Sandro Marcelo de Moraes Valente1,2,3*ABOMI – Academia Brasileira de Odontologia Militar / Brazilian Academy of Military Dentistry, Rio de Janeiro, Brazil.ATO- Academia Tiradentes de Odontologia / Tiradentes Academy of Dentistry, Sao Paulo, Brazil.Sandro Valente Institute, Rio de Janeiro, Brazil.

Essential oils (EOs) and Oleoresins (ORs) are well distinguished for their antioxidant properties and they can be broadly used in the food industry as preservatives. The present study was executed for evaluating the synergistic interactions on antioxidant efficacy of EOs and ORs of Cinnamomum zeylanicum, Syzygium aromaticum, Zingiber officinale and their combinations. EO and ORs were obtained by hydro-distillation and solvent extraction and the main components of ORs and EO were also analyzed using HPLC and GCMS respectively. In-vitro antioxidant properties were investigated by DPPH free radical scavenging assay, Total Antioxidant Activity (TAC) by phosphomolybdenum method and ABTS radical scavenging activity assay. EOs and ORs which consisted with different chemical constituents and different Total Phenolic Content (TPC) and Total Flavanoid Content (TFC) exhibited a range of variation in the inhibition percentage of DPPH and IC50 values (0.1645-6.5181 mg/mL). The TAC of EOs and ORs was within the range of 0.27-3.94 mg AAE/mg. The oleoresins showed higher inhibition percentages and TAC compared to EOs of same spice. This study revealed that clove bud contains higher antioxidant properties than cinnamon and ginger. Significant reductions in IC50 values were shown in EO blends compared to the oleoresin blends. The combination of cinnamon EO/clove bud EO and combination cinnamon EO/ginger EO showed strong synergy in tested samples. Therefore, both EOs and ORs of Cinnamomum zeylanicum, Syzygium aromaticum, Zingiber officinale and their blends are excellent sources for natural and effective natural antioxidant agents in the food industry.

Malnutrition related diabetes mellitus (MRDM) is rare type of diabetes which is associated with long term malnutrition .It is classified in 2 subgroups by the American Diabetes Association as Fibrocalcific or fibrocalculous pancreatic diabetes (FCPD) and Protein-deficient pancreatic diabetes (PDPD)/protein-deficient diabetes mellitus (PDDM). This review summarises about the diagnosis criteria , prevalence and pathophysiology of FCPD and PDDM. Various clinical studies have been carried out to understand the impact of malnutrition on the glucose homeostasis. Different animal models have been developed to study the pathophysiological aspects of MRDM. This review also focuses on the management of diabetes in terms of Medical nutrition treatment (MNT) , pain management, exocrine management, diabetes management and ayurvedic management . Keywords:- Malnutrition related Diabetes mellitus (MRDM), Fibrocalcific or fibrocalculous pancreatic diabetes (FCPD), protein-deficient diabetes mellitus (PDDM), diagnosis criteria of MRDM, management of MRDM.

A document by Satya Deo Pandey. Click on the document to view its contents.

Age-related diseases have become more common with the advancing age of the worldwide population. Such diseases involve multiple organs, with tissue degeneration and cellular apoptosis. To date, there is a general lack of effective drugs for treatment of most age-related diseases and there is therefore an urgent need to identify novel drug targets for improved treatment. Acid-sensing ion channel 1a (ASIC1a) is a degenerin/epithelial sodium channel family member, which is activated in an acidic environment to regulate pathophysiological processes such as acidosis, inflammation, hypoxia, and ischemia. A large body of evidence suggests that ASIC1a plays an important role in the development of age-related diseases (e.g., stroke, rheumatoid arthritis, Huntington’s disease, and Parkinson’s disease.). Herein we present: 1) a review of ASIC1a channel properties, distribution, and physiological function; 2) a summary of the pharmacological properties of ASIC1a; 3) and a consideration of ASIC1a as a potential therapeutic target for treatment of age-related disease.

