This prospective cohort study was conducted from July 2013 to May 2019. The functional and radiological outcome in displaced, neglected fracture of lateral condyle of the humerus treated with open reduction and internal fixation (ORIF) with Kirschner wire was assessed. The sample size was 44 children aged between 2 to 15 years Milch type I and II displaced lateral condyle of humerus fracture, four weeks and older were included. Carrying angle and infection was assessed clinically. Union and elbow functions were evaluated radiologically using the Mayo elbow score. The mean age of the children was 6.82 ± 2.83 years. Fracture was Milch type I in 11 (25%), and type II in 33 (75%). Pre- and post-operatively, Mayo elbow score was 3.63 ± 0.57 and 1.56 ± 0.50, respectively. Good to excellent functional outcome, and union was observed in delayed presenting lateral condyle of humerus fractures. Key Words Lateral condyle humerus, Children, Delayed presentation, Mayo elbow score.The objective of the study was to determine whether Hounsfield Unit density would differentiate between cholesteatoma and other causes of opacification, such as granulation tissue in previously operated ears. Temporal bone computer tomography (CT) scans of 47 patients, who had revision mastoid surgeries, were evaluated retrospectively. A circular 5 mm2 region of interest (ROI) was placed at aditus ad antrum to measure Hounsfield Unit (HU) density. There was no statistically significant difference between cholesteatoma and non-cholesteatoma groups in terms of HU densities. Intraclass correlation coefficient test showed an intraclass correlation of 0.41 between measurements done by radiologists and otorhinolaryngologists, which showed poor reliability. Contrary to previous studies in unoperated ears, in operated ears HU density at aditus level cannot be a reliable diagnostic adjunct. Moreover, when it is considered that interrater reliability was poor between radiologists’ and otolaryngologists’ measurements, a need for further studies arise to solidify findings in this study. Key Words Cholesteatoma diagnostic imaging, Middle ear surgery, Revision mastoidectomy.Bronchial mucoepidermoid carcinoma is a rare disease in the field of thoracic surgery, and it is even more rarer in children. A 10-year Chinese child whose chief complaint was intermittent fever and cough for one year was referred to our hospital. Based on the imaging, pathology and immunohistochemistry findings, the patient was diagnosed with right inferior lobar bronchial mucoepidermoid carcinoma; and was treated with video-assisted thoracoscopic (VATS) right inferior lobe resection and had a good prognosis. Key Words Mucoepidermoid carcinoma, Child, Lobe resection, VATS.In this case report we describe a case of a 13-year male with neurofibromatosis type-1, who had been suffering from progressive thoracic kyphoscoliosis that resulted in spinal cord compression and paraplegia. The report is meant to highlight the importance of timely detection and adequate follow-up of spinal deformities, associated with neurofibromatosis. Such deformities, if not effectively addressed, may progress corresponding to skeletal growth and lead to secondary problems, as was seen in our patient, who ultimately developed paraplegia. Key Words Neurofibromatosis, Kyphoscoliosis, Paraplegia.Multiple carboxylase deficiency organic Acidemia is a rare inherited metabolic disorder. It is autosomal recessive disorder of two types Holocarboxylase deficiency and Biotinidase deficiency. It is the metabolic disorder resulting from deficiency of biotin as a co-enzyme or reduced activity of biotin-dependent carboxylases (propionyl CoA carboxylase, and 3-methylcrotonyl CoA carboxylase and pyruvate carboxylase). A case of two months’ female child is reported, who presented with recurrent infantile seizures and skin rash since birth; and biochemically with metabolic acidosis, hyper-ammonemia (on and off) since birth with multiple hospitalization. She had past history of jaundice. One sibling’s death at 2nd day of life due to similar complaints. Initial presentation of raised ammonia and lactate levels were the first indication to this organic academia, which was later proven by increased peak levels of various organic acids on urine organic acid analysis by gas chromatography-mass spectrometry. Key Words Multiple carboxylase deficiency, Holocarboxylase synthetase deficiency, Biotinidase deficiency.Isolated sphenoid sinus mucocoeles are rare; whereas, benign lesions usually discovered incidentally. These may present with headache, diplopia, visual loss or ocular motor nerve palsies, due to slow expansion and mass effects. Prompt endoscopic removal is the key to prevent permanent sequelae. We present the case of a 63-year femele, who presented with sudden loss of vision of the left eye, along with periorbital and retrobulbar pain for the last one month. She was found to have „no light perception” vision in the left eye and optic atrophy. Neuroimaging was performed, which revealed a sphenoid sinus mucocoele, impinging on the left optic nerve. Our ENT Department performed endoscopic sinus surgery and removed it, but her vision did not return at 6-month follow-up. Although very rare, sphenoid sinus mucocoeles should be considered in the differential diagnosis of any patient, who presents with sudden visual loss. Key Words Sphenoid sinus, Mucocoele, Optic neuropathy, Visual loss.To implement and evaluate a simplified, rapid, single-day emergency management technique for pediatric mandibular fractures, the author applied the current technique of using combined lingual splint with Risdon wiring under sedation anesthesia as a cohort study in a group of pre-school mandibular fracture children aged 4 to 6 years. Clinical outcome variables were fixation length and reduction simplicity, post-reduction occlusion, recovery of mouth opening, and degree of postoperative edema and pain. Age, gender, fracture site and the cause of injury were other study variables. The study involved 11 children suffering from a mandibular fracture in the dental bearing region. The majority of them were males with a proportion of 72.7%. The clinical results obtained from the combined technique were promising in terms of rapid surgical duration, simplicity of fracture reduction, decreased postoperative pain and edema, rapid recovery of mouth opening without a recorded complication. It could be concluded that combining Risdon wiring with lingual splint is a simple, fast, and reliable fixation technique for managing pre-school mandibular pediatric fractures. Key Words Lingual splint, Pediatric, Mandibular, Fracture.This study explored the relationship between the pretreatment systemic immune-inflammation index (SII) and overall survival (OS) in gastric cancer (GC) patients. A systemic literature search was performed to find out the articles that estimated the relationship of SII with specific clinical parameters and OS in GC patients. Nine articles (including 10 studies) were included. A total of 3,850 cases were eventually included. In GC patients, there was no association between pretreatment SII and gender (OR=0.991, p=0.944) or differentiation (OR=1.093, p=0.687). However, pretreatment SII was related to depth of tumor invasion (OR=0.340, p less then 0.001), lymph node metastasis (OR=0.447, p less then 0.001) and TNM stage (OR=0.361, p less then 0.001) in GC patients. The ORs of 1-year, 3-year and 5-year OS were 0.467 (I2=0.0%; p=0.682), 0.355 (I2=85.6%; p less then 0.001) and 0.507 (I2=56.4%; p=0.057). The pretreatment SII could be used as an indicator of the depth of tumor invasion, lymph node metastasis, TNM stage and overall of gastric cancer patients. However, more multi-centres researches are needed to confirm these findings. Key Words Systemic immune-inflammation index (SII), Prognosis, Gastric cancer.

