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Objective: To assess the efficacy and safety of IPL in patients with inflammatory Acne Vulgaris. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Dermatology, Pakistan Air Force Hospital, Fazaia Medical College, Islamabad Pakistan, from Aug 2019 to Jan 2020. Methodology: Ninety patients with inflammatory facial acne were enrolled and received four Intense Pulsed Light (IPL) sessions at two weeks intervals with fluence 25J/cm2 and 420nm cut-off filter. The duration of treatment for each patient was two months. Clinical improvement was assessed using the Global Acne Grading System score (GAGs score). Results: Mean age of the patients was 18.5±3.3years, of which nine were males (10%), and 81 were females (90%). IPL was effective in 42(46.7%) patients with inflammatory acne vulgaris. The median GAGS score before treatment was 20(22–19), and after treatment was 10(12-9), with a significant p-value(

Illustrating the synthesis of doped and undoped CeO2 nanomaterial and its potential application as a promising catalyst for additives to minimize emissions from spark ignition (SI) engines fueled with gasoline blends.

Objective: To determine the magnitude and effects of diabetes mellitus in patients of sudden sensorineural hearing loss and on the final outcome of therapy. Study Design: Cross sectional study. Place and Duration of Study: ENT unit of Medical Teaching Institution Abbottabad, from Jul 2018 to Jun 2020. Methodology: A total of 84 patients presented who had idiopathic sudden sensorineural hearing loss by using non probability consecutive sampling enrolled in the study. Basic parameters, age, diabetes mellitus and hearing loss were used for data collection. The data was analyzed by using SPSS version 23. Results: Out of total 52 (61.9%) were male and 32 (38.1%) were female, mean age was 45.62 ± 14.12 years from 14-85 years. A large number of patients presented within one week of onset of hearing loss 57 (67.86%). In our patient group 18 patients (21.4%) had diabetes mellitus and 66 patients (78.6%) did not have diabetes mellitus at presentation. Initial Hearing loss at presentation was significantly more in patients who had diabetes mellitus p=0.006 and there was statistically strong association between the final hearing improvement and diabetes mellitus p

Objective: To compare the occurrence of hypocalcemia in patients undergoing subtotal and total thyroidectomy. Study Design: Comparative prospective study. Place and Duration of Study: Surgical departments of Ayub Teaching Hospital, Abbottabad and Combined Military Hospital, Rawalpindi, from Mar 2018 to Feb 2020. Methodology: A total of 171 patients were selected for this study and they were divided into 2 groups. Group 1 consisted of 95 patients undergoing Total thyroidectomy whereas group 2 had 76 patients undergoing Subtotal thyroidectomy. It was a comparative prospective study and the groups were made by convenience sampling. The data was analyzed by SPSS-23. Results: In total thyroidectomy group Hypocalcemia was detected after 48 hours in 34 patients (35%) while in subtotal thyroidectomy group hypocalcemia was detected in 20 patients (28%). Tests for hypocalcemia were also done after two months of surgery and low levels were detected in 7 patients (7.5%) who had total thyroidectomy and in 2 patients (5%) in the group undergoing subtotal thyroidectomy. There was no significant difference in hypocalcemia after 48 hour (p=0.22) and 2 months postoperatively (p=0.6) between patients of Total Thyroidectomy and Subtotal Thyroidectomy. Conclusion: Total thyroidectomy is not associated with increased risk of permanent hypocalcemia as compared to Subtotal thyroidectomy. Because of its advantages Total thyroidectomy should be the preferred surgical procedure for patients presenting with benign euthyroid multi nodular goiter.

Metal Organic framework (MOFs) a diverse class of complex organic metal assemblages has been attracting a great interest due to its easy tunability and modified characteristics during the past few years. These nanoscale-to-microscale-sized structures have been employed in different applicative fields due to their striking functional chemistry. Barium MOF synthesis is based on barium metal ions tri-linked organically to form a cubic structure and features photolumincity. Ba-MOF was synthesized by hydrothermal method and structural and optical analysis was performed using X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM), Energy Dispersive Spectroscopy (EDS), Raman Spectroscopy and Zeta Potential. The presence of cubic structure and organic carbon and oxygen linkages was indicated by XRD peaks. EDS directs the presence of barium as well as carbon and oxygen (organic linkers). Raman analysis paid for witnessing the evidence of the synthesis of MOF structure by validating the peak location. The photoluminescence spectrum was applied to measure the bandwidth to study the photoluminescence characteristics. The PL spectrum presented a wide bandwidth of 107.4 nm indicating Ba-MOF to be an efficient photoluminescent nanocomposite for photoluminescence-based applications. Zeta potential value of [Formula: see text] mV characterized anionic behavior and high stability of fabricated Ba-MOF.

