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Environmental pollution by heavy metals and other toxic substances has increasingly become a global health concern. Lead is a hazardous environmental contaminant that is been released to the surface causing deleterious health effects to man. Various strategies have been employed such as excavation, precipitation, and vitrification to remove lead from polluted sites. However, bioremediation of heavy metal contaminated sites has served as a cost-effective and ecofriendly tool for detoxifying and restoration of ecological entities. In this study, we reported the isolation and optimization of two novel lead-resistant isolates from active goldmine contaminated site of Anka, Zamfara state Nigeria. Results of Atomic Absorption Spectroscopy (AAS) showed higher lead concentration from the sampled sites (p

Environmental contamination, primarily driven by human activities such as industrialization, urbanization, and agricultural practices, has led to the accumulation of heavy metals, particularly molybdenum, in urban soils. This contamination adversely affects plant growth, food security, and poses health risks. This study explores the bioreduction potential of Bacillus cereus strain BUK_BCH_BTE1 in transforming toxic hexavalent molybdate to molybdenum blue which is a less toxic state. The bacterium was isolated from agricultural soil in Nigeria and identified through 16S rRNA sequencing. Factors influencing molybdate reduction were optimized, including carbon and nitrogen sources, molybdate, and phosphate concentrations. Glucose was found to be the most effective carbon source, while ammonium sulfate was the preferred nitrogen source. Molybdate reduction was most efficient at a concentration of 20 mM, and a phosphate concentration of approximately 3.5 mM was optimal. These findings contribute to understanding molybdate bioreduction and its potential application in addressing heavy metal pollution in the environment. Bacillus cereus strain BUK_BCH_BTE1 shows promise as an effective agent for molybdate bioreduction, with implications for mitigating environmental and health hazards associated with molybdenum contamination.

Fungal processes for the treatment of dye contaminated wastewater have the advantage of being cost-effective, environmentally friendly, and producing less sludge. This research was therefore aimed at isolating and characterizing fungus capable of decolourizing and utilizing azo dye (dimethyl yellow) as a sole carbon source using one-factor-at-a-time. Pour plating method was used to isolate the fungus on mineral salt media (MSM) following serial dilution. The isolate was then morphologically and molecularly identified as Aspergillus quadrilineatus strain BUK_BCH_BTE1 with the accession number OK178927 based on ITS1 and ITS2 rRNA gene sequence and molecular phylogenetic analysis. Characterization was conducted by studying the effect of temperature, incubation time, substrate concentration, pH, inoculum size and effect of heavy metals. The decolourization and growth of dimethyl yellow by the isolated Aspergillus quadrilineatus was optimal at substrate concentration of 200 μɡ/mL, temperature of 30 °C, 100–200 μL inoculum size, pH 5.0, and 72-h incubation time. The isolate was found to tolerate up to 4 ppm of Hg, Cu and Zn, with maximum inhibition shown by Cr and Ar. LC/MS analyses of the intermediate compounds produced during decolourization of dimethyl yellow suggested that in the fungal biodegradation of dimethyl yellow detected the formation of dimethyl yellow, 2,6-dichloro-p-benzoquinone, 1,2,3,5-tetrafluoro-4-nitrobenzene, and 3,4-dinitrobenzoic acid as metabolites. The finding from this study suggested that the isolate is a suitable candidate in bioremediation of coloured effluents particularly containing these compounds.

Palm oil mill effluent (POME) has a high concentration of organic matter and total suspended solids. However, improper disposal of oil refining wastes containing oils, fats, and sludge can cause environmental damage and harm human health due to their toxic, carcinogenic, and polluting effects. This research was carried out to solve the harmful effects caused by the release of POME to the environment. The goal of this study was to isolate a naturally occurring bacterium that could degrade POME and use it as a single carbon source. Bacteria were isolated from POME-contaminated medium using an enrichment technique. Judging by 16S rRNA partial gene sequencing, morphological, biochemical, and molecular identification methods, the isolated bacteria was identified as a novel Bacillus sp. The effects of substrate concentration, inoculum size, pH, temperature, and incubation time on the bacterial growth were investigated using a ''one factor at a time'' (OFAT) approach. The optimal conditions for the bacterium's growth were found to be pH 7.5, 35 °C, 20 % v/v substrate concentration, 6 % v/v inoculum size, and 96 hours of incubation. The isolate is capable of reducing 84 % of COD and 91 % of BOD from a POME sample. The high degradation potential of POME by the isolate suggests it can be used as a good option for bioremediation of POME-polluted areas.

Chlorpyrifos, being a frequently used organophosphate pesticide poses a significant threat to human health due to its prolonged presence in soil, plants, and water, this has raised concern. Consequently, researchers have shifted their attention towards finding methods to mitigate its toxicity or eliminate it from the environment. This has highlighted the importance of bioremediation. This study was aimed at analyzing and characterizing the metabolites of chlorpyrifos degradation by Bacillus sp. strain UPMB10 isolated from polluted environment using Gas Chromatography-Mass Spectrometry. The bacteria were successfully isolated utilizing the enrichment technique in mineral salt media, followed by screening to obtain the best isolate. Identification of the isolate was done at morphological, biochemical, and molecular levels, with a focus on the 16S rRNA gene. Phylogenetic analysis revealed the close relationship between the bacterium and Bacillus sp. strain UPMB10. Optimization (One Factor at A Time) was done to determine best growth conditions of the isolate. The optimal growth conditions obtained include, incubation time of 48 hours, a substrate concentration of 4 g/L, a pH of 7.0, a temperature of 37 °C, and an inoculum size of 2 % (v/v), these quantitative data revealed valuable insights into the factors affecting efficient degradation of pesticide. Gas Chromatography-Mass Spectrometry analysis demonstrated that the bacterium achieved a remarkable degradation efficiency of 99 % after 48 hours of incubation. Notably, Mesitylene and Dimethylmalonic acid were obtained as some of the metabolites of chlorpyrifos degradation. This result provides insight into the transformation of products generated during degradation process. The study finding revealed that Bacillus sp. strain UPMB10 exhibits a remarkable capacity for chlorpyrifos degradation, making it a promising candidate for bioremediation of insecticides and acaricides.

λ-cyhalothrin (LC), a frequently used synthetic pyrethroid insecticide, poses a substantial risk to human health and the environment due to its prolonged presence in plants, soil, and water. This study aimed to identify and characterize bacteria with the ability to degrade and utilize λ-cyhalothrin as their sole carbon and energy source. The bacteria were isolated by employing an enrichment technique on mineral salt media through a series of dilution steps. Strain isolated underwent identification through morphological, biochemical, and molecular analyses, specifically employing 16S rRNA and phylogenetic analysis, which disclosed its classification as Bacillus sp. With the accession number OR133746. Physio-cultural conditions, including temperature, initial substrate concentration, pH, incubation time and inoculum size affecting the strain's activity were investigated in MSM using a one-variable-at-a-time approach. The optimal conditions for bacterial growth and λ-cyhalothrin degradation was found to be a substrate concentration of 6 g/L, a temperature of 30 °C, a pH of 6.5, and an incubation time of 96 hours. The results of Gravimetric analysis revealed that the selected isolate exhibited notable degradation rates of 75.4 % and 100 % after 72 hours and 96 hours of incubation, respectively. These findings highlight the exceptional efficiency of the strain in degrading λ-cyhalothrin. Consequently, this strain emerges as a promising candidate for tackling pollution attributed to λ-cyhalothrin through bioremediation processes.

In the agricultural sector, a class of chemical compounds known as chlorinated phenol and phenoxyacetic acid are employed as herbicides, wood preservatives, and pesticides. Certain groups of chlorinated phenoxyacetic acid are used as herbicides for agricultural and domestic application. They are listed as priority pollutants by the United States Environmental Protection Agency (USEPA). Thus, this study focuses on bacterial isolation for 2,4-dichlorophenoxyacetic acid herbicide degradation been a toxic contaminant that hinders the quality of the soil over time, availability of certain soil microbes, non-targeted plants and poses health risk even to humans such as Hodking's lymphoma, respiratory infections e.t.c. These therefore, make it necessary to search for scientific way of dealing with this chemical from our environments. Incubation time, substrate concentration, pH, temperature, and inoculum size in mineral salt medium were all the parameters tested during the study, while 2,4-dichlorophenoxyacetic acid (2,4-D) herbicide was used as the alternative source of carbon. Following systemic dilution of sample on mineral salt medium, three bacterial isolates (D1, D2, and D3), were isolated and subjected to lots of screening. D2 was proven to be the best. During molecular identification that involves polymerase chain reaction, gel electrophoresis, sequence alignment and phylogentic analysis, the isolated bacteria was found to be Achromobacter xylosoxidans. The bacterial isolate grew and degraded 2,4-dichlorophenoxyacetic acid herbicide at optimum conditions of 96 h incubation time, 0.72g L−1 substrate concentration, 7.5 pH, 40 °C temperature, and 400 μg/L inoculum size. High Performance Liquid Chromatography (HPLC) analysis of the residual 2,4-dichlorophenoxyacetic acid herbicide and the standard solution probe of the isolate was able to degrade up to 95.38 % of the substrate indicating great potentiality in bioremediation of herbicide polluted environments thereby, reducing if not all eliminating these toxic contaminants from our surroundings.

Herbal remedies are alternative option for the treatment, management, and prevention of different disease conditions such as malaria in most African communities due to their easy access and economic advantages. Heavy metals contaminations from the plant ingredients, processing or anthropogenic activities may render the herbal harmful for human consumption. Therefore, risk assessment of contaminating metals and antioxidant activities were determined in Agbo, a popular anti-malarial herbs mixture sold in Kano. The samples were collected from different locations across Kano State and labelled as A, B, C. The concentrations of some human cancer-causing (Cadmium Cd; Lead Pb and Chromium Cr) and some non-cancer-causing metals such as Copper Cu; Nickel, Ni in the sample were evaluated. The antioxidant properties were also evaluated using various assays, which include 2,2-diphenyl-2-picrylhydrazyl (DPPH), hydrogen peroxide (H2O2) scavenging actions, Metal Chelating, phosphomolybdate test and Reducing power properties of Agbo. Some phytochemicals (Phenolic acids, flavonoids, tannins, saponins and alkaloids) were found to be present. The values predicting the probability of human developing risk of cancer ailment after the ceaseless consumption of the herbal mixtures was found higher than a standard threshold limit (>10−4) established by USEPA. While the non-cancer predicted risk index projected the Cr, Pb and Cd (from sample B) as the leading metal pollutants of the herbal mixtures posing a risk index of more than one (>1), while Ni and Pb (from sample A and C) showed a relative safe quotient. The determined IC50 value for reducing power showed the herbal mixtures exhibiting almost same antioxidant activities with sample C having the highest (IC50 6.32 μg/mL), followed by sample B (IC50 6.36 μg/mL) and sample A (IC50 6.39 μg/mL). This suggests that excess consumption of this mixtures may be generally beneficial health-wise but unsafe due to the heavy metals which could expose the consumers to probable cancer risks and other biological process distraction.

Atrazine herbicide is known to disrupt the endocrine system and is potentially carcinogenic. Its continual application leads to high residue levels in soil, causing water pollution, which when consumed is associated with devastating health effects. This research reported the isolation and characterization of a new bacterial strains from active agricultural soil with the potential to biodegrade atrazine as a sole carbon source. An enrichment method was utilized to isolate the bacteria (A1, A2, B1, B2, C1 and C2) on mineral salt media (MSM) following serial dilution. Six isolates were screened for their tolerance to various concentrations of atrazine (500 to 1500 mg∙L‐1), and only isolate B1 tolerated up to 1500 mg∙L‐1 atrazine. The isolate was identified molecularly as Bacillus safensis strain BUK_BCH_BTE6 based on 16S rRNA gene sequencing and molecular phylogenetic analysis. Characterization of the isolate based on the effects of temperature, pH, substrate concentration, incubation time, inoculum size, and heavy metals revealed optimum growth and atrazine degradation at 35 °C, a pH of 7.5, 400 mg∙L‐1, at 48 h, and inoculum size of 600 µL, respectively. The growth of the isolate was inhibited by 2 ppm Hg, Cd, Cr, Pb, Ar, and Ni, while Fe, Cu, and Zn stimulated it. GC‐MS analysis revealed a degradation efficiency of 88.85% within 120 h, while metabolites such as desethyldeisopropylatrazine, deisopropylatrazine, N‐ethylammelide, and cyanuric acid were also detected. This isolate is a highly atrazine‐tolerant and efficient atrazine degrader that could be employed for bioremediation of atrazine‐polluted sites.