To determine the association of peripheral blood counts (cytopenia and normal counts) with bone marrow findings in patients with malignant neoplasms.

Descriptive study. Place and Duration of the Study King Edward Medical University from 2017 to 2019.

Patients having malignant diseases, of both gender and all ages, were included. Clinical data and results of bilateral bone marrow aspiration and biopsy were noted. Results were categorised as groups with bone marrow infiltration, normal morphology with normal cellularity and normal morphology with decreased cellularity. Results were analysed using SPSS V21 applying Chi-square test, keeping the confidence interval 95% and p-value of <0.05 as significant.

A total of 157 patients were included (107 men, 50 women). The main categories of neoplasm included non-Hodgkin’s lymphoma [93 (59.2%)] Hodgkin’s lymphoma [31 (19.7%)], and solid organ malignancy [33 (21.0%]. Bone marrow infiltration was seen in 50 (31.8%) patients, normal morphology with decreased celtaging and selection of treatment options. Key Words Peripheral blood counts, Bone marrow infiltration, malignant neoplasms, bone marrow hypocellularity.

To determine the factors, management and outcome of colorectal tumors presenting at Emergency Department, Mayo Hospital, Lahore.

Observational study.

Accident & Emergency Department, Mayo Hospital, Lahore, from August 2017 to July 2019.

Conducted on 40 consecutive patients who presented in the Accident and Emergency Department, Mayo Hospital, Lahore; determined to have colon or rectal cancer as the cause of intestinal obstruction or perforation, were studied. Data was abstracted from patient charts. Studied variables included patient’s demographic data, indication for admission, surgical procedure done, complications, histopathology and mortality rate.

Forty patients underwent operations of colon and rectum during the study period. Mean age at presentation was 37.8 ± 16.7 years. Intestinal obstruction (75%) was the main presenting symptom. Ascending colon was the main site involved (50%), followed by recto-sigmoid mass (15%) and rectal mass (12.5%); 80% patients subjected to the stoma formation.and ascending colon cancers were more frequent among such cases. Most patients had to undergo stoma formation in emergency. Mortality is significantly associated with higher ASA score, absence of screening colonoscopy and postoperative medical complications. Key Words Colorectal carcinoma, Adenocarcinoma, Ascending colon, Wound infection, Emergency, Young males, Screening colonoscopy, ASA score.

To describe the short-term results of mini-gastric bypass (MGB), the complications in patients who underwent mini-gastric bypass surgery (MGB), and evaluate the value of the neutrophil to lymphocyte ratio (NLR) in predicting complications at an early stage.

A descriptive, analytical study.

Elazığ Medical Park Hospital, Elazığ, Turkey from January, 2016 to July 2019.

Data of patients who had undergone MGB for morbid obesity at the Department of Surgery, Medical Park Hospital, Elazığ, Turkey from January 2016 to July 2019 were retrospectively evaluated. Demographic characteristics, preoperative body weight, body mass index (BMI), weight change after surgery, and postoperative complications were evaluated. The collected data were statistically analysed. The Kolmogorov-Smirnov and Shapiro-Wilk tests were used to evaluate the data distribution. Results A total of 95 patients were included in the study. The median preoperative BMI was 40.7 kg/m2 (40.2-42.5), the median NLR was 2.1 (1.5-2.8), and the medianc bypass, Morbid obesity.

To evaluate the factors affecting the success of semi-rigid ureteroscopy in proximal ureter stones.

Descriptive study.

Department of Urology, Nevşehir State Hospital, Turkey between March 2017 and October 2019.

Patients, who underwent a semi-rigid ureteroscopic lithotripsy (URSL) operation for proximal ureteral stones, were evaluated retrospectively in terms of gender, age, stone side, stone size, stone density, the type of lithotripsy, placement of the stone cone, the type of anesthesia and postoperative stone-free rates, which were recorded. The diameter of the ureter with the stones and the distances of the stones to the ureteropelvic junction (UPJ) were measured. Patients who had stone-free status after the URSL were labelled as group I. Patients whose stones were pushed back during URSL were labelled as group II.

The distance of the stone to the UPJ was statistically significantly higher in group I (p=0.006). The rate of using stone cone in patients in group I was statistically significantly higher than in patients in group II (p=0.001). The rate of stones in the middle ureter in group I was statistically higher than group II (p<0.001). The rate of using laser lithotriptor in group I was statistically higher than group II (p=0.007).

