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This research implements an evolutionary optimized finite differences scheme (FDS) for nonlinear electrohydrodynamics ion drag flow dynamics in a cylindrical conduit (EHD-IDFCC). In the scheme, finite differences are exploited to discretize governing expressions of EHD-IDFCC, represented with a nonlinear singular seconder order differential equation, into a nonlinear equations-based system. The fitness function based on residual error is constructed for the FDS-based discretized EHD-IDFCC model. Its optimization is conducted with the global search capability of genetic algorithms (GAs) aided by the local search efficacy of the interior-point method (IPM), i.e., FDS-GA-IPM. The performance of the designed stochastic numerical solver FDS-GA-IPM is evaluated for a variant of the EHD-IDFCC model for different scenarios to measure the effect of axial flow velocity by varying the electric Hartmann numbers, as well as the nonlinearity factor. Statistical interpretations based on histogram illustrations, probability plots, and boxplots in terms of the cost function, mean absolute error (MAE), Thai inequality coefficients (TIC), and coefficient of determination metrics (R2) are used to endorse the accuracy, convergence, stability, and strength of the FDS-GA-IPM.

Cyclophosphamide (CTX) is an anticancer medication that suppresses host immunity as well as adversely affects mucosal inflammation and gut microflora dysbiosis. The gut microflora is recognized as a substantial factor in host metabolism and immunological homeostasis. To improve immunity and inhibit cytotoxic and homeostatic imbalances triggered by CTX, it is essential to monitor immunoregulators. In this research, we assessed the impact of Octopus peptide hydrolysate (OPH) on immune modulation, intestinal integrity, and gut microbial composition in CTX-induced immune-deficient mice. The results revealed that OPH increased body weight, and immunological organ indices, and improved the histological changes in the colon, thymus, and spleen. The OPH stimulated the secretion of cytokines (IL-1β, IL-6, and TNF-α) and antibodies (IgM and IgA) while reducing the ratio of lipopolysaccharide (LPS) and diamine oxidase (DAO) in the serum. OPH further enhanced goblet cell and mucus production, upregulated the expression of gut tight-junction proteins (Occludin, Zonula Occludin-1, Mucin-2, and Claudin-1), and activated the TLR4/NF-κB cascade (p-IκBα, P65/p-p65). In addition, OPH treatment declined the Bacteroidetes/Firmicutes ratio, enhanced the relative ratio of Alistipes/Lachnospiraceae, and reversed the ecological equilibrium of the gut microflora. The findings revealed that OPH serves as a prebiotic to prevent CTX-mediated disruption in the intestinal barrier and boosts gut mucosal immunity by attenuating gut microflora imbalance, implying that OPH could be used as an immunological ingredient in nutritious foods to regulate the immune system and protect the gut from inflammatory diseases.

Neurofibromatosis type 1 (NF1) is a complex multisystem genetic disorder that requires long-term, age-specific monitoring and multidisciplinary care. NF1 symptom burden can significantly affect the quality of life and impose a substantial economic burden on patients and their families. The approval and widespread availability of mitogen-activated protein kinase (MEK) inhibitors such as selumetinib for NF1-related plexiform neurofibromas have revolutionized the standard of care for patients with NF1, however their effective utilization hinges on early recognition of NF1. We present a consensus manuscript describing the challenges observed in the Arabian Gulf Cooperation Council (GCC) for diagnosing and managing NF1. Experts from the GCC also present recommendations for the early recognition and management of NF1 and its complications. A referral pathway that can play a crucial role in helping primary healthcare providers refer their patients to experts is also proposed. Increasing the availability and accessibility of genetic testing at an affordable cost and optimizing personalized NF1 care are essential for NF1 management. Developing regional guidelines for NF1 management and establishing NF1 centers of excellence may facilitate better care and outcomes for patients with NF1 in the GCC region.

Osteoporosis, a systemic bone disease, is characterized by decreased bone mass, deterioration of skeletal structure, and increased bone susceptibility. Age, environment, hormone levels, nutrition, and immunity are all factors that influence bone mass. Currently, intestinal flora has been recently recognized as a key regulator of bone mass. The blood's microbiome role in bone health and in the pathogenesis of osteoporosis remains unknown. In this study, the abundance of various blood's microbial taxa in osteoporosis patients were analyzed. We investigated the associations between prominent bacterial taxa and other clinical indicators (i.e. biochemical, blood cell counts and CT scan). DNA was extracted from the whole blood samples of patients with degenerative bone diseases with or without osteoporosis (i.e. n = 8; ST and n = 12, T group) and healthy controls (n = 4, N group). The 16S rRNA gene sequencing technique was utilized to characterize the blood microbiome taxaThe Shannon–Winner and dilution curves revealed that all the characterized species in the sample and the sequencing data were reliable. The number of bacterial taxa in blood and annotated operational taxonomic units were positively correlated with neutrophils. This support that bacteria exist within or adhere to the neutrophil's membrane. The abundance of Yersinia ruckeri, Rhodanobacter_uncultured bacterium, Enterobacter spp., and Raoultella spp increased in the ST group as compared with the N group. Hence, indicate their potential role in the onset and progression of osteoporosis. These findings provide new insights into the association between blood microbiota and bone health. This study could open a new horizon in exploring the clinical application of blood microbiome to improve bone health.

IntroductionInitiated in June 2019, this collaborative effort involved 15 public and private sector hospitals in Pakistan. The primary objective was to enhance the capacity for pediatric neuro-oncology (PNO) care, supported by a My Child Matters/Foundation S grant.MethodsWe aimed to establish and operate Multidisciplinary Tumor Boards (MTBs) on a national scale, covering 76% of the population (185.7 million people). In response to the COVID-19 pandemic, MTBs transitioned to videoconferencing. Fifteen hospitals with essential infrastructure participated, holding monthly sessions addressing diagnostic and treatment challenges. Patient cases were anonymized for confidentiality. Educational initiatives, originally planned as in-person events, shifted to a virtual format, enabling continued implementation and collaboration despite pandemic constraints.ResultsA total of 124 meetings were conducted, addressing 545 cases. To augment knowledge, awareness, and expertise, over 40 longitudinal lectures were organized for healthcare professionals engaged in PNO care. Additionally, two symposia with international collaborators and keynote speakers were also held to raise national awareness. The project achieved significant milestones, including the development of standardized national treatment protocols for low-grade glioma, medulloblastoma, and high-grade glioma. Further protocols are currently under development. Notably, Pakistan's first pediatric neuro-oncology fellowship program was launched, producing two graduates and increasing the number of trained pediatric neuro-oncologists in the country to three.DiscussionThe initiative exemplifies the potential for capacity building in PNO within low-middle income countries. Success is attributed to intra-national twinning programs, emphasizing collaborative efforts. Efforts are underway to establish a national case registry for PNO, ensuring a comprehensive and organized approach to monitoring and managing cases. This collaborative initiative, supported by the My Child Matters/Foundation S grant, showcases the success of capacity building in pediatric neuro-oncology in low-middle income countries. The establishment of treatment protocols, fellowship programs, and regional tumor boards highlights the potential for sustainable improvements in PNO care.