This article introduces briefly current status of the Covid-19 pandemic and discusses “antidotes” of coronavirus (SARS-CoV-2 and its variants), that is, “ISISI” barriers from locals, nations or regions to the globe, namely, [Isolation with Masks, Unit protective clothing, Stay at “home”, and Travel restriction (MUST); Screening and testing; Individual immunity by healthy E(e)SEEDi lifestyle, bio-agents (chemical agents, convalescent plasma, neutralizing antibody, and Chinese medicine), and vaccination; Social and medical supports; International cooperation and information sharing]. Since there are several major coronavirus variants with more infectious, such as Delta and Omicron, many more cases with cardiac injury and cardiac arrest need better cardiovascular prevention and protection. With further understanding of the pathogenesis of Covid-19 and development of novel mRNA vaccines and discovery of new antiviral drugs, such as Molnupiravir and Paxlovid, people will do better in fighting against SARS-CoV-2 and its variants and cardiovascular protection in the pandemic and post-Covid-19 era.

Background and Purpose: The widespread abuse of antibiotics have led to increasing resistance of many important human pathogens. The urgent need to develop novel antimicrobial therapies has stimulated great interest in antimicrobial peptides as therapeutic candidates for the treatment of infectious diseases. Scorpion venom-derived peptide Androctonus Amoreuxi Antimicrobial Peptide 1 (AamAP1) is a new type of host defense peptide with broad-spectrum but moderate antimicrobial property. Most importantly, AamAp1 has been proved to be highly hemolytic and displays significantly high toxicity against mammalian cells. The aim of this study was to evaluate the antimicrobial activity and mechanism of a novel synthetic antimicrobial peptide GK-19 deriving from AamAP1 and its derivatives. Experimental Approach: Five bacteria and three fungi were used to evaluate the antimicrobial effect of GK-19 in vitro. Mouse models of scalded combined with skin and soft tissue infections were used to evaluate the antimicrobial effect of GK-19 in vivo. Key Results: The results indicated that Gk-19 could not only inhibit Gram-positive and Gram-negative bacterial growth but also kill fungi by permeabilizing microbial membrane. Cellular and in vivo studies proved that GK-19 showed negligible toxicity to mammalian cells, low hemolytic activity and high stability in plasma. Furthermore, in mouse models of scald combined with skin and soft tissue infections induced by either Methicillin-Resistant Staphylococcus Aureus (MRSA) or Candida Albicans, GK-19 showed significant antimicrobial and healing effects. Conclusion and Implications: The novel scorpion venom-derived peptide analogue GK-19 is a promising drug candidate in the battle against multi-resistant bacterial and fungal infections.

EES originating in the stomach is rare, and has never been reported by Chinese. As the imaging findings are non-specific, this clinical category may be misdiagnosed before surgery. Awareness of stomachal Ewing tumors may facilitate prompt diagnosis than the more commonly encountered gastrointestinal stromal tumor(GIST).

