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Objectives: Underlying medical conditions are critical risk factors for COVID-19 susceptibility and its rapid clinical manifestation. Therefore, the preexisting burden of non-communicable diseases (NCDs) makes the preparedness for COVID-19 more challenging for low- and middle-income countries (LMICs). These countries have relied on vaccination campaigns as an effective measure to tackle COVID-19. In this study, we investigated the impact of comorbidities on humoral antibody responses against the specific receptor-binding domain (RBD) of SARS-CoV2. Methods: A total of 1005 patients were selected for the SARS-CoV-2 specific immunoglobulin G (IgG1, IgG2, IgG3, and IgG4 subclasses) and total antibody (TAb) tests (IgG and IgM), of which 912 serum samples were ultimately selected based on the specimen cutoff analyte value. Patients with multimorbidity (N = 60) were recruited for follow-up studies from the initial cohort, and their immune response (IgG and TAb) was measured at multiple time points after the second dose of vaccination. Siemens Dimension Vista SARS-CoV-2 IgG (CV2G) and SARS-CoV-2 TAb assay (CV2T) were used to carry out the serology test. Results: Out of a total of 912 participants, vaccinated individuals (N = 711) had detectable antibody responses up to 7–8 months. The synergistic effect of natural infection and vaccine response was also studied. Participants with breakthrough infections (N = 49) mounted a greater antibody response compared to individuals with normal vaccination response (N = 397) and those who were naturally infected before receiving the second dose of vaccine (N = 132). Investigation of the impact of comorbidities revealed that diabetes mellitus (DM) (N = 117) and kidney disease (N = 50) had a significant negative impact on the decline of the humoral antibody response against SARS-CoV-2. IgG and TAb declined more rapidly in diabetic and kidney disease patients compared to the other four comorbid groups. Follow-up studies demonstrated that antibody response rapidly declined within 4 months after receiving the second dose. Conclusion: The generalized immunization schedule for COVID-19 needs to be adjusted for high-risk comorbid groups, and a booster dose must be administered early within 4 months after receiving the second dose.

Goal: The present study aimed to demonstrate the applicability of the fuzzy goal programming to frame the decision support system for the decision-makers to deal with the real-life problem of the agriculture sector namely the apple cultivation planning problem and to obtain an optimum solution. Design / Methodology / Approach: The proposed method occurred within the apple-producing sector in the Kashmir valley of India and included the collection of data through interviews and surveys with various farmers. Also, the results were drawn with the help of LINGO 18.0. Results: The current finding implies that all of the desired objectives have been met, as well as an optimal solution. The proposed model offers a significant approach for designing plans to determine various agricultural activities in a fuzzy decision environment. Finally, the current study conducts a case study in the apple cultivation sector to obtain various competing objectives. Sensitivity analysis was also performed on its preferential weight parameters. Limitations of the investigation: It should be noted that the parameters related to production cost, transportation cost, and cost of material may change over the years. The selling price may also vary according to the quality of apples and over the years. Because of natural factors, the annual production of apples may also vary. Practical implication: The current study shows that using fuzzy goal programming techniques in an apple production process has a huge potential to increase farmers' income. It can be concluded that the current study can help decision-makers to deal with real-life planning issues in the agricultural sector. Future research can also take advantage of other initiation strategies. Originality/Value: The study looks at the applicability of the fuzzy goal programming paradigm in a new field of apple production in the agriculture sector. According to our knowledge, this is the first time the optimization model has been used in the apple cultivation sector.