Lead is one of the most toxic heavy metals ever known by man today, which has zero biological role. It is known to cause anemia and affect the nervous and reproductive systems with irreversible effects. Its continual usage leads to its high accumulation polluting the soil and water bodies with devastating health effects. This research, aimed at isolation and characterization of indigenous lead tolerant bacteria from contaminated soil of Anka. Results of Atomic Absorption Spectrophotometry (AAS) showed high concentration of lead (738 mg/kg) of the affected sites above the EPA standard (400 mg/kg). Similarly, a mineral salt media was used to isolate the bacteria following serial dilution. An indigenous bacterial isolate (Ac) with potential to tolerate up to 3000 mg/L Pb(NO3)2 was isolated and molecularly identified based on 16s rRNA sequencing as Bacillus cereus strain BUK_BCH_BTE2 with the accession number MT160412. The isolate was further characterized for its optimum growth and tolerance conditions using one factor at a time (OFAT). Sucrose with an optimum concentration of 5 g/L was the best carbon source for the isolate. The isolate was found to utilize ammonium sulphate as the best nitrogen source at a concentration of 2.5 g/L, with an optimum pH and tempertaure of 7.0 and 37 °C respectively. A concentration of 1000 mg/L Pb(NO3)2 was found to be the optimum concentration for the isolate. The optimum incubation time and inoculum size were found to be 48 hrs and 100 μL respectively. The fact that the isolate could tolerate high Pb(NO3)2 concentration makes it suitable for future bioremediation work involving lead.

Bioremediation process is one of the most effective methods which facilitates the cleaning of contaminated sites and restores contaminated sites through the broad biodegradative capabilities evolved by microorganisms towards undesirable organic compounds. In this study, Alcaligenes sp. with potential to degrade and utilize used engine oil as its source of carbon and energy was isolated, identified and its growth parameters optimized for efficient and better breakdown of the pollutant. Alcaligenes sp. was isolated from a used engine oil contaminated soil in an old mechanic shop, after enrichment using a carbon free (Bush-Nell Haas) media which was supplemented with used engine oil. The bacterium was identified (morphologically, biochemically, and molecularly) and studied for its ability to extract carbon from used engine oil hence degrading used engine oil. Thereafter, the various growth parameters of the bacterium isolate were optimized. Data obtained showed optimum growth parameter of 2% (v/v) used engine oil (carbon source), pH 7, temperature 37 °C, inoculum size 2 ml and incubation time 240 hours. Also, measured ribosomal RNA (16S RNA) sequence and phylogenetic analysis revealed that the isolate is a very close relative of Alcaligenes species. The degradation potential of the isolate was assessed using gravimetric analysis, and a percentage degradation of 92.5% was discovered. Overall, the results of this study suggest that Alcaligenes sp. can effectively degrade used engine oil, hence, a potential remediation organism against engine oil contamination and spills on soils or water surface.

Chromium, a transition metal element widely distributed in the earth's crust, with the valence from −2 to +6, but exists mainly in the form of trivalent and hexavalent states. Hexavalent chromium Chromium (VI) is often found in soil and ground water due to its widespread industrial use such as tannery, electroplating, and steel industries. Chromium (VI) is toxic, mutagenic, carcinogenic, and teratogenic and much more toxic to many plants, animals, and bacteria inhabiting aquatic environments because it is motile, highly toxic, soluble in water and it is a strong oxidizing agent that causes severe damage to cell membranes while the trivalent chromium Cr (III) is the most stable form of chromium and relatively immobile in the aquatic system due to its lower solubility. This study therefore, aims at identifying a bacterium that can reduce Chromium (IV) to (III) using a pour plate technique on Luria Bertani medium amended with K2Cr2O7. Graphs and tables were used for the data analysis. The effects of incubation time, pH, temperature, inoculum size, and potassium dichromate (K2Cr2O7) concentration were then examined to characterize the bacterium based on one factor at a time. To assess Chromium (VI) reduction, a spectrophotometric study of the 1, 5-diphenyl carbazide test (DPC) at 370 nm was utilized. By using molecular phylogenetic analysis and partial 16s ribosomal RNA analysis, the isolate was found to be Acinetobacter sp. strain BUK_BCH_BTE 5. The findings demonstrated that tryptic soy broth (TSB), with an optimal K2Cr2O7 level of 200 mg/L, pH of 6.5, 35 °C temperature, inoculum size of 2%, as well as incubation time of 48 h, was the most successful approach for decreasing chromium (VI). Following Nickel (Ni), the isolate was found to withstand the highest doses of Lead (Pb), Mercury (Hg), Zink (Zn), Iron (Fe), Cadmium (Cd), Arsenic (As), and Cupper, in that order. A reduced culture's (supernatant) larvacidal bioassay showed a 30% decrease in toxicity in just 48 hours, indicating that the isolate is a promising candidate, and that the reduction method is less dangerous for decontaminating chromium-contaminated environments.

