physiotherapeutic rehabilitation of the musculoskeletal disorders. Objective: To compare the effects of strengthening exercises with and without soft tissue mobilization (STM) for pain and disability reduction in females with TNS. Methods: A single-blinded, parallel-group randomized controlled trial was conducted at the National Institute of Rehabilitation Medicine, Pakistan, from April to July 2016. A total of n=30 females, aged 30-70 years, were recruited through non-probability convenient sampling technique and randomly allocated to the experimental and control group. The experimental group received STM and neck isometric strengthening exercises, whereas the control group received neck isometric strengthening exercises only. The Numeric Pain Rating Scale (NPRS) was used to assess the pain intensity, while Neck Disability Index (NDI) was used for the neck-related disability. The data was collected at the baseline, after the 4th session and after the 8th session. The repeated measure analysis of variance (RM ANOVA) was used to analyse within the group changes, while the independent t-test was used to analyse the differences between the groups. The data was analysed by using SPSS version 21.Results: The mean age of the study participants was 47.9 ± 8.95 years. Within groups’ changes showed that pain intensity, individual items of NDI and its total score showed significant improvement in both the groups from the baseline to the 8th session (p £ 0.05). After the 8th session, the experimental group showed more significant reduction (p £ 0.05) in pain intensity and neck disability as compared to the control group. Conclusions: Soft tissue mobilization when combined with neck isometric strengthening exercises was more effective than exercises alone for reducing the pain intensity and disability in females with tension neck syndrome.

Abstract Background Hypolipidemic agents have been shown to be helpful in the primary and secondary prevention of cardiovascular disease. Most often, statins are prescribed to treat hyperlipidemia. There are a number of statins available in the market today, but atorvastatin is the most widely prescribed. It is essential that the drugs should have the appropriate amount of active pharmaceutical ingredient and meet the necessary physical properties. The main purpose of the study was to evaluate the quality of different marketed brands of atorvastatin calcium tablets available in Saudi Arabia. Methods In this study, innovator product coded as (AS-1) and five generics brands (coded as AS-2 to AS-6) of atorvastatin tablets 20 mg available in Saudi Arabia were evaluated for in vitro dissolution test, weight variations, friability and hardness tests. The analysis of drug was carried out by “high-performance liquid chromatography” (HPLC) method using C18 column (4.6 × 150 mm, 5 μm). The mobile phase was consisted of acetonitrile and HPLC water (pH 2.1, adjusted with orthophosphoric acid) in ratio of 52:48 v/v, the flow rate was 1.0 ml/min. Atorvastatin was detected at a wavelength of 254 nm. Results According to the results of the dissolution study, the investigated products released more than 90% of atorvastatin in 15 min. Within 60 min, the brands AS-1, AS-3, AS-5, and AS-6 depicted nearly 100% atorvastatin release, while the brand AS-2 displayed 91.69% drug release. According to our findings, the investigated atorvastatin innovator (AS-1) and generic brands such as AS-2 to AS-6 were of good pharmaceutical quality. Conclusions All generic brands of atorvastatin tablets available in the Saudi Arabian market met the pharmacopoeia's consistency checks such as weight variation, friability, hardness and in vitro dissolution. Hence, focusing on their in vitro release properties, it was determined that these brands could be used interchangeably.

Mycobacterium tuberculosis (Mtb) defends host-mediated killing by repressing the autophagolysosome machinery. For the first time, we report NCoR1 co-repressor as a crucial host factor, controlling Mtb growth in myeloid cells by regulating both autophagosome maturation and lysosome biogenesis. We found that the dynamic expression of NCoR1 is compromised in human peripheral blood mononuclear cells (PBMCs) during active Mtb infection, which is rescued upon prolonged anti-mycobacterial therapy. In addition, a loss of function in myeloid-specific NCoR1 considerably exacerbates the growth of M. tuberculosis in vitro in THP1 differentiated macrophages, ex vivo in bone marrow-derived macrophages (BMDMs), and in vivo in NCoR1MyeKO mice. We showed that NCoR1 depletion controls the AMPK-mTOR-TFEB signalling axis by fine-tuning cellular adenosine triphosphate (ATP) homeostasis, which in turn changes the expression of proteins involved in autophagy and lysosomal biogenesis. Moreover, we also showed that the treatment of NCoR1 depleted cells by Rapamycin, Antimycin-A, or Metformin rescued the TFEB activity and LC3 levels, resulting in enhanced Mtb clearance. Similarly, expressing NCoR1 exogenously rescued the AMPK-mTOR-TFEB signalling axis and Mtb killing. Overall, our data revealed a central role of NCoR1 in Mtb pathogenesis in myeloid cells.