Semi-rigid URSL is a useful technique in the proximal ureter stones. The distance of the stone to the UPJ affects the success; and using laser lithotripsy and stone cone increases the success. Key Words Ureteral stone, Ureterorenoscopy, Laser lithotriphsy, Pnomotic lithotripsy.

Semi-rigid URSL is a useful technique in the proximal ureter stones. The distance of the stone to the UPJ affects the success; and using laser lithotripsy and stone cone increases the success. Key Words Ureteral stone, Ureterorenoscopy, Laser lithotriphsy, Pnomotic lithotripsy.ABSTRACT Objective To compare the 12-month mortality for patients with severe emphysema who underwent either endobronchial valve (EBV) or coil treatments with those managed with standard of care (SoC). Bronchoscopic lung volume reduction (BLVR) is a useful treatment option in patients with chronic obstructive pulmonary disease (COPD), who have severe emphysema.

A case-control study.

Department of Pulmonology, Yedikule Pulmonary Diseases and Thoracic Surgery Education and Research Hospital, Turkey, between January 2018 and January 2019.

Medical data of patients diagnosed with severe/very severe emphysema between January 2010 and January 2017 were evaluated. One hundred and forty-eight patients with advanced COPD-emphysema phenotype, who met the BLVR treatment criteria, were evaluated. One hundred and twenty-four patients with 12-month follow-up data, 73 patients treated with BLVR, 43 cases of EBV, 30 cases of coil treatment, and 51 patients managed with standard of care (SoC) were analysed for this study.

A total of 20 (16.1%) patients died at the end of 12th month and 4 (3.2%) in the early period. At the end of the 12th month, mortality was found in 7 patients (9.6%) in the BLVR group (3 underwent EBV and 4 received coil treatment, respectively), and 13 (25.5%) patients in the SoC group. There was no statistically significant difference in mortality between groups in the early period, but it was lower in the BLVR group at the end of 12th month.

BLVR treatment significantly decreases mortality compared to SoC in patients with advanced emphysema. Key Words Emphysema, Mortality, Endobronchial valve, Coil, Bronchoscopic lung volume reduction.

BLVR treatment significantly decreases mortality compared to SoC in patients with advanced emphysema. Key Words Emphysema, Mortality, Endobronchial valve, Coil, Bronchoscopic lung volume reduction.ABSTRACT Objective To compare the efficacy of intra-dermal platelet rich plasma (PRP) versus 50% trichloracetic acid (TCA) using chemical reconstruction of skin scars (CROSS) technique in the treatment of atrophic acne scars.

Non-randomised controlled trial.

Sheikh Zayed Hospital, Rahim Yar Khan, from October 2019 to April 2020.

In this study, cases of either gender and age 20 to 40 years with atrophic acne scars were included. The severity of the scar was graded on the basis of global acne scarring grading system. The cases in group A were managed by monthly injections of 1 ml intra-dermal PRP every month; while those in Group B were given treatment with 50% TCA, which was applied by CROSS technique every month. Both treatments were offered for three months. They were assessed at every four weeks for initial three months. Then these cases were followed another three months and final outcome was seen at 6th month.

In this study, there were 92 cases, 46 in each group. The mean age in group A and B was 27.72 ± 8.05 vs. 26.50 ± 8.20 years (p= 0.474). The mean global scar score at baseline was 36.07 ± 5.37 vs. 38.70 ± 4.80 (p= 0.015). The mean scar score at 4 weeks was 28.87 ± 5.27 vs. 29.00 ± 3.07 (p= 0.885), at 8 weeks 23.22 ± 4.10 vs. 23.11±2.49 (p=0.878), at 12 weeks 14.15 ± 3.05 vs. 17.57 ± 4.51 (p<0.001), and at 24 weeks it was 7.09 ± 1.46 vs. 10.09 ± 3.58 (p = <0.001).

PRP is significantly better than 50% TCA in reducing post-acne atrophic scars. Key Words Acne, Atrophic scar, Platelet rich plasma, 50% TCA.

PRP is significantly better than 50% TCA in reducing post-acne atrophic scars. Key Words Acne, Atrophic scar, Platelet rich plasma, 50% TCA.

To compare endonasal and external septoplasty for type 2 caudal septal deviations in terms of operative time, aesthetic and functional outcome.

Descriptive Analysis.

ENT Department, Mayo Hospital/ K.E.M.U, Lahore, from October 2019 to October 2020.

Record of patients operated for septal deviations in 2019 were retrospectively reviewed. All patients, diagnosed with type 2 caudal septal deviations, were included; while those with marked inferior turbinate hypertrophy, deviated nasal septum after trauma, and those who could not be followed-up, were excluded. Twenty-eight patients, operated by external approach, were placed in group A; and 32 patients, who had endonasal surgery, were placed in group B. Functional outcome was assessed by nasal obstruction symptom evaluation (NOSE) scale; and cosmetic deformity was assessed by visual analog scale (VAS) pre- and postoperatively at six months. Operative time was measured for both the groups.

Sixty patients were included. Mean preoperative NOSE scale score f evaluation (NOSE) score, Visual analogue scale (VAS).

Extracorporeal septoplasty resulted in better aesthetic outcome; though endonasal septoplasty had shorter operative time. Both surgical techniques resulted in good functional outcome. Key Words Nasal septum, Nasal surgical procedures, Deviated nasal septum, Caudal deviation septum, Septoplasty, Septorhinoplasty, Nasal obstruction symptoms evaluation (NOSE) score, Visual analogue scale (VAS).