Lowering the Threshold for Left Bundle Branch Area PacingLukasz P. Cerbin, MD1 and Lohit Garg, MD11 Division of Cardiac Electrophysiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.Relevant Disclosures: NoneFunding: NoneCorresponding Author: Lohit Garg, MDDivision of Cardiac Electrophysiology, University of Colorado Anschutz Medical Campus12401, E. 17th Ave, Aurora, Colorado-80045Email: Lohit.garg@cuanschutz.eduCardiac pacing remains the mainstay of therapy for conduction system disease and irreversible bradyarrhythmias. Due to known complications from chronic RV pacing and electromechanical dissociation1,2, there has been a growing interest in physiologic pacing. While cardiac resynchronization therapy (CRT) with LV pacing from a lead in the coronary sinus has been shown to ameliorate some of the morbidity from RV septal pacing3, activation is still via myocyte to myocyte conduction rather than engaging the specialized conduction system. Furthermore, LV lead placement can be challenging and response to CRT is heterogeneous and difficult to predict4. And finally, CRT’s role in patients with preserved LV systolic function has not been established.In this light, there has recently been a substantial growth in conduction system pacing directly engaging the native His-Purkinje conduction system. This began with a case series published in 2000 demonstrating selective his bundle capture and subsequent permanent His bundle pacing (HBP) lead placement in patients with heart failure and tachycardia induced cardiomyopathy secondary to atrial fibrillation5. Additional studies demonstrated the feasibility and clinical benefit of HBP as a strategy for CRT6,7. However, continued research revealed high capture thresholds and low R wave amplitudes, calling this technique into question8. Furthermore, HBP failed to demonstrate improved outcomes in patients with underlying LBBB, likely due to the presence of conduction disease distal to the site of capture9. Due to these concerns, the enthusiasm for HBP gradually waned, with a subsequent rise in interest in left bundle branch area pacing (LBBAP). This approach utilizes the same lead and implant technique to fix a lumenless pacing lead approximately 1.5 cm distal to the anatomical His bundle within the interventricular septum, directly engaging the left bundle.In this issue, Mehta et al. describe a single center’s experience of implantation of left bundle branch area pacing leads, complete with one year follow-up data. Their retrospective study included 65 patients over an 18 month period who received a 3830 Medtronic lead for LBBAP. Only patients with one year of follow up data were included. Importantly, they excluded 7 patients in whom LBBAP implant was unsuccessful, resulting in a reported implant success rate of 91.8%. The reported procedure time was 72.7 +/- 28.8 minutes. The mean QRS duration decreased significantly in patients with pre-existing LBBB, was unchanged in those with pre-existing RBBB, and increased significantly in patients without pre-exiting bundle branch block. At one year follow-up, they found a significantly higher capture threshold compared to threshold at implant (p<0.0001), although they noted that the absolute increase (0.2-0.3 V) was relatively modest. No short or long-term complications related to device implant were identified.This study underscores several important points regarding LBBAP. Firstly, procedural success is high, with the authors reporting an implant success rate of 91.8% in this study. Reasons for implant failure included unacceptably high pacing thresholds, inability to meet parameters used to ensure capture of the left bundle, and anatomic constraints in one patient that prohibited lead placement. This success rate is similar to that reported in other studies10. Other studies have found higher implant success rate with LBBAP as compared to HBP11. Secondly, this success rate is likely easily reproducible as the implant technique does not require additional or specialized training, only a long delivery sheath and some familiarity with the mechanism to fix the 3830 lead to the interventricular septum. With preliminary data suggesting improved outcomes compared to traditional RV septal pacing12and the relative ease of procedural proficiency, it would seem that this technique could rapidly become the gold standard for pacemaker implantation.While there is great enthusiasm for LBBAP, several key questions remain. Firstly, this study, along with a recent publication from the Geisinger-Rush Conduction System Pacing Registry12, are the first to publish one year data following LBBAP lead implant. While lead parameters were reported to be stable at one year in this study, longer term data are needed. Furthermore, in addition to data on long term lead parameters and clinical efficacy, long term safety outcomes will be important. Particularly, subclinical perforation of the helix into the LV may carry thrombotic risk and long term data on whether this increases stroke risk will be important13. One prior study found two cases of subclinical septal perforation occurring after LBBAP lead placement14. Another case report described a patient presenting with presyncope two weeks after device implant with perforation of the lead into the LV and associated lack of capture up to 3.5 V @ 0.4 ms (bipolar)15. The incidence and risk factors for these events has yet to be established and the associated morbidity, including stroke risk from thromboembolism, remains uncharacterized. Another question that needs to be addressed is that of extractability of LBBAP leads. While there have been few published reports of successful extraction of these leads16, these lumen-less leads represent unique challenges in terms of extraction tools and technique. More data is needed to characterize the approach and outcomes for extraction of LBBAP leads.Finally, the criteria for left bundle capture, as opposed to left septal pacing, has yet to be firmly established, with both being included in the catch-all term “left bundle branch area pacing.” A recent study by Wu et al. utilized temporary HBP leads and LV septal mapping with multielectrode catheters during LBBAP lead implant to identify markers of selective LBBP17. They identified several useful parameters, including paced RBBB pattern (100% sensitive), LBB potential on the lead electrogram, abrupt shortening of stim-LV activation time (LVAT) and certain stim-LVAT times (which varied based on the presence or absence of an underlying LBBB). Another study from the same group utilized a decapolar coronary sinus catheter to examine differences in LV activation time and depolarization with left bundle capture versus left septal pacing, finding that the a model combining the presence of a LBBB potential on the lead coupled with a validated stim-LVAT had excellent test characteristics (AUC = 0.985) to differentiate conduction system from septal pacing18. In the current study, the authors reported 67.7% of patients with selective left bundle capture and 32.3% with left septal pacing when applying this algorithm. A scientific consensus on how to identify left bundle capture is essential to both study the long term clinical benefits in patients undergoing LBBAP implantation as well as establishing criteria to guide implanting physicians attempting to achieve selective left bundle capture.In summary, left bundle branch area pacing remains an exciting and burgeoning area within cardiac electrophysiology. This study by Mehta et al. demonstrated stable and acceptable lead parameters one year after LBBAP implantation, adding evidence of the long term safety and efficacy of this technique. Several questions remain, including longer term efficacy, the incidence of subacute and chronic complications, the ability to extract these leads when indicated, and the effect of LBBAP clinical outcomes. Furthermore, rigorous definitions for left bundle capture and left septal pacing need to be agreed upon. However, if these data can be replicated on a larger scale and longer term data shows similar safety and efficacy, LBBAP may likely represent the gold standard for pacing for bradyarrhythmia indications in the near future.

