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Introduction: Bowel cancer is a significant global health concern, ranking as the third most prevalent cancer worldwide. Laparoscopic resections have become a standard treatment modality for resectable colorectal cancer. This study aimed to compare the clinical and oncological outcomes of medial to lateral (ML) vs lateral to medial (LM) approaches in laparoscopic colorectal cancer resections. Methods: A retrospective cohort study was conducted at a UK district general hospital from 2015 to 2019, including 402 patients meeting specific criteria. Demographic, clinical, operative, postoperative, and oncological data were collected. Participants were categorised into LM and ML groups. The primary outcome was 30-day complications, and secondary outcomes included operative duration, length of stay, lymph node harvest, and 3-year survival. Results: A total of 402 patients (55.7% males) were included: 102 (51.6% females) in the lateral mobilisation (LM) group and 280 (58.9% males) in the medial mobilisation (ML) group. Right hemicolectomy (n=157, 39.1%) and anterior resection (n=150, 37.3%) were the most performed procedures. The LM group had a shorter operative time for right hemicolectomy (median 165 vs. 225 min, P<0.001) and anterior resection (median 230 vs. 300 min, P<0.001). There was no significant difference between the two groups in terms of wound infection (P=0.443), anastomotic leak (P=0.981), postoperative ileus (P=0.596), length of stay (P=0.446), lymph node yield (P=0.848) or 3-year overall survival rate (Log-rank 0.759). Discussion: The study contributes to the limited evidence on ML vs LM approaches. A shorter operative time in the LM group was noted in this study, contrary to some literature. Postoperative outcomes were comparable, with a non-significant increase in postoperative ileus in the LM group. The study emphasises the safety and feasibility of both approaches.

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BACKGROUND & AIMS: Chronic migraine poses a global health burden, particularly affecting young women, and has substantial societal implications. This study aimed to assess the efficacy of Greater Occipital Nerve Block (GONB) in individuals with chronic migraine, focusing on the impact of local anesthetics compared with placebo. METHODS: A meta-analysis and systematic review were conducted following the PRISMA principles and Cochrane Collaboration methods. Eligible studies included case-control, cohort, and randomized control trials in adults with chronic migraine, adhering to the International Classification of Headache Disorders, third edition (ICHD3). Primary efficacy outcomes included headache frequency, duration, and intensity along with safety assessments. RESULTS: Literature searches across multiple databases yielded eight studies for qualitative analysis, with five included in the final quantitative analysis. A remarkable reduction in headache intensity and frequency during the first and second months of treatment with GONB using local anesthetics compared to placebo has been reported. The incidence of adverse events did not differ significantly between the intervention and placebo groups. CONCLUSION: The analysis emphasized the safety and efficacy of GONB, albeit with a cautious interpretation due to the limited number of studies and relatively small sample size. This study advocates for further research exploring various drugs, frequencies, and treatment plans to enhance the robustness and applicability of GONB for chronic migraine management.

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In this paper, we investigate the optimal conditions to the boundaries where the unique existence of the solutions to an advection-diffusion-reaction equation is secured by applying the contraction mapping theorem from the study of fixed points. Also, we extract, traveling wave solutions of the underlying equation. To this purpose, a new extended direct algebraic method with traveling wave transformation has been used. Achieved soliton solutions are different functions which are hyperbolic, trigonometric, exponential, and some mixed trigonometric functions. These functions show the nature of solitons. Two and three-dimensional plots are drawn using different values of parameters and coefficients for the comparison and behavior of solitons as combined bright-dark, dark, and bright solitons.