Due to inadequate treatment, diabetes mellitus, which is characterized by hyperglycemia, is a global health challenge that requires creative management techniques. This study explores the therapeutic potential of Abelmoschus esculentus L. Moench fruit extracts in diabetes, offering an ample approach includes phytochemical analysis, qualitative and quantitative assessments, antidiabetic efficacy, antioxidant potential, and in vivo and in vitro investigations. Thin-layer chromatography (TLC), high-performance liquid chromatography (HPLC), and gas chromatography–mass spectrometry (GC–MS) were utilized to disclose the phytochemical profile of the fruit extracts, which indicated a diverse range of bioactive compounds. Four polyphenolic compounds including chlorogenic acid, quercetin, rutin, and morin were confirmed by HPLC fingerprinting, with rutin being the most prevalent. Qualitative analysis reveals the presence of carbohydrates, emodin, terpenoids, lignin, glycosides, and anthraquinones, while indicating the absence of amino acids, anthocyanins, phlobatannins, lactones, and leucoanthocyanins. Quantitative analysis reveals total phenolic, tannin, and flavonoid. In vitro assessments demonstrate the ability of the extracts to inhibit alpha amylase. Radical scavenging activities were evaluated through DPPH assay, underscoring their antioxidant capacity with high effect in methanol extracts. Additionally, the methanol extract decreased the blood glucose level of Type 2 diabetic mice. Notably, test samples stabilized blood glucose levels, reversed deviations in blood profile parameters, blood biochemistry, and regulated organ weight. Based on its antioxidant and antidiabetic effects, as well as positive effects on the physiology of Type 2 diabetic mice, A. esculentus emerges as an important nutraceutical vegetable. As an important nutraceutical vegetable, it holds promise for diabetes management. A. esculentus can be incorporated into dietary interventions for individuals with diabetes, harnessing its natural antioxidant and antidiabetic properties. Our findings validate the traditional use of A. esculentus in green therapeutics. In conclusion, A. esculentus emerges as a valuable ally in the fight against diabetes, bridging the gap between ancient wisdom and modern science. Further research and practical implementation are warranted to fully realize its potential.

Abstract Paediatric pneumonia is a respiratory infection that affects infants and young children under the age of 3. This disease is the leading cause of infant and child mortality in developing countries because of the weak immune system of young children. The difficulty and length of time required to identify the pathogen and causative agent are the main reasons for this high mortality rate. In addition, the identification of certain causative agents is particularly important for the treatment of paediatric pneumonia. In this study, we explored the possible mechanisms by which pathogenic Enterococcus faecalis induced pneumonia in vivo. The potential virulence factors of bacteria isolated from the intestines of paediatric pneumonia patients were determined. Taken together, the results suggested that lysophosphatidic acid (LTA) from pathogenic E. faecalis decreases the expression of platelet-activating factor receptor (PAFR), which in turn disrupts the function of intestinal tight junctions (Occ and Ccldn1), leading to the entry of LE-LTA into the bloodstream because of the disruption of the intestinal barrier. Although LTA can enter circulation, it cannot directly infiltrate the lungs, which indicates that lung inflammation in mice is not caused by the direct entry of LE-LTA into the lungs. We further found that LTA activates immune cells, such as CD8 + T cells and type 2 innate lymphocytes, in vivo. Interleukin-6 and interleukin-17 can produce large amounts of inflammatory factors and thus promote the development of pneumonia. In conclusion, our findings demonstrate that the LTA of pathogenic E. faecalis in the intestine is a virulence factor that can cause paediatric pneumonia. This study found that intestinal bacterial virulence factors can induce immune responses in the lungs and blood. These findings could provide further insight into the mechanism of infectious diseases in the lung that are caused by bacteria in the intestine.

Abstract Type-1 Diabetes Mellitus (T1DM) is regarded as a multifunctional, immune-related disease which causes massive destruction of islet β-cells in pancreas resulting in hyperglycemic, hypoinsulinemia and hyperlipidimic conditions. The aim of the present study, was to investigate the hypothesis that streptozotocin (STZ)-induced T1DM in Balb/c mice when treated with crude polysaccharide from seaweed, Dictyopteris divaricata (CDDP) depicts improvement in diabetes-related symptoms. Treatment with CDDP resulted in decreased body weight loss, improved food consumption and water intake disbalances. The CDDP effectively improved fasting blood glucose, oral glucose tolerance (OGTT), serum insulin, insulin secretion, rejuvenation of β-cells mass, serum lipid profile and pro-inflammatory cytokines levels. Additionally, treatment with CDDP increased the population of beneficial bacteria such as Firmicutes, Bacteroidetes and Lactobacillus at phylum, family and genus levels by 16S rRNA sequencing. Furthermore, immunohistological examination confirmed that CDDP reduces the inflammation and restored the structural morphology of colon and upraised the levels of insulin receptor substrate-1 (IRS-1), Mucin-2 (MUC-2) and tight-junction proteins (TJs) whereby maintaining the gut structures and barrier permeability. Thus, the above presented data, highlights the safe and therapeutic effects of crude polysaccharide (CDDP) from D. divaricata in the treatment and restoration of T1DM disorders and can be used as a food supplement alternative to diabetes medicine.

Abstract Edible mushrooms have now been suggested as promising sources of biological functional ingredients and are the subject of the most recent nutrition research and novel functional foods. Polysaccharides from mushrooms exhibit impressive biological effects, notably against obesity. Obesity is a chronic metabolic disorder characterized by chronic inflammation, gut dysbiosis, and hyperpermeability of the colon. Here, we prove that mushrooms Morchella esculenta polysaccharide (MEP) effects on HFD-induced obesity, colonic inflammation, and gut microbiota dysbiosis. Our findings demonstrate MEP supplementation attenuates obesity parameters and reduces inflammation in the colon via regulation of Toll-like receptor 4 (TLR4), nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), and inactivation of nuclear factor kappa B (NF-κB). Furthermore, MEP administration restores gut microbiota dysregulation by ameliorating Firmicutes to Bacteroidetes proportion as well as enhancing beneficial bacteria, like Lactobacillus, and inhibiting pathogenic bacteria like Enterococcus. MEP improves gut integrity by increasing tight junction proteins (TJs) and reducing endotoxin levels by controlling Lipopolysaccharide (LPS) in HFD-induced obese mice. These results demonstrated the therapeutic efficacy of MEP in attenuating HFD-induced obesity via regulating inflammatory cascades, ameliorating the gut microbiome, and modulating gut integrity.