Catheter ablation in children has evolved to become a highly effective and safe therapy. Each iterative improvement in ablation technology provides another opportunity to investigate how much incremental benefit can be made without sacrificing safety. Contact force sensing catheters represent an example of such technology that has become commonplace in adult ablation. Its capability in predicting lesion size and collateral damage to critical structures has not been meticulously explored. Backhoff and colleagues describe an animal ablation model where they quantitate lesion characteristics at the atrium, atrioventricular groove, and ventricle using low and high contact force targets, with a specific focus on assessing for coronary arterial injury. In this controlled experiment, chronic lesion characteristics were widely variable (~0-8 mm diameter) yet there was a statistically significant (albeit small) increase in lesion diameter for high (vs low) contact force lesions delivered to the atrioventricular groove. The risk of chronic sub-clinical coronary artery injury was 1-2%.

Objective: To evaluate for cardiac involvement in recovered COVID-19 patients using cardiac magnetic resonance imaging (MRI). Methods: A total of 30 subjects recently recovered from COVID-19 and abnormal left ventricular global longitudinal strain were enrolled. Routine investigations, inflammatory markers and cardiac MRI were done at baseline with follow-up scan at 6 months in individuals with abnormal baseline scan. Additionally, 20 age-and sex-matched individuals were enrolled as healthy controls (HCs). Results: All 30 enrolled subjects were symptomatic during active COVID-19 disease and were categorized as mild: 11 (36.7%), moderate: 6 (20%) and severe: 13 (43.3%). Of the 30 patients, 16 (53.3%) had abnormal CMR findings. Myocardial edema was reported in 12 (40%) patients while 10 (33.3%) had LGE. No difference was observed in terms of conventional LV parameters however, COVID-19 recovered patients had significantly lower right ventricular (RV) ejection fraction, RV stroke volume and RV cardiac index compared to HCs. Follow-up scan was abnormal in 4/16 (25%) with LGE persisting in 3 patients. Myocardial T1 (1284 + 43.8 ms vs 1147.6 + 68.4 ms; P<0.0001) and T2 values (50.8+16.7 ms vs 42.6+3.6 ms; P=0.04) were significantly higher in post COVID-19 subjects compared to HCs. Similarly, T1 and T2 values of severe COVID-19 patients were significantly higher compared to mild and moderate cases. Conclusions: An abnormal CMR was seen in half of recovered patients with persistent abnormality in one-fourth at six months. Our study suggests a need for closer follow-up among recovered subjects in order to evaluate for long term cardiovascular sequalae.

