Predictive Efficacy of Haematological Biomarkers in COVID-19 infection

Introduction: The ongoing Corona Virus Pandemic is linked with high rates of morbidity and mortality globally. Early and effective predictors of clinical outcomes are urgently required to develop effective management protocols.Objective: To investigate the predictive efficacy of haematological biomarkers in Covid -19 infectionMethods: Blood samples were drawn from COVID‐19 infected pneumonia patients. Baseline clinical information was collected and quantification of hemostatic variable was done.  Laboratory data both groups expired and recovered were compared using t- test, Mann Whitney- U test, chi squared-test and Kruskal Wallis test. Multivariate regression analysis was performed to determine the independent contribution of haematological variable in Covid19 related mortality. Receiver operating characteristic curve were drawn to find the predictive efficacy of significantly related parameters.Results: Out of 191 patients 68.1%  were male. D‐dimer (median 800 ng/mL; IQR 200‐3200) and NLR (median 10.40; IQR 3.20-22.80) were found to be predominantly raised and significantly correlated with Covid mortality in multivariate regression analysis. The optimum cutoff value of D-dimer to predict in-hospital mortality was 450 ng/ml with a sensitivity of 71.6% and a specificity of 95.8%. The optimum cutoff value of NLR to predict in-hospital mortality was 5.450 with a sensitivity of 70.1% and a specificity of 71%.Conclusion: D-dimer and NLR could be used as the significant indicators in predicting the mortality of COVID-19

SELF CONDEMNATION, INDEBTEDNESS AND FINANCIAL STRESS: FINDINGS OF A CROSSSECTIONAL STUDY IN PAKISTAN

To determine various aspects of the Micro Economy that entails the foundation of Financial Stress arising for an individual in Pakistan. The essential focus of this study is firstly, on how behavioral factors or Personality Traits affect the degree of Financial Stress that an individual undergoes; and secondly, how conditions of Indebtedness of a person accentuate the conditions of distress. Assortments of constraints arising from Dependency burdens and Household Saving patterns that go hand-in-hand with the Economic Positionality are also brought into consideration with the help of this paper, focusing solely on results obtained for developing nations, such as Pakistan itself. Financial Stress was measured on a ten-item ordinal scale, consisting of a set of questions included in the survey questionnaire, while the preferred models used in this paper consisted of Ordered Probit and Tobit Models which estimated this cross-sectional study and the relationships of the two core variables; Self Condemnation, as well as Indebtedness with individuals’ financial stress. This study therefore, was able to depict that increased levels of Self Condemnation among individuals, due to a lack of resources or income, as well as high rates of Personal Debt in proportion to Individual Incomes; both have a positive significant relationship with the level of Financial Stress that these persons undergo. Government Policies and regulations of institutions can however, have an auspicious impact on the micro level as exploitation of the underprivileged can be controlled, and benefits be provided, leading to the uplifting of distress among the population

Pattern of Head Injury and Recovery in First and Second Rider in Motor Bike Accidents

To compare the rate and pattern ofhead injury sustained by the first vs. second riderand mortality rate and functional outcome of the twogroups.Methods: In this cross sectional study all adultpatients presenting with head injury resulting froma motorcycle accident, during the study period wereenrolled.Proforma’s were filled by the on-dutydoctor, including the demographic details, detailsregarding helmet and first or second rider,neurological status, additional injuries andradiological pattern of injury. These patients weredivided into two groups: Group-1 (First riders) andGroup-2 (Second riders) and both groups werecompared for the above details, and followed. Allpatients received the standard treatment for theirrespective injuries and the two groups werecompared for the mortality and neurological andfunctional outcome, assessed by using the ExtendedGlascow Outcome Scale. (EGOS).Results: A total of 360 patients were included in thestudy. Of these,65% patients were in group-1 and35% were in group-2. The mean age of the twogroups was 27.86 and 30.12 years respectively. Allpatients in group-1 were males while 61.9% ingroup-2 were males. Majority of the riders in bothgroups were not wearing helmets at the time ofaccident. Major injury in both the groups was facialinjury but the frequency of facial injury wassignificantly higher in group-1 as compared togroup-2 i.e. 20.5% vs. 11.9% (p = 0.040). CT brainshowed normal scan in 15.4% patients in group-1and in 2.4% patients in group-2. In group-1, CT brainshowed highest frequency of traumatic braincontusions (24.4%) followed by Extraduralhematomas (14.1%) and cranium fracture (12.8%). Ingroup-2, CT brain showed highest frequency oftraumatic brain contusions (35.7%) followed bycranium fracture (16.7%), ASDH (9.5%) and TSAH(9.5%). Complete recovery was significantly higherin group-1 as compared to group-2 (p = 0.011).Conclusion: In motor bike riding head injury is apotential threat not only to the 1st rider but also tothe 2nd rider as well. By using helmets head injury,which is fatal in most of the instances, can beavoided

Study of Multi-Classification of Advanced Daily Life Activities on SHIMMER Sensor Dataset

