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Anasarca is generalized swelling of the body following accumulation of fluid in the extracellular compartments. It may result from multiple aetiology mainly of renal, hepatic or cardiovascular origin. The aim of this case report is to highlight the challenges encountered in making diagnosis in a patient with anarsaca. We report a case of a 34 year old transporter who presented with anasarca. He had clinical features and risk factors suggestive of renal, hepatic and cardiovascular disease. However investigations ruled out renal, hepatic or cardiovascular diseases as the aetiology of the anarsaca. The anarsarca was also noted to be unresponsive to diuretics. The diagnosis of the disease causing the anarsaca was therefore a dilemma.

Introduction: Permanent vascular access (arteriovenous fistula (AVF), arteriovenous graft (AVG)) is susceptible to acute events that reduce patency. The temporary central venous catheter (CVC) constitutes bridging therapy for primary vascular access dysfunction. The impact of “residence time” on the rate of dysfunction/thrombosis or infection remains to be explored.AIM: 1) To evaluate the impact of CVC residence time on outcomes (infection or Thrombosis/dysfunction) in consecutive temporary CVCs adjusted for the insertion site (upper site vs. lower site).2) To establish a cut-off resident time.Patients and methods: Seventeen prevalent hemodialysis patients with three consecutive CVCs are followed up prospectively in an observational study for a period equivalent to the permanence of the CVCs. The data is recorded at the beginning of the CVC time. The diagnosis of catheter-related bloodstream infection and thrombosis/dysfunction is made following the K-Doqi 2019 guidelines.Statistical analysis: Seventeen hemodialysis patients (51 CVCs) were included. The ‘CVC resident time’ of each individual patient ((i.e. βcoefficient (log-transformed)*AUC)) was determined using LMM and then inserted into multivariate Cox models to assess infection and dysfunction/thrombosis outcomes (Joint Models). The AUC was calculated at various baseline levels of CVC time (10th……50th percentile). The cut-off point for thrombosis in CVC time corresponds to the mean of the CVC time at the 30th percentile of all CVCs.Results: The CVC time is different for CVC’s site insertion and sequence. From the analysis of multivariate joint models, CVC resident time appears not to be significant for infection, but heterogenicity for the insertion site (ref3-4=upper site) is significant for the outcome of thrombosis/dysfunction. From the study of survival analysis, the free survival from outcomes by CVC site insertion appears to be significant for thrombosis/dysfunction. The average time of CVCs’ calculation at the 30th percentile is 14 days (cut-off).Conclusion: No tunneled hemodialysis Catheter (NTHC) residence time is considered not to be a risk factor for infection, but it represents a risk factor for lower access thrombosis. After the cut-off time of 14 days, the advantage of the higher NTHCs is lost.

The proliferation and popularity of open source hardware and software, such as Arduino and Raspberry PI, together with IoT and Embedded System, has brought the health industry to rapid evolution, creating portable and low-cost medical devices for monitoring vital signals. Electrocardiographic (ECG) equipment plays a vital role for diagnosis of cardiac disease. However, the cost of this equipment is huge and the operation is too much complex which cannot offer better services to a large population in developing countries. In this paper, I have designed and implemented a low cost fully portable ECG monitoring system using android smartphone and Arduino. The results obtained by the device were tested comparing them with those obtained from a traditional ECG used in clinical practice on 70 people, in resting and under-activity conditions. The values of beats per minute (BPM), ECG waveform and ECG parameters were identical, and presented a sensitivity of 97.8% and a specificity of 78.52%.

Rice bakanae disease is a typical seed-borne disease caused by Fusarium fujikuroi that occurs in seedling beds and in fields. Fungicide seed treatment is an effective solution to this disease. In this study, we used a triple-fungicide suspension identified as 11% FMA, which is composed of 1.1% fludioxonil, 3.3% metalaxyl-M and 6.6% azoxystrobin to coat rice seeds for the prevention of bakanae disease. 11% FMA is water-logging resistant for rice seed treatment. Results showed that the mycelial growth of F. fujikuroi was significantly inhibited by 11% FMA in the laboratory test. Seed dressing with FMA at the rate of 1, 2, and 4 g per kg of seeds promoted seed germination and growth of seedling roots. Treatment with 11% FMA under all dose rates prevented rice bakanae disease of seedlings by more than 90%, especially by more than 95% at 4, 6 and 8 g per kg of seeds. During the subsequent maturation period, rice bakanae control efficiency reaches above 95% as well at 6 or 8 g per kg of seeds, slightly larger than about 92% at 1 or 2 g per kg of seeds. Above all, the rice yield notably improved by 11% with 1 g/kg, by around 8% with 2, 4, or 8 g/kg and by 5% with 6 g/kg treatment. 

Post-Traumatic Stress Disorder (PTSD) is a disorder that affects not only military veterans but also the general public specifically children. They may replay the event and its aftermath, avoid talking about it, have low self-esteem, and be unable to develop meaningful connections. Mentally sick individuals in Pakistan frequently face an obstacle, as discussing mental health is taboo. Mentally ill people are publicly humiliated in Pakistan, and sufferers are occasionally referred to as “pagal.” Even parents ignore the symptoms of their children. 

Experience with allogeneic hematopoietic stem cell transplantation (HSCT) in mycosis fungoides/Sezary syndrome (MF/SS) is limited to a small number of case reports and case series [1,2]. The advantage of allogeneic HSCT has been indicated in progressive disease in the review of CIBMTR study groups [3]. A consensus is still not available about the intensity and the content of the conditioning regimen due to the rarity of the disease and heterogeneous patient groups.

A case study on Jakob Erdheim-Chester disease. Jakob Erdheim, pathologist, collector, scientist and educator was born in 1874 in Galicia and received his medical degree from the University of Vienna in 1900. He became interested in pathology and joined the Pathology Institute of the Municipal Hospital (Lainz) of Vienna

Background: Subclavian venous access for pacemaker lead insertion is a common procedure and is normally considered safe in the hands of an expert. However, subclavian venepuncture is not without complications, starting from mild subcutaneous hematoma to pneumothorax. We here present a case of hemoptysis occurring after difficult subclavian vein puncture, which subsequently improved on conservative management only. Case Summary: A 65-year-old gentleman, post aortic valve replacement had persistent high-grade AV block and was taken up for a dual chamber pacemaker implantation. Immediately following venous access, he had a bout of hemoptysis, which recovered on its own. Post procedure chest x-ray was suggestive of alveolar hemorrhage which cleared gradually in next three-four days. Discussion: Post subclavian venepuncture hemoptysis is known; but it is a rare complication, arising either because of lung parenchyma injury or arterial injury. This is mostly benign and improves on conservative management only; however rarely it may be massive and life threatening where transcatheter arterial embolization may be required.

The SARS-CoV-2 (COVID-19) pandemic outbreak has led to some lockdowns and changed human mobility and lifestyle in this country. Mashhad, one of the most polluted cities in Iran has experienced critical air pollution conditions in recent years. In the present study, the potential relationships between air quality conditions (such as popular index and criteria air pollutant concentration) and COVID-19 cases and deaths were investigated in Mashhad, Iran. To do that, the Long Short-Term Memory (LSTM) based hybrid deep learning architecture was implemented on AQI, meteorological data (such as temperature, sea level pressure, dew points, and wind speed), traffic index and impact number of death, and active cases COVID-19 from March 2019 to March 2022 in Mashhad. The results reveal the LSTM model could predict the AQI accurately. The lower error between the real and predicted AQI, including MSE, MSLE, and MAE is 0.0153, 0.0058, and 0.1043, respectively. Also, the cosine similarity between predicted AQI and real amounts of it is 1. Moreover, in the first peak of the pandemic (Aug 2021), we have the minimum amount of AQI. Meanwhile, by increasing the number of active cases and death and by starting lockdown, because the traffic is decreased, the air quality is good and the amount of AQI related to PM2.5 is 54.68. Furthermore, the decrease the active cases and death in pandemic causes a significant increase in AQI, which is 123.52 in Nov 2021, due to a decline in lockdowns, resumption of human activities, and probable temperature inversions. 

A key platform underpinning the traditional understanding of the cardiovascular system, with respect to the behavior of large arterial vessels, is Otto Frank’s Windkessel Hypothesis [1]. This hypothesis posits simply that the smooth muscle walls of large arteries do not undergo rhythmic contractions in synchrony with the heartbeat but, rather, behave as passive elastic tubes undergoing distension from pulsatile pressure waves. The Windkessel Hypothesis is elegant, well described for over a century, ingrained in the understanding of cardiovascular medicine and physiology, and simply wrong. Several groups have now shown that the arterial smooth muscle wall undergoes rhythmic activation in synchrony with the heartbeat in a variety of tissues, including human brachial artery; canine coronary, femoral, and carotid arteries; rabbit aorta; feline pulmonary artery and rodent aorta [2-8]. The phasing of these events is such that the upstroke of the contraction slightly precedes the upstroke of the pulse wave, suggesting nomenclature for the events as pulse synchronized contractions, or PSCs [3,6-8]. PSCs have been found to be of neurogenic origin, sensitive to the neural blocker tetrodotoxin [3,8]. Although the specific neural pathways regulating PSCs have not been elucidated, the alpha-adrenergic system is at least partially involved, as evidenced by reduction or blockade of PSCs by the alpha-adrenergic blocker phentolamine [8]. Further, PSCs have not been observed following vessel excision in in vitro studies, as an intact nervous system is not present. The pacemaker for the PSC resides in the right atrium, as suggested by two lines of evidence. First, pacing of the right atrial region to faster than spontaneous frequencies leads to a one-to-one correspondence of PSC frequency with the stimulation rate [3]. Additionally, excision of the right, but not the left, atrial appendage results in elimination of PSCs [3]. As the pacemaker region for PSCs and the heartbeat both lie in the right atrium, this may potentially allow for coordination between the heartbeat and pulse wave with PSCs [3,5,8]. Extensive evaluations also have been performed showing the PSC was not an artifact produced either by cardiac contractility or from the vessel distension from the pulse wave [3,5,6].