Objective of investigation: Integrated ecological farming combines rice growth and aquaculture, and is an effective way to improve soil productivity by increasing soil nutrient supply and reducing agricultural non-point source pollution. We investigated the impacts of cultivation patterns, including integrated ecological farming (IEF), rice and vegetable rotation pattern (RVP), and conventional rice cropping pattern (CRP), on the characteristics of soil phosphorus in the Pearl River Delta (PRD). Experimental material: The study area was located in Zengcheng District, Guangzhou City, China. Method of investigation: Tiessen’s classification was used to analyze soil phosphorus fraction contents and its availability. Data collection: Following rice harvesting, topsoil (0–10 cm) and subsoil (10–20 cm) were collected from each field via an S-shaped 5-point sampling method, and the collected samples were mixed into a single sample. Result and conclusions: SOC and phosphorus fractions were significantly influenced by cultivation patterns; IEF significantly increased SOC and phosphorus in the soil. Soil phosphorus was dominated by moderately labile P (40.67–49.41%). IEF also significantly increased soil microbial biomass carbon, phosphorus, and acid phosphatase (ACP) by 67.68, 46.68, and 15.87% compared to RVP, and by 134.14, 65.99, and 30.20% compared to CRP, respectively. SOC and ACP were the primary factors influencing the conversion and effectiveness of soil phosphorus. The integrated ecological cropping pattern can alleviate low phosphorus activity in PRD paddy soils while promoting a sustainable soil nutrient cycle within the ecosystem and guiding the sustainable development of rational soil fertilization in the region.

Aim: North China leopard (Panthera pardus japonensis), is the most widespread subspecies of leopard and one of the rare and endangered species in China. It is currently confined to several isolated reserves, and little is known about its habitat network connectivity with land use changes. We proposed an approach for the evaluation of the impacts of land use changes on landscape connectivity for North China leopard. Location: The Great Taihang Region, in the north of China, covers the entire territory of Shanxi province, as well as some districts and counties in Beijing, Hebei and Henan provinces. Methods: We analysed multiple background layers affecting North China leopard movement patterns, including environmental and anthropogenic factors, and generated a landscape resistance surface. Then we used Circuit theory-based connectivity models to delineate pathways suitable for species movement, and evaluate the connectivity status of core areas and the impacts of land use changes on landscape connectivity. Results: We identified 33 least cos distance paths in 1990 and 34 paths in 2020, and four key barrier areas. The landscape connectivity has not been greatly improved with the land use changes, especially with the increase of forest land from 26.61 to 34.85%. Nevertheless, there is a decreasing trend on connectivity in some key movement barrier areas. Improving landscape connectivity at a broad spatial scale is as important as protecting the habitats (natural reserves) where the species lived. Main conclusions: Our study can serve as an example of how to explore the relationships between land use changes and landscape connectivity for species at broad spatial scales with limited movement patterns data. This information is proved to be critical for enhancing landscape connectivity for conservation concern of North China leopard and planning of natural reserves network.