To investigate the effect of localisation of the fracture line according to the trans-epicondylar line on open reduction rates and postoperative reduction quality.

Observational study.

Department of Orthopedic and Traumatology, Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, Turkey, from January 2011 to December 2018.

Pediatric cases (37 females-54 males) which underwent surgery with Gartland type three supracondylar humerus fracture having extension deformity, were included and examined retrospectively. Localisation of fracture line according to trans-epicondylar line, presence of postoperative rotation, sagittal and coronal deformity, reduction type and surgery duration were noted.

According to trans-epicondylar level, fracture line passed through upper level of the line in 68 cases, while it passed through lower level in 23 cases. Rotation rate of patients, whose fraction line localisation was lower according to trans-epicondylar level (60.87%), was higher than upper localization patients (8.82%, p<0.001). It has been observed that the relation between localisation of fracture line according to trans-epicondylar level and sagittal deformity, coronal deformity, reduction type and surgery durations were similar (p>0.05).

Determination of localisation of fracture line according to trans-epicondylar level in preoperative roentgenograms may allow the surgeon to predict the possibility of postoperative rotation deformity. Key Words Fracture line, Humerus, Supracondylar, Pediatric, Epicondyle.

Determination of localisation of fracture line according to trans-epicondylar level in preoperative roentgenograms may allow the surgeon to predict the possibility of postoperative rotation deformity. Key Words Fracture line, Humerus, Supracondylar, Pediatric, Epicondyle.

To evaluate the predictive significance of systemic inflammation markers (SIMs) in patients with glioblastoma multiforme (GBM), who were treated with bevacizumab (Beva).

Descriptive study.

The study was conducted at the Bezmialem Vakif University School of Medicine Hospital, Istanbul, Turkey, from January 2014 to September 2019.

A total of 107 patients, 49 (45.8%) female and 58 (54.2%) male, were retrospectively included in the study. The cut-off values for the SIMs-C-reactive protein to albumin ratio (CAR), neutrophil to lymphocyte (NLR) platelet to lymphocyte ratio (PLR), and systemic immune-inflammatory index (SIII))-were defined by receiver operating characteristic (ROC) analysis. Overall survival (OS) was plotted using the Kaplan-Meier method and compared using the log-rank test. Cox regression analysis was performed for univariate and multivariate analyses.

ROC analysis was performed to determine the optimal prognostic value of each parameter. CAR 1.32, NLR 2.9, PLR 159, and SIII 785 were deteed by Beva. Key Words C-reactive protein-to-albumin ratio (AR), Glioblastoma multiforme, Neutrophil-to-lymphocyteratio (NLR), Platelet-to-lymphocyte ratio (PLR), Predictive score.

To compare clinical outcome in patients of chronic myeloid leukemia (CML) with and without megakaryocytic clustering.

Cross-sectional comparative study.

Pathology Department and CML Clinic Oncology Department, King Edward Medical University from March 2018 to March 2019. Methodology Ninety-four patients diagnosed with chronic phase of CML were included. Complete record of complete blood count, splenomegaly, findings of bone marrow aspirate and trephine biopsy was noted. Bone marrow trephine biopsy was reviewed for megakaryocytic clustering. Sokal scoring was done; and follow-up data for clinical outcome, i.e complete hematological response (CHR) at 3 months and major molecular response (MMR) at 6 months and 1 year (as per Institute’s protocol) was obtained. All the data were analysed using SPSS version 25.

Megakaryocytic clustering was present in 57 (60.6%) patients and absent in 37 (39.4%). In patients with megakaryocytic clustering, CHR was absent in 12 (21.1%), MMR at 6 months was absent in 21 (36.8%) and MMR at 1 year was absent in 25 (43.9%) patients. In patients without megakaryocytic clustering, absent CHR, MMR at 6 months and MMR at 1 year were seen in 1 (2.7%), 2 (5.4%) and 2 (5.4%x), respectively. The correlation of megakaryocytic clustering and high sokal score was found to be statistically significant with a p-value <0.001.

Patients with megakaryocytic clustering have poor clinical outcome as indicated by their sokal score, absent CHR, MMR at 6 months and 1 year. Key Words Chronic myeloid leukaemia, Megakaryocytic clustering, Complete haematological response, Major molecular response, Cytogenetic response.

Patients with megakaryocytic clustering have poor clinical outcome as indicated by their sokal score, absent CHR, MMR at 6 months and 1 year. Key Words Chronic myeloid leukaemia, Megakaryocytic clustering, Complete haematological response, Major molecular response, Cytogenetic response.

To compare the clinicopathological characteristics, treatment responses, survival analysis of osseous Ewing sarcoma (OES) and extraosseous ES (EES).

Observational study.

Ankara City Hospital and Ankara Numune Training Research Hospital Medical Oncology Clinics from January 2005 to February 2020.

Clinicopathological characteristics of histologically confirmed ES/PNET and followed up, and treatment modalities were recorded from patients’ registration data-base of the hospital. Lactate dehydrogenase (LDH), alkaline phosphatase (ALP), hemoglobin were measured before chemotherapy or surgery. The patients with a second cancer, gall bladder/biliary tract diseases, viral hepatitis and other bone diseases were excluded.

Sixty seven patients evaluated retrospectively. Out of the total patients, 56.7% consisted of OES, and 43.3% consisted of EES. The median age of the EES group (26 years) was significantly higher than that of the OES group (22 years, p = 0.008). The most common metastasis region was lung in both the groups. Age, LDH levels and stage of the disease were found to be statistically significant prognostic factors in univariate and multivariate analysis. The median OS of patients who started with local treatment (surgical, surgical ± radiotherapy) and followed up with chemotherapy was 82.6 months (95% CI, 55.2-110.1), while the median OS of patients who received local treatment between or after chemotherapy was 43.4 months (95% CI, 13.2-73.6, p = 0.042).