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Objective: To compare the functional and radiological outcomes of treatment of volar Barton's fractures using T plate with and without distal end screws. Methods: This randomized control trial was conducted at the department of Orthopedics, Mayo Hospital, Lahore, Pakistan from December 2021 to May 2022. Total 60 patients (30 in each group) were randomly allocated to either group A (T-Plate with distal end screws) or B (T-Plate without distal end screws). Patients were followed up on day-0, day-14, day-28 and day-90. Assessments of patients were done by Green O'Brien Score for pain, Modified Warden Score for callus formation on radiographs at 12-weeks of follow-up and Stewart Score for displacement of fracture. Results: At 90th day, significant difference was seen in Green O'Brien Score (Excellent score: Group-A: 80% vs. Group-B: 90%, p=0.278) while Stewart scores remained comparable (Excellent Score: Group-A: 93.33% vs. Group-B: 96.67%, p=0.221) between treatment groups. Fracture healing assessed with Modified Warden score for score 4 did not show significant difference between both groups at 90th day. i.e. (Group-A: 96.67% vs. Group-B: 96.67%). However, callus formation assessed with Modified Warden score for score 3 showed significant differences between groups at 90th day. i.e. (Group-A: 53.33% vs. Group-B: 86.67%, p=0.001). Conclusion: Both treatment approaches appear to yield comparable outcomes in terms of clinical assessment, Stewart scores, and fracture healing, with a potential advantage for T-plate without distal end screw in callus formation at the 90th day.Trial registration: IRCT20221231056999N1.

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A serious eye condition called cataracts can cause blindness. Early and accurate cataract detection is the most effective method for reducing risk and averting blindness. The optic nerve head is harmed by the neurodegenerative condition known as glaucoma. Machine learning and deep learning systems for glaucoma and cataract detection have recently received much attention in research. The automatic detection of these diseases also depends on deep learning transfer learning platforms like VeggNet, ResNet, and MobilNet. The authors proposed MobileNetV1 and MobileNetV2 based on an optimized architecture building lightweight deep neural networks using depth-wise separable convolutions. The experiments used publicly available data sets with both cataract & normal and glaucoma & normal images, and the results showed that the proposed model had the highest accuracy compared to the other models.

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This study aimed at co-encapsulating borage seed oil (BSO)- and peppermint oil (PO) blends in ultrasound-assisted complex nanoparticles stabilized by soy protein isolate (SPI) and purity gum ultra (PGU) in different ratios: SPI/PGU-1:0 (NP1), 0:1 (NP2), 1:1 (NP3), 1:3 (NP4), and 3:1 (NP5). The BSO- and PO-loaded SPI/PGU complex nanoparticles (BP-loaded SPNPs) coded as NP4 (SPI-PGU-1:3) revealed a zeta potential of -33.27 mV, a PDI of 0.14, and the highest encapsulation efficiency (81.38 %). The main interactions observed among SPI, PGU, BSO, PO, and a blend of BSO and PO, as determined by FTIR and molecular docking, involved hydrophobic effects, electrostatic attraction, and H-bonding. These interactions played crucial roles in the production of BP-loaded SPNPs. XRD results validated the alterations in the structure of BP-loaded SPNPs caused by varying proportions of SPI and PGU. The thermal capacity of BP-loaded SPNPs (NP4), as determined by TGA, exhibited the lowest amount of weight loss compared to other BP-loaded SPNPs. Morphological results revealed that NP4 and NP5 exhibited a spherical surface and two distinguishable layers, indicating successful coating of PGU onto the droplet surface. In addition, BP-loaded SPNPs (NP4) exhibited a higher antioxidant effect due to their improved progressive release and prolonged release of co-encapsulated BSO and PO during in vitro digestion. The comprehensive investigation of the co-encapsulation of BSO and PO in complex nanoparticles, dietary supplements, and double-layered emulsified systems provides valuable insights into the development of functional foods.

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OBJECTIVE: To evaluate the early detection of vascular obstruction in microvascular flaps using a thermographic camera. STUDY DESIGN: A cross-sectional study. Place and Duration of the Study: Department of Plastic Surgery, Jinnah Burn and Reconstructive Surgery Centre, Lahore, Pakistan, from July to December 2023. METHODOLOGY: Microvascular flaps with cutaneous islands were monitored postoperatively with a thermographic camera in addition to conventional clinical methods. The decision to re-explore was based on conventional methods, and confirmation was achieved through intraoperative findings of vascular obstruction during re-exploration. RESULTS: Thirty-one patients who underwent microvascular surgery were monitored postoperatively with a thermographic camera. There were 20 (64.5%) anterolateral thigh flaps, 4 (12.9%) radial forearm flaps, 3 (9.7%) scapular-parascapular flaps, 1 (3.2%) medial plantar flap, 1 (3.2%) myocutaneous gracilis flap, 1 (3.2%) latissimus dorsi (LD) flap, and 1 (3.2%) chimeric adductor longus and gracilis flap. Three (9.7%) flaps developed postoperative vascular obstruction. The thermographic camera detected complications two to four hours earlier than conventional methods, with a statistically significant difference (p >0.109). CONCLUSION: A thermographic camera is a valuable, non-invasive, and simple tool for monitoring microvascular flaps. It can detect complications several hours earlier and has the potential to be a practice-changing modality. KEY WORDS: Microvascular flaps, Thermographic camera, Vascular obstruction.