Healthcare is experiencing a fast change from a hospital-centric and specialist-focused model to one that is dispersed and patient-centric. Numerous technological advancements are driving this fast evolution of the healthcare sector. Communication technologies, among others, have permitted the delivery of customized and distant healthcare services. The present 4G networks and other wireless communication technologies are being utilized by the healthcare industry to create smart healthcare applications. These technologies are continuously evolving to meet the expectations and requirements of future smart healthcare applications. At the moment, current communication technologies are incapable of meeting the dynamic and complex demands of smart healthcare applications. Thus, the future 5G and beyond 5G networks are expected to support smart healthcare applications such as remote surgery, tactile internet and Brain-computer Interfaces. Future smart healthcare networks will combine IoT and advanced wireless communication technologies that will address current limitations related to coverage, network performance and security issues. This paper presents 5G-based smart healthcare architecture, key enabling technologies and a deep examination of the threats and solutions for maintaining the security and privacy of 5G-based smart healthcare networks.

Photoelectrochemical cells (PECs) are a promising option for directly converting solar energy into chemical energy by producing hydrogen (H2) gas, thus providing a clean alternative to consuming fossil fuels. H2 as fuel is free from any carbon footprints and negative environmental impacts. Therefore, the H2 production, especially directly using sunlight in PECs, is critically important for the rapidly growing energy demand of the world. Although promising, PECs are inefficient and must overcome a few inherent losses in producing H2—the most important being the activation overpotential (ηa) required for splitting water. This work analyzes the impact of ηa on solar-to-fuel efficiency (ηSTF) and H2 production rate (HPR). This work also discusses choosing appropriate photo-absorbing materials based on their energy bandgaps and suitable electrode pairs to achieve desired ηSTF and HPR for different electrical and optical PEC configurations. Significant changes are observed in ηSTF and HPR when ηa is considered in water splitting.

Herein, biologically synthesized silver nanoparticles (AgNP) from amomum subalatum (AS) leaf extract (i.e. AgNP-AS) for spectrophotometric detection of Hg2+ ions. The formation of AgNP-AS has been confirmed by UV-Visible, X-ray diffraction (XRD), Fourier transform infrared (FTIR) and Transmission electron microscopy (TEM). The different characterization results showed that AgNP-AS exhibit a strong absorption band at 432 nm, crystallinity and spherical morphology with 4.9 nm average particle size. The AgNP-AS shows a good sensitivity towards Hg2+ ions by a decrease in its absorption intensity with a limit of detection (LOD) of 0.41 μM. Also besides, AgNP-AS shows a good selectivity towards Hg2+ ions over other heavy metal ions. The detection mechanism was thoroughly investigated with increasing Hg2+ ions concentration by observing the variation in the zeta potential. Moreover, to extend the applicability, the AgNP-AS was successfully applied to river and tap water samples treated with known concentrations of Hg2+ ions with a percentage recovery and relative standard deviation (RSD) values in the range of 96–101.1% and 1.6–6.2%, respectively. Therefore, the as-prepared AgNP-AS can be practically applied to samples of drinking water for the detection of Hg2+ ions.