Textile industry wastewater contains azo dye leftovers, which have a deleterious impact on most environmental systems. Because of safety and cost considerations, biological waste treatment is the best alternative. The goal of the study was to isolate and characterized fungus that could decolorize and use azo dye (Congo red) as a single carbon source. After serial dilution on mineral salt media, the fungus was isolated using the pour plating procedure. Based on gene sequencing of ITS1 and ITS2 ribosomal RNA region and molecular phylogenetic analysis the strain was identified as Aspergillus quadrilineatus with the accession number OK178927. Temperature, pH, substrate concentration, incubation period, inoculum size, and the influence of interacting heavy metals in Mineral Salt Medium were all investigated during the characterization process Congo red is used as the sole carbon source. This fungal isolate grew and decolorized Congo red best at 400 μɡ/ml substrate concentration, 30 °C temperature, 5.0 pH, an inoculum size of 200 μL, and a 72-h incubation time. The isolate was shown to withstand up to 6 ppm of Zink (Zn), Chromium (Cr), and Cupper (Cu), with Iron (Fe) and Arsenic (Ar) showing the most inhibition. Comparing Congo red's metabolites to a standard database of organic substances. LC/MS analyses of the intermediate compounds produced during Congo red decolorization revealed the formation of Isamine blue, p-bromo-N-(2-naphthyl)-benzenesulfonamide, 4-acetomido-N,N-dicyclohexyl-3-nitrobenzene, and azobenzene-2-sulfenyl bromide as metabolites in the fungal biodegradation of Congo red. The isolate might be a good candidate for bioremediation.

In recent years, the degradation of pollutants by microorganisms has emerged as a feasible and cost-effective strategy for restoring the quality of the environment. Anthracene is an integral part of many carcinogenic polyaromatic hydrocarbons (PAHs) and causes skin irritation. The aimed of the study is to investigate the anthracene-degrading ability bacteria and from environmental samples and characterized them using an enrichment technique. The bacterial strain was identified as Achromobacter xylosoxidans based on molecular identification achieved via 16SrRNA sequencing and phylogenetic analysis. The strain, designated as BUK_BTEG6 (accession number OM52853), was found to efficiently degrade anthracene as the sole carbon and energy source. A one factor at a time (OFAT) approach was utilized to determine the optimal growth factors that include substrate concentration, temperature, pH, and inoculum size. Results indicated that 400-600 mg/L was found as the optimal growth conditions as substrate concentration with temperature to be 35 °C, pH of 7.5 after 72 hours of incubation. Moreover, the GC-MS analysis of the culture medium confirmed the presence of degradation metabolites such as 9-10 anthraquinone, anthracene cis 1,2 dihydro diol, catechol, and cis-cis muconic acid. This isolate represents a potential candidate for use in environmental bioremediation strategies aimed at eliminating anthracene contamination from the environment.

Introduction Extracorporeal membrane oxygenation (ECMO) is associated with a high rate of neurologic complications. Multimodal neurologic monitoring (MNM) has the potential for early detection and intervention. We examined the safety and feasibility of noninvasive MNM during ECMO. We hypothesized that survivors and non-survivors would have meaningful differences in transcranial Doppler (TCD) sonography and electroencephalographic (EEG) characteristics, which we aimed to identify. We also investigated adverse neurologic events and attempted to identify differences in EEG and TCD characteristics among patients based on the type of ECMO and the occurrence of these events. Material and methods We performed an observational study on all patients undergoing ECMO at Baylor St. Luke's Medical Center's critical care unit in Houston, Texas, United States, from January 2017 to February 2019. All patients underwent a noninvasive MNM protocol. Results NM was completed in 75% of patients; all patients received at least one component of the monitoring protocol. No adverse events were noted, showing the feasibility and safety of the protocol. The 60.4% of patients who did not survive tended to be older, had lower ejection fractions, and had lower median right middle cerebral artery (MCA) pulsatility and resistivity indexes. Patients undergoing venoarterial (VA)-ECMO had lower median left and right MCA velocities and lower right Lindegaard ratios than patients who underwent venovenous-ECMO. In VA-ECMO patients, EEG less often showed sleep architecture, while other findings were similar between groups. Adverse neurologic events occurred in 24.7% of patients, all undergoing VA-ECMO. Acute ischemic stroke occurred in 22% of patients, intraparenchymal hemorrhage in 4.9%, hypoxic-ischemic encephalopathy in 3.7%, subarachnoid hemorrhage in 2.5%, and subdural hematoma in 1.2%. Conclusion Our results suggest that MNM is safe and feasible for patients undergoing ECMO. Certain EEG and TCD findings could aid in the early detection of neurologic deterioration. MNM may not just be used in monitoring patients undergoing ECMO but also in prognostication and aiding clinical decision-making., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Siddiqui et al.)

