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Background: One of the common causes of chronic allograft nephropathy is nonadherence to medications, contributing to 30% of graft loss in the developed world. The non-adherence is attributed predominantly to pill burden.Once-daily dosing of tacrolimus instead of conventional twice-daily dosing may enhance adherence to medication and improve long-term outcomes. The present study is a retrospective analysis comparing the safety and effectiveness of De Novo (use from day 1) once daily (OD) Tacrolimus (extended-release capsules) to conventional twice-a-day (BD) tacrolimus, in renal transplant recipients operated at Suguna Hospital Bangalore India. Material and Methods: Records of 24 Transplant patients on De novo OD Tacrolimus were analyzed and compared retrospectively to 24 transplant patients treated De Novo with conventional BD tacrolimus on a regular follow-up for at least 2 yrs. post-transplant at our center. Results: Various parameters recorded till the last follow-up were analyzed and compared. The average weight of the cohort (64.6 kg vs. 66.6 kg), average tacrolimus dose (2.7 mg vs. 2.15 mg), average Tac dose/kg body weight (0.04 mg vs. 0.03 mg), average Sr.Creatinine, at Last, Follow up (1.2 mg/dl vs. 1.32 mg/dl) were comparable in both groups and were statistically insignificant (p > 0.05). However, there was a higher incidence of Post-Transplant Diabetes Mellitus (PTDM) noted in the Conventional BD Tacrolimus group (20.83%) compared to the OD Tacrolimus group (4.1%) and it was statistically significant (p = 0.17). The Infection rate of 41.67% in the conventional BD Tacrolimus group was much higher compared to the OD Tacrolimus group (4.17%) which was statistically significant (p = 0.01). There was 100% patient and graft survival at the end of two years in both groups. Tacrolimus Dose for OD and Conventional BD dosing were similar, unlike earlier studies recommending a 10% increase in dose for OD tacrolimus compared to BD dosing.Conclusion: OD Tacrolimus dose is comparable to conventional BD dose Tacrolimus in its safety and Efficacy; however, it scores over conventional BD dose Tacrolimus in terms of post-transplant infections and post-transplant diabetes mellitus (PTDM) and a more stable serum trough level. 

The post-harvest health and microbial safety of plant products and foods continue to be a global concern to farmers, consumers, regulatory agencies and food industries. A study was carried out to evaluate the pathogenicity of fungi associated with post-harvest rot of oranges, watermelons and bananas in Lafia, Nasarawa State, Nigeria. Healthy fruits inoculated with fungal spores obtained from rotted fruit tissues were incubated at ambient temperature conditions and observed daily for the appearance and development of tissue rot. Oranges and Watermelons had the highest number of fungal isolates (3) compared to banana (2). Fungi belonging to the genus Curvularia were the most isolated (37.50%), followed by both Aspergillus and Colletotrichum (25.00% respectively) and lastly Alternaria (12.50%). The highest tissue rot diameter of sweet orange (2.40 cm) was induced by Alternaria sp. followed by Curvularia geniculate (1.40 cm) and lastly Colletotrichum sp. (1.28 cm). The highest rot of banana fruit tissues was produced by A. niger (3.90 cm), followed by Curvularia geniculate (3.40 cm). Aspergillus sp. produced the highest tissue rot diameter on watermelon fruits (1.93 cm), followed by Colletotrichum sp. (1.30 cm) and lastly Curvularia geniculate (1.20 cm). Differences in the susceptibilities of different fruits to rot by fungal pathogens were significant (p ≤ 0.05). There is need for improved handling of fruits after harvest to prevent losses due to bacterial and fungal rots in the study area.

Indole acetic acid (AIA) is the most important plant growth hormone since it intervenes in the mechanisms of cell growth and differentiation and is produced mostly in the meristematic zones of the plant for apical dominance or root growth. AIA is also produced in root nodules and plant galls. In the latter cases, its presence is associated with endophytic bacteria. Although it is a plant growth hormone, it is also produced by bacteria such as Azospirillum brasilense and Bradyrhizobium japonicum. These species live in the soil (rhizosphere) or can colonize the roots (endophytic) of their hosts. From these bacteria, there are also isolates that are nitrogen fixers, which in addition to providing growth factors to plants, contribute by releasing nitrogenous molecules that improve plant nutrition.