Background and Objectives: Anaerobic bacteria like Fusobacterium can lead to severe and life-threatening infections. The inherent complexities in the isolation of these bacteria may result in diagnostic and therapeutic delays, thereby escalating both morbidity and mortality rates. We aimed to examine data from patients with infections due to Fusobacterium to gain insights into the epidemiology and clinical outcomes of patients with these infections. Methods and Results: We conducted a retrospective analysis of clinical data from a cohort of patients with cultures positive for Fusobacterium species at a tertiary care medical center in the United States. Between 2009 and 2015, we identified 96 patients with cultures positive for Fusobacterium. Patients could be categorized into three groups based on the site of primary infection. Patients with head and neck infections constituted 37% (n 36). Patients with infections of other soft tissue sites accounted for 38.5% (n 37). Patients with anaerobic bacteremia due to Fusobacterium formed 24% (n 23) of the cohort. Surgical intervention coupled with antibiotic therapy emerged as cornerstones of management for patients with head and neck or other soft tissue infections, who generally exhibited more favorable outcomes. Patients with bacteremia were older, more likely to have malignancy, and had a high mortality rate. When speciation was available, Fusobacterium necrophorum was the most frequently isolated species. Conclusions: Our retrospective analysis of epidemiology and clinical outcomes of Fusobacterium infections revealed three distinct cohorts. Patients with head, neck, or soft tissue infections had better outcomes than those with bacteremia. Our findings highlight the importance of employing management strategies based on infection site and underlying comorbidities in patients with Fusobacterium infections. Further research is needed to investigate the optimal therapeutic strategies and identify prognostic indicators to improve clinical outcomes for these complex infections.

ZnO is an important II-IV n-type direct bandgap semiconductor material that has exhibited wide consideration due to its applications in optoelectronic devices. In the present investigation, untreated and plasma-treated ZnO NPs were fabricated by a sol-gel route and analyzed with XRD, Raman, UV-Vis spectra, and I–V characteristic techniques. To be used in electronic applications, the ZnO nanoparticles were subjected to a plasma treatment process to tune their optical, vibrational mode, structural and electrical properties. XRD confirmed the pure Wurtzite tetragonal phase crystalline nature of produced samples. The average crystalline size, lattice constant, unit cell volume, and porosity were found in the range of 3.81–4.68 nm, a = 3.217–3.323 Å and c = 2.032–2.178 Å, 5.662–11.274 Å3 and 7.09–5.03%, respectively. The Raman spectra revealed that the intensity of Raman bands was increased due to the increase in the vibrational amplitude and increase in force constants with the enhancement in grain size, these spectra results are in good agreement with XRD and reveal the purity of samples. The bandgap found reduced from 3.56 eV to 3.39 eV by plasma treatment. The electrical studies revealed that plasma treatment improves the electrical properties of ZnO NPs without producing any structural distortions. I–V characteristic curves confirmed that the conductivity was increased from 8.3 X 10−6 to 5.5 X 10−4 ℧ cm−1 on plasma treatment which caused an increase in leakage current. The improved structural, vibrational mode, optical and electrical properties of prepared ZnO NPs make them a suitable candidate for application in electronic devices.

The police are an important part of a society, responsible for the upkeep of law and order and for listening to the public’s grievances. The latter is the concern of this study, which focuses on analysing the politeness strategies used by the members of the Punjab Police in conversation with the complainants in the police stations of Lahore. Moreover, this paper also studies how politeness strategies are used by the police to impart its own public self-image (face) to the public. The study adopted the politeness strategies framework (positive, negative, bald on-record, off record) outlined originally by Brown and Levinson (1987) to tag utterances exchanged between the police and the complainants. The study used a mini-ethnographic case study for the collection of data from police stations through observations, field notes and semi-structured interviews. Three police stations were observed for triangulation purposes where interactions between the complainants and the front-desk officers were noted down. Moreover, interviews were taken from front-desk officers, sub-inspectors, inspectors and SHOs. The observations and supporting interviews have shown that the police are keen on maintaining a positive face (i.e., maintaining solidarity and cordialness) which was in contrast to the complainants who by default maintained a negative face (i.e., maintained a serious demeanour, and had a more direct, to-the-point attitude). This goes on to show the conscious effort made by the police to maintain a friendly outlook, and shun stereotypical tags of being impolite, rude, and overpowering with the complainants.