Abstract Water constitutes ≈70–90% of the organism's body by mass and is highly important for its survival. Water contains a variety of chemical contaminants introduced by various sectors, resulting in contamination that has a direct impact on the ecosystem. Various approaches are in practice to tackle these issues. Among these, semiconductor photocatalysis appears to be the cutting‐edge technology for the degradation of wastewater contaminants. Herein, the fabrication of Fe3O4−SiO2 nanocomposite via facile co‐precipitation and Stober methods are reported. Various characterization techniques are employed for the structural elucidation, morphology, crystallinity, and stability of the as‐prepared composite. The nanocomposite is employed in catalytic and photocatalytic applications toward the removal of methylene blue (MB) and methyl orange (MO) dyes from a comparative perspective. It is observed that the composite can remove about 93% of MB and 51% of MO within 7 and 6 h, respectively. These findings indicate that the nanocomposite has a higher MB removal effectiveness than the MO. This trend can be accredited to the difference in the chemical structure of both dyes. The nanocomposite is also evaluated for antioxidant and antileishmanial activity, and it is shown to be quite effective even at very low concentrations.

Background: The disposition of patients presenting with ST-elevation myocardial infarction (STEMI) is commonly the coronary care unit. Recent studies have suggested that low-risk STEMI patients could be managed in a lower-acuity setting immediately after percutaneous coronary intervention (PCI). We sought to determine the frequency of downstream intensive-care therapy used in our “stable” STEMI patients post-PCI. Methods: A single-centre, retrospective review was completed of consecutive patients who underwent primary PCI for STEMI between 2013 and 2016. Post-PCI, patients were defined as being stable if they had not required intensive-care therapy or suffered significant complications. Intensive-care therapies and complications were defined as invasive/noninvasive ventilation, pacing, cardiac arrest, use of vasopressors/inotropes, dialysis, stroke, or major bleeding. This group of stable patients had their course followed to discharge. Results: A total of 731 patients presented with STEMI for primary PCI. Of these, 132 patients (18%) required intensive-care therapies and/or had complications prior to PCI and were excluded. After PCI, 599 STEMI patients (82%) were defined as stable, according to the above definition. Of these, 11 patients (1.8%) required intensive-care therapies during their hospitalization. Zwolle scores were significantly higher in patients with complications (6.3 ± 4.4 vs 2.0 ± 1.5, P < 0.0001). The most frequent intensive-care complications and therapies were cardiac arrest (7 patients, 1%) and vasopressor use (4 patients, 0.7%). These complications most frequently occurred on the first admission day (6 patients, 1%). Conclusions: Patients who are stable at the completion of their primary PCI rarely develop complications that require intensive care. These patients are easily identified for triage to a lower-acuity setting, alleviating congestion in cardiac care units and reducing hospitalization costs. Résumé: Introduction: Les patients qui subissent un infarctus du myocarde avec élévation du segment ST (STEMI) aboutissent souvent à l’unité de soins coronariens. Des études récentes ont montré que les patients exposés à un faible risque de STEMI pouvaient être pris en charge dans les soins de faible acuité immédiatement après l’intervention coronarienne percutanée (ICP). Nous avons cherché à déterminer la fréquence des traitements de soins intensifs en aval utilisés après notre ICP chez les patients STEMI qui étaient dans un état stable. Méthodes: Une étude rétrospective unicentrique a été réalisée auprès de patients consécutifs qui subissaient une ICP primaire en raison d’un STEMI entre 2013 et 2016. Après l’ICP, les patients étaient considérés être dans un état stable s’ils n’avaient pas besoin de traitements de soins intensifs ou ne souffraient pas de complications importantes. Les traitements de soins intensifs et les complications étaient définis par la présence de la ventilation effractive ou non effractive, de la stimulation cardiaque, de l’arrêt cardiaque, de l’utilisation de vasopresseurs ou d’inotropes, de la dialyse, de l’accident vasculaire cérébral et de l’hémorragie majeure. Ce groupe de patients dans un état stable obtenaient leur sortie de l’hôpital. Résultats: Un total de 731 patients STEMI ont subi une ICP primaire. Parmi eux, 132 patients (18 %) ont eu besoin de traitements de soins intensifs et/ou ont eu des complications avant l’ICP et ont été exclus. Après l’ICP, 599 patients STEMI (82 %) ont été considérés comme étant dans un état stable, conformément à la définition ci-dessus. Parmi eux, 11 patients (1,8 %) ont eu besoin de traitements de soins intensifs durant leur hospitalisation. Les indices de Zwolle étaient significativement plus élevés chez les patients qui avaient des complications (6,3 ± 4,4 vs 2,0 ± 1,5, P < 0,0001). Les complications et les traitements aux soins intensifs les plus fréquents étaient l’arrêt cardiaque (sept patients, 1 %) et l’utilisation de vasopresseurs (quatre patients, 0,7 %). Ces complications sont survenues plus fréquemment à la première journée de l’admission (six patients, 1 %). Conclusions: Les patients qui sont dans un état stable après l’ICP primaire ont rarement des complications qui exigent des soins intensifs. L’orientation de ces patients, facilement repérés au triage, vers des soins de faible acuité, allège la congestion aux unités de soins intensifs et réduit les coûts d’hospitalisation.

Lactobacillus rhamnosus (LBS) is a well-documented probiotic strain in oncology and has a pivotal role in clinical applications. Here, we have investigated the protective effect of Lactobacillus rhamnosus on intestinal mucositis induced by cisplatin (CP) and explored the underlying mechanisms targeting inflammatory proteins, as well as the histological changes in the intestinal tissue of mice, in addition, the bacterial strains that may be related to the health-enhancing properties. BALB/c mice were pre-treated with or without LBS via oral gavage, followed by mucositis induction with cisplatin. Our results revealed that the LBS-treated groups significantly attenuated proinflammatory cytokine levels (IL-1β, IL-6, and TNF-α) compared to the CP group. Furthermore, LBS mitigated the damaged tight junction integrity caused by CP via up-regulating the levels of claudin, occludin, ZO-1, and mucin-2 protein (MUC-2). Finally, the 16S rRNA fecal microbiome genomic analysis showed that LBS administration enhanced the growth of beneficial bacteria, i.e., Firmicutes and Lachnospiraceae, while the relative abundance of the opportunistic bacteria Bacteroides and Proteobacteria decreased. Collectively, LBS was found to beneficially modulate microbial composition structure and functions and enrich the ecological diversity in the gut.