Coronavirus disease 2019 (COVID-19) is currently a significant cause of acute respiratory failure worldwide, leading to irreversible fibrotic lung disease. In patients with persistent respiratory failure after acute COVID-19 infection, lung transplant is an emerging option. Here, we have presented a case where the patient required venovenous extracorporeal membrane oxygenation (VV-ECMO) support for 33 days until a bilateral lung transplant was performed on day 71 after the initial COVID-19 infection. The early outcomes have been favorable. Currently, no guidelines exist for an acceptable time period after initial COVID-19 infection, duration of negative COVID polymerase chain reaction (PCR) testing, or negative Vero cell culture in the setting of persistent positive COVID PCR testing before listing for a lung transplant. Due to a lack of standardized guidelines, this patient was not listed for a lung transplant until the COVID-19 PCRs came negative on days 47 and 49 after the infection.

Fall is a prominent issue due to its severe consequences both physically and mentally. Fall detection and prevention is a critical area of research because it can help elderly people to depend less on caregivers and allow them to live and move more independently. Using electrocardiograms (ECG) signals independently for fall detection and activity classification is a novel approach used in this paper. An algorithm has been proposed which uses pre-trained convolutional neural networks AlexNet and GoogLeNet as a classifier between the fall and no fall scenarios using electrocardiogram signals. The ECGs for both falling and no falling cases were obtained as part of the study using eight volunteers. The signals are pre-processed using an elliptical filter for signal noises such as baseline wander and power-line interface. As feature extractors, frequency-time representations (scalograms) were obtained by applying a continuous wavelet transform on the filtered ECG signals. These scalograms were used as inputs to the neural network and a significant validation accuracy of 98.08% was achieved in the first model. The trained model is able to distinguish ECGs with a fall activity from an ECG with a no fall activity with an accuracy of 98.02%. For the verification of the robustness of the proposed algorithm, our experimental dataset was augmented by adding two different publicly available datasets to it. The second model can classify fall, daily activities and no activities with an accuracy of 98.44%. These models were developed by transfer learning from the domain of real images to the medical images. In comparison to traditional deep learning approaches, the transfer learning not only avoids "reinventing the wheel," but also presents a lightweight solution to otherwise computationally heavy problems., This research was funded by the research support program of Fb2, Frankfurt University of Applied Sciences. The research of D.G.-U. has been supported in part by the Spanish MICINN under grants PGC2018-096504-B-C33 and RTI2018-100754-B-I00, the European Union under the 2014-2020 ERDF Operational Programme and the Department of Economy, Knowledge, Business and University of the Regional Government of Andalusia (project FEDER-UCA18-108393). The research of I.M.-B. has been supported in part by the European Commission (ERDF), the Spanish Ministry of Science, Innovation and Universities [RTI2018-093608-BC33].

Background Anemia in chronic kidney disease (CKD) patients develop primarily due to iron and erythropoietin deficiency, factors contributing to this include uremia induced inhibition of erythropoiesis, shortened red cell survival and nutritional deficiency. Erythropoietin stimulating agents (ESA) used in CKD increases iron demand for the production of new red blood cells (RBCs). Oral iron does not provide a reliable route to meet the demand of the iron required and poses the risk of side effects. The intravenous formulation provides the fastest route, although multiple intravenous formulations are available they require multiple dosing and still carry a risk of an adverse event. Ferric derisomaltose/iron isomaltoside (IIM) is an intravenous formulation of iron recently approved by the Food and drug administration (FDA) for patients intolerant to oral iron and non-dialysis dependent CKD patients. FDI is administered in high dose usually in a single administration. In this systematic review, we evaluated the published literature for the efficacy and safety of ferric derisomaltose in both dialysis-dependent and dialysis independent patients. Material/Methods A literature search was done using the following databases: PubMed, Cochrane, Embase, Clinical trials.gov, and Web of Science. The search was completed without using any filter and we used the Mesh Terms for "anemia", "iron deficiency anemia" "chronic kidney disease" and "ferric compounds". Total of 316 which were further screened and we included 2 trials, and 2 prospective studies. Case reports, preclinical trials, meta-analyses, and review articles were excluded. We followed the PRISMA guidelines for literature search and selection of studies. We only included the trial studies that were completed. We excluded the studies that did not report efficacy and safety. Results In total, amongst the four studies, 1558 CKD patients received ferric derisomaltose in a single dose. Patients in all stages of CKD were studied but most patients were between stages I to stage III CKD, stage IV and V(dialysis-dependent) were studied by Kalra et al (2020). A single dose of 1000 mg/dl of IIM, was administered intravenously. The mean pre-treatment haemoglobin level varied from 9.6g/dl to 10.6 g/dl. The mean serum ferritin ranged from 82.4 µg/L to 161.9 µg/L and the mean transferrin saturation ranged in patients from 15.8% to 18.51%. IIM receiving patients were compared with iron sucrose receiving patients by Bhandari et al, and oral iron by Kalra et al (2015). The remaining two studies compared single IIM with multiple IIM dosages. The results are summarised in the table below. Efficacy: The increase in haemoglobin ranged between 0.9 g/dL to 6.58 g/dL from baseline measured at 8 weeks. At the same time, serum ferritin showed an increase in baseline serum ferritin from 104 µg/L to 277 µg/L and transferrin saturation (TSAT) increased in the range of 5.3%-11.4 %. All markers of iron deficiency showed significant improvement. It achieved a greater Hb response irrespective of ESA treatment in both haemodialysis dependent and non-dependent patients. In the comparison group by Bhandari et al, iron sucrose receiving patients also had similar efficacy as IIM. On the other hand, those receiving oral iron in the study by Kalra et al (2015) had much poorer efficacy as compared to IIM Safety: Severe adverse effect was seen in a total of 10 (0.6%) patients who developed hypersensitivity reaction, acute myocardial infarction and injection site-related adverse effects with hypersensitivity being the most common. 15 (0.9%) patients discontinued the treatment. 21 (1.3%) died, and the death was attributed to end-stage renal disease. Conclusion Ferric derisomaltose is an effective parenteral iron therapy to treat iron deficiency when compared to oral iron therapy, however, its efficacy is very similar to other parenteral iron formulations. In terms of safety, being used as a single dose it relatively has lesser adverse events but can seldom lead to discontinuation of the drug. This drug can be recommended for iron therapy especially considering single-dose administration but more studies need to be carried out in comparison to other parenteral formulations to further clarify its efficacy in dialysis-dependent CKD patients. Figure 1 Figure 1. Disclosures Anwer: BMS / Celgene: Honoraria, Research Funding; GlaxoSmithKline: Research Funding; Janssen pharmaceutical: Honoraria, Research Funding; Allogene Therapeutics: Research Funding.

Background Anemia in inflammatory bowel disease (IBD) presents as a common extraintestinal manifestation resulting in many complications. This condition is often missed or underrated, anemia is secondary to blood loss or defective absorption of iron which can result in a combination of iron deficiency anemia (IDA) or anemia of chronic disease (ACD). The management is iron replacement therapy which improves the quality of life in these patients. Due to the constraints in the use of oral iron, parenteral preparations are more used in IBD patients. Commonly used iron sucrose and ferric carboxymaltose are often associated with side effects leading to poor compliance. Our study explores data about ferric derisomaltose also known as iron isomaltoside (IIM), a recently approved IV iron preparation. The FDA approved this drug in 2020 for patients with poor compliance with other iron preparations. We explored the efficacy and safety data of ferric derisomaltose in adult patients with IBD. Material/Methods A literature search was performed using the following databases: PubMed, Cochrane, Embase, Clinical trials.gov, and Web of Science. The search was completed without using any filter and we used the MeSH Terms for "anemia", "iron deficiency anemia", "inflammatory bowel disease", and "ferric compounds". A total of 1590 articles were screened, and we finally selected 2 trials and 2 observational studies. We followed the PRISMA guidelines for literature search and selection of studies. Case reports, preclinical trials, meta-analyses, and review articles were excluded. Trial and observational studies related to IBD were included. Results In total, 294 patients with anemia in inflammatory bowel disease received ferric derisomaltose intravenously as a single dose between 500 mg to 2000 mg. All patients were >18 years of age. The mean pre-treatment hemoglobin (Hb) level varied from 10.0 g/dL to 12.3 g/dL. The mean serum ferritin ranged from 19.6 µg/L to 57 µg/L and the mean transferrin saturation (TSAT) ranged from 8.8% to 18.5%. J. Stein et al investigated the effectiveness and safety of IIM in routine practical care of IDA in IBD patients. Dahlerup et al (NCT01599702) compared single dose IIM with multiple dosages of IIM in IBD patients. The remaining two studies investigated the effectiveness and safety of high dose IIM in patients with IBD. Results are summarized in Table 1. Efficacy: The increase in hemoglobin ranged from 0.6 g/dl to 2.9 g/dl from baseline while the increase in serum ferritin ranged between 102 µg /L to 250 µg /L and transferrin saturation increased in the range of 15.0%-23.7% in 10 to 52 weeks post iron isomaltoside (IIM) therapy. All markers of iron deficiency anemia showed significant improvement. In the observational study by J. Stein et al, the hemoglobin increased from a mean of 10.7 g/dl to 13.1 g/dl, serum ferritin increased from 57 µg /L to 146 µg /L, and TSAT from 8.8% to 23.7% at 16 weeks. Dahlerup et al demonstrated a Hb increase of >2 g/dl in 75% of patients at 10 weeks. According to W. Reinisch et al (NCT 01410435), there was a mean increase in serum ferritin from 32 µg /L to 102 µg /L and a decrease in TSAT from the baseline, but this decrease was not statistically significant. Safety: Adverse events were noted in 8 (3.6%) patients. Out of the 8 patients, 4 ( Conclusion Ferric derisomaltose has demonstrated a substantial increment in iron parameters in anemia in patients with IBD. This was measured in terms of hemoglobin response, serum ferritin, and transferrin saturation. Greater Hb response was achieved irrespective of concomitant treatment with steroids and anti-TGF-ß.The adverse events were mild, and patients recovered showing high compliance. Since the average duration of follow-up in our study was 21 weeks, long-term follow-up is limited for this drug, we need further studies to assess the need for maintenance therapy. Figure 1 Figure 1. Disclosures Anwer: GlaxoSmithKline: Research Funding; BMS / Celgene: Honoraria, Research Funding; Janssen pharmaceutical: Honoraria, Research Funding; Allogene Therapeutics: Research Funding.