Climate change is increasing aridity in grassland and desert habitats across the southwestern United States, reducing available resources and drastically changing the breeding habitat of many bird species. Increases in aridity reduce sound propagation distances, potentially impacting habitat soundscapes, and leading to a breakdown of the avian soundscapes in the form of loss of vocal culture, reduced mating opportunities, and local population extinctions. We developed an agent-based model to examine how changes in aridity will affect both sound propagation and the ability of territorial birds to audibly contact their neighbors. We simulated vocal signal attenuation under a variety of environmental scenarios for the south central semi-arid prairies of the United States, ranging from contemporary weather conditions to predicted extremes under climate change. We also simulated how changes in physiological conditions, mainly evaporative water loss (EWL), would affect singing behavior. Under extreme climate change conditions, we found significantly fewer individuals successfully contacted all adjacent neighbors than did individuals in either the contemporary or mean climate change conditions. We also found that at higher sound frequencies and higher EWL, fewer individuals were able to successfully contact all of their neighbors, particularly in the extreme and extreme climate change conditions. These results indicate that climate change-mediated aridification may disrupt the avian soundscape, such that vocal communication no longer effectively functions for mate attraction or territorial defense. As climate change progresses increased aridity in current grasslands may favor shifts toward low frequency songs, colonial resource use, and altered songbird community compositions.

Ψ-Hilfer fractional derivative as a generalization of many important nonlocal derivatives such as Riemann-Liouville, Caputo and Hadamard fractional derivatives, has a great importance in fractional calculations and theory of fractional differential equations. Accordingly, in this paper, we study the multiplicity results for Ψ-Hilfer fractional problems. Specially, our goal is to establish the existence of infinitely many nontrivial or distinct weak solutions for a nonlocal Ψ-Hilfer fractional problem by using critical point theory.

Primary yolk sac tumors (YST) are rare pre-pubescent tumors. A 40-year-old with chronic testicular swelling was diagnosed with YST with pulmonary metastasis, pulmonary embolism, and left leg DVT, undergoing 4 cycles of BEP chemotherapy and left orchiectomy. This report highlights the aggressive course but adequate treatment response to adult YSTs.

This paper analyses how the extended geometric series behaves on the computation of various parts of the series. This idea will enhance the knowledge of researchers working in sequence, series, summability and its applications.

Routine exome sequencing (ES) in individuals with neurodevelopmental disorders (NDD) remains inconclusive in >50%. Research analysis of unsolved cases can identify novel candidate genes but is time consuming, subjective, and hard to compare between labs. The field therefore needs automated and standardized assessment methods to prioritize candidates for matchmaking. We developed AutoCaSc (https://autocasc.uni-leipzig.de) based on our candidate scoring scheme (CaSc). We validated our approach using synthetic trios and real in-house trio ES data. AutoCaSc consistently (94.5%) scored variants in valid novel NDD genes in the top three ranks. In 93 real trio exomes, AutoCaSc identified most (97.5%) previously manually scored variants while evaluating additional highly scoring variants missed in manual evaluation. It identified candidate variants in previously undescribed NDD candidate genes ( CNTN2, DLGAP1, SMURF1, NRXN3, PRICKLE1). AutoCaSc enables anybody to quickly screen a variant for its plausibility in NDD. After contributing >40 descriptions of NDD associated genes, we provide usage recommendations based on our extensive experience. Our implementation is capable of pipeline integration and therefore allows screening of large cohorts for candidate genes. AutoCaSc empowers even small labs to a standardized matchmaking collaboration and to contribute to the ongoing identification of novel NDD entities.

The physical properties of the Technosols formed by the deposition of tailings may constitute a physical barrier that limits water movement and plant development due to the properties received from the tailings. This study aimed to evaluate the physical quality of the Technosols formed by the rupture of the Fundão Dam, Mariana, MG, Brazil, based on the evaluation of physical properties and Load Bearing Capacity Models (LBCM). For that, three areas under different types of vegetation were selected: eucalyptus (Euc), forest with human-assisted revegetation (RF), and forest with natural vegetation (NF). Three sampling subareas were demarcated in each area: non-impacted areas (Ni), directly impacted areas (Di), and partially impacted areas (Pi). Undisturbed samples were collected in two layers and subjected to the uniaxial compression test after they were equilibrated at different matric potentials. Soil compression curves and LBCM were elaborated. Soil bulk density (BD), total porosity (TP), organic matter (OM), texture, sand fractionation, and particle density (PD) were also determined. The results showed that the clay content was less significantly, and the silt and very fine sand content was higher significantly in the Technosols, generating an increase in BD and reduction in TP. Technosols generally exhibited greater load-bearing capacity, due to higher pre-consolidation pressure values attained by these soils, as a result of the lower clay and OM contents. The high resistance of these soils is one limitation for revegetation of the areas evaluated, being necessary use of management practices that promote full regeneration of the soil physical properties.