Background: First-pass efficacy (FPE) has been established as an important predictor of favorable functional outcomes after endovascular thrombectomy (ET) in anterior circulation strokes. In this retrospective cohort study, we investigate predictors and clinical outcomes of FPE in posterior circulation strokes (pcAIS). Methods: The Stroke Thrombectomy and Aneurysm Registry database was used to identify pcAIS patients who achieved FPE. Their baseline characteristics and outcomes were compared with the non-FPE group. The primary outcome was a 90-day modified Rankin Scale (mRS) of 0-3. Univariate (UVA) and multivariate (MVA) analyses were done to evaluate predictors of FPE. Safety outcomes included distal emboli, vessel rupture, symptomatic intracranial hemorrhage, and mortality. Results: Of 359 patients, 179 (50%) achieved FPE. Clot burden, occlusion site, and ET technique-related variables were similar between the two groups except for shorter procedure time with FPE. The primary outcome was significantly better with FPE (56.4% vs. 32.8%, p  < 0.001). Complications were similar except for a higher rate of distal emboli in non-FPE group (11.1% vs. 3.2%, p  = 0.032). Atrial fibrillation (Afib) had increased odds (aOR: 2.06, 95% CI; 1.24, 3.4, p  = 0.005) and prior ischemic stroke had decreased odds (aOR: 0.524, 95% CI; 0.28, 0.97, p  = 0.04) of FPE. Afib was the only independent predictor of FPE on MVA (1.94, 95% CI; 1.1, 3.43, p  = 0.022). Conclusions: Higher rate of FPE in Afib-related pcAIS could possibly be explained by the differences in clot composition and degree of in-situ atherosclerotic disease burden. Future studies are warranted to explore the relationship of clot composition with ET outcomes.

Introduction: Understanding outcomes after Vein of Galen malformation (VOGM) embolization has been limited by small sample size in reported series and predominantly single center studies. To address these limitations, we perform an individual-participant meta-analysis (IPMA) to identify risk factors associated with all-cause mortality and clinical outcome after VOGM endovascular embolization., Methods: We performed a systematic review and IPMA of VOGM endovascular outcomes according to PRISMA guidelines. Individual patient characteristics including demographic, intra/post-operative adverse events, treatment efficacy (partial or complete occlusion), and clinical outcome were collected. Mixed-effects logistic regression with random effects modeling and Bonferroni correction was used ( p  ≤ 0.003 threshold for statistical significance). The primary and secondary outcomes were all-cause mortality and poor clinical outcome (moderate/severe developmental delay or permanent disabling injury), respectively. Data are expressed as (mean ± standard deviation (SD)) or (odds ratio (OR), 95% confidence interval (CI), I 2 , p -value)., Results: Thirty-five studies totaling 307 participants quantifying outcomes after endovascular embolization for VOGM were included. Follow up time was 42 (±57) months. Our analysis contained 42% neonates (<1 month) at first embolization, 45% infants (1 month ≤2 years), and 13% children (>2 years). Complete occlusion was reported in 48% of participants. Overall all-cause mortality was 16%. Overall, good clinical outcome was achieved in 68% of participants. First embolization as a neonate [OR = 6.93; 95% CI (1.99-24.08); I 2  < 0.01; p  < 0.001] and incomplete embolization [OR = 10.87; 95% CI (1.86-63.55); I 2  < 0.01; p  < 0.001] were associated with mortality. First embolization as a neonate [OR = 3.24; 95% CI (1.47-7.15); I 2  < 0.01; p  < 0.001], incomplete embolization [OR = 5.26; 95% CI (2.06-13.43); I 2  < 0.01; p  < 0.001], and heart failure at presentation [OR = 3.10; 95% CI (1.03-9.33); I 2  < 0.01; p  = 0.002] were associated with poor clinical outcomes. Sex, angioarchitecture of lesion, embolization approach (transvenous vs. transarterial), and single or multistage embolization were not associated with mortality or clinical outcome., Conclusions: We identify incomplete VOGM embolization independently associated with mortality and poor clinical outcome. While this study provides the highest level of evidence for VOGM embolization to date, prospective multicenter studies are needed to understand the optimal treatment strategies, outcomes, and natural history after VOGM embolization., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2022 Savage, Hale, Parr, Hedaya, Saccomano, Tsemo, Hafeez, Tanweer, Kan, Solomon, Meila, Dirks, Blount, Johnston, Rocque, Rozzelle, Bhatia, Muthusami, Krings and Jones.)