Today the field of wireless sensors have the dominance in almost every person’s daily life. Therefore researchers are exasperating to make these sensors more dynamic, accurate and high performance computational devices as well as small in size, and also in the application area of these small sensors. The wearable sensors are the one type which are used to acquire a person’s behavioral characteristics. The applications of wearable sensors are healthcare, entertainment, fitness, security and military etc. Human activity recognition (HAR) is the one example, where data received from wearable sensors are further processed to identify the activities executed by the individuals. The HAR system can be used in fall detection, fall prevention and also in posture recognition. The recognition of activities is further divided into two categories, the un-supervised learning and the supervised learning. In this paper we first discussed some existing wearable sensors based HAR systems, then briefly described some classifiers (supervised learning) and then the methodology of how we applied the multiple classification techniques using a benchmark data set of the shimmer sensors placed on human body, to recognize the human activity. Our results shows that the methods are exceptionally accurate and efficient in comparison with other classification methods. We also compare the results and analyzed the accuracy of different classifiers

Extensively Drug-Resistant Salmonella typhi XDR Infection at Rawalpindi Medical University and Allied Hospitals

Objective: To evaluate the prevalence of extensively drug-resistant Salmonella typhi (XDR) in RMU Allied Hospitals. Study Design: A descriptive cross-sectional study. Material and Methods: It is a cross-sectional, prospective study conducted at RMU Allied Hospitals from January 2019–December 2019. Blood culture samples were received in the pathology lab, they were collected by simple random sampling and processed by conventional incubation. Antibiotic susceptibility of the isolates was done on Muller Hinton agar using modified Kirby Bauer disk diffusion method and antibiotic zone diameters were measured according to CLSI guidelines. Results: Out of the total 8045 cultures, 911 (11%) showed growth, among which 179 (20%) were Salmonella typhi and 135 (15%) XDR Salmonella. Meropenem revealed the highest sensitivity, Chloramphenicol, and Augmentin revealed the highest resistance. Conclusion: Blood culture results revealed Salmonella typhi 20% with a significant number of XDR Salmonella 15%. Antibiotics susceptibility pattern exhibits Meropenem and Azithromycin as the only antibiotics for XDR Salmonella. Salmonella typhi infection has a significantly high prevalence among children as compared to adults. (p=0.0017) Injudicious use of antibiotics is one of the important aspects of the occurrence of antibiotic-resistant Salmonella

Antepartum transabdominal amnioinfusion in oligohydramnios - a comparative study

Background: The purpose of this study was to evaluate the role of antepartum transabdominal amnioinfusion in oligohydramnios with the view to improving pregnancy outcome in oligohydramnios, a serious complication of pregnancy that is associated with a poor perinatal outcome and complicates 1-5% of pregnancies.Methods: The study comprised of a prospective analysis of 130 pregnant women with oligohydramnios, divided into two groups, the study and control group of 65 patients each and were similar with regard to age, gravidity, parity, gestational age. TAA was performed on all patients in the study group and the results were compared and analyzed.Results: Mean gestational age at first treatment was 29.98 weeks in study group. Mean pre-procedure amniotic fluid index was 4.01 and post-procedure was 12.49. A total of 106 infusions were done on 65 patients (mean1.63). Mean latency period in study group was 49.53 and in controls 26.49. There was significant decrease in fetal distress in patients in study group. 30 % of patients needed caesarean section in study group compared to 60% in controls. Number of preterm deliveries was 18 and 45 respectively in study and control groups. 61% of newborns in the study group weighed more than 2.5 kg compared to only 24% in control group. Neonatal ICU admissions and newborn deaths were lesser in study group.Conclusions: Transabdominal amnioinfusion is an extremely useful procedure to reduce complications arising from oligohyramnios. It significantly increases the latency period, decreases the occurrence of fetal distress preterm deliveries, need for caesarean or instrumental deliveries, improves birth weight of the newborns and significantly reduces the neonatal morbidity and mortality

Hamltonian Connectedness and Toeplitz Graphs

A square matrix of order n is called Toeplitz matrix if it has constant elements along all diagonals parallel to the main diagonal and a graph is called Toeplitz graph if its adjacency matrix is Toeplitz. In this paper we proved that the Toeplitz graphs , for   and  are Hamiltonian  connected

Diagnostic implications of bronchial lavage in patients with pleural tuberculosis

Introduction: The presence of Mycobacterium tuberculosis in a respiratory specimen is diagnostic in patients with pleural effusion. It is difficult to obtain sputum even after induction in these patients. An alternative method of acquiring respiratory specimens is via bronchial lavage. This study was undertaken to evaluate the diagnostic yield of acid-fast bacilli (AFB) smear, AFB culture, and Xpert assay of bronchial lavage fluid in the workup of pleural tuberculosis patients.Material and methods: All patients who met the inclusion criteria of the study underwent thoracentesis, pleural biopsy, and bronchial lavage. Specimens of pleural fluid, pleural biopsy, and bronchial lavage fluid were sent for acid fast bacilli smear, culture, and Xpert assay.Result: Bronchial lavage AFB smear, culture, and Xpert assay was positive in 9.5%, 17.9%, and 26.2% of patients, respectively. It gave an immediate diagnosis in 22 (26.2%) patients.Conclusion: Bronchial lavage, though not a surrogate to pleural biopsy, offers an additional approach to the early diagnosis of pleural tuberculosis in patients not producing sputum. Besides being diagnostic, this method also has epidemiologic significance in containing the tuberculosis epidemic because detecting Mycobacterium in bronchial lavage confirms that the patient is infectious