Inflammatory bowel disease (IBD) is a persistent, lifelong inflammation of the digestive system. Dextran sulfate sodium is commonly used to induce colitis in experimental animal models, which causes epithelial damage, intestinal inflammation, mucin depletion, and dysbiosis of the gut microbiota. Various prebiotics, polysaccharides, and polypeptides are used for IBD treatment. In this study, we used a murine model utilizing BALB/c mice, with 10 mice per group, to investigate the treatment effect of sea conch peptide hydrolysate (CPH) on DSS-induced colitis mice. Colitis was induced through the administration of 2.5% DSS in drinking water over a seven-days period. Furthermore, on the eighth day of the experiment, sea conch peptide hydrolysate (CPH) at low (100 mg/kg), medium (200 mg/kg), and high (400 mg/kg) doses, which were continued for 14 days, were assessed for medicinal purposes in DSS-induced colitis mice. Our results showed that CPH treatment significantly alleviated the severity and symptoms of colitis. The epithelial integrity and histological damage were improved. Intestinal inflammation and inflammatory cell infiltration were improved. Furthermore, the expression of pro-inflammatory cytokines was reduced, and intestinal barrier integrity was restored by elevating the tight junction proteins. Moreover, 16s RNA sequencing revealed dysbiosis of the gut microbiota was observed upon DSS treatment, which was reinstated after CPH treatment. An increased level of Firmicutes and Lactobacillus was observed in the treatment groups. Finally, our results suggest that CPH would be recommended as a functional food source and also have the potential to be used as a medicinal product for different gastrointestinal disorders.

Abstract Hepatocellular carcinoma is one of the leading causes of cancer-associated death across the globe. Malignant ascites are the major clinical attributes in cancer patients. Despite the advancements in HCC treatments such as chemotherapy, radiotherapy, surgery, and hormonal therapy, researchers are pursuing novel natural edible compounds for the treatment of cancer to eliminate dreadful side effects. Pleurotus ostreatus is one of the most edible cuisines in Asia as well as all over the world. It has been a source of nutritious diet since it was classified as an edible mushroom with no or negligible side effects. The present study focused on the natural anti-cancerous and anti-ascites capabilities of polysaccharides extracted from Pleurotus ostreatus in-vivo as well as in-vitro. Administration of polysaccharide Pleurotus ostreatus showed a significant decrease in tumor cell metastasis while the increase in the survival period among mice models of H22 malignant ascites. Downregulation of regenerative genes Foxp3 and Stat3 and secretion of immunological factors such as IL-2, TNF α, and INF γ were observed after treating with the partially pure extracted polysaccharide. Twining with the hypothesis of tumor suppression in-vivo model polysaccharide showed a decrease in invasion and migration abilities and henceforth responsible for the gene regulation such Cytochrome C which supposedly induced the chain of gene regulation process resulting in apoptosis in HCC cell lines observed in-vitro experiments. Collective research findings manifested that polysaccharide extracted from Pleurotus ostreatus bears anti-proliferative activity and thus influence tumor suppression in-vivo and in-vitro against hepatocellular carcinoma and can be used for therapeutic purposes as a potential anti-cancerous source in the future.

A main cause of cancer-related mortality, colorectal cancer (CRC) is one of the most prevalent cancers in the world. A number of variables, including a poor dietary and lifestyle, genetics, metabolic problems, and inheritance, are linked to the risk of CRC. However, it has been studied extensively about the involvement of various environmental factors which facilitates the development of this particular type of cancer in both genders. These elements includes excessive consumption of meat, refined grain and their products, starch, sugars in distinct forms, and alcohol are at top of the list. Hence, to execute the significance of Lactobacillus acidophilus CGMCC 878 (L.A 878) which may possibly hinder the development as well as progression of chemically induce colorectal tumor in in-vivo model via transformation of gut microbiota. We had established CRC in male Sprague-Dawley rats through subcutaneously inject the carcinogen named 1,2 dimethylhydrazine hydrochloride (DMH). We had detected the microbial diversity among different groups which included in the study by evaluation of stool samples by the virtue of molecular genetic computation. Although, we had targeted the bacterial V3 region by using classic molecular technique of PCR-DGGE (Polymerase chain reaction- Denaturing Gradient Gel Electrophoresis) followed by excision of amplified bands and were cloned for sequencing. The DGGE profiles of distinct groups demonstrated significant alterations between DMH group, short-term L. acidophilus group (p ​

Abstract Silver nanoparticles (Ag. NPs) have shown a biological activity range, synthesized under different environment-friendly approaches. Ag. NPs were synthesized using aqueous crude extract (ACE) isolated from Plantago lanceolata. The ACE and Ag. NPs were characterized and assessed their biological and antioxidant activities. The existence of nanoparticles (NPs) was confirmed by color shift, atomic force microscopy (AFM), and UV–Vis’s spectroscopy. The FT-IR analysis indicated the association of biomolecules (phenolic acid and flavonoids) to reduce silver (Ag+) ions. The SEM study demonstrated a sphere-shaped and mean size in the range of 30 ± 4 nm. The EDX spectrum revealed that the Ag. NPs were composed of 54.87% Ag with 20 nm size as identified by SEM and TEM. AFM has ended up being exceptionally useful in deciding morphological elements and the distance across of Ag. NPs in the scope of 23–30 nm. The TEM image showed aggregations of NPs and physical interaction. Ag. NPs formation also confirmed by XPS, DRS and BET studies. Ag. NPs showed efficient activity as compared to ACE, and finally, the bacterial growth was impaired by biogenic NPs. The lethal dose (LD50) of Ag. NPs against Agrobacterium tumefaciens, Proteus vulgaris, Staphylococcus aureus, and Escherichia coli were 45.66%, 139.71%, 332.87%, and 45.54%, with IC50 (08.02 ± 0.68), (55.78 ± 1.01), (12.34 ± 1.35) and (11.68 ± 1.42) respectively, suppressing the growth as compared to ACE. The antioxidant capacity, i.e., 2,2-diphenyl-1-picrylhydrazyl (DPPH) of Ag. NPs were assayed. ACE and Ag. NPs achieved a peak antioxidant capacity of 62.43 ± 2.4 and 16.85 ± 0.4 μg mL−1, compared to standard (69.60 ± 1.1 at 100 μg mL−1) with IC50 (369.5 ± 13.42 and 159.5 ± 10.52 respectively). Finally, the Ag. NPs synthesized by P. lanceolata extract have an excellent source of bioactive natural products (NP). Outstanding antioxidant, antibacterial activities have been shown by NPs and can be used in various biological techniques in future research.

