Understanding DNA sequence similarity is essential for uncovering evolutionary relationships and functional insights across diverse biological systems, particularly in the era of rapidly expanding genomic data, DNA sequence similarity analysis plays a central role in comparative genomics, evolutionary biology, and phylogenetic reconstruction. However, the rapid expansion of genomic databases has made large-scale sequence comparison increasingly challenging for traditional alignment-based approaches due to their high computational cost and limited efficiency for highly divergent sequences. Alignment-free methods provide an attractive alternative, but many existing techniques still face limitations in phylogenetic accuracy and computational efficiency. In this study, we propose a novel alignment-free method for DNA sequence similarity analysis based on dynamic template matching and subsequence similarity representation. The approach generates a sub-sequence similarity score number (SSSN) vector using direct and complementary nucleotide matching and reconstructs phylogenetic relationships from the resulting feature vectors. The method was evaluated using two benchmark datasets and four standard biological datasets. Experimental results show that the proposed approach achieves high phylogenetic accuracy (95–100 https://github.com/machbah/DPTM_Seq_Sim Github repository.
Background:Infections caused by multidrug-resistant/difficult-to-treat (MDR/DTR) Pseudomonas aeruginosa present a significant challenge for treatment. Ceftolozane-tazobactam (C/T) and ceftazidime-avibactam (C/A) are important options that combine β-lactam and β-lactamase inhibitors, but their effectiveness compared to each other is still unclear. Methods:We performed a systematic review and meta-analysis, evaluated by Grading of Recommendations Assessment, Development, and Evaluation (GRADE), of comparative observational studies that included hospitalized adults with confirmed MDR/DTR P. aeruginosa infections up to 10 October 2025 (English only). Studies comparing C/T directly with C/A and matched therapies were included. We used random-effects Mantel-Haenszel models to calculate pooled risk ratios (RR) with 95% confidence intervals (CIs), and we assessed heterogeneity with I 2. We reviewed the certainty of evidence using GRADE. Results:Six observational cohorts (n = 1161) met our criteria. There were no significant differences between C/T and C/A for clinical success (RR: 1.07, 0.89-1.29; I 2 = 40%), 30-day all-cause mortality (RR: 1.02, 95% CI: 0.83-1.27; I 2 = 0%), 30-day recurrence (RR: 0.85, 0.46-1.57; I 2 = 48%), 90-day recurrence (RR: 0.80, 0.63-1.02; I 2 = 0%; P = 0.08), emergence of resistance (RR: 0.73, 0.30-1.81; I 2 = 84%), and microbiological response failure (RR: 0.91, 0.66-1.26; I 2 = 8%). There was a non-significant trend that slightly favored C/T for 90-day recurrence. According to GRADE, the certainty of evidence varied from low to very low, mainly due to non-randomized study designs and variability across studies. Conclusions:In current comparative cohorts, C/T and C/A show similar outcomes for severe MDR/DTR P. aeruginosa infections. More high-quality randomized trials are needed to better define any potential differences and clarify long-term recurrence and resistance risks.
Introduction and importance:While cefepime-induced neurotoxicity is a known complication of beta-lactam therapy in renal impairment, its diagnosis is uniquely challenging in patients with complex neurosurgical baselines. This case illustrates the risk of diagnostic anchoring where the presence of a ventriculoperitoneal shunt diverts clinical suspicion toward mechanical failure and obscures a reversible toxic etiology. Case presentation:A 63-year-old female with subarachnoid hemorrhage, slit ventricle syndrome, and a ventriculoperitoneal shunt presented with septic shock and acute kidney injury. Following renal adjustment of cefepime for Pseudomonas bacteremia, she developed profound altered mental status. Initial evaluation prioritized shunt malfunction, yet computed tomography was confounded by chronic slit ventricle physiology. Electroencephalography revealed generalized triphasic waves characteristic of metabolic encephalopathy rather than structural dysfunction. Clinical discussion:Cefepime-induced neurotoxicity (CIN) pathophysiology involves gamma-aminobutyric acid-A receptor inhibition amplified by reduced renal clearance and sepsis-induced blood-brain barrier disruption. Here, the clinical picture was masked by the overlap between toxic encephalopathy and insidious shunt failure symptoms. This necessitated distinguishing toxicity from nonconvulsive status epilepticus or hydrocephalus using electroencephalogram (EEG), defying the heuristic that neurological decline in shunted patients is mechanical until proven otherwise. Conclusion:This case underscores that CIN can mimic mechanical shunt failure, which necessitates a high index of suspicion in patients with indwelling neurosurgical hardware. Early EEG utilization is critical to overcome diagnostic bias and ensure prompt antibiotic discontinuation rather than unnecessary neurosurgical intervention.
Background: Subtrochanteric femoral fractures are unstable injuries characterized by high mechanical stress, cortical bone predominance and an increased risk of fixation failure. Optimal implant selection remains controversial, particularly for unstable fracture patterns. This study aimed to compare the outcomes of proximal femoral nailing and locking plate fixation in the management of closed subtrochanteric femoral fractures. Methods: This comparative study was conducted at the Department of Orthopaedics, President Abdul Hamid Medical College Hospital, Kishoreganj, Bangladesh, from January to December 2025. Fifty adult patients with closed subtrochanteric femoral fractures were divided into two groups: proximal femoral nailing (PFN, n=25) and proximal femoral locking plate fixation (PFLP, n=25). Intraoperative parameters, postoperative recovery, radiological union, functional outcomes using the Harris Hip Score and complications were evaluated. Statistical analysis was performed using SPSS version 25.0, with significance set at p<0.05. Results: The mean operative time was significantly shorter in the proximal femoral nailing group (85.4 ± 12.5 min) than in the locking plate group (110.6 ± 15.3 min). Intraoperative blood loss was lower with nailing (180 ± 40 mL vs. 270 ± 60 mL). Time to partial weight bearing (4.8 ± 1.2 vs. 6.2 ± 1.6 weeks) and radiological union (17.6 ± 3.1 vs. 20.8 ± 3.7 weeks) were significantly earlier with nailing. Mean Harris Hip Score was higher following nailing (83.5 ± 6.4 vs 77.2 ± 7.8). Conclusion: Proximal femoral nailing provides superior operative efficiency, faster recovery and improved functional outcomes compared with proximal femoral locking plate fixation.
Dengue is an increasing public health concern in Bangladesh, but its impact on health-related quality of life (HRQoL) remains poorly explored. In 2024, Bangladesh experienced a substantial rise in dengue cases. This study aimed to assess the HRQoL of hospitalized dengue patients in Bangladesh and identify its associated factors. The cross-sectional observational study was conducted among hospitalized dengue patients in Bangladesh. HRQoL was measured using the EQ-5D-3L. Multivariable regression models examined the associations between demographic, socio-economic, and clinical factors and HRQoL outcomes (EQ-5D-3L index and EQ-VAS scores). A total of 490 hospitalized dengue patients were included, with a median age of 27 years. The majority of the patients were aged below 40 years (79