Patients with extrosseus ES were significantly older. Age, LDH levels, stage of disease, local treatment followed by systemic therapy are important associated factors. Key Words Osseous ewing sarcoma, Extraosseous ewing sarcoma, Chemotherapy, Local treatment.

Patients with extrosseus ES were significantly older. Age, LDH levels, stage of disease, local treatment followed by systemic therapy are important associated factors. Key Words Osseous ewing sarcoma, Extraosseous ewing sarcoma, Chemotherapy, Local treatment.

To investigate the prognostic effect of red distribution width (RDW) in patients with gastric cancer.

Observational study.

Department of Surgical Oncology, Ankara University School of Medicine, between November 2010 and January 2020.

Patients diagnosed with adenocarcinoma by biopsy, who underwent radical surgery and lymph node dissection, and had preoperative RDW value, were inducted. Patients who had history of active inflammation in the past three months, received treatment for hematology disorder, blood transfusion, malignancy other than gastric cancer, autoimmune disease, venous thrombosis, or under 18 years of age, and those having cardiac and cerebrovascular diseases and distant metastases were excluded from the study. Apart from diagnosis, preoperative blood values, clinicopathologial, demographic features, and follow-up data were included in the study.

RDW average value was 15.11 ± 2.87 and median value was 14.3%. For RDW cut off value, 13.4% was accepted as reference from previous studies was divided into two groups as <13.4% and ≥13.4%. While it was <13.4% in 119 patients; in 292 patients, it was „≥13.4%”. High RDW value showed poor survival (p<0.001).

RDW, the current hematological marker, can be used as an important indicator for monitoring the progression and prognosis of gastric cancer. Key Words Gastrectomy, Gastric cancer, Laparoscopy, Surgical oncology, Red distribution width, survival.

RDW, the current hematological marker, can be used as an important indicator for monitoring the progression and prognosis of gastric cancer. Key Words Gastrectomy, Gastric cancer, Laparoscopy, Surgical oncology, Red distribution width, survival.

To identify utility of chest computed tomography severity score (CT-SS) as an additional tool to COVID-19 pneumonia imaging classification in assessing severity of COVID-19.

Descriptive analytical study Place and Duration of Study Armed Forces Institute of Radiology and Imaging, (AFIRI) Rawalpindi, from April 2020 to June 2020.

Five hundred suspected COVID-19 cases referred for high resolution computed tomography – chest were included in the study. Cases were categorised by radiological findings using COVID-19 pneumonia imaging classification, proposed in the radiological society of North America expert consensus statement on reporting chest CT findings related to COVID-19. CT-SS was calculated for all scans. Patients were clinically classified according to disease severity as per 'Diagnosis And Treatment Program of Pneumonia of New Coronavirus Infection’ recommended by China’s National Health Commission. The relationships between radiological findings, CT-SS, and clinical severity were explored.

Based on the radiological findings, 298 cases were graded as typical, 34 as indeterminate, 15 as atypical, and 153 as negative for pneumonia. The apical and posterior basal segments of lower lobes were most commonly involved. The CT-SS showed higher values in patients of severe group as compared to those in moderate group (p < 0.05). CT-SS threshold for recognising severe COVID-19 was 18.5 (area under curve, 0.960), with 84.3% sensitivity and 92.5% specificity.

In coherence with COVID-19 pneumonia imaging classification, CT-SS may provide a comprehensive and objective assessment of COVID-19 severity. Key Words COVID-19, COVID-19 pneumonia, CT-SS, High resolution computed tomography.

In coherence with COVID-19 pneumonia imaging classification, CT-SS may provide a comprehensive and objective assessment of COVID-19 severity. Key Words COVID-19, COVID-19 pneumonia, CT-SS, High resolution computed tomography.

To determine the correlation of old age, pulmonary artery pressure (PAP) and mean arterial blood pressure (MABP) during anesthetic induction in elderly patients.

Prospective cohort study.

Central Hospital affiliated to Chongqing Medical University from September 2016 to September 2019.

A total of 75 elderly patients with pulmonary hypertension, who underwent surgery under general anesthesia, were inducted. Each 25 patients were allocated into 65-74 years, 75-84 years, and ≥85 years groups. PAP was invasively measured using a right heart floating catheter before induction, while MAP was measured using an invasive radial artery catheter at one minute before and within five minutes after anesthetic induction.

PAP and PAMP, both increased with age (p <0.001). MAP at one minute before induction significantly increased with aging, while MAP measured at 1, 3 and 5 minutes after anesthetic induction, exhibited tendencies of significant decrease with aging (p <0.05). The correlation analysis results revealed that mean MAP during anesthesia induction was significantly associated with PASP before induction (r = -0.384 and -0.532 for Kendall and Spearman correlation analyses; both p<0.05).

Increased PAP may be involved in the association between with aging and increased risk of hypotension during induction. Key Words General anesthesia, Hypotension, Pulmonary arterial blood pressure, Old age.

Increased PAP may be involved in the association between with aging and increased risk of hypotension during induction. Key Words General anesthesia, Hypotension, Pulmonary arterial blood pressure, Old age.

To analyse changes in semen parameters according to different age groups in men presenting to an infertility clinic, and determine the age threshold for decline in semen quality.

Observational study.

Andrology Laboratory, Department of Urology, Kahramanmaraş Sütçü İmam University, Turkey, from January 2018 to December 2019.