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OBJECTIVE: To compare oral pregabalin with oral sertraline for treatment of uraemic pruritus. STUDY DESIGN: Randomised controlled trial. Place and Duration of the Study: Department of Nephrology, Pak Emirates Military Hospital Rawalpindi, Pakistan, from October 2023 to January 2024. METHODOLOGY: Patients with end-stage renal disease having pruritus for at least 6 weeks were included. Exclusion criteria comprised other dermatological or systemic diseases associated with pruritus, mental health issues, thrice-a-week haemodialysis schedule, and use of other treatments for uraemic pruritus. They were randomised to receive either pregabalin 75mg daily or sertraline 50mg daily for six weeks using computer-generated sequences. The Urdu version of the 5-D Itch scale was used to document the severity of pruritus at the baseline and at the end of therapy. Side effects to the treatment were also monitored. RESULTS: There were 8 (16.67%) females and 40 (83.33%) males, with a mean age of 52.19 ± 12.19 years. The baseline 5-D Itch scale scores were equal in both groups. Mean improvement in 5-D Itch scale scores was 3.75 ± 1.26 and 2.08 ± 1.18 with pregabalin and sertraline, respectively (p <0.001). Side effects were reported by 2 (8.33%) patients on pregabalin and none using sertraline (p = 0.489). CONCLUSION: Pregabalin was found to be more effective than sertraline in treating uraemic pruritus, though with a statistically insignificant trend towards a higher frequency of side effects. KEY WORDS: Chronic renal failure, Pruritus, Renal dialysis, Selective serotonin reuptake inhibitors, Uraemia.

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The murine model is invaluable for studying intricate interactions among gut microbes; hosts; and diseases. However; the impact of genetic variations in the murine microbiome; especially in disease contexts such as Klebsiella pneumoniae (Kp) infection; still needs to be explored. Kp; an opportunistic global pathogen; is becoming increasingly prevalent in regions like Asia; especially China. This study explored the role of the gut microbiota during Kp infection using mouse model; including wild-type and rpoS mutants of Kp138; KpC4; and KpE4 from human; maize; and ditch water; respectively. Under stress conditions; RpoS reconfigures global gene expression in bacteria; shifting the cells from active growth to survival mode. Our study examined notable differences in microbiome composition; finding that Lactobacillus and Klebsiella (particularly in WKp138) were the most abundant genera in mice guts at the genus level in all wild-type treated mice. In contrast; Firmicutes were predominant in the healthy control mice. Furthermore; Clostridium was the dominant genus in all mutants; mainly in ∆KpC4; and was absent in wild-type treated mice. Differential abundance analysis identified that these candidate taxa potentially influence disease progression and pathogen virulence. Functional prediction analysis showed that most bacterial groups were functionally involved in biosynthesis; precursor metabolites; degradation; energy generation; and metabolic cluster formation. These findings challenge the conventional understanding and highlight the need for nuanced interpretations in murine studies. Additionally; this study sheds light on microbiome-immune interactions in K. pneumoniae infection and proposes new potential therapeutic strategies.

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Diabetic foot is one of the complications in type 2 diabetes mellitus. Adequate knowledge and practice are an important aspect to control further deteriorating conditions such as ulcers and amputations. Thus, the objective of this cross-sectional study was to investigate the impact of the education levels of diabetic patients on diabetic foot care knowledge and practice. This cross-sectional study with a convenient sampling technique was conducted on 534 patients with diabetes mellitus from public and private care hospitals. The data was collected using a validated, pretested and structured bilingual (Arabic, English) questionnaire. There were 534 patients interviewed, 39.1% of whom were males and 60.9% of whom were females and 61.4% of the patients had had T2DM for over 10 years. There was a significant difference in education levels between the male and female patients (53.8% and 46.2%, P = .001). Furthermore, 83.9% patients were married. The difference in education between the married and the single, divorced, and widowed patients was significant (P = .007). Patients with uncontrolled HbA1c were 2.43 times more likely to have hypertension (RR = 2.43, P = .03), while patients with highly uncontrolled diabetes had 3.1 times more chances of hypertension (RR = 3.1, P = .009). Heart disease prevalence was 3.27 times higher in diabetes patients with uncontrolled HbA1c and 3.37 times higher in patients with highly uncontrolled HbA1c. Patients with diabetes who have been diabetic for more than 10 years have a greater risk of heart disease (RR = 2.1; P = .03). Patients with lower education levels exhibited more diabetic complications compared to patients with higher education levels (P < .05). The present study highlights the importance of education and awareness campaigns targeting diabetic patients, especially those with lower education levels, to improve diabetes control and prevent, or manage, comorbidities. Healthcare providers should also prioritize patient education and medication adherence to improve diabetes management and reduce the risk of complications.

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[This corrects the article DOI: 10.1371/journal.pone.0295116.].

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Genome analysis of individuals affected by retinitis pigmentosa (RP) identified two rare nucleotide substitutions at the same genomic location on chromosome 11 (g.61392563 [GRCh38]), 69 base pairs upstream of the start codon of the ciliopathy gene TMEM216 (c.-69G>A, c.-69G>T [GenBank: NM_001173991.3]), in individuals of South Asian and African ancestry, respectively. Genotypes included 71 homozygotes and 3 mixed heterozygotes in trans with a predicted loss-of-function allele. Haplotype analysis showed single-nucleotide variants (SNVs) common across families, suggesting ancestral alleles within the two distinct ethnic populations. Clinical phenotype analysis of 62 available individuals from 49 families indicated a similar clinical presentation with night blindness in the first decade and progressive peripheral field loss thereafter. No evident systemic ciliopathy features were noted. Functional characterization of these variants by luciferase reporter gene assay showed reduced promotor activity. Nanopore sequencing confirmed the lower transcription of the TMEM216 c.-69G>T allele in blood-derived RNA from a heterozygous carrier, and reduced expression was further recapitulated by qPCR, using both leukocytes-derived RNA of c.-69G>T homozygotes and total RNA from genome-edited hTERT-RPE1 cells carrying homozygous TMEM216 c.-69G>A. In conclusion, these variants explain a significant proportion of unsolved cases, specifically in individuals of African ancestry, suggesting that reduced TMEM216 expression might lead to abnormal ciliogenesis and photoreceptor degeneration.

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Newcastle disease virus (NDV) is a highly infectious viral disease that impacts birds globally, especially domestic poultry. NDV is a type of avian paramyxovirus which poses a major threat to the poultry industry due to its ability to inflict significant economic damage. The membrane protein, Hemagglutinin-Neuraminidase (HN) of NDV is an attractive therapeutic candidate. It contributes to pathogenicity through various functions, such as promoting fusion and preventing viral self-agglutination, which allows for viral spread. In this study, we used pharmacophore modeling to identify natural molecules that can inhibit the HN protein of NDV. Physicochemical characteristics and phylogenetic analysis were determined to elucidate structural information and phylogeny of target protein across different species as well as members of the virus family. For structural analysis, the missing residues of HN target protein were filled and the structure was evaluated by PROCHECK and VERIFY 3D. Moreover, shape and feature-based pharmacophore model was employed to screen natural compounds' library through numerous scoring schemes. Top 48 hits with 0.8860 pharmacophore fit score were subjected towards structure-based molecular docking. Top 9 compounds were observed witihin the range of -8.9 to -7.5 kcal/mol binding score. Five best-fitting compounds in complex with HN receptor were subjected to predict biological activity and further analysis. Top two hits were selected for MD simulations to validate binding modes and structural stability. Finally, upon scrutinization, A1 (ZINC05223166) emerges as potential HN inhibitor to treat NDV, necessitating further validation via clinical trials.