In this case report, a medical sales representative consumed 250 mg of Baclofen out of curiosity. Baclofen has life-threatening complications like seizures, respiratory depression and coma. A majority of patients recover on symptomatic treatment. Baclofen has a great potential for abuse and overdose; therefore, its use must be strictly monitored

Purpose. Sentinel lymph node (SLN) biopsy in the surgical treatment of early stage breast cancer is currently employed as part of the routine protocol. Recent studies have shown the use hemosiderin, a new marker derived from the patient’s blood, capable of facilitating the surgical procedure. However, the hypothesis that the blood-derived marker would be hemosiderin arose only from clinical data and preliminary research. This study aimed to study the blood derivative characteristics, leading to clarification of the main substance responsible for SLN marking. Methods. Preclinical tests were conducted in Wistar rats to evaluate SLN tissue marking. After obtaining hemoglobin, the fraction was assessed, and lymphatic mapping and SLN identification of the popliteal region were performed. Drainage time, standard concentration, tissue marking after proteolysis, and thermostability were assayed. Histopathological evaluation by optical microscopy following the animal procedure. Box plots were generated for graphic presentation. Results. It was found that hemoglobin is the main responsible for the labeling of SLN. This labeling process can be optimized by applying 3% nitrite and protease inhibitors to the hemoglobin concentrate for 48h, respecting the drainage time of 2h maintaining the sample temperature at 25°C. Conclusion. This study demonstrates the possible clinical applicability of the hemoderivative protein as a tissue marker in identifying the sentinel lymph node in early and locally advanced breast cancer. The marking process is optimized by standardizing the homeostatic conditions of the biological marker.

Inguinal hernia may contain the bladder as one of its contents, while bilateral inguinal bladder herniation is rare. Urinary obstruction and obesity are associated with increased abdominal pressure and are risk factors of bladder herniation. Clinicians should be aware of the bladder hernia in elderly with chronic dysuria and obesity.

This clinical image presents a rare variant of scabies occurring in an infant with specific clinical presentation that can mislead diagnosis. Clinicians should be aware of such infection to avoid complications.

In this paper, we use the $\tilde{q}$-homotopy analysis transform method ($\tilde{q}$-HATM) to investigate the explicit solutions of the Kundu-Eckhaus equation and the massive Thirring model. Kundu-Eckhaus equation is a nonlinear partial differential equation found in quantum field theory, weakly nonlinear dispersive water waves, and nonlinear optics, as well as massive Thirring model, an exactly solvable quantum field theory that defines the self-interactions of a Dirac field in $(1+1)$ dimensions. The presented method combines the Yang transform methodology with the $\tilde{q}$-homotopy analysis technique and the fractional derivative described by the Caputo-Fabrizio (CF) operator in an intriguing way. The fixed point postulate is addressed in an attempt to illustrate that the resulting solution for the presented fractional order framework exists and is unique. We assess the predicted framework in the context of fractional order reinforcement and exhibit the performance of the prospective approach. The physical performance of the $\tilde{q}$-HATM solutions is also depicted using graphs for various fractional orders and simulation techniques.The present study demonstrated that the potential strategy is simple to apply and very systematic, productive, and precise in analyzing the behaviour of non-linear PDEs of fractional order that emerge in engineering and quantum field theory.