Semen analysis records of infertile men, who were referred to Andrology Laboratory, were retrospectively evaluated. The age groups were categorised as 20-29, 30-34, 35-39, 40-44, and 45-55 years. Each group was completed to 100 semen samples retrospectively and sequentially without any preferences. The differences of semen parameters between age groups were analysed with the one-way ANOVA test. Linear relationship was checked by ANOVA.

The mean age of 500 patients was 37.18 ± 8.11 years. While no linear relationship was observed in semen volume, concentration, and total sperm count with age (p=0.133, p=0.290 and p=0.261, respectively). A linear decline was observed in progressiven analysis, Sperm.Null.Fertility is one of the key factors in the economic and productive success of the equine industry. Despite this, studies on the genetic causes affecting reproductive performance are scarce, especially in mares, where the genetic architecture of the reproductive traits is extremely complex. Today, with the increasing availability of new genomic methodologies for this species, we are presented with an interesting opportunity to understand the genetic basis of equine reproductive disorders. These include, among others, novel techniques for detecting chromosomal abnormalities, whose association with infertility in horses was established over 50 years ago; new sequencing technologies permitting an accurate detection of point mutations influencing fertility, as well as the study of inbreeding and molecular homozygosity, which has been widely suggested as one of the main causes of low reproductive performance in horses. Finally, over the last few years, reproductive performance has also been associated with copy number variants and candidate genes detected by genome-wide association studies on fertility traits. However, such studies are still scarce, probably because they depend on the existence of large and accurate phenotypic datasets of reproductive and/or fertility traits, which are still difficult to obtain in equines.Metabolic disorders of the circulatory system of animals (e.g., hyperglycemia and hyperlipidemia) can significantly affect immune function; however, since there is currently no reliable animal model for hyperproteinemia, its effects on immunity remain unclear. In this study, we established an animal model for hyperproteinemia in an invertebrate silkworm model, with a controllable plasma protein concentration (PPC) and no primary disease effects. We evaluated the influence of hyperproteinemia on innate immunity. The results showed that high PPC enhanced hemolymph phagocytosis via inducing a rapid increase in granulocytes. Moreover, while oenocytoids increased, the plasmacytes quickly dwindled. High PPC inhibited hemolymph melanization due to decreased phenoloxidase (PO) activity in the hemolymph via inhibiting the expression of the prophenoloxidase-encoding genes, PPO1 and PPO2. High PPC upregulated the gene expression of antimicrobial peptides via differential activation of the Toll and Imd signaling pathways associated with NF-κB signaling, followed by an induction of inconsistent antibacterial activity towards Gram-positive and Gram-negative bacteria in an animal model of high PPC. Therefore, high PPC has multiple significant effects on the innate immune function of the silkworm circulatory system.Salvia divinorum Epling and Játiva is a perennial mint from the Lamiaceae family, endemic to Mexico, predominantly from the state of Oaxaca. Due to its psychoactive properties, S. divinorum had been used for centuries by Mazatecans for divinatory, religious, and medicinal purposes. In recent years, its use for recreational purposes, especially among adolescents and young adults, has progressively increased. The main bioactive compound underlying the hallucinogenic effects, salvinorin A, is a non-nitrogenous diterpenoid with high affinity and selectivity for the k-opioid receptor. The aim of this work is to comprehensively review and discuss the toxicokinetics and toxicodynamics of S. divinorum and salvinorin A, highlighting their psychological, physiological, and toxic effects. Potential therapeutic applications and forensic aspects are also covered in this review. The leaves of S. divinorum can be chewed, drunk as an infusion, smoked, or vaporised. Absorption of salvinorin A occurs through the oral mucosa orcal profiles.Ecological adaptation plays an important role in the process of plant expansion, and genetics and epigenetics are important in the process of plant adaptation. In this study, genetic and epigenetic analyses and soil properties were performed on D. angustifolia of 17 populations, which were selected in the tundra zone on the western slope of the Changbai Mountains. Our results showed that the levels of genetic and epigenetic diversity of D. angustifolia were relatively low, and the main variation occurred among different populations (amplified fragment length polymorphism (AFLP) 95%, methylation sensitive amplification polymorphism (MSAP) 87%). In addition, DNA methylation levels varied from 23.36% to 35.70%. Principal component analysis (PCA) results showed that soil properties of different populations were heterogeneous. Correlation analyses showed that soil moisture, pH and total nitrogen were significantly correlated with genetic diversity of D. angustifolia, and soil temperature and pH were closely related to epigenetic diversity. Simple Mantel tests and partial Mantel tests showed that genetic variation significantly correlated with habitat or geographical distance. However, the correlation between epigenetic variation and habitat or geographical distance was not significant. Our results showed that, in the case of low genetic variation and genetic diversity, epigenetic variation and DNA methylation may provide a basis for the adaptation of D. angustifolia.The teaching of physical education today still incorporates innovative methodologies in order to create quality physical education. This article sets out to describe which pedagogical model is used in the initial training of physical education teachers at the University of Granada, from the perspective of the students. The study adopted an exploratory, descriptive and comparative research design, applying a survey to a sample of 303 physical education students. The students perceive that their teachers make use of different organising modalities, methodological strategies and assessment systems that favour the use of active methodologies. The structural equations model for analysing predictive relations between the three methodological components (organising modalities, methodological approaches and evaluation systems) was fitted correctly, obtaining positive relations between the three components. The