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This work examines the (2+1)-dimensional Boiti-Leon-Pempinelli model, which finds its use in hydrodynamics. This model explains how water waves vary over time in hydrodynamics. We provide new explicit solutions to the generalized (2+1)-dimensional Boiti-Leon-Pempinelli equation by applying the Sardar sub-equation technique. This method is shown to be a reliable and practical tool for solving nonlinear wave equations. Furthermore, different types of solitary wave solutions are constructed: w-shaped, breather waved, chirped, dark, bright, kink, unique, periodic, and more. The results obtained with the variable coefficient Boiti-Leon-Pempinelli equation are stable and different from previous methods. As compared to their constant-coefficient counterparts, the variable-coefficient models are more general here. In the current work, the problem is solved using the Sardar Sub-problem Technique to produce distinct soliton solutions with parameters. Plotting these graphs of the solutions will help you better comprehend the model. The outcomes demonstrate how well the method works to solve nonlinear partial differential equations, which are common in mathematical physics.With the help of this method, we may examine a variety of solutions from significant physical perspectives.

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Tick infestation poses an important challenge to livestock in Pakistan. Farm management practices and environmental variables can influence tick infestation prevalence in animals. To this end, a cross-sectional survey of 96 farms in four different geographical districts (24 farms from each district) was conducted in Punjab, Pakistan, between October 2021 and January 2022. An epidemiological questionnaire was designed focusing on farm management practices and their impact on tick infestations at these farms. Data were collected via in-person interviews. Regional and farm-specific variables' associations were evaluated using Pearson's chi-square test and Fischer's exact test, respectively. A multivariable logistic regression model was used to identify significant risk factors. This study identified that using soft bedding materials, e.g., wheat straw, leaf litter or plain soil posed a significant risk of tick infestation. Additionally, the absence of quarantine measures, open sheds and inadequate drainage were found as contributing factors in univariable analysis. Higher tick prevalence in the hotter seasons highlighted the influence of Punjab's extreme weather on tick infestation. Despite regular veterinary visits and the use of acaricidal drugs, the prevalence of tick infestation at these farms suggested potential drug resistance in the ticks. The study recommended establishing quarantine practices, improving farms' drainage systems and bedding and using a combination of chemical and traditional remedies to tackle drug resistance in ticks. Education and awareness programs on tick-borne diseases and control measures are advocated to reduce the tick infestation burden on animals. Further research on longitudinal studies to better understand tick population dynamics and develop effective acaricides is encouraged. This called for collaborative control efforts among farmers, veterinarians and research institutions.

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In developing countries, smart grids are nonexistent, and electricity theft significantly hampers power supply. This research introduces a lightweight deep-learning model using monthly customer readings as input data. By employing careful direct and indirect feature engineering techniques, including Principal Component Analysis (PCA), t-distributed Stochastic Neighbor Embedding (t-SNE), UMAP (Uniform Manifold Approximation and Projection), and resampling methods such as Random-Under-Sampler (RUS), Synthetic Minority Over-sampling Technique (SMOTE), and Random-Over-Sampler (ROS), an effective solution is proposed. Previous studies indicate that models achieve high precision, recall, and F1 score for the non-theft (0) class, but perform poorly, even achieving 0 %, for the theft (1) class. Through parameter tuning and employing Random-Over-Sampler (ROS), significant improvements in accuracy, precision (89 %), recall (94 %), and F1 score (91 %) for the theft (1) class are achieved. The results demonstrate that the proposed model outperforms existing methods, showcasing its efficacy in detecting electricity theft in non-smart grid environments.