Background The Woven EndoBridge (WEB) device was explicitly designed for wide-neck intracranial bifurcation aneurysms. Small-scale reports have evaluated the off-label use of WEB devices for the treatment of sidewall aneurysms, with promising outcomes. Purpose To compare the angiographic and clinical outcomes of the WEB device for the treatment of sidewall aneurysms compared with the treatment of bifurcation aneurysms. Materials and Methods A retrospective review of the WorldWideWEB Consortium, a synthesis of retrospective databases spanning from January 2011 to June 2021 at 22 academic institutions in North America, South America, and Europe, was performed to identify patients with intracranial aneurysms treated with the WEB device. Characteristics and outcomes were compared between bifurcation and sidewall aneurysms. Propensity score matching (PSM) was used to match by age, pretreatment ordinal modified Rankin Scale score, ruptured aneurysms, location of aneurysm, multiple aneurysms, prior treatment, neck, height, dome width, daughter sac, and incorporated branch. Results A total of 683 intracranial aneurysms were treated using the WEB device in 671 patients (median age, 61 years [IQR, 53-68 years]; male-to-female ratio, 1:2.5). Of those, 572 were bifurcation aneurysms and 111 were sidewall aneurysms. PSM was performed, resulting in 91 bifurcation and sidewall aneurysms pairs. No significant difference was observed in occlusion status at last follow-up, deployment success, or complication rates between the two groups. Conclusion No significantly different outcomes were observed following the off-label use of the Woven EndoBridge, or WEB, device for treatment of sidewall aneurysms compared with bifurcation aneurysms. The correct characterization of the sidewall aneurysm location, neck angle, and size is crucial for successful treatment and lower retreatment rate. © RSNA, 2022 See also the editorial by Hetts in this issue.

Present article reads three dimensional flow analysis of incompressible viscous hybrid nanofluid in a rotating frame. Ethylene glycol is used as a base liquid while nanoparticles are of copper and silver. Fluid is bounded between two parallel surfaces in which the lower surface stretches linearly. Fluid is conducting hence uniform magnetic field is applied. Effects of non-linear thermal radiation, Joule heating and viscous dissipation are entertained. Interesting quantities namely surface drag force and Nusselt number are discussed. Rate of entropy generation is examined. Bvp4c numerical scheme is used for the solution of transformed O.D.Es. Results regarding various flow parameters are obtained via bvp4c technique in MATLAB Software version 2019, and displayed through different plots. Our obtained results presents that velocity field decreases with respect to higher values of magnetic parameter, Reynolds number and rotation parameter. It is also observed that the temperature field boots subject to radiation parameter. Results are compared with Ishak et al. (Nonlinear Anal R World Appl 10:2909-2913, 2009) and found very good agreement with them. This agreement shows that the results are 99.99% match with each other., (© 2021. The Author(s).)

Introduction: Botulinum neurotoxin (BoNT) is one of the most potent and extensively studied neurotoxins with clinical applications across several different medical specialties. This review article explores the latest evidence for therapeutic applications of BoNT in patients receiving critical management in an intensive care unit (ICU)., Areas Covered: The authors did a literature search in PubMed, Google Scholar, and Texas Medical Center Library database for studies describing the use of BoNT in a critical care setting. They extracted information on study design, patient selection, methodology, and results of relevant studies. Based on initial identification of 85 studies and after conducting screening, the authors identified 61 studies to be included in this review. In an ICU setting, BoNT has been used for several neurological and non-neurological indications. However, the supporting evidence is mostly limited to small observational studies., Expert Opinion: The use of BoNT in this setting is largely underutilized due to paucity of well-designed clinical trials and financial barriers. Further research is needed to provide evidence for the safety and efficacy of BoNT and to optimize the dosing and injection techniques for various conditions encountered in this setting.

Background: A new clinical syndrome has been recognized following the COVID-19 vaccine, termed thrombosis with thrombocytopenia syndrome (TTS). The following systematic review focuses on extrapolating thrombotic risk factors, clinical manifestations, and outcomes of patients diagnosed with TTS following the COVID-19 vaccine., Methods: We utilized the World Health Organization's criteria for a confirmed and probable case of TTS following COVID-19 vaccination and conducted a systematic review and posthoc analysis using the PRISMA 2020 statement. Data analysis was conducted using SPSS V25 for factors associated with mortality, including age, gender, anti-PF4/heparin antibodies, platelet nadir, D-dimer peak, time to event diagnosis, arterial or venous thrombi., Results: Of the 175 studies identified, a total of 25 studies with 69 patients were included in this systematic review and post hoc analysis. Platelet nadir ( P  < .001), arterial or venous thrombi ( χ 2 = 41.911, P  = .05), and chronic medical conditions ( χ 2 = 25.507, P  = .041) were statistically associated with death. The ROC curve analysis yielded D-dimer (AUC = .646) and platelet nadir (AUC = .604) as excellent models for death prediction., Conclusion: Adenoviral COVID-19 vaccines have been shown to trigger TTS, however, reports of patients having received mRNA COVID-19 vaccines are also present. Healthcare providers are recommended to maintain a high degree of suspicion among individuals who have received the COVID-19 vaccine within the last 4 weeks.