Purpose: The extrusion of implant material is a rare complication but has been reported in several cases following anterior cervical spine surgery. A posterior spontaneous percutaneous rod extrusion after rigid occipitocervical (OC) instrumentation (screw and rod construct) has not been reported yet. The authors discuss potential complications after cervical spine surgery and its clinical management.Methods: This is a case report of a 56-year-old patient after posterior OC spine surgery with initially unobserved implant failure and posterior percutaneous rod extrusion. The implant failure with a missing rod has been documented 4 years later during a routine follow-up visit.Results: At the four-year follow-up, the asymptomatic patient presented with a stable occipitocervical junction and an improved range of motion after generalized sepsis with an epidural spinal abscess, decompression and posterior OC instrumentation. A computed tomography scan of the implant failure of a broken rod was noticed two years postoperatively. The patient failed to return to the clinic. For years postoperatively he returned to the clinic and the broken rod could not be detectable in-situ on the X-rays anymore. Conclusion: The posterior percutaneous rod extrusion following an OC instrumentation not noticed by the patient, is a very rare complication that has not been described in the literature yet. Once seen back in the clinic, the patient unexpectedly reported an improved ROM without neck pain. Usually, revision surgery or implant removal is recommended if an implant failure is documented.

The World Health Organisation (WHO) defines anemia as a global public health problem. It is a medical condition in which the number of red blood cells or the hemoglobin concentration within them is below the physiological range. We present a case of a 40-year-old woman with Abnormal Uterine Bleeding (AUB) accompanied by malaise, weakness, and tachycardia. The patient reported heavy menstrual bleeding for the past 14 days. Speculum examination revealed that the bleeding was from the uterus. There were no pathological findings during a gynecological and transvaginal ultrasound examination. A complete blood count performed at the time of her arrival showed a low hemoglobin level of 24 g/L, a low hematocrit level of 7,4%, a mean corpuscular volume of 98,7 fL and a number of red blood cells 0,75 x 1012/L. Due to the severity of the anemia, she was given 6 units of red blood cell transfusion, 2 fresh frozen plasmas and tranexamic acid accompanied with calcium carbonate. The curettage was performed. The pathohistological finding was endometrium in proliferation. Afterward, the hemoglobin level increased to 90 g/L. Their past medical history revealed that she abused alcohol. On an abdominal CT scan, Alcohol-Related Liver Disease (ARLD) was confirmed. We should keep in mind that coagulopathy could be the underlying cause of abnormal uterine bleeding and that anemia must be analyzed for successful treatment. A multidisciplinary approach to anemia caused by AUB is required in cases of severe anemia.

Background: Stroke is the most common cause of permanent disability and the third most common cause of death in Palestine. We aimed to examine patterns of stroke presentation, causes, management and outcomes at the largest public Mistry of health hospitals in Palestine.Methods: Comprehensive data from all patients with acute ischemic stroke who were admitted to al-Shifa hospital between November 2021 and July 2022 and treated with alteplase alone or endovascular intervention with or without alteplase were prospectively collected and compare with acute ischemic stroke patients who were treated with medical care alone at Palestine medical complex hospital at 2018. Acute ischemic stroke presentation patterns, in-hospital evaluation and management, mortality, and morbidity were evaluated. Results: Medical care alone group: 138 patients with acute ischemic stroke, mean age was 65 ± 14 years and 49% were women. Most of the patients received antiplatelet therapy (98%), although none received thrombolysis. Only 17% received physical therapy evaluation. In-hospital mortality was 13%, and a modified ranking score of 0 -2 was in 44 patients (32%). Endovascular intervention with/without alteplase group: 56 patients with acute ischemic stroke. The mean age was 61 ± 12 years and 41% were women. All patients received brain computed tomography scans, although few received other investigations such as carotid Doppler (13%). Most patients with ischemic stroke received antiplatelet therapy (99%), although 39 patients (70%) received thrombolysis. Only 61% received physical therapy evaluation. In-hospital mortality was 7%. The modified ranking score 0 - 2: 32 patients (57%).Conclusion: This study conducted in Palestine showed that among patients with acute ischemic stroke, functional outcomes according to modified ranking score 0 - 2 were better by endovascular therapy with/without alteplase than with medical care alone.