Abstract Background Critically-ill Covid-19 patients require extensive resources which can overburden a healthcare system already under strain due to a pandemic. A good disease severity prediction score can help allocate resources to where they are needed most. Objectives We developed a Covid-19 Severity Assessment Score (CoSAS) to predict those patients likely to suffer from mortalities within 28 days of hospital admission. We also compared this score to Quick Sequential Organ Failure Assessment (qSOFA) in adults. Methods CoSAS includes the following 10 components: Age, gender, Clinical Frailty Score, number of comorbidities, Ferritin level, D-dimer level, neutrophil/lymphocyte ratio, C-reactive Protein levels, systolic blood pressure and oxygen saturation. Our study was a single center study with data collected via chart review and phone calls. 309 patients were included in the study. Results CoSAS proved to be a good score to predict Covid-19 mortality with an Area under the Curve (AUC) of 0.78. It also proved better than qSOFA (AUC of 0.70). More studies are needed to externally validate CoSAS. Conclusion CoSAS is an accurate score to predict Covid-19 mortality in the Pakistani population.

Background and Aim: Bluetongue (BT) is a non-contagious, infectious disease of wild and domestic ruminant animals caused by the BT virus (BTV). Bangladesh having a border with a BTV-endemic country, India and a substantial number of susceptible animals. Therefore, this study aimed to estimate BTV seroprevalence and potential risk factors. Materials and Methods: We collected 150 serum samples from indigenous sheep from Chattogram, Bangladesh. We screened the serum samples using a competitive enzyme-linked immunosorbent assay for detecting BTV-specific immunoglobulin. Results: We detected antibodies against BTV in 39.3% (59/150; 95% confidence interval: 31.5–47.6) of all sampled sheep. Factors like sampling site, sheep rearing location, rearing sheep with other farm species, and body condition score had a significant (p < 0.05) influence on the seroprevalence of BTV. Conclusion: The findings show that indigenous sheep have a higher BTV seroprevalence, necessitating sustained surveillance for early diagnosis and a better understanding of virus epidemiology in Bangladesh.

Introduction: Dyspepsia is a common problem in regular outpatient clinical practice. In Kashmir province of North India little research has been done on studying clinically important endoscopic findings in non resolving dyspeptic patients of different ages and ethnicities. The purpose of this study was to assess the diagnostic value of Upper Gastrointestinal Endoscopy (UGIE) in patients with non resolving dyspepsia who had not undergone endoscopic evaluation previously. Aim: To determine the diagnostic value of endoscopy in patients with non resolving dyspepsia and to correlate the endoscopic findings with clinical perspective of patients with or without alarming symptoms and signs. Materials and Methods: This retrospective cross-sectional, single-centre study was done in the Department of General Medicine, SKIMS Medical College and Hospital (tertiary care hospital), Srinagar, Jammu and Kashmir, India, from July 2017 to June 2022. Study involved 1600 patients who presented with non resolving dyspepsia and underwent endoscopic evaluation. Non resolving dyspepsia was defined as persistent upper abdominal discomfort associated with heart burn or bloating after three to six weeks of adequate proton pump inhibitor therapy. Data was gathered and analysis was done based on demographics, clinical symptoms with or without alarming features by using Statistical Package for the Social Sciences (SPSS) software version 22.0. Results: A total of 1600 patients were incorporated in the study. The mean±Standard Deviation (SD) age of the study group was 52±10 years, and 63% of the patients were males. Epigastric pain was the predominant symptom (61%) followed by heartburn (22%). Abnormal endoscopic findings were noted in 47.75% of the patients involved in this study. Gastritis (19.4%) was the most common finding observed. Gastric carcinoma was the least common diagnosis, seen in 2.93% subjects mostly in the elderly age group. Conclusion: In the present study, patients with dyspepsia frequently had normal or clinically insignificant upper gastrointestinal endoscopic findings regardless of age. Based on the present study conducted in a large number of patients invasive procedure like UGIE should be reserved for patients having definite alarming features as majority of patients don’t have clinically significant findings and should be treated adequately on Functional Dyspepsia (FD) protocol before a definitive investigative procedure is performed. The present study strongly indicates overuse of UGIE especially in the absence of alarming features.