In the present business environment, rapidly developing technology and the competitive world market pose challenges to the available assets of industries. Hence, industries need to allocate and use available assets at the optimum level. Thus, industrialists must create a good decision plan to guide their performance in the production sector. As a result, the present study applies the Meta-Goal Programming technique to attain several objectives simultaneously in the textile production sector. The importance of this study lies in pursuing different objectives simultaneously, which has been almost ignored till now. The production scheduling problem in a textile firm is used to illustrate the practicability and mathematical validity of the suggested approach. Analysis of the results obtained demonstrates that the solution met all three meta-goals with some original goals being met partially. An analysis of the sensitivity of the approach to the weights of the preferences was conducted. (original abstract)

Objectives: This study aimed to assess the rate of inactive disease in Bangladeshi patients with Takayasu arteritis (TA) treated with prednisolone and to identify the characteristics in patients that may guide in choosing induction therapy. Methods: The longitudinal study enrolled active TA patients who received 1 mg/kg/day of prednisolone. Disease activity was assessed by Indian Takayasu Activity Score - C-Reactive Protein (ITAS-CRP) and ITAS2010 at baseline and after 1, 3, and 6 months. The patients who did not achieve inactive disease or again became active during tapering of prednisolone received methotrexate. Results: Among 12 active TA patients, one patient succumbed to death after 15 days. ITAS2010 1 month after steroid showed a significant difference between remission and nonremission patients (P 0.0001). However, five out of 11 (45.45%) patients became inactive. These five patients had onset of symptoms

AIM/OBJECTIVE: This retrospective study aimed to analyze the device-related complication rates and compare them with the literature. BACKGROUND: When it comes to providing care for cancer patients who need a continuous or frequent venous access channel for either their primary care treatments or their supportive care treatments, portacaths play a crucial role. Many cases are straight forward, however there may occasionally be issues. MATERIALS AND METHODS: A total of 59 consecutive patients (20 males and 39 females) having a mean age of 57.07 - 16.01 years presented to the interventional radiology department of Shifa International Hospital Islamabad who were implanted with portacaths from 2017 to 2023 were included. We retrospectively assessed all infectious and noninfectious complications associated with the implanted device. RESULT: The most common indication for portacath insertion was malignancy (94.9%) with breast cancer being more common. The most common site for portacath placement was the right internal jugular vein (76.3 %) followed by the left internal jugular vein (23.7%). The average period for which porta cath was placed was 13 months. No complications were seen in 67.8% of the patients. Infectious causes were seen in 25.4% of the cases, while noninfectious complications were seen in 6.8% of the cases. Following microbiology reports it was seen that pseudomonas aeruginosa was the common bug seen in infectious cases. CONCLUSION: Although portacaths are associated with lower complication rates, infections by different bugs are still the most common complications and should be prevented by taking appropriate steps. [ABSTRACT FROM AUTHOR]

The study was aimed to record the ocular ultrasonographic changes in the confirmed clinical cases of MCF. The cases were confirmed using hemi-nested polymerase chain reaction assay. Ocular ultrasonography was performed using a 10–18 MHz linear transducer (My Lab 40 Vet). Clinical signs observed were corneal oedema, lacrimation, photophobia, corneal oedema and hyperaemia of conjunctiva. In two animals, mild corneal oedema was observed while in four animals each, moderate and severe corneal oedema was recorded. In all the animals, corneal oedema initially appeared at the limbus with subsequent involvement of the entire cornea with varying degree of severity. Hemi-nested polymerase chain reaction was used for confirming the diagnosis. Ocular ultrasonographic examination revealed significant increase in the thickness of the cornea, iris and ciliary body. Anterior uveitis, characterized by thickened iris, exhibiting crust and trough formation covering the major part of the anterior surface of the lens was recorded in nine animals. There was no recovery in any of the case and the animals died within one month of the diagnosis of the MCF. Significant ultrasonographic changes were evident in eyes of animals affected with the malignant catarrhal fever. Ultrasonography may therefore be used for monitoring the ocular changes especially in the anterior segment of the opaque eyes.