Purpose: To study the prescribing pattern of antibiotics in outpatients and emergency departments in the Gulf region. To compare the appropriateness of prescriptions and antibiotics commonly prescribed for respiratory tract infection. Method: The search was limited to the years 2008-2020, and articles had to be in English. Articles were searched from various resources and evaluated using PRISMA. Forty-one articles were selected and screened, and in the end, 17 articles were included in the study. All articles were selected from the gulf region of six countries: UAE, Saudi Arabia, Qatar, Oman, Yemen, and Bahrain. Only primary literature were included. Inpatient and literature from other countries outside the gulf region were excluded. Result: Penicillins, cephalosporins, and macrolides are highly useful antibiotics for respiratory tract infections. Ceftriaxone IV is recommended in acute respiratory tract infection if therapy with penicillin fails. Most of the antibiotic prescriptions in Gulf countries are inappropriate. Inappropriate antibiotic prescribing in the gulf region varies from place to place and reaches a maximum of 80%. Antibiotics may be prescribed with the wrong dosage or frequency and inappropriate guidelines. Penicillins are prescribed at about 50-60%; the most common penicillins prescribed are amoxicillin and co-amoxiclave. Cephalosporins are prescribed at about 30%, and the most common are third-generation. Macrolides are prescribed at about 17-20%, and the most common macrolides are azithromycin and clarithromycin. Fluoroquinolones are prescribed at about 10-12%, of which levofloxacin and ciprofloxacin are more commonly prescribed with metronidazole at 10%. Conclusion: It is suggested that the antibiotic-prescribing pattern in outpatient and emergency departments in the Gulf region are highly inappropriate and need improvement through education, following guidelines, annual vaccination, and stewardship programs; the most prescribed antibiotic is amoxicillin/co-amoxiclave, and the most often encountered infection in outpatients is acute respiratory tract infection., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2020 Mahmood, Gillani, Saeed, Hafeez and Gulam.)

Introduction Ocular involvement in leukemia may occur because of direct leukemic infiltration or because of secondary ophthalmic involvement as a result of abnormalities related to blood like anemia, thrombocytopenia, and leukocytosis. In some patients with leukemia, ophthalmic signs can precede the systemic features and can help in early diagnosis of systemic leukemia. Due to the scarcity of data on this topic from Pakistan, we conducted this study to determine the pattern of ocular involvement in patients with leukemia presenting in our settings. Methods This cross-sectional study was conducted in a tertiary care hospital of Pakistan over a period of one year. The study comprised of both newly diagnosed and follow-up patients of acute leukemia of age more than 15 years. Patients underwent detailed ophthalmic anterior and dilated posterior segment examination. Patient's demographic profile, type of leukemia, chemotherapy status, and hematologic findings were also documented. Results There were 97 leukemic patients in the study with 55 (56.7%) males and 42 (43.3%) females. Various ophthalmic manifestations were observed in 47 (48.45%) patients. Forty-two (43.3%) were diagnosed cases with acute lymphocytic leukemia (ALL) and 55 (56.7%) suffered from acute myelogenous leukemia (AML). Ophthalmic manifestations were present in 29 patients of AML (52.7%) and 18 patients of ALL (42.85%). Ocular involvement was significantly more common in newly diagnosed (n=32) as compared with follow-up patients (n=15) (p-value = 0.032). Posterior segment (n=48) was the most common site of ocular involvement (n=48, 49.5%) with retinal hemorrhages seen in 40 patients (41.2%) and papilloedema in seven cases (7.2%). Thirty-three (70.2%) out of 47 patients with ophthalmic manifestations were asymptomatic while 14 (29.8%) had ocular symptoms at the time of initial presentation. Conclusion Ophthalmic manifestations were present in about half of the patients with leukemia. Ocular involvement was more prevalent in newly diagnosed cases and in patients with AML., Competing Interests: The authors have declared that no competing interests exist.