Objective: To assess the knowledge of physicians working in the emergency department in choosing appropriate diagnostic imaging in different clinical scenarios. Method: The cross-sectional study was conducted at the Emergency Department of the Aga Khan University Hospital, Karachi, from January 3 to July 2, 2018, and comprised registered medical officers, residents, and consultants of either gender involved in emergency care decision-making. Data was collected using a structured questionnaire that had 10 clinical scenarios based on the American College of Radiology Appropriateness Criteria guidelines. Data was analysed using SPSS 17. Results: Of the 82 participants, 50(61%) were males and 32(39%) were females. The overall mean age was 34.06±6.42 years. Of the total, 50(61%) subjects had appropriate knowledge regarding imaging. The overall mean number of correct responses was 6.90±1.20. Those belonging to the Emergency Medicine specialty had significantly higher odds of having appropriate knowledge compared to participants belonging to other specialties when adjusted for age, gender, position of practice and years of Emergency Medicine training (Odds ratio: 4.73; 95% confidence interval: 1.07-20.91). Conclusion: Physicians belonging to the Emergency Medicine specialty were more likely to have adequate knowledge regarding imaging appropriateness compared to other specialties. Key Words: Appropriateness criteria, Emergency medicine, American College of Radiology, Resident education, Guidelines.

Coronavirus disease 2019 (COVID-19) infection primarily involves the respiratory system but has many noteworthy extra pulmonary manifestations as well. We write this review to highlight the basis of some pathophysiological mechanisms of COVID-19 infection-induced endocrine dysfunction. Different scientific databases and institutional websites were searched to collect and consolidate the most up-to-date data relating to COVID-19 infection and endocrine systems. Hypopituitarism, central diabetes insipidus, SIADH, thyroid abnormalities, hyperglycemia, adrenal insufficiency, orchitis and alteration in sperm morphology have been reported in case reports of patients with COVID-19 infection. Data focusing on COVID-19 vaccination was also searched to summarize the effect, if any, on the endocrine system. Endocrinopathies noted post COVID-19 vaccination, including cases of adrenal hemorrhage, new onset Type II Diabetes Mellitus and subacute thyroiditis, are also discussed in this review. This review calls attention to the misinformation relating to COVID-19 vaccination with supposed endocrine effects such as infertility and problems with pregnancy. Rebutting these misconceptions can help increase compliance and maximize COVID-19 vaccination to the public.

Abstract Background The emergence of methicillin‐resistant Staphylococcus aureus (MRSA) and methicillin‐resistant Staphylococcus pseudintermedius (MRSP) have a significant health impact on people with direct or supportive occupations in veterinary medicine including veterinarians, animal handlers, laboratory personnel and pet owners. Objectives This cross‐sectional survey was conducted to determine the prevalence of and risk factors for S. aureus, S. pseudintermedius, MRSA and MRSP in dogs in Bangladesh. Methods A total of 358 swab samples were collected from different body sites of 150 dogs attending a university teaching veterinary hospital between January and June 2018. Standard bacteriological procedures were followed to isolate Staphylococcus, and identification was confirmed to the species level by PCR to detect the nuc gene. MRSA and MRSP were confirmed by the presence of the mecA gene. Results The prevalence of coagulase‐positive S. aureus and S. pseudintermedius in dogs were 16% and 45.3%, respectively. S. aureus and S. pseudintermedius isolates displayed the highest resistance against nalidixic acid (95.2% and 91%, respectively) and erythromycin (89.3% and 84.7%, respectively). Notably, all the staphylococcal isolates showed resistance to ≥3 antimicrobial classes. The prevalence of MRSA and MRSP in dogs was 8.7% and 6%, respectively. Multivariable logistic regression analysis identified the following variables as risk factors for MRSA colonisation in dogs: dogs with dermatitis (odds ratio [OR], 12.24, 95% CI: 3.12–57.33; p < 0.001) and history of antibiotic use (OR 8.73, 95% CI: 2.23–43.10; p < 0.001). Presence of otitis (OR 14.22; 95% CI: 1.64–103.58; p = 0.008) and oral lesions (OR 9.48, 95% CI: 1.14–64.82; p = 0.002) were identified as the significant risk factors for the carriage of MRSP. Conclusions The circulation of multidrug‐resistant S. aureus and S. pseudintermedius is a serious concern to dogs and humans. To our knowledge, this is the first report of S. pseudintermedius and MRSP affecting dogs in Bangladesh.