Abstract Background Salmonella enterica serovar Typhimurium (Salmonella Typhimurium) is a zoonotic pathogen responsible for severe intestinal pathology in young chickens. Natural resistance-associated macrophage protein (NRAMP) family has been shown to be associated with resistance to intracellular pathogens, including Salmonella Typhimurium. The role of NRAMP proteins in macrophage defence against microbial infection has been ascribed to changes in the metal-ion concentrations inside the bacteria-containing phagosomes. The present study was conducted to investigate tissue-specific (liver, spleen and caecum) expression kinetics of NRAMP gene family (NRAMP1 and NRAMP2) in broilers from day 0 to day 15 after Salmonella Typhimurium challenge concomitant to clinical, blood biochemical and immunological parameters survey. Results Clinical symptoms appeared 4 days post-infection (dpi) in infected birds. Symptoms like progressive weakness, anorexia, diarrhoea and lowering of the head were seen in infected birds one-week post-infection. On postmortem examination, liver showed congestion, haemorrhage and necrotic foci on the surface, while as the spleen, lungs and intestines revealed congestion and haemorrhages. Histopathological alterations were principally found in liver comprising of necrosis, reticular endothelial hyperplasia along with mononuclear cell and heterophilic infiltration. Red Blood Cell (RBC) count, Haemoglobin (Hb) and Packed Cell Volume (PCV) decreased significantly (P

This article, published in the Arab Journal of Interventional Radiology, provides a pictorial review of currently available interventional radiology (IR) guided procedures for treating portal hypertension. The study, conducted in Pakistan, outlines the role of IR in diagnosing and treating complications related to portal hypertension. The article discusses various treatment options, including transjugular intrahepatic portosystemic shunt (TIPS), transjugular hepatic biopsy, sharp hepatic venous recanalization, CARTO, and portal vein embolization. The authors conclude that minimally invasive IR procedures are effective in diagnosing and managing portal hypertension-related complications, and are particularly beneficial in a developing country like Pakistan. [Extracted from the article]

This article, published in the Arab Journal of Interventional Radiology, presents a retrospective study on the complication rate associated with totally implantable venous access devices, specifically Portacaths. The study analyzed 59 patients who were implanted with Portacaths between 2017 and 2023 at Shifa International Hospital Islamabad. The most common indication for Portacath insertion was malignancy, with breast cancer being the most common type. The study found that while Portacaths are generally associated with low complication rates, infections by different bacteria, particularly pseudomonas aeruginosa, were the most common complications. The authors recommend taking appropriate steps to prevent these infections. [Extracted from the article]

This article, titled "Let's Dive in Ultrasound-Guided Renal Biopsy Complications in the Last Decade: A Single-Institute Study," aims to assess the complications associated with ultrasound-guided renal biopsies at a specific institution over the past 10 years. The study found that percutaneous renal biopsy, while important for diagnosing renal pathologies, can lead to various complications such as hematuria, drop in hemoglobin, pain, infection, and hematoma formation. However, the study also noted that ultrasound-guided biopsy has fewer complications and better adequacy. The researchers recommend close monitoring of patients post-procedure for 24 hours to reduce morbidity and mortality rates. [Extracted from the article]

This article, published in the Arab Journal of Interventional Radiology, reviews the pattern of in-stent stenosis after transjugular intrahepatic portosystemic shunt (TIPS) using the Fluency stent graft. The study conducted a retrospective review of 32 patients who underwent TIPS with the Fluency stent graft in combination with bare metal stents. The results showed that the majority of in-stent stenosis occurred at the portal vein end when using the combination of Fluency with a bare metal stent for TIPS creation. The authors suggest that this may be due to the difficulty in identifying portal venous access on fluoroscopy, leaving the proximal parenchymal tract uncovered by the Fluency stent and potentially leading to intimal hyperplasia and TIPS stenosis. [Extracted from the article]