Type 2 diabetes mellitus (T2DM) is a health issue that causes serious worldwide economic problems. It has previously been reported that natural polysaccharides have been studied with regard to regulating the gut microbiota, which plays an important role in T2DM. Here, we investigate the effects of Morchella esculenta polysaccharide (MEP) on a high-fat diet (HFD) and streptozotocin (STZ)-induced T2DM in BALB/c mice. The administration of MEP effectively regulated hyperglycemia and hyperlipidemia and improved insulin sensitivity. We also determined an improvement in gut microbiota composition by 16sRNA pyrosequencing. Treatment with MEP showed an increase in beneficial bacteria, i.e., Lactobacillus and Firmicutes, while the proportion of the opportunistic bacteria Actinobacteria, Corynebacterium, and Facklamia decreased. Furthermore, the treatment of T2DM mice with MEP resulted in reduced endotoxemia and insulin resistance-related pro-inflammatory cytokines interleukin 1β (IL-1β), tumor necrosis factor-alpha (TNF-α), and interleukin 6 (IL-6). Moreover, MEP treatment improved intestinal permeability by modulating the expression of the colon tight-junction proteins zonula occludens-1 (ZO-1), occludin, claudin-1, and mucin-2 protein (MUC2). Additionally, MEP administration affects the metagenome of microbial communities in T2DM mice by altering the functional metabolic pathways. All these findings suggested that MEP is a beneficial prebiotic associated with ameliorating the gut microbiota and its metabolites in T2DM.

ABSTRACT: Background: Given changes in the care and outcomes of acute myocardial infarction (AMI) patients over the past several decades, we sought to develop prediction models that could be used to generate accurate risk-adjusted mortality and readmission outcomes for hospitals in current practice across Canada. Methods: A Canadian national expert panel was convened to define appropriate AMI patients for reporting and develop prediction models. Preliminary candidate variable evaluation was conducted using Ontario patients hospitalized with a most responsible diagnosis of AMI from April 1, 2015 to March 31, 2018. National data from the Canadian Institute for Health Information was used to develop AMI prediction models. The main outcomes were 30-day all-cause in-hospital mortality and 30-day urgent all-cause readmission. Discrimination of these models (measured by c-statistics) was compared with that of existing Canadian Institute for Health Information models in the same study cohort. Results: The AMI mortality model was assessed in 54,240 Ontario AMI patients and 153,523 AMI patients across Canada. We observed a 30-day in-hospital mortality rate of 6.3%, and a 30-day all-cause urgent readmission rate of 10.7% in Canada. The final Canadian AMI mortality model included 12 variables and had a c-statistic of 0.834. For readmission, the model had 13 variables and a c-statistic of 0.679. Discrimination of the new AMI models had higher c-statistics compared with existing models (c-statistic 0.814 for mortality; 0.673 for readmission). Conclusions: In this national collaboration, we developed mortality and readmission models that are suitable for profiling performance of hospitals treating AMI patients in Canada. RÉSUMÉ: Contexte: Compte tenu des changements apportés au cours des dernières décennies aux soins des patients ayant subi un infarctus aigu du myocarde (IAM) et aux issues d'un tel événement, nous avons voulu élaborer des modèles prédictifs pouvant servir à calculer de façon précise les résultats relatifs à la mortalité et aux réadmissions, ajustés selon les risques, pour les hôpitaux dans la pratique actuelle au Canada. Méthodologie: Un groupe national d'experts canadiens a été mis sur pied et a reçu le mandat de définir les critères appropriés applicables aux patients ayant subi un IAM aux fins de déclaration des cas et d’élaborer des modèles prédictifs. L’évaluation préliminaire des variables proposées a été effectuée à partir de patients hospitalisés en Ontario entre le 1er avril 2015 et le 31 mars 2018 chez lesquels l'IAM était le diagnostic principal à l'origine de l'hospitalisation. Les données à l’échelle nationale de l'Institut canadien d'information sur la santé (ICIS) ont été utilisées pour élaborer des modèles prédictifs d'IAM. Les deux principales issues évaluées étaient la mortalité hospitalière toutes causes confondues à 30 jours et la réadmission urgente toutes causes confondues à 30 jours. Le pouvoir discriminant de ces modèles (mesuré par la statistique C) a été comparé à celui des modèles existants de l'ICIS dans la même cohorte de l’étude. Résultats: Le modèle de mortalité par IAM a été évalué auprès de patients ayant subi un IAM, dont 54 240 en Ontario et 153 523 dans l'ensemble du Canada. Nous avons observé un taux de mortalité hospitalière à 30 jours de 6,3 % et un taux de réadmission urgente à 30 jours toutes causes confondues de 10,7 % au Canada. Le modèle canadien final de prédiction de la mortalité par IAM était constitué de 12 variables et avait une statistique C de 0,834. Pour la réadmission, le modèle comportait 13 variables et présentait une statistique C de 0,679. Le pouvoir discriminant des nouveaux modèles d'IAM présentait une statistique C supérieure à celle des modèles existants (statistique C de 0,814 pour la mortalité et de 0,673 pour la réadmission). Conclusions: Dans le cadre de cette collaboration nationale, nous avons élaboré des modèles prédictifs de la mortalité et de la réadmission hospitalière qui permettent d’établir un profil des résultats obtenus par les hôpitaux traitant des patients ayant subi un IAM au Canada.

Objectives. To determine the one-year and five-year occurrence and prognosticators of major adverse cardiac events (MACE: composition of all-cause death, myocardial infarction, target vessel revascularization, and vessel thrombosis), mortality, and target lesion revascularization (TLR) in patients with in-stent restenosis (ISR) treated with drug-eluting balloons (DEBs). Background. DEBs have become an emerging therapeutic option for ISR. We report the results of a single-center retrospective study on the treatment of ISR with DEB. Methods. 94 consecutive patients with ISR treated with the paclitaxel-eluting balloon were retrospectively studied between August 2011 and December 2019. Results. The one-year MACE rate was 11.8%, and the five-year MACE rate was 39.8%. The one-year mortality was 5.3%, and the five-year mortality rate was 21.5%. The one-year TLR rate was 4.3%, and the five-year rate was 18.7%. The univariable-Cox proportional hazard models for TLR showed lesion length, and the number of DEBs per vessel is associated with adverse outcomes with H.R. of 1.038 (1.007–1.069) and 4.7 (1.6–13.8), respectively. Conclusion. Our data indicate that at one year, DEBs provide an effective alternative to stenting for in-stent restenosis. Our five-year data, representing one of the longest-term follow-ups of DEB use, demonstrate high rates of MACE. The high five-year MACE reflects all-cause mortality in a high-risk population. This is offset by a reasonable five-year rate of TLR, indicating that DEB provides both short-term and long-term benefits in ISR.