Pterostilbene (PTS) is a naturally occurring phytoalexin. PTS displays limited water solubility, which consequently results in its diminished oral bioavailability. Therefore, a ternary inclusion complex (TIC) of PTS with β-cyclodextrin (βCD) in the presence of ternary substance Pluronic® F-127 (PLF) was prepared using microwave technology. The PTS-TIC was characterized by dissolution performance. Further, the prepared TIC was characterized by DSC, FTIR, NMR, XRD, and SEM analysis. Additionally, the antioxidant activity of PTS and PTS-TIC was also evaluated. Phase-solubility studies revealed that PTS’s solubility in water was increased by 6.72 times when βCD/PLF was present. In comparison with PTS, prepared PTS-TIC produced a considerable improvement in PTS release. After 1 h, 74.03 ± 4.47% of PTS was released from PTS-TIC. Outcomes of DSC, FTIR, NMR, XRD, and SEM analysis revealed that the PTS was enclosed in the βCD cavity. In terms of antioxidant properties, the PTS-TIC formulation demonstrated superior activity compared to PTS, possibly attributed to the improved solubility of PTS resulting from the formation of TIC using microwave technology. It was concluded that microwave technology proved to be an extremely beneficial means of interacting PTS with βCD. In addition to increasing the solubility of PTS, the findings are also expected to improve its bioavailability by increasing its solubility. As a result, this study could provide insight into potential methods for enhancing the solubility of polyphenolic substances like PTS.

Objective: To examine the prevalence of antibody IgG/IgM and designing follow-up study of six months and to perform the molecular characterization and sequence analysis of spike protein of SARS-CoV-2. Study Design: Prevalence study. Place and Duration of the Study: The study was conducted in the Post-Graduate Lab of the National University of Medical Sciences (NUMS) Rawalpindi, Pakistan from January 2021 to June 2021. Methods: 112 suspected patients with mild and severe symptoms were tested by PCR (polymerase chain reaction) and all were positive. Antibody profiling of vaccinated and non-vaccinated patients was performed by enzyme-linked immunosorbent assay (ELISA) and followed up for up to six months. Results: Ten patients were identified as re-infected and were subsequently re-tested via PCR and DNA sequencing. The IgG/IgM of immunized patients was 11.87IU/mL and 3.87IU/mL in non-immunized individuals. Genomic analysis indicated that all the sequences belong to delta variant (21A and 21J sub-lineages). Mutations were observed in spike protein at I1169V, D950N in 21A and T951I and S254F in 21J sub-lineages. Conclusion: This study revealed the significance of measuring antibody levels among vaccinated and unvaccinated individuals. Additionally, mutations in the spike gene of the delta variant of SARS-CoV2 can influence the pathogen's mutation rate, leading to changes in its transmissibility and pathogenicity. How to cite this: Rizwan M, Ahad A, Aziz S, Lone NA, Naz T, Khan MB, Jafri L, Ali L. A Study on Prevalence and Molecular Characterization of Spike Protein of SARS-COV-2 in Pakistan. Life and Science. 2023; 4(4): 458-468. doi: http://doi.org/10.37185/LnS.1.1.400