Background: The global burden of patients affected by chronic liver disease (CLD) has shown a steady rise over the last few decades and is now considered the 11th most frequent cause of death globally. In addition, as the world population is facing increased obesity rates coupled with alcohol consumption, these rates are predicted to continue to rise. The Objective was to assess the appearance of Lipiodol retention upon different MRI sequences with a special focus on non-contrast sequences. Lipiodol Transarterial chemoembolization (TACE) has become the standard treatment for unresectable hepatocellular carcinoma (HCC) without vascular invasion. However, data regarding Lipiodol TACE imaging via MRI is limited and results are not familiar to radiologists for regular assessment of treatment response. Methods: After IRB and EC approval, we included all those patients who underwent TACE treatment with Lipiodol and chemotherapeutic agent; having both 4-6-week post-treatment CT and MRI imaging. This criterion was fulfilled by a total of 25 patients. Only lipiodol-containing areas within the lesion were noted for signal intensities on all MRI sequences and labelled as hyperintense, isointense, hypointense and mixed intensity. Data was entered and analyzed by SPSS v27. Frequencies and percentages were calculated for qualitative data. Results: The most sensitive sequence in detecting Lipiodol retention was Fat suppressed T1 imaging sequence, with low signal intensity seen on T1 weighted fat-suppressed sequences in up to 76% of lesions. While on non-fat suppressed T1 weighted images, 60% of Lipiodol retention areas appeared hyperintense. 52% of lesions showed a hypointense appearance on the T2 weighted sequence. A much more variable appearance was seen in Diffusion-weighted imaging sequences demanding cautious interpretation. MR patterns were clearer in patients having more than 50% lipiodol retention on CT and lesion size more than 2 cm. Conclusion: While MRI is deemed as a reliable and most useful imaging modality for assessing HCC's following lipiodol TACE it requires cautious interpretation with knowledge of variable signal appearance seen on different imaging sequences. [ABSTRACT FROM AUTHOR]

Management of renal emergencies has revolutionized over the past years and in that domain intervention radiology has gained an emerging role as the minimally invasive procedures aid at salvaging renal function and minimizing morbidity and mortality. Aim of this study is to highlight emerging importance of newer transcatheter therapies available to intervention radiologists in managing renal emergencies,attending in detail the techniques and clinical outcomes of interventional procedures. METHOD: We compiled few of the procedures performed at Shifa international hospital, Islamabad from January 2017- January 2023. These include: Management of fibromuscular dysplasia. Renal angiomyolipoma embolization. Renal artery giant aneurysm coiling/ embolization. Management of post renal biopsy bleed. Post partial nephrectomy bleed management. Embolization of renal cell carcinoma metastasis to stomach and small bowel. Renal cyst alcohol ablation. CONCLUSION: Knowledge about the disease, procedures of intervention developed for their management and their clinico-therapeutic outcomes can help efficiently treat the patients with renal illnesses. [ABSTRACT FROM AUTHOR]

Background: Acquired uterine vascular abnormalities are a rare cause of potentially lifethreatening bleeding. These include uterine artery pseudoaneurysms (UAP)and acquired arteriovenous malformations. The objective of this study was to describe our experience with the diagnosis of acquired uterine vascular abnormalities and its treatment with uterine preservation. It was a retrospective cohort study. Methods: Eight patients were enrolled from the hospital database who presented to our Interventional Radiology department from April 2017 to March 2021 for uterine artery embolisation (UAE) with a history of iatrogenic/acquired uterine vascular abnormalities confirmed on imaging. These included two patients with uterine artery pseudoaneurysm (PA) concurrently with arteriovenous malformation (AVM), one with uterine artery PA and five having uterine AVMs. Embolisation agents used were histoacryl glue, lipiodol, PVA particles, and gelfoam slurry. Medical records, imaging studies, and telephonic contact with patients were assessed for patient presentation, intraprocedural details, and follow up to record treatment success. Statistical analysis was performed using descriptive statistics. Results: Bilateral UAE was performed in six patients, while two patients underwent unilateral UAE. Three of the patients presented with life-threatening bleeds requiring multiple transfusions. Clinical as well as angiographic success was achieved in all patients with immediate control of haemorrhage. No complications were observed during follow-up. Two of the patients were able to conceive normally within one year, though it resulted in a miscarriage. Conclusion: Acquired/iatrogenic uterine vascular abnormalities are a rare but important cause of life-threatening haemorrhage that can be expertly managed and successfully treated using UAE, which is rapid, safe, and minimally invasive, with the added advantage fertility preservation. [ABSTRACT FROM AUTHOR]