Electric discharge machining with a powder mix dielectric is a promising technique to harden a work piece’s surface using electricity with a high energy density. The quality of the electrical discharge-machined surface is related to its surface integrity in which the surface’s roughness, residual stresses, micro hardness and surface micro cracks are some of the major factors. In this research, graphite powder was mixed in a dielectric with a particle size of 20 µm, 30 µm, and 40 µm, with the concentration of the graphite powder ranging from 2 g/L to 4 g/L. Moreover, the peak current and pulse time on were also coupled with an additive of graphite powder to investigate the effect on the surface quality, i.e., the recast layer thickness, micro hardness and crater depth as well as the material removal rate (MRR) and tool wear rate (TWR). A Box–Behnken design was employed to design the experiments and the experimental results revealed that the graphite powder size and concentration coupled with the electrical parameters (peak current and pulse time on) significantly influenced the recast layer thickness, micro hardness, crater size, MRR and TWR. The crater depth and micro hardness were maximized at a higher concentration and particle size, while the recast layer thickness was reduced with a higher gain size.

BACKGROUND & OBJECTIVE: Treatments for ureteral calculi evolve, over the past decades from open ureterolithotomy to minimally invasive procedures. Objective of this study is to compare the efficacy of pneumatic versus laser lithotripsy in ureteric stones. METHODOLGY: A RCT study was conducted in Department of Urology Sir Ganga Ram Hospital, Lahore from 1st March 2018 to 31st August 2018. Patients were divided into two groups. In group A, 2 Fr pneumatic probe was used for pneumatic lithotripsy, while in group B, 550 μm fiber probe was used for laser lithotripsy. RESULTS: Efficacy of Group A (pneumatic lithotripsy) was seen in 57 (77.63%) patients while in Group B (laser lithotripsy) was seen in 71 (93.42%) patients with p-value of 0.006 CONCLUSION: Laser lithotripsy in ureteric stones is better as compared to pneumatic lithotripsy.

The gut microbiota is important in regulating host metabolism, maintaining physiology, and protecting immune homeostasis. Gut microbiota dysbiosis affects the development of the gut microenvironment, as well as the onset of various external systemic diseases and metabolic syndromes. Cyclophosphamide (CTX) is a commonly used chemotherapeutic drug that suppresses the host immune system, intestinal mucosa inflammation, and dysbiosis of the intestinal flora. Immunomodulators are necessary to enhance the immune system and prevent homeostasis disbalance and cytotoxicity caused by CTX. In this study, shrimp peptide hydrolysate (SPH) was evaluated for immunomodulation, intestinal integration, and microbiota in CTX-induced immunosuppressed mice. It was observed that SPH would significantly restore goblet cells and intestinal mucosa integrity, modulate the immune system, and increase relative expression of mRNA and tight-junction associated proteins (Occludin, Zo-1, Claudin-1, and Mucin-2). It also improved gut flora and restored the intestinal microbiota ecological balance by removing harmful microbes of various taxonomic groups. This would also increase the immune organs index, serum levels of cytokines (IFN-ϒ, IL1β, TNF-α, IL-6), and immunoglobin levels (IgA, IgM). The Firmicutes/Bacteroidetes proportion was decreased in CTX-induced mice. Finally, SPH would be recommended as a functional food source with a modulatory effect not only on intestinal microbiota, but also as a potential health-promoting immune function regulator.

Objectives: 1:To determine outcome of first relapse of Hodgkin Lymphoma with standard dose chemotherapy. 2: To identify the prognostic factors predicting survival outcome in pediatric relapsed Hodgkin lymphoma. Methods: This was a retrospective analysis of 43 patients with HL who relapsed at least 3 months after completion of initial treatment from January 2001 to December 2010. Probabilities of OS, EFS and cumulative incidence were calculated by Kaplan-Meier method. Log rank tests were used to compare survival curves and p-value

We propose to perform wearable sensors-based human physical activity recognition. This is further extended to an Internet-of-Things (IoT) platform which is based on a web-based application that integrates wearable sensors, smartphones, and activity recognition. To this end, a smartphone collects the data from wearable sensors and sends it to the server for processing and recognition of the physical activity. We collect a novel data set of 13 physical activities performed both indoor and outdoor. The participants are from both the genders where their number per activity varies. During these activities, the wearable sensors measure various body parameters via accelerometers, gyroscope, magnetometers, pressure, and temperature. These measurements and their statistical are then represented in features vectors that used to train and test supervised machine learning algorithms (classifiers) for activity recognition. On the given data set, we evaluate a number of widely known classifiers such random forests, support vector machine, and many others using the WEKA machine learning suite. Using the default settings of these classifiers in WEKA, we attain the highest overall classification accuracy of 90%. Consequently, such a recognition rate is encouraging, reliable, and effective to be used in the proposed platform.

Canola (Brassica napus L.) meal is a by-product after oil extraction from canola seed and is of relatively low value. This meal may have additional value in the biotechnology, food, and pharmaceutical industries if health-promoting useful bioactive compounds can be identified. Hence, seven canola meal extracts (CMEs) were generated using different organic solvents for two genotypes. HPLC and LCMS analyses were employed for the determination of the phenolic and antioxidant activity of meal extracts, including recovery of major biological compounds. When comparing genotype-1 with genotype-2, the latter had higher antioxidant activity in acetone extract (AE). This study also indicated seven major glucosinolates in CMEs in which water (WE) appeared to be the best solvent for the recovery of glucosinolates. Higher quantities of phenolic, glucosinolate, and antioxidant were present in genotype-2 compared with genotype-1. Using HPLC-DAD and LC-MS analysis 47 compounds were detected. We could identify 32 compounds in canola meal extracts: nine glucosinolates and twenty-three phenolic derivatives. Phenolic compounds in canola meal were conjugates and derivatives of hydroxycinnamic acid (sinapic, ferulic, and caffeic acids). Among phenolics, kaempherol as conjugate with sinapic acid was found; sinapine and trans-sinapic acid were the most abundant, as well as major contributors to the antioxidant and free radical scavenging activities of canola meal extracts. Some samples exhibited mild to moderate in-vitro antidiabetic activity in a Dipeptidyl Peptidase-IV inhibition assay.