Sinapic acid (SA) is a bioactive phenolic acid; its diverse properties are its anti-inflammatory, antioxidant, anticancer, and antibacterial activities. The bioactive compound SA is poorly soluble in water. Our goal was to formulate SA-transethosomes using thin-film hydration. The prepared formulations were examined for various parameters. In addition, the optimized formulation was evaluated for surface morphology, in-vitro penetration studies across the Strat M®, and its antioxidant activity. The optimized formulation (F5) exhibited 74.36% entrapment efficacy. The vesicle size, zeta potential, and polydispersity index were found to be 111.67 nm, −7.253 mV, and 0.240, respectively. The surface morphology showed smooth and spherical vesicles of SA-transethosomes. In addition, the prepared SA-transethosomes exhibited enhanced antioxidant activity. The SA-transethosomes demonstrated considerably greater penetration across the Strat M® membrane during the study. The flux of SA and SA-transethosomes through the Strat M® membrane was 1.03 ± 0.07 µg/cm2/h and 2.93 ± 0.16 µg/cm2/h. The enhancement ratio of SA-transethosomes was 2.86 ± 0.35 compared to the control. The SA-transethosomes are flexible nano-sized vesicles and are able to penetrate the entrapped drug in a higher concentration. Hence, it was concluded that SA-transethosome-based approaches have the potential to be useful for accentuating the penetrability of SA across the skin.

This umbrella review aimed to determine the various drugs used to treat trigeminal neuralgia (TN) and to evaluate their efficacies as well as side effects by surveying previously published reviews. An online search was conducted using PubMed, CRD, EBSCO, Web of Science, Scopus, and the Cochrane Library with no limits on publication date or patients’ gender, age, and ethnicity. Reviews and meta-analyses of randomized controlled trials pertaining to drug therapy for TN, and other relevant review articles added from their reference lists, were evaluated. Rapid reviews, reviews published in languages other than English, and reviews of laboratory studies, case reports, and series were excluded. A total of 588 articles were initially collected; 127 full-text articles were evaluated after removing the duplicates and screening the titles and abstracts, and 11 articles were finally included in this study. Except for carbamazepine, most of the drugs had been inadequately studied. Carbamazepine and oxcarbazepine continue to be the first choice for medication for classical TN. Lamotrigine and baclofen can be regarded as second-line drugs to treat patients not responding to first-line medication or for patients having intolerable side effects from carbamazepine. Drug combinations using carbamazepine, baclofen, gabapentin, ropivacaine, tizanidine, and pimozide can yield satisfactory results and improve the tolerance to the treatment. Intravenous lidocaine can be used to treat acute exaggerations and botulinum toxin-A can be used in refractory cases. Proparacaine, dextromethorphan, and tocainide were reported to be inappropriate for treating TN. Anticonvulsants are successful in managing trigeminal neuralgia; nevertheless, there have been few studies with high levels of proof, making it challenging to compare or even combine their results in a statistically useful way. New research on other drugs, combination therapies, and newer formulations, such as vixotrigine, is awaited. There is conclusive evidence for the efficacy of pharmacological drugs in the treatment of TN.

The main purpose of the current research was to determine the impact of cumin and green tea on the pharmacodynamics and pharmacokinetics of amlodipine in hypertensive rats. Wistar rats were given 40 mg/kg of L-NAME orally every day for two weeks in order to induce hypertension. The groups treated with herbs received L-NAME with a daily oral dose of cumin (200 mg/kg) and green tea (200 mg/kg), respectively. After the treatment for 14 days, blood pressure was measured at specific intervals using a tail-cuff BP-measurement device for 24 h. For oral pharmacokinetics of amlodipine (single dose, 1 mg/kg), the blood samples were collected at predetermined intervals up to 24 h, and plasma samples were analyzed using UPLC-LC MS/MS. In comparison to the hypertensive control group, green tea and cumin significantly decreased systolic and diastolic blood pressures, as well as mean arterial pressures. Green tea has demonstrated a more prominent effect on pharmacodynamic of amlodipine compared to cumin. The rats treated with amlodipine, cumin + amlodipine, and green tea + amlodipine exhibited AUC0-t of 38.85 ± 14.8 ng h/mL, 52.05 ± 10.2 ng h/mL, and 114.73 ± 24.94 ng h/mL, respectively. In addition, it has been observed that co-administration of green tea and cumin increases the Cmax and T1/2 of amlodipine. The results indicated a potential interaction between amlodipine and the investigated herbs in hypertensive rats. Hence, precautions should be taken while concurrently administrating amlodipine with the investigated herbs.

