Lung carcinoma: its profile and changing trends

BACKGROUND: Lung Carcinoma is the leading causes of morbidity and mortality worldwide with an incidence of 1.3 million cases per year. This study was undertaken to determine prevalence of various histological types of lung carcinoma and to analyse their changing trends with time. METHODS: This is a retrospective analytical study. A total of 330 cases of lung carcinoma were analysed from 2003 to 2008. Cases from Khyber Pakhtunkhwa and Federally Administered Tribal Area (FATA) were included in this study. Furthermore, only cases of lung carcinoma were considered while other malignancies were excluded. RESULTS: Squamous Cell carcinoma was found in 42.7% of cases. Overall male to female ratio was 2.67:1. Prevalence of Squamous Cell carcinoma increased from 32% to 57.9% while that of Small Cell carcinoma increased from 12% to 17.1%. Unspecified type showed decrease from 36% to 5.3%. Increase in the prevalence of Squamous Cell carcinoma was found in both males and females while change in the prevalence of Small Cell carcinoma was found on!y in males. CONCLUSION: Squamous Cell carcinoma was the most prevalent variant of lung carcinoma in our region, followed by Adenocarcinoma. Male to female ratio across different histological patterns did not show significant variation. Increase in the prevalence of Squamous Cell carcinoma was statistically significant in both males and females while in case of Small Cell carcinoma change in its prevalence was also significant in males

Estimation of Indices of Health Service Readiness with A Principal Component Analysis of the Tanzania Service Provision Assessment Survey.

Service Provision Assessment (SPA) surveys have been conducted to gauge primary health care and family planning clinical readiness throughout East and South Asia as well as sub-Saharan Africa. Intended to provide useful descriptive information on health system functioning to supplement the Demographic and Health Survey data, each SPA produces a plethora of discrete indicators that are so numerous as to be impossible to analyze in conjunction with population and health survey data or to rate the relative readiness of individual health facilities. Moreover, sequential SPA surveys have yet to be analyzed in ways that provide systematic evidence that service readiness is improving or deteriorating over time. This paper presents an illustrative analysis of the 2006 Tanzania SPA with the goal of demonstrating a practical solution to SPA data utilization challenges using a subset of variables selected to represent the six building blocks of health system strength identified by the World Health Organization (WHO) with a focus on system readiness to provide service. Principal Components Analytical (PCA) models extract indices representing common variance of readiness indicators. Possible uses of results include the application of PCA loadings to checklist data, either for the comparison of current circumstances in a locality with a national standard, for the ranking of the relative strength of operation of clinics, or for the estimation of trends in clinic service quality improvement or deterioration over time. Among hospitals and health centers in Tanzania, indices representing two components explain 32 % of the common variance of 141 SPA indicators. For dispensaries, a single principal component explains 26 % of the common variance of 86 SPA indicators. For hospitals/HCs, the principal component is characterized by preventive measures and indicators of basic primary health care capabilities. For dispensaries, the principal component is characterized by very basic newborn care as well as preparedness for delivery. PCA of complex facility survey data generates composite scale coefficients that can be used to reduce indicators to indices for application in comparative analyses of clinical readiness, or for multi-level analysis of the impact of clinical capability on health outcomes or on survival

MHD Flow and Heat Transfer of Casson Nanofluid through a Porous Media over a Stretching Sheet

The present chapter aims at investigating the magnetohydrodynamic (MHD) boundary layer flow and heat transfer of a non-Newtonian fluid over a stretching surface through a porous medium. Casson fluid model is utilized to describe the non-Newtonian fluid behavior. Two types of nanofluids, that is, Ag-water and Cu-water, are studied. The governing partial differential equations are transformed into a system of coupled non-linear ordinary differential equations using similarity transformations and then solved numerically using the Keller box method. Numerical results are obtained for the velocity, temperature, skin friction coefficient and Nusselt number. The influence of the various governing parameters viz. Casson parameter, magnetic parameter, porosity parameter and Prandtl number on the flow and heat transfer characteristics of the nanofluids is plotted graphically and discussed in detail. The chapter shows that with an increase in the Casson parameter, the velocity field decreases whereas the temperature profile increases. A decrease in the momentum boundary layer thickness and an increase in the thermal boundary layer thickness are noted with an increase in the magnetic parameter

The Art of Gratefulness

Researchers have conducted positive psychology interventions (PPI) that have demonstrated the benefits of practicing thanks. To our knowledge, prior studies have typically been conducted over a short time frame. This study expanded on the existing body of knowledge by evaluating the art of gratefulness over a 4-week duration among university students. Significant effects indicated that participants experienced fewer negative feelings and higher affect during the PPI than the during control

Diffusion tensor imaging for ruptured cerebral arteriovenous malformation

Non-ruptured arteriovenous malformations (AVMs) rarely cause tract disruption. Few studies have described how ruptured AVMs influence white matter (WM) tract morphology. We reviewed consecutive AVM cases treated at a tertiary care hospital where diffusion tensor imaging (DTI) tractography was obtained preoperatively. DTI was performed using the Synaptive Plan (Synaptive Medical Inc., Toronto, Canada). Quality control was performed by clinical application specialist. Perinidal fractional anisotropy (FA) value of corticospinal tracts (CST) was obