Scrotal Scintigraphy in Testicular Torsion: An Experience at a Tertiary Care Centre

Introduction: Accurate diagnosis of testicular torsion is important to avoid serious consequences of any delay in proper management. Objective of this study was to compare performance parameters of scrotal scintigraphy and scrotal ultrasound to correctly and confidently diagnose the etiology of an acute scrotum in university hospital settings. Materials and Methods: This is an observational study with a retrospective analysis of data from July 2004 to March 2009. A total of 21 patients (age three years to 37 years) were referred from Emergency Department for scrotal scintigraphy to rule out testicular torsion. All patients went through a standard protocol for scrotal scintigraphy upon referral to Nuclear Medicine Department. Scrotal ultrasound was performed either before or immediately after the scintigraphy. Results: Confirmation of the diagnosis in all 21 patients was based either on the histopathological report of the surgical specimen (n=7) or through clinical follow up (for conservative treatment; n=14). At presentation, nine patients (43%) had left sided pain, and 12 patients (57%) had right sided pain (p>0.05). Eight patients (38%) were diagnosed to have testicular torsion on scintigraphy; one of them turned out to be false positive (testicular abscess). Sensitivity of scrotal scintigraphy to diagnose testicular torsion was 100%, specificity 93%, negative predictive value (NPV) 100% and positive predictive value (PPV) 88%. Conclusion: Scrotal scintigraphy in an acute scrotum is a feasible procedure to be performed on emergency basis, and it is a valid and reliable test to diagnose testicular torsion when US is doubtful or non conclusive

A COMPREHENSIVE REVIEW OF MACHINE LEARNING AND DEEP LEARNING APPLICATIONS IN CYBERSECURITY: AN INTERDISCIPLINARY APPROACH

Cybersecurity is increasingly becoming a critical concern as the complexity and frequency of cyber-attacks continue to rise. Machine learning (ML) and deep learning (DL) have emerged as powerful tools to enhance cybersecurity systems, offering dynamic capabilities in real-time threat detection, anomaly detection, and intrusion prevention. This article (45) presents a systematic review of the applications of ML and DL in cybersecurity, adhering to the PRISMA guidelines. The review covers several key domains, including network security, cloud security, and Internet of Things (IoT) security, highlighting how ML/DL models like convolutional neural networks (CNNs) and recurrent neural networks (RNNs) outperform traditional rule-based systems. It also addresses challenges such as adversarial attacks, data privacy concerns, and the computational resource demands of DL models. Current solutions like adversarial training, federated learning, and model optimization techniques are examined for their potential to mitigate these issues. The findings suggest that while ML/DL technologies hold great promise, further research and innovation are necessary to overcome the inherent challenges, ensuring that these systems can be deployed effectively and securely in real-world environments

Effects of Simulated Equestrian Therapy in improving Motor Proficiency among Down Syndrome Children- A Randomized Controlled Trial

International Journal of Exercise Science 17(1): 1193-1207, 2024. The objective of this study was to investigate the effectiveness of Simulated Equestrian Therapy and Neuro-Motor Therapy in improving Motor Proficiency among Down syndrome children using a double-blinded Randomized Controlled Trial. This study was conducted at Dar-ul-Sukun Institute and Dr. Ziauddin Hospital from April to September 2023 by enrolling a total of 56 participants with Down syndrome (DS) after obtaining informed, voluntary assent from the guardians of the participants. Each participant was allocated randomly to the treatment group (n = 28) that received Simulated Equestrian Therapy (SET) and the control group (n = 28) that received Neuro-motor Therapy (NMT) using the envelop method of simple random sampling. The participants and their guardians were blind to the allocations. Participants’ blood pressure and heart rate were recorded before and after each session to ensure safety. Each participant was assessed at baseline and after 6th and 12th week of intervention using Bruinink’s test of motor proficiency (BOT-2). The data was analyzed using Medcalc software. The results reveal significant findings for improving motor proficiency after 12th week of intervention of SET and NMT. No protocol was found to be superior to another in improvement of the tested parameters. Hence, our study concludes that SET and NMT effectively improve motor proficiency among DS children. However, studies with a follow-up period should be conducted to further evaluate these therapies’ long-term benefits

Design and Testing of DWT based Image Fusion System using MATLAB -Simulink

ABSTRACT: Image fusion is extracting the required information from the two input images. The resultant will be the complete featured images. This is done by averaging the two images. in this paper focusing on DWT with different filters are haar, biorthogonal and daubechies to measure the quality of the image .When PSNR performance is high with MSE is low ,image quality is good. The DWT filters gives the different PSNR value, by comparing the filters, daubechies filter is chosen as best. This design is analysed and tested in MATLAB SIMULINK R2012b.The model is generated using MATLAB software

A new modality of treatment for non-united fracture of the humerus in a patient with osteopetrosis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Osteopetrosis introduces technical limitations to the traditional treatment of fracture management that may be minimised with specific pre-operative planning. Extreme care and caution are required when drilling, reaming, or inserting implants in patients with osteopetrosis. Caution must be exercised throughout the postoperative course when these patients are at greatest risk for device failure or further injury.</p> <p>Case presentation</p> <p>We present our experience of treating such a fracture where a patient presented with a non-united fracture of the humerus. The bone was already osteoporotic. We successfully used a new technique which has not been described in the literature before. This included the use of a high-speed drill to prepare the bone for screw fixation. Bone healing was augmented with bone morphogenic protein.</p> <p>Conclusion</p> <p>This technique can give invaluable experience to surgeons who are involved in treating these types of fracture.</p

DISSOLUTION ENHANCEMENT OF DIACEREIN USING WATER SOLUBLE CARRIER BY SOLID DISPERSION TECHNOLOGY

Diacerein is generally used in the treatment of Osteoarthritis , this drug comes under the class anthraquinone. The drug is practically insoluble in water and exhibits exceptionally slow and intrinsic dissolution rate with poor bioavailability. In the present study, diacerein and β-cyclodextrin (β-CD) solid dispersions were prepared with a view to study the effect and influence of β-CD on the solubility and dissolution rate of this poorly aqueous soluble drug. Phase solubility profile revealed that the solubility of diacerein was significantly increased in the presence of β-CD and indicating the possible 1:1 stoichiometric inclusion complex with a stability constant of 339.66 M-1. Effect of variable such as drug: Carrier ratios were studied. Physical characterization of the solid dispersion was characterized by Fourier transform infrared spectroscopy (FT-IR), Differential scanning calorimetry (DSC) and X-ray diffraction studies (XRD). These studies revealed that a distinct loss of drug crystallinity in the solid dispersion is ostensibly accounting for enhancement of dissolution rate in distilled water containing 0.1% Tween 80. The scanning electron microscopy (SEM) study revealed that all the binary systems appeared as agglomerates and exhibiting the presence of a homogenous solid phase which could also be responsible for the enhanced dissolution rate in comparison with the pure drug. The drug release from the prepared solid dispersion exhibited a first order kinetics. Solid dispersion of diacerein showed a 7.66 times fold increase in dissolution rate over the pure drug

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Chemical pneumonitis and subsequent reactive airways dysfunction syndrome after a single exposure to a household product: a case report

<p>Abstract</p> <p>Introduction</p> <p>Household products are usually safe to use. Adverse events arising from their use are mostly reported in patients with pre-existing atopy or pulmonary problems and usually only after a prolonged exposure to such products. We report the case of a patient with no prior problems who developed significant side effects from a single exposure to a domestic product.</p> <p>Case presentation</p> <p>A 43-year-old Caucasian American man, previously in good health, used a domestic aerosol product called 'Stand N' Seal "Spray-On" Grout Sealer' in an enclosed room in his house. The product contained n-butyl acetate (<5%), propane (10%), isobutane (<5%), C8-C9 petroleum hydrocarbon solvent (80%), a fluoropolymer resin and a solvent. Within a few hours of exposure to the sealant, he developed rapidly progressive shortness of breath and a severe non-productive cough. By the time he reached the emergency room he was severely hypoxic. A diagnosis of chemical pneumonitis was made based on the clinical scenario and the diffuse infiltrates on the computer tomography scan. With supportive therapy, his condition improved and he was discharged from the hospital. However, he continued to have symptoms of intermittent cough and shortness of breath in response to strong odours, fumes, cold air and exertion even after his chest radiograph had normalized. Three months later, bronchial hyper-responsiveness was documented by a methacholine inhalation test and a diagnosis of reactive airways dysfunction syndrome was made. The patient was started on high-dose inhaled steroids and his symptoms improved. The mechanism of toxicity and determination of the exact agent responsible is still under investigation.</p> <p>Conclusion</p> <p>A household product may still prove unsafe to use even after it has gone through vigorous testing and approval processes. Even healthy individuals are susceptible to adverse outcomes after a brief exposure. Extra precautions should be taken when using any chemical product at home.</p

Challenges and Considerations in Assessing GERD: A Critical Review of a Study in Southern Punjab, Pakistan [Response to Letter]

Muhammad Fawad Rasool,1 Rimsha Sarwar,1 Muhammad Subhan Arshad,1,2 Imran Imran,3 Hamid Saeed,4 Abdul Majeed,1 Muqarrab Akbar,5 Muhammad Omer Chaudhry,6 Anees Ur Rehman,1 Waseem Ashraf,3 Tanveer Ahmad,7 Waleed Badoghaish,8 Faleh Alqahtani9 1Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan; 2Department of Pharmacy, Southern Punjab Institute of Health Sciences, Multan, 60000, Pakistan; 3Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan; 4University College of Pharmacy, Allama Iqbal Campus, University of the Punjab, Lahore, 54000, Pakistan; 5Department of Political Science, Bahauddin Zakariya University, Multan, 60800, Pakistan; 6School of Economics, Bahauddin Zakariya University, Multan, 60800, Pakistan; 7Institute for Advanced Biosciences (Iab), CNRS UMR5309, INSERM U1209, Grenoble Alpes University, La Tronche, 38700, France; 8Department of Internal Medicine, College of Medicine, University of Tabuk, Tabuk, 71411, Saudi Arabia; 9Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi ArabiaCorrespondence: Muhammad Fawad Rasool; Faleh Alqahtani, Email [email protected]; [email protected]

Comparison of Sonographic Quantitative Assessment of Splenomegaly in Thalassemia Patients Receiving Whole Blood and Packed Red Cell Transfusions

Objective: An observational cross-sectional study to assess sonographic splenomegaly quantitatively in thalassemia patients grouped with respect to transfusion given whole blood vs packed red cells. Methods: A study was conducted among 330 patients equally divided into two groups, undergoing an abdominal ultrasound examination with a transducer frequency ranging from 3-5 MHz during the period December 2021 to August 2022. An independent t-test was applied to compare the splenic volume in thalassemia patients given whole blood transfusions versus packed red cells transfusions, and Cohen's d was used to indicate the standardized difference between two ultrasound splenic volume means. Results: The mean splenic volume of the patients who received whole blood cells was 320.62 ± 219.05 cm3, which is greater than the patients who received packed red cells, whose mean was 60.72 ± 58.72 cm3, The splenomegaly was quantitatively assessed in six age groups ranging from 1 to 3 years, 4 to 6 years, 7 to 9 years, 10 to 12 years, 13 to 15 years, and 16-18 years and mean splenic volume in each age group was compared to those receiving whole blood or packed red cells transfusion. there is a statistically significant difference between both transfusion receiving groups, having a larger Cohen’s d size effect of 1.62. Conclusion: Ultrasound is a reliable imaging modality for assessing splenic volume and linear parameters of the spleen with greater splenomegaly in thalassemia patients with whole blood transfusions than those with packed red cells when quantitatively assessed according to relevant age groups. Thalassemia patients should be transfused packed red cells to delay splenomegaly, that should be assessed sonographically