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Background and objectives Obesity is a major global health concern linked with increased risk of chronic diseases. This study aimed to assess the levels of fibroblast growth factor 21 (FGF21) in subjects with obesity after gastric sleeve surgery and explore its correlation with lipid and glycemic parameters. Methods This retrospective cohort study included 28 obese male subjects aged 25 to 50 years, undergoing gastric sleeve surgery. Plasma levels of FGF21 were measured by enzyme-linked immunosorbent assay (ELISA) before and six to 12 months after surgery. Other parameters including body mass index (BMI), fasting glucose, lipid profile, and insulin were also assessed and homeostatic model assessment (HOMA) was used to estimate insulin resistance. Results There was a significant increase in systemic FGF21 levels after surgery (45.12 vs. 126.16 pg/mL, p = 0.007). There was also a notable reduction in BMI (51.55 vs. 39.14, p < 0.001), insulin levels (20.06 vs. 8.85 mIU/L, p < 0.001), HOMA scores (6.94 to 2.49, p < 0.001), and glucose levels (7.33 vs. 6.08, p = 0.039). Lipid profile analysis post-surgery showed an increase in total cholesterol (4.38 vs. 5.09 mmol/L, p < 0.001) and high-density lipoprotein (HDL) (0.88 vs. 1.52 mmol/L, p < 0.001), with a decrease in triglycerides (1.75 vs. 1.01 mmol/L, p = 0.007). FGF21 positively correlated with growth hormone (GH), p = 0.0015, r = 0.59, and with insulin like growth factor 1 (IGF-1), p = 0.03, r = 0.431. Conclusion FGF21 levels were increased following gastric sleeve surgery in obese male patients and were positively correlated with growth hormone and insulin IGF-1. These findings provide insights into the metabolic alterations following bariatric surgery and highlight the potential role of FGF21 as an important molecule in obesity management and treatment.

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Lumpy skin disease (LSD) is a critical problem for cattle populations, affecting both individual cows and the entire herd. Given cattle's critical role in meeting human needs, effective management of this disease is essential to prevent significant losses. The study proposes a deep learning approach using the MobileNetV2 model and the RMSprop optimizer to address this challenge. Tests on a dataset of healthy and lumpy cattle images show an impressive accuracy of 95%, outperforming existing benchmarks by 4-10%. These results underline the potential of the proposed methodology to revolutionize the diagnosis and management of skin diseases in cattle farming. Researchers and graduate students are the audience for our paper.

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Objectives: In Pakistan, the degradation of drinking water quality is exacerbated by the increasing population size and rapid industrialization. Contaminated water serves as the predominant source of numerous diseases, including diarrhea, gastroenteritis, and typhoid. This article explores the evolution of waterborne diseases across 21 districts of the Khyber Pakhtunkhwa province in Pakistan by monitoring changes in the clustering solutions. Methods: The data employed in this study were sourced from 21 districts of KP by the Director-General Health Services. Cluster analysis was utilized to uncover patterns in waterborne disease incidence, while principal component analysis was employed to reveal underlying patterns and reduce dimensionality. Additionally, the MONItoring Clusters (MONIC) framework was applied for change detection, facilitating the identification of significant shifts in disease patterns over time and aiding in the understanding of temporal dynamics. Results: Our analysis indicates that two clusters survived consistently over time, while other clusters exhibited inconsistency. Profiling of the surviving clusters (C12 → C24 → C32 → C43) suggests a gradual increase in cases of bloody diarrhea in the Swat Valley, Hangu, Karak, and Lakki Marwat regions. Similarly, profiling of the surviving clusters (⊙→ C22 → C34 → C44) suggests an increase in the acute watery diarrhea (non-cholera) and typhoid fever in the regions of Peshawar, Nowshera, and Swabi. Conclusion: The findings of this study hold significant importance as they pinpoint the most vulnerable regions for various waterborne diseases. These insights offer valuable guidance to policymakers and health officials, empowering them to implement effective measures for controlling waterborne diseases in the respective regions of Khyber Pakhtunkhwa, Pakistan.

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Electronic and structural properties of calcium clusters with a varying size range of 2-20 atoms are studied using a two-step scheme within the GW and density functional theory (DFT) with generalized gradient approximation (GGA). The GGA overestimates the binding energies, optimized geometries, electron affinities, and ionization potentials reported in the benchmark. The ground-state structure geometry and binding energy were obtained from the DFT for the ground-state structure of each cluster. The binding energy of the neutral clusters of the calcium series follows an increasing trend, except for a few stable even and odd clusters. The electronic properties of the calcium cluster were studied with an all-electron FHI-aims code. In the G 0 W 0 calculation, the magic cluster Ca10 has relatively high ionization potential and low electron affinity. The obtained ionization potentials from the G 0 W 0 @PBE calculation showed that the larger cluster has less variation, whereas the electron affinities of the series have an increasing trend. The ionization potentials from the G 0 W 0 benchmark for the calcium cluster series have not yet been described in the literature.