Objective: To determine the frequency of fibromyalgia American college of rheumatology (ACR) 2010/2011 criteria) in patients with rheumatoid arthritis and its impact on disease activity score (DAS-28). Study Design: Cross-sectional study. Place and Duration of study: Department of Rheumatology and Immunology, Sheikh Zayed Hospital Lahore from Jun 2016 to Feb 2017. Patients and Methods: Total 140 diagnosed patients of rheumatoid arthritis by criteria ACR 2010 were included in this study. ACR modified 2010/2011 criterion of fibromyalgia was used to diagnose co existing fibromyalgia in these patients. Clinically disease activity status was assessed by standardized and validated DAS-28 calculator; 2ml of blood was drawn and sent to laboratory for estimation of erythrocyte sedimentation rate for all study participants. Results: The mean age, duration of disease, DAS-28 of sampled population was 49.12 ± 8.5 years, 7.36 ± 3.8 years, 4.08 ± 1.1 respectively. Out of 140 patients, 127 patients (90.7%) were females. Fibromyalgia was diagnosed in 41 patients (29.1%). The mean DAS-28 score in patients of rheumatoid arthritis with fibromyalgia was 5.39 ± .58 while for patients of without fibromyalgia it was 3.54 ± 0.69 (p-value

Change is a definite phenomenon in human life. Societies change with the passage of time. Due to the scientific inventions the world has become a global village.In modern time the most important thing for the Islamic jurists is to find an Islamic solution to the modern problems and to give such an interpretation to the Islamic laws to encompass the rapidly changing world and its needs.If the interpretations of these circumstances are done in the light of Urf or Habit,it can prove helpful in getting more balanced and adequate solution. Urf is from Irfan which means knowledge, having acquaintance or simply knowing.Besides, Urf, Rituals and Customs have different kinds. Some of them are related with the practical life and human rights. And some of them are related with ethics and values, some are related with costumes and the way of life and others are connected only with satisfaction of self and nothing else. A saying or action which is proved through Reason or Sharia is called "Maroof' and it is opposite to "Munkir" or denial. "Adat" or Habit is also used as Urf. Urf and "Adat" are Synonymous. Every quality which is liked by reason and which satisfies the conscience is called Urf and the action which is done by people perpetually, with all the reason and experience and is considered correct naturally is called Urf. The basic sources of Islamic Law are Quran and Sunnah. Both of them are not revealed in a single day. In the beginning there was the first verse of "Sura Iqra" and nothing else. The people were converting to Islam and the number was increasing day by day. Here a question arises that if law in Arabic means the criterion to have a correct estimation then what were the Islamic Laws at the beginning. As an answer to this question this explanation is quite appropriate that the basis of Islamic Laws were actually those rites and traditions which were the remnants of Ibrahimi Millat and were established among Arabs at that time. Islam discarded all the bad factors and accepted the remaining with some modification and reformation. Urf or Custom shall not be considered as the sole basis of Sharias if we do so then it will pave the wav for certain bad things like Ribbah (interest) and Gambling which are entirely against the prmciples of Sharia and this will certainly distort the basic structure of Sharia in totality. Therefore, such an Urf which is in contrast with the basic prmciples of Sharia shall be shun and considered null and void. With the change in Urf and Customs of the society the Law will also be changed provided that the Law/Rule is for a specific time and people. It does not mean that a Law/Rule of the Quran and Sunnah shall be changed but it will be considered that a specific Law/Rule was based on a certain Urf and because that Urf is no more in vogue, therefore, the specific Law/Rule will not be practiced anymore. Keeping in mind the savings of Islamic Jurists it can be concluded that Urf is not a permanent argument of Sharia that a Law should be made only on the basis of Urf but it is a source and an argument through which an understanding of the jargon of the Sharia's rule and the register of the two opposing sides in a certain matter is understood and which can help delimit some loose matter and ascertain some definite argument.

Valorization of vegetable oil waste residues is gaining importance due to their high protein and polyphenol contents. Protease inhibitors (PIs), proteins from these abundantly available waste residues, have recently gained importance in treating chronic diseases. This research aimed to use canola meal of genetically diverse Brassica napus genotypes, BLN-3347 and Rivette, to identify PIs with diverse functionalities in therapeutic and pharmacological applications. The canola meal PI purification steps involved: native PAGE and trypsin inhibition activity, followed by ammonium sulfate fractionation, anion exchange, gel filtration, and reverse-phase chromatography. The purified PI preparations were characterized using SDS-PAGE, isoelectric focusing (IEF), and N terminal sequencing. SDS-PAGE analysis of PI preparations under native reducing and nonreducing conditions revealed three polymorphic PIs in each genotype. The corresponding IEF of the genotype BLN-3347, exhibited three acidic isoforms with isoelectric points (pI) of 4.6, 4.0, and 3.9, while Rivette possessed three isoforms, exhibiting two basic forms of pI 8.65 and 9.9, and one acidic of pI 6.55. Purified PI preparations from both the genotypes displayed dipeptidyl peptidase-IV (DPP-IV) and angiotensin-converting enzyme (ACE) inhibition activities; the BLN-3347 PI preparation exhibited a strong inhibitory effect with lower IC50 values (DPP-IV 37.42 µg/mL; ACE 129 µg/mL) than that from Rivette (DPP-IV 67.97 µg/mL; ACE 376.2 µg/mL). In addition to potential human therapy, these highly polymorphic PIs, which can inhibit damaging serine proteases secreted by canola plant pathogens, have the potential to be used by canola plant breeders to seek qualitative trait locus (QTLs) linked to genes conferring resistance to canola diseases.

The corrosion behavior of aluminum 1060 in hydrated salt phase change materials (PCM) melts comprised of Na _2 HPO _4 ·12H _2 O - Na _2 SO _4 ·10H _2 O was investigated through electrochemical tests as a function of pH. The pH of PCM medium was adjusted by adding H _2 SO _4 or NaOH. Electrochemical impedance spectroscopy reveals the existence of concentration difference layer at aluminum/PCM interface ascribed to the adsorption of PCM species and the formation of aluminum oxides. The observed anodic branch of DC polarization exhibits potential independence which is ascribed to the formation of surface oxide film and the accumulation of hydrogen molecules inside surface pores. The oxide film formed at neutral condition is characterized as the most compact and corrosion resistant while as the environmental pH shifts away from 7 the oxides/aluminum dissolution is accelerated and more aluminum 1060 substrate is exposed.

Background: Dengue fever (DF) has become a major public health concern globally. It is an infection caused by a virus of the family Flaviviridae, with five serotypes (DENV 1–5). Recent years have seen an increase in the preva­lence of the disease in Pakistan. The current study was carried out to evaluate the clinical features, laboratory find­ings and demographic information of the patients reported during the dengue outbreak in Multan of Pakistan in 2015. Methods: The hospital documentation-based data of confirmed DF cases were collected for the 6 months period from a Tertiary Care Hospital in Multan, Pakistan. The patients were labeled as confirmed on the basis of NS1 and IgM positivity by ELISA. The data collected were analyzed using SPSS. Results: Overall, 361 patients were investigated (78.67% males and 21.33% females), with maximum infection rate in the age group of 18–35yr (50.41%). Mean hospital stay was 2.64d (SD 1.2), while mean fever duration was 5.27 (SD 1.57). Outbreak occurred during the months from Jul–Dec, while maximum patients were reported in Oct (287). No mortality was reported, and all patients recovered. Conclusion: Better management practices and timely reporting can reduce the risk factors associated with the dis­ease.

