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Background: Microbial keratitis is an important cause of ocular morbidity, with emerging organisms and drug resistance posing a real threat to vision of patients.Case presentation: A 30-year-old female presented with infective keratitis in the left eye. She had been using rose nectar as home remedy for her ailment. With no improvement in her symptoms, she presented to the eye emergency department, where she was started on empirical therapy with moxifloxacin, which was shifted to levofloxacin eye drops after the antimicrobial susceptibility test results came in. Microbiological examination revealed infection with rare gram-negative bacilli . The patient responded well to the treatment with 1.5% levofloxacin eye drops and her vision improved from 20/120 to 20/30 over a course of 3 months.Conclusion: Treatment of microbial keratitis with those antibiotics that the organism is most sensitive to is of paramount importance today, where we often find patients on a cocktail of eye drops, which leads to further resistance and vision deterioration. Culturing of cornea scrapings and antimicrobial susceptibility testing of the isolated organism is now the standard guideline to be followed in the investigation of microbial keratitis.

Objective: to determine how frequently children in developing countries like Pakistan with urolithiasis have metabolic abnormalities alongwith clinical features. Study Design: Descriptive Cross Sectional study. Setting: Department of Paediatric, National Institute of Child Health, Karachi. Period: January 2021 to February 2022. Material & Methods: To determine how frequently local children with urolithiasis have metabolic problems. A total of 80 children who were aged 4 to 14 years and who had renal stones were included, while those suffering from chronic kidney diseases, liver and biliary tract diseases and children, receiving vitamin D supplementation are excluded. Urine samples were analyzed urinary uric acid, calcium, Demographics and metabolic abnormalities--hypercalciuria, hyperuricosuria analyzed. Results: The study analysis included 80 patients. Seventy one patients (88.8%) had metabolic abnormalities. Most frequent metabolic abnormality was hypercalciuria 60(75%) followed by hyperuricosuria in 52(65%) of participants. There was no significant association observed between metabolic abnormalities and age, gender and BMI classification. Conclusion: Metabolic abnormalities were found 88.8% of children presenting with urinary lithiasis. The most frequent abnormality observed was hypercalciuria followed by hyperuricosuria. Early identification helps manage such patients appropriately, mitigating long-term sequelae. [ABSTRACT FROM AUTHOR]

Within the neoteric decade, cloud computing has grown as emerging technology which is an on-demand availability of network resources, particularly data storage without any management by users. However, the occurrence of security threats and vulnerability has gradually increased in this processing technology due to its notable growth. In addition to that, he existing Systematic Literature Reviews (SLRs) are only limited with cloud related issues and does not provides their impact on other technologies. This Systematic Literature Review (SLR) examines the security threats experienced by cloud computing along with QoS by edge computing and scheduling. Various consumers and cloud service providers (CSP) obtained benefits from the cloud computing environment. However, various privacy and security challenges occur in this digital age. This SLR mainly aims to review the state of the art research studies on secure cloud computing with high QoS and its challenges. This SLR examined numerous research studies related to cloud computing security with secure service level agreement (SLA) which are published between 2019 to 2022 from the reputed electronic databases. Cloud computing security is ensured mostly based on trust evaluation, implementation of blockchain technology, authentication, and cryptography techniques, and implementing edge computing in the cloud environment. This SLR also analyzed the research gaps of the previous research papers and provides future research directions to obtain secure cloud computing environment with high QoS performance [ABSTRACT FROM AUTHOR]

Over the past decade, there has been a rapidly rising trend of malware (ransomware) that limits user access by encrypting the data and demanding the ransom against the decryption key. In most cases, such encryption may lead to a permanent data loss. In order to prevent this unwanted encryption, we propose a method based on Moving Target Defense (MTD) approach. Our method is based on the alteration of the attack surface to reduce the attack success ratio. We have used multiple layers of MTD. The first layer generates random extensions that hide the existing known file extensions. This will protect user files against those ransomware variants which encrypt files having some specific extensions. Our second layer of protection uses event‐based MTD in which tasks are scheduled to change file extensions at the occurrence of specific events which mostly occur due to the execution of ransomware in the system. As a result of our proposed method, we have successfully protected user files against well‐known ransomware variants such as WannaCry, Cerber, Locky, Tesla, Revil, Bitlocker, Darkside, Ranzy. [ABSTRACT FROM AUTHOR]

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is often the cause of serious ocular infections that are difficult to treat, and these ocular infections are a significant public health problem. Aims and Objective: The study aimed to determine the prevalence and antimicrobial susceptibility pattern of MRSA in ocular infections. Materials and Methods: The patients were recruited from the outpatient and inpatient departments from July 2018 to February 2021 from the Institute of Ophthalmology and study was done in the Department of Microbiology, JNMC, AMU, Aligarh (UP). MRSA was identified by Cefoxitin disk diffusion method. Polymerase chain reaction was used for detection of mecA gene. Results: Seventy-six S. aureus were found in 350 patients with clinically suspected various bacterial infections. Among all S. aureus, 41 (53.94%) were MRSA. Maximum 10 (24.4%) MRSA were isolated from lacrimal apparatus infection followed by 7 (17%) in lid infection, and 6 (14.6%) in keratitis. All MRSA isolates were positive for mec A gene. MRSA isolates showed 85.3% sensitivity to amikacin and 100% to vancomycin. Fluoroquinolones showed resistance to the majority of MRSA strains. Conclusion: MRSA is the main pathogen of ocular infections, resistant to a wide range of antibiotics. The monitoring of antibiotic sensitivity patterns, regular surveillance of associated ocular diseases, and strict antibiotics policy should be followed in an institute. [ABSTRACT FROM AUTHOR]

Byline: Jyoti. Garg, Geoffrey. Liew, Shariq. Khan With the more frequent use of the laryngeal mask airway (LMA) over endotracheal tubes for general anaesthesia, various cranial nerve injuries have been [...]

Introduction: Oropharyngeal swabs for diagnosis of COVID-19 often induce violent coughing, which can disperse infectious droplets onto providers. Incorrectly doffing personal protective equipment (PPE) increases the risk of transmission. A cheap, single-use variation of the face shield invented by a Singaporean team, SG Shield, aims to reduce this risk. This manikin study aimed to study the efficacy of the SG Shield in combination with standard PPE.Methods: A person attired in full PPE whose face and chest was lined with grid paper stood in front of an airway manikin in an enclosed room. A small latex balloon containing ultraviolet fluorescent dye was placed in the oral cavity of the manikin and inflated until explosion to simulate a cough. Three study groups were tested: (a) control (no shield), (b) face shield and (c) SG Shield. The primary outcome was droplet dispersion, determined quantitatively by calculating the proportion of grid paper wall squares stained with fluorescent dye. The secondary outcome was the severity of provider contamination.Results: The SG Shield significantly reduced droplet dispersion to 0% compared to the controls (99.0%, P = 0.001). The face shield also significantly reduced droplet contamination but to a lesser extent (80.0%) compared to the control group (P = 0.001). Although the qualitative severity of droplet contamination was significantly lower in both groups compared to the controls, the face shield group had more contamination of the provider's head and neck.Conclusion: The manikin study showed that the SG Shield significantly reduces droplet dispersion to the swab provider's face and chest. [ABSTRACT FROM AUTHOR]

Vast amounts of data are transferred through communication networks resulting in node congestion, which varies according to peak usage times. The Glowworm Swarm Optimization (GSO) algorithm is inspired by the rummaging and courtship behavior of glowworms. The glow intensity of glowworms is a measure of fitness that attracts other glowworms in its neighborhood. This work applies the GSO algorithm to the computer network congestion problem in order to lessen the network burden by shifting loads to the fittest neighborhood nodes, thereby enhancing network performance during peak traffic times, when the response of systems on the network would go down. The proposed solution aims to alleviate the burdened nodes, thereby improving the flow of traffic throughout the network, improving the users' experience and productivity, and efficiency. In this paper, three swarm algorithms, namely Particle Swarm Optimization (PSO), Cuckoo Search (CK), and GSO have been employed to solve the network load balancing problem. The results produced by GSO show improvement of 71.17%, 74.14%, and 84.15% in networks consisting of 50, 100, and 200 nodes in peak hour load, while PSO shows 13.87%, 11.75%, and 23.72%, and CK 10.61%, 3.19%, and 6%. The results prove the superior performance of GSO. [ABSTRACT FROM AUTHOR]

Abstract Leeches are a class of segmented invertebrates, known for their blood-feeding habits and used in phlebotomy to treat various ailments since antiquity. In Europe, medicinal leeches have recently been [...]