model also showed positive and negative influences in the opinion of the students in the planning of the teaching-learning methodologies and some of the methodological components. The results indicate that the perception and opinion of the physical education students take on a special role in the development of student-centred methodologies.We discuss the implications of possible contagion of COVID-19 through e-cigarette aerosol (ECA) for prevention and mitigation strategies during the current pandemic. This is a relevant issue when millions of vapers (and smokers) must remain under indoor confinement and/or share public outdoor spaces with non-users. The fact that the respiratory flow associated with vaping is visible (as opposed to other respiratory activities) clearly delineates a safety distance of 1-2 m along the exhaled jet to prevent direct exposure. Vaping is a relatively infrequent and intermittent respiratory activity for which we infer a mean emission rate of 79.82 droplets per puff (6-200, standard deviation 74.66) comparable to mouth breathing, it adds into shared indoor spaces (home and restaurant scenarios) a 1% extra risk of indirect COVID-19 contagion with respect to a „control case” of existing unavoidable risk from continuous breathing. As a comparative reference, this added relative risk increases to 44-176% for speaking 6-24 min per hour and 260% for coughing every 2 min. Mechanical ventilation decreases absolute emission levels but keeps the same relative risks. As long as direct exposure to the visible exhaled jet is avoided, wearing of face masks effectively protects bystanders and keeps risk estimates very low. As a consequence, protection from possible COVID-19 contagion through vaping emissions does not require extra interventions besides the standard recommendations to the general population keeping a social separation distance of 2 m and wearing of face masks.Brucellosis is an infectious zoonosis that has huge economic and public health implications globally. The disease is prevalent in humans, livestock and wildlife in Sub-Saharan Africa. A cross-sectional study was conducted between 6 May 2017 and 31 July 2020 during which 1712 sera from 175 cattle herds in five districts from Southern, Western and Eastern Provinces of Zambia were collected and screened against brucellosis. The Rose Bengal Test (RBT) and competitive Enzyme-linked Immuno Assay (c-ELISA) were used in serial testing for the detection of antibodies against Brucella species. A total of 127 animals from 37 herds tested positive, giving overall individual animal and herd-level seroprevalences of 7.53% (95% CI 6.28-8.78%) and 21.14% (95% CI 15.0-27.2%), respectively. Namwala district had the highest herd seroprevalence (33.9%, 95% CI 21.6-46.1%), while Lundazi did not record any seropositivity. Comparably, Southern Province had the highest individual animal (8.97%, 95% CI 7-11%) and herd-level (28.5%, 95% CI 20.3-36.7%) seroprevalences, although this was not statistically significant. Within Southern Province, higher seropositivity was observed in Namwala district (OR 8.55; CI 2.66-27.44), among female animals (OR 2.48; CI 1.38-4.46) and in those aged 11 years and above (OR 2.67; CI 1.34-5.34) as well as in gravid cows (OR 4.34; CI 2.08-8.92). Seropositivity was also observed among some animals with hygromas (OR 6.5; CI 0.45-94.08) and those with a history of abortion (OR 1.13; CI 0.18-7.28) although the findings were not statistically significant. Brucella seroprevalence among traditional cattle in Zambia remains high. Control programs against bovine brucellosis must be introduced to reduce its impact on human health and animal production.The coronavirus disease 2019 (COVID-19) has a great impact on healthcare workers (HCWs) that includes negative mental health outcomes, such as post-traumatic stress, anxiety and depressive symptoms. In this cross-sectional study, we report on mental health outcomes among HCWs in Cyprus. Data were collected between 3 May and 27 May 2020, with the use of an online questionnaire that included demographics (sex, age, occupation, education, work sector, years of work experience), the 9-item Patient Health Questionnaire (PHQ-9) which assesses depressive symptoms, the Impact of Events Scale Revised (IES-R), which measures post-traumatic stress disorder (PTSD) symptoms, and the-10 item Perceived Stress Scale (PSS-10) which quantifies stress responses. Participants (42% physicians, 24% nurses, 18% physiotherapists, 16% classified as „other”) were 58% of female gender and aged 21-76. A total of 79 (18.6%) and 62 HCWs (14.6%) reported clinically significant depressive (PHQ-9 ≥ 10) and post-traumatic stress (IES-R > 33) symptoms respectively. Nurses were more likely than physicians to suffer from depression (adjusted prevalence ratio 1.7 (1.06-2.73); p = 0.035) and PTSD (adjusted prevalence ratio 2.51 (1.49-4.23); p = 0.001). Even in a country with a rather low spread of the COVID-19, such as Cyprus, HCWs reported a substantial mental health burden, with nurses reporting increased depressive and PTSD symptoms compared to other HCWs.Two different zinc-based metal-organic frameworks (MOFs) were investigated to remove one of the most used fluoroquinolone antibiotic, Ofloxacin (OFL), from polluted water. The most common zeolitic imidazolate framework-8 (ZIF-8) and the green Zn(II) and benzene-1,3,5-tri-carboxylate (Zn3(BTC)2) were prepared through a facile synthetic route and characterized by means of Fourier-Transform Infrared (FT-IR) Spectroscopy, X-ray Powder Diffraction (XRPD), and Scanning Electron Microscopy (SEM) analyses. The two MOFs were compared in terms of both adsorption and kinetic aspects under real conditions (tap water, natural pH). Results showed that OFL was adsorbed in remarkable amounts, 95 ± 10 and 25.3 ± 0.8 mg g-1 on ZIF-8 and Zn3(BTC)2, respectively, following different mechanisms. Specifically, a Langmuir model well described the ZIF-8 profile, while for Zn3(BTC)2, cooperative adsorption occurred. Moreover the kinetic results were quite different, pseudo-second-order and sigmoidal, respectively. The suitability of ZIF-8 and Zn3(BTC)2 as adsorbent phases for water depollution was tested on tap water samples spiked with OFL 10 µg L-1. The obtained removal efficiencies, of 88% for ZIF-8 and 72% for Zn3(BTC)2, make these materials promising candidates for removing fluoroquinolone antibiotics (FQs) from polluted waters, notwithstanding their limited reusability in tap water, as demonstrated by in-depth characterization of the two MOFs after usage.Community psychiatry is a modern and effective form of care for patients with mental disorders. The aim of the study was to assess the impact of a rehabilitation program at the Mental Health