Background: Patient satisfaction is an important parameter of evaluating health care services from a patients perspective. In terms of people centered healthcare, it has gained importance over last few decades; but the concept is generally neglected in quality assessment of healthcare setups by developing countries like Pakistan. We aimed to assess the level of satisfaction among outpatients receiving healthcare services at the surgicaloutpatient department, Civil Hospital Karachi, Pakistan; and identify the aspects of healthcare service delivery's quality associated with patient's dissatisfaction. Methods: A cross sectional study was conducted at the surgical outpatient department, Civil Hospital Karachi(CHK). Information relating to patient's evaluation of health care service delivery, and level of satisfaction were collected through post consultation survey of 454 patients attending the OPD from 28th February, 2014to 30th April, 2014. Results: We found that almost three quarters (75.1%, n=341) of the patients attending surgical outpatient department were not satisfied. They were less likely to be satisfied if they evaluated the interpersonal communication as poor; namely: staff behavior (OR=0.15, 95% CI[0.03-0.82]), service by the attending doctors in terms of explanation regarding their ailment and its treatment(OR=0.13, 95% CI[0.02-0.63]), and over crowd handling by staff members(OR=0.37, 95% CI[0.20-0.66]). They were also less likely to be satisfied if they evaluated the following facilities as poor: over all cleanliness (OR=0.20, 95% CI[0.07-0.56]), and toilet facilities(OR=0.34, 95% CI[0.18-0.63]). Conclusion: This study identifies high dissatisfaction level among outpatients. Furthermore, the influential, alterable variables related to administrative issues and interpersonal communication between patients and hospital staff at outpatient department may provide implications for public sector hospitals aiming at improving the quality of healthcare in developing countries.

We perform image-based denomination recognition of the Pakistani currency notes. There are a total of seven different denominations in the current series of Pakistani notes. Apart from color and texture, these notes differ from one another mainly due to their aspect ratios. Our aim is to exploit this single feature to attain an image-based recognition that is invariant to the most common image variations found in currency notes images. Among others, the most notable image variations are caused by the difference in positions and in-plane orientations of the currency notes in images. While most of the proposed methods for currency denomination recognition only focus on attaining higher recognition rates, our aim is more complex, i.e., attaining a high recognition rate in the presence of image variations. Since, the aspect ratio of a currency note is invariant to such differences, an image-based recognition of currency notes based on aspect ratio is more likely to be translation- and rotation-invariant. Therefore, we adapt a two step procedure that first extracts a currency note from the homogeneous image background via local entropy and range filters. Then, the aspect ratio of the extracted currency note is calculated to determine its denomination. To validate our proposed method, we gathered a new dataset with the largest and most diverse collection of Pakistani currency notes, where each image contains either a single or multiple notes at arbitrary positions and orientations. We attain an overall average recognition rate of 99% which is very encouraging for our method, which relies on a single feature and is suited for real-time applications. Consequently, the method may be extended to other international and historical currencies, which makes it suitable for business and digital humanities applications.

The paper proposes a sensors platform to control a barrier that is installed for vehicles entrance. This platform is automatized by image-based license plate recognition of the vehicle. However, in situations where standardized license plates are not used, such image-based recognition becomes non-trivial and challenging due to the variations in license plate background, fonts and deformations. The proposed method first detects the approaching vehicle via ultrasonic sensors and, at the same time, captures its image via a camera installed along with the barrier. From this image, the license plate is automatically extracted and further processed to segment the license plate characters. Finally, these characters are recognized with the help of a standard optical character recognition (OCR) pipeline. The evaluation of the proposed system shows an accuracy of 98% for license plates extraction, 96% for character segmentation and 93% for character recognition.

Objectives: To assess the role of incentive spirometry in trauma patients managed with tube thoracostomy in preventing postoperative pulmonary complications. Trauma injury accounts for 30% of all life years lost in the U.S.4 Chest trauma constitutes the major part of trauma. The majority of chest trauma requires careful surveillance and no surgical intervention. Tube thoracostomy may be required in the treatment of chest trauma. Incentive spirometer as a mechanical device helps in the lung expansion and encourages the residual collection either fluid or air to come out of the pleural space and drain it out through the chest tube. Materials and Methods: The study was conducted on patients coming with chest trauma to accident and emergency department of Civil Hospital Karachi, from January 2013 till July 2014. A total of 100 patients with chest trauma admitted through A&E department were enrolled in this research after taking written consent for tube thoracostomy and agreed to be the part of this research protocol. After assessment and consent the patients underwent tube thoracostomy under local anesthesia. The patients were divided into two groups by envelope technique, group A (n=50), who were advised to use incentive spirometer post procedure and the other was group B (n=50) who were not advised the use of incentive spirometer. Both the groups were then managed on same protocol of antibiotics and pain killers and were observed for the recovery in terms of removal of chest tube.

We assume Bistatic Phase Multiple Input Multiple Output radar having passive Centrosymmetric Cross Shape Sensor Array (CSCA) on its receiver. Let the transmitter of this Bistatic radar send coherent signals using a subarray that gives a fairly wide beam with a large solid angle so as to cover up any potential relevant target in the near field. We developed Heuristic Computational Intelligence (HCI) based techniques to jointly estimate the range, amplitude, and elevation and azimuth angles of these multiple targets impinging on the CSCA. In this connection, first the global search optimizers, that is,are developed separately Particle Swarm Optimization (PSO) and Differential Evolution (DE) are developed separately, and, to enhance the performances further, both of them are hybridized with a local search optimizer called Active Set Algorithm (ASA). Initially, the performance of PSO, DE, PSO hybridized with ASA, and DE hybridized with ASA are compared with each other and then with some traditional techniques available in literature using root mean square error (RMSE) as figure of merit.

Neurofibromatosis type 1 (NF1) is a complex multisystem genetic disorder that requires long-term, age-specific monitoring and multidisciplinary care. NF1 symptom burden can significantly affect the quality of life and impose a substantial economic burden on patients and their families. The approval and widespread availability of mitogen-activated protein kinase (MEK) inhibitors such as selumetinib for NF1-related plexiform neurofibromas have revolutionized the standard of care for patients with NF1, however their effective utilization hinges on early recognition of NF1. We present a consensus manuscript describing the challenges observed in the Arabian Gulf Cooperation Council (GCC) for diagnosing and managing NF1. Experts from the GCC also present recommendations for the early recognition and management of NF1 and its complications. A referral pathway that can play a crucial role in helping primary healthcare providers refer their patients to experts is also proposed. Increasing the availability and accessibility of genetic testing at an affordable cost and optimizing personalized NF1 care are essential for NF1 management. Developing regional guidelines for NF1 management and establishing NF1 centers of excellence may facilitate better care and outcomes for patients with NF1 in the GCC region. [ABSTRACT FROM AUTHOR]