BACKGROUND: Congestive cardiac failure (CCF) and deep vein thrombosis (DVT) may coexist in a patient. The prevalence of DVT has been reported up to 34.1% in CCF patients, and its presence may increase the morbidity and mortality of CCF patients. The presence of DVT may increase the morbidity and mortality of CCF patients. With this background in mind, we conducted a study to know the prevalence of DVT in CCF patients from our part of the world. MATERIALS AND METHODS: An analytical cross-sectional study was carried out over a period of 1 year from March 2015 to February 2016 on 50 patients admitted with CCF to our hospital. After obtaining information on underlying comorbid illness, duration of CCF symptoms, and preliminary investigations, the patients were subjected to venous Doppler ultrasound. RESULTS: A total of 50 patients admitted with the diagnosis of CCF were enrolled in this study. The mean age of patients was 63.28 ± 9.5 years. The mean body mass index of the patients was 24.48 ± 2.8 kg/m2. Five out of 50 patients were found to have deep vein thrombosis in our study. The duration of symptoms of more than 10 days before seeking medical consultation was statistically significant in patients of CCF with DVT. CONCLUSION: In our study, 10% of patients with CCF had DVT on venous Doppler ultrasound. A longer duration of CCF symptoms before seeking medical consultation was significantly associated with DVT in our patients.

Background: Automobile exhaust is an important cause of air pollution, which is a leading health menace and is growing perpetually. Traffic police personnel are exposed to automobile exhaust more than anyone else, and the resulting lung involvement may be asymptomatic. Materials and Methods: This observational cross-sectional study was conducted among 136 traffic police personnel, aged 18–59 years, working for more than 6 months in the traffic police of Kashmir valley. In addition, 140 age- and sex-matched, healthy unexposed Kashmiri's served as controls. Pulmonary functions were measured by RMS Helios 401 PC based spirometer. Results: Sixteen (11.2%) out of 136 traffic police personnel had abnormal pulmonary function test (PFT) as compared to 5 (3.6%) out of 140 controls. Traffic police personnel's had significantly declined forced expiratory volume in 1 s (FEV 1) and forced vital capacity. Eight (5.8%) had obstructive, 7 (5.1%) had restrictive, and 1 (0.7%) traffic police personnel had mixed pattern on PFT. Duration of exposure to automobile exhaust of more than 10 years was significantly associated with pulmonary function abnormality (P = 0.038). Conclusion: Air pollution due to automobile exhaust may be the factor responsible for pulmonary function abnormalities in traffic police personnel. Besides protective measures during duty hours, traffic police personnel should be subjected to periodic assessment of their lung functions.

Introduction: Hypertension is common following successful renal transplantation and has adverse effects on cardio-vascular and graft health. Blood pressure (BP) readings obtained during clinical visits can be misleading and ambulatory blood pressure monitoring (ABPM) is a more reliable and accurate non-invasive method of BP monitoring. Aims and Objectives: To compare office BP with ambulatory BP recordings in successful adult kidney transplant recipients (KTRs). Material and Methods: Office BP (OBP) was measured with mercury sphygmomanometer according to standardized procedure as the mean of two readings taken 1 minute apart; thereafter, 24 hour ABPM was done using automated oscillometric device (Meditech device) in 56 KTRs. Results: OBP missed hypertension in 68% of KTRs who had normal OBP (masked phenomenon) and OBP overestimated hypertension in 11% of KTRs with uncontrolled OBP (white coat phenomenon). Thirty-four percent of patients were normal dippers, 32% non-dippers, 25% reverse dippers and 9% were extreme dippers. Conclusions: ABPM is a valuable tool in detecting dipping status, white coat and masked phenomena which are frequent problems among KTRs and should be considered as part of routine management of hypertension in KTRs.