Support Centre in Tarnowskie Góry (Poland) on reducing severity of anxiety and depression symptoms, as well as improving overall quality of life during the COVID-19 pandemic. The study involved 35 patients, examined with an authors’ questionnaire on sociodemographic data, the Hospital Scale of Anxiety and Depression (HADS) and the Short Form Health Survey (SF-36). Data was obtained during the first national lockdown and compared to data gathered before the pandemic on the same study group. Imposed restrictions, negative emotional state during lockdown, subjectively assessed higher health risk and a low level of knowledge about the COVID-19 pandemic did not significantly correlate with a severity of depression and anxiety, as well as general quality of life. However, the comparison of the results obtained in HADS and SF-36 scales show a significant improvement in both categories. Rehabilitation activities, including physical training, cognitive exercise and social therapy, reduce the severity of the symptoms and have a positive effect on the overall quality of life in patients suffering from schizophrenia and affective disorders. Therefore, holistic mental health support services may positively affect building an individual resilience. The severity of anxiety symptoms during the COVID-19 pandemic shows a negative correlation with the patient’s age.Hydraulic oil is the key medium for the normal operation of hydraulic machinery, which carries various wear debris. The information reflected by the wear debris can be used to predict the early failure of equipment and achieve predictive maintenance. In order to realize the real-time condition monitoring of hydraulic oil, an impedance debris sensor that can detect inductance and resistance parameters is designed and studied in this paper. The material and size of wear debris can be discriminated based on inductance-resistance detection method. Silicon steel strips and two rectangular channels are designed in the sensor. The silicon steel strips are used to enhance the magnetic field strength, and the double rectangular detection channels can make full use of the magnetic field distribution region, thereby improving the detection sensitivity and throughput of the sensor. The comparison experiment shows that the coils in series are more suitable for the monitoring of wear debris. By comparing and analyzing the direction and the presence or absence of the signal pulses, the debris sensor can detect and distinguish 46 µm iron particles and 110 µm copper particles. This impedance detection method provides a new technical support for the high-precision distinguishing measurement of metal debris. The sensor can not only be used for oil detection in the laboratory, but also can be made into portable oil detection device for machinery health monitoring.Amorphous boron carbon nitride (a-BCN) films exhibit excellent properties such as high hardness and high wear resistance. However, the correlation between the film structure and its mechanical properties is not fully understood. In this study, a-BCN films were prepared by an arc-sputtering hybrid process under various coating conditions, and the correlations between the film’s structure and mechanical properties were clarified. Glow discharge optical emission spectroscopy, X-ray photoelectron spectroscopy, Fourier-transform infrared spectroscopy, and Raman spectroscopy were used to analyze the structural properties and chemical composition. Nanoindentation and ball-on-disc tests were performed to evaluate the hardness and to estimate the friction coefficient and wear volume, respectively. The results indicated that the mechanical properties strongly depend on the carbon content in the film; it decreases significantly when the carbon content is less then 90%. On the other hand, by controlling the contents of boron and nitrogen to a very small amount (up to 2.5 at.%), it is possible to synthesize a film that has nearly the same hardness and friction coefficient as those of an amorphous carbon (a-C) film and better wear resistance than the a-C film.This study clarifies the effects of pre-soaked zeolite sand as an internal curing material on the hydration, strength, autogenous shrinkage, and durability of alkali-activated slag (AAS) mortars. The liquid-to-binder ratio (L/b) of all of the AAS mortars was 0.55. Sodium hydroxide solution was used as an alkali activator and an internal curing liquid. Calcined zeolite and natural zeolite sand replaced the standard sand at 15% and 30%, respectively. The setting time, autogenous shrinkage, compressive strength, ultrasonic pulse velocity, and surface electrical resistivity were tested. The following conclusions were drawn (1) The addition of zeolite significantly reduces the autogenous shrinkage of AAS mortar. Compared with the control group, 30% calcined zeolite reduced the autogenous shrinkage by 96.4%. Moreover, the autogenous shrinkage of the AAS mortars was noticed in two stages (a variable temperature stage and an ambient temperature stage), and the two stages split at one day of age. (2) The compressive strength of all of the specimens increased as the zeolite sand content increased, and the highest compressive strength was obtained for AAS combined with 30% natural zeolite sand. (3) Internal curing accelerated the formation of the second peak of heat flow and reduced the accumulated heat release. (4) Calcined zeolite sand delayed the setting time of the AAS mortars. (5) The addition of zeolite significantly reduced the surface electrical resistivity of the AAS mortars. In summary, zeolite sand is extremely useful as an internal curing agent to reduce autogenous shrinkage and to increase the compressive strength of AAS mortars.This scoping review aims to describe occupational therapy interventions carried out with multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS) patients in occupational therapy. A peer review of the literature was conducted in different databases Pubmed, Scopus, Web of Science and Embase, and in some occupational therapy journals. A search of the literature published was carried out before December 2019. The inclusion criteria were as follows (1) articles evaluating the intervention of occupational therapy in MS or ALS including experimental, randomized, nonrandomized and exploratory studies; (2) written in English or Spanish; (3) adult population (over 18 years old). The initial search identified 836 articles of which we included 32 divided into four areas of intervention fatigue-targeted interventions, cognitive interventions, physical interventions and others. Only 16 studies were carried out exclusively by occupational therapists. Most occupational therapy interventions are aimed at fatigue and physical rehabilitation.