The utilization of the Internet and wireless communication reaches its pinnacle from one side of the planet to the other. Marking the rise of criminal activity in recent years sees enormous growth in security breaches and data theft-related cases in mobile phones. To mitigate them, the implementation of security patches, safety fixes, and updates in mobile devices is of high priority for the organization. The need to foster techniques and procedures in the field to be able to extract and precisely dissect digital crime cases, providing valuable tactical data about the investigation. Mobile forensics is a developing branch assisting the investigator in criminal trials and investigations. Acquisition, Collection, and Analysis of mobile phones settle the purpose of recovering cumulative and corroborative evidence. Upgradation and innovation of mobile devices with time imposed a challenge to mobile forensic technology to extract information from such devices. The study aims at extracting comparative and statistical approaches in the analysis of Physical data acquisition utilizing significant versatile mobile criminological proprietary tools. The proposed study also introduces newly developed utility tools along with their characteristic features which help in successful data extraction from mobile devices.

Infections caused by extended-spectrum β-lactamases (ESBLs)-producing bacteria in particular Klebsiella Pneumoniae (KPE+), are on a constant rise and are a noted cause of outbreaks in neonatal intensive care units (NICUs). In the NICU of Policlinico di Foggia, an outbreak of infections in 2018 brought to the start of a serial check of presence and favorable conditions associated with KPE+ diffusion. The outbreak was controlled by improving basic hygiene measures such as hand washing, the use of disposable gloves and gowns, and removing a potential environmental contamination source such as the water bottle warmer.

Aim and objective:1.    To study the manifestations of fungal corneal ulcer in different age groups and sex 2.    To study the distribution of fungal corneal ulcer in relation to occupation3.    To know the effect of Natamycin and Fluconazole as anti-fungal agents.Materials and methods: This is a retrospective analysis of microbiology records of patients presenting with suspected microbial keratitis seen between January 2021 and June 2021. Patients with positive fungal cultures were analyzed in detail for the type of fungus isolated.Results: 90 patients with suspected microbial keratitis were reviewed. A microbiological diagnosis of mycotic keratitis was established 9 (10%) patients over a period of 6 months, based on positive fungal cultures. Filamentous fungi were isolated more often than yeasts. Aspergillus species followed by Fusarium species were the commonest filamentous fungi isolated. Conclusion: Over a period of 6 months, the cumulative incidence of mycotic keratitis was 10%. The pathogenic organisms most frequently responsible for mycotic keratitis were Aspergillus species. When beginning an empirical therapy for mycotic keratitis, etiological factors were helpful. Eight of the 90 patients with corneal ulcers who were admitted to the patient department for treatment had positive fungal cultures in Sabouraud’s media. The age range of 50 to 60 years had a high prevalence of illness. There were 90 total cases of corneal ulcers. Out of those there were 8 (8.8%) incidences of fungal ulcers. More men than women were impacted. Workers in agriculture are more impacted than others. The main cause of a fungus-induced corneal ulcer was trauma.Natamycin was the better option for the treatment of fungal keratitis. Filamentous fungi (Aspergillus species, fusarium, and curvularia) responded effectively to Natamycin 5% eyedrop.

Trying to understand the causes of climate change can be confusing. On the one hand, methane (CH4) emissions from cattle, and methane emissions from food wastes in landfills, are said to contribute to greenhouse gases (GHGs) that drive climate change.  People are working on feed additives for dairy cows to reduce their methane emissions. But, at the same time, cattle manure and food wastes can be fed into anaerobic digesters to convert these organic wastes to biogas; the resulting “renewable methane” or “renewable natural gas” (RNG), can be used in place of fossil natural gas and avoid extra GHG emissions and stop global warming. Can we have it both ways?  Burning gasoline in our cars and trucks generates carbon dioxide (CO2), which is said to contribute to climate change. But more than 8 billion people on planet Earth, breathe in oxygen and exhale carbon dioxide every minute of the day. And so do all the other animals who live on this planet, breathe in oxygen and exhale carbon dioxide. Is our breathing also contributing to climate change, just as the emissions from our automobile tailpipes?It is time to step back from all the hype, evaluate the various sources of CO2 and CH4 being generated and review the “mass balance” of these gases in our atmosphere. Some of these are part of the natural biogenic carbon cycle and some are simply adding to the overall mass balance. What is driving climate change - excess GHGs from the biogenic carbon cycle, excess emissions from other sources, or both? Let’s take a fresh look at the available data.  (Of course, water vapor also plays a part in the climate change story, as a “positive feedback” effect. As non-condensable GHGs rise in concentration and slightly warm the planet, slightly warming oceans add a bit more water vapor to the story and push the warming up a bit more).  During the past few decades, a great deal of pertinent data has been carefully observed and recorded, by world-class scientists and engineers. This data is available in the public domain and is now easily available on the internet. These data sources come from reputable organizations, such as NASA (National Atmospheric and Space Administration), NOAA (National Oceanic and Atmospheric Administration), USGS (United States Geological Survey) and international organizations such as the “Global Carbon Project” and “Our-World-in-Data”.  How much of the growing concentration of CO2 (and CH4) in our atmosphere can be attributed to out-of-control emissions of biogenic carbon? How much of the CO2 rise can be attributed to fossil fuel emissions: 10%, 50%, 90%, or more?  The available data appear to show that the emissions from burning fossil fuels, more than account for all of the rise of carbon dioxide in our atmosphere during the past 60 years, or longer.  In comparison, the biogenic carbon cycle data seem to be very consistent, year after year, decade after decade and have little or no impact on climate change. But, let’s have a closer look at the available data, and let the data speak for itself.

Cotton crop is infested with different kinds of insects in the production cycle. Jassids, thrips, aphids and whiteflies are among the sucking pests, and bollworms (American and spotted) and Spodoptera caterpillars attack leaves and bolls. Bollworms can cause up to 40% - 50% crop losses in severe incidences.

Natural products are becoming increasingly important as an unlimited source for obtaining chemical substances with possible pharmacological potential. Current existing drugs for the treatment of cutaneous leishmaniosis produce major side effects; therefore the search for new drugs is justified. The stem bark of Zanthoxylum chiloperone var. Angustifolium Engl. (Rutaceae) is traditionally used in Paraguay for its antiparasitic properties. The leaf extract was evaluated for the first time to determine its leishmanicidal activity in BALB/c mice infected with amastigote forms of Leishmania amazonensis (PH8). The mice were treated orally with the extract at three concentrations (100, 50 and 10 mg/mL), intralesional (50 mg/mL), and subcutaneously using glucantime as a control (100 mg/mL). The percentage of decrease in parasite load was measured and with intralesional 50 mg/kg a reduction of 72% occurred, with the reference drug (Glucantime) a reduction of 62% was obtained with the same oral dose a reduction of 50%, while with an oral dose of 10 mg/mL the percentage of reduction was 55%. When the oral dose was increased to 100 mg/mL, the reduction percentage of the parasitic load was only 16%. These results indicated that the leaf extract of Z. chiloperone var. angustifolium Engl. at low oral concentrations (50 and 10 mg/mL) had very good activity against L. amazonensis, and it was even more efficacious intralesionally at 50 mg/mL but at the oral dose of 100 mg/kg has very reduced antiparasitic activity. This study showed the efficacy of the extract leaves of Z. chiloperone in reducing the parasite load in an in vivo test, so its use as a potential leishmanicidal could be suggested to develop and evaluate new drugs for the oral treatment of leishmaniosis disease with fewer side effects and lower cost.

Determining the extent of immunity induced by booster doses of COVID-19 vaccinations is crucial for informing recommendations for booster dose regimens as well as constant adjustments of immunization strategies amongst different groups of people within the population. The study involved 31 healthy volunteers (majority were healthcare professionals) who completed either vaccination course with Pfizer or Moderna mRNA vaccines and received a third dose of the vaccine. Here we report results on the evaluation of an antibody response to four different SARS-CoV-2 antigens: RBD, S1, S2 and nucleocapsid prior to third dose and two and four weeks after a booster vaccination. We detected a peak of high titers of antibodies after the third dose with a gradual decline after four weeks. No significant differences were seen between the two vaccines in terms of antibody response. There were no gender discrepancies between the two vaccines. Our results suggest that: third doses are necessary due to the emergence of different SARS-CoV-2 variants and postvaccination antibody testing continues be essential in determining possible standardization of SARS-CoV-2 vaccines regimens.

The study aimed to examine the chemical composition of Acacia melanoxylon wood as a potential raw material for pulp and paper manufacturing. Samples of Acacia melanoxylon were taken systematically based on tree height at the bottom (10%), middle (50%), and top (90%) of market height. The sample was sorted, dried, milled, and sieved, and all chemical compositions were determined by the standards outlined in ASTM except cellulose and hemicellulose, which were determined by the Kurschner-Hoffer and alkali extraction methods, respectively. The results of the study showed that the overall average values of chemical composition along tree height levels were 45.02%, 21.94%, 23.79%, 5.52%, 3.24% and 0.48% for cellulose, hemicellulose, Klason lignin, hot-water solubility, alcohol-benzene extracts, and ash content, respectively. Except for hot-water extractives, the chemical composition of the bottom and top portions differed significantly. Generally, this study suggests that the chemical composition of Acacia melanoxylon wood is well suited for pulp and paper production.

Subacute sclerosing panencephalitis is a rare, slow, and insidious neurodegenerative disease caused by measles. This disease mostly has a classic course. However, sometimes it can be presented with atypical manifestations. In this paper, we aim to present a six years old male patient that was hospitalized due to seizures and ataxia. Cerebral magnetic resonance imaging was normal on the first day of admission, but within a few days, the patient started to be apathetic. On the seventh day, magnetic resonance imaging showed hyperintense lesions in the thalamic, brainstem, and periventricular areas. Periodic epileptiform discharges were detected in the repeated electroencephalogram. Investigations from the cerebrospinal fluid showed markedly elevated measles virus IgG at 230U/ml consistent with the diagnosis of SSPE which should always be ruled out when a patient comes in with uncontrollable seizures, ataxia and apathy.

Background: Having claimed lives, HIV/AIDS is still a significant global public health concern. Antiretroviral therapy (ART) is now widely available, and this rapid expansion of access is dramatically improving HIV epidemic survival rates worldwide.Objectives: The aim of this study was to identify the mortality risk factors and survival status of ART patients attending Hawassa Comprehensive Specialized Hospital in 2020.Methods: In a five-year retrospective cohort research, all patients seen between January 2015 and December 2019 were analyzed. The data were analyzed with SPSS 25.0. The Kaplan-Meier Log-rank model was employed to gauge the survival time of ART patients based on explanatory variables. Both bivariate and multivariate Cox proportional hazards regression models were employed to identify the independent causes of mortality.Results: Patients on ART had a 74% overall survival probability. With a median survival of 34 months, there are 0.135 deaths for every 100 person-years. Hemoglobin level (HR = 2.38; 95% CI = 3.3-6.3), WHO clinical stage III and IV (HR = 3; 95% CI = 2.2-9.5, p = 0.04), Age >=60 (HR = 1.6; 95% CI = 1.3-2, p = 0.04) and Functional status bed ridden (HR = 3.1; 95% CI = 1.2-9.4,p = 0.04) were all independent predictors of death among RVI patients.Conclusion: In comparison to trials conducted in wealthy countries, the survival rate of ART patients in this study was low. Patients who are anemic; WHO advanced clinical stage; old age, and functional status bedridden should be closely followed and monitored.

Background: One of the types of the complex control system is medico-biological, which includes a set of methods and measures aimed at assessing the health, and functional state of the athlete’s body, taking into account the reaction of his systems to various loads. CrossFit is a constantly varied and high-intensity functional training program in which with increasing the training load, the pulse rate increases.The context and purpose of the study: The research was aimed to find out the frequency of heart rate of adolescent judokas in the presence of CrossFit-trainings in the process of physical fitness, for which a pedagogical scientific experiment was held at the youth sports and cultural training center after V. Zakaryan (Hrazdan city). From the groups of 10-12-year-olds practicing judo at the sports school, one experimental and control group was formed, each with 10 athletes. During CrossFit-trainings “Tabata”, “AMRAP”, “21-15-9” and “WOD” methods were mainly used. Athletes’ pulse rate was measured manually at the wrist before training, during training, and immediately after training in order to control the athletes’ feelings toward the training load.Results: In the September-June period, with the implementation of the CrossFit-training program, the heart rate of athletes before training was on average 102,2 bpm, during training 158,3 bpm and immediately after training – 157,8 bpm.Conclusion: The indicators obtained as a result of the research correspond to the norms suggested in literature sources.

Invagination or intussusception is the protrusion of proximal intestinal segments through the distal segments, Transient Intussusception can be easily diagnosed by Abdominal CT.In this report, an incidentally found ‘’Duodeno-jejunal Invagination’’ tilted case, was presented with CT images.

Chronic thromboembolic pulmonary hypertension is a notoriously underdiagnosed cause of severe pulmonary hypertension. It is a form of precapillary pulmonary hypertension (PH) that results from intraluminal thrombus organization and fibrous formation which ultimately results in the complete obliteration of pulmonary arteries, resulting in increased pulmonary vascular resistance which leads to the development of pulmonary hypertension and as a result right heart failure. The mechanism involves the narrowing of the pulmonary artery which increases blood pressure within the lungs and impairs blood flow which increases the workload of the right side of the heart ultimately causing right heart failure. Pulmonary hypertension can also cause arrhythmias, blood clots, and bleeding in the lungs. Even though CTEPH is a deadly condition, among all forms of pulmonary hypertension, CTEPH is the only curable form. Echocardiography is the initial assessment tool for suspected PH. A right heart catheterization may be performed to confirm the presence of pulmonary hypertension. Confirmation of CTEPH requires a V/Q scan. Although ventilation/perfusion scintigraphy has a major role in the evaluation of patients with suspected CTEPH, nowadays CTA chest is being used widely as it produces much better-quality images compared to V/Q scan. Without treatment, the prognosis is very poor. Out of three treatment modalities such as; pulmonary endarterectomy (PEA) surgery, balloon pulmonary angioplasty (BPA), and medical therapy, surgery is the gold standard. The physician must be familiar with the disease entity, early diagnosis, and appropriate treatment to improve survival. Here we present a literature review on this topic.

Congenital cystic adenomatoid malformation of the lung (CCAM) is characterized by an adenomatoid proliferation of bronchiole-like structures and cysts formation. The condition is most commonly found in newborns and children and may be associated with other malformations; rarely, the presentation is delayed until adulthood. We herein report two cases of CCAM in adult patients. 22 years old healthy female with pre-employment health screening chest x-Ray showed a lesion in the upper lobe of the right lung. In another case, a computed tomographic scan of the thorax (CT) confirmed a mass in the upper right lung. A 28-year-old male presented with recurrent respiratory tract infection resistant to antimicrobial therapy. CT scan of the thorax showed a mass in the left lung upper zone. Surgical resection was performed in both cases, and histopathology of the resected specimen showed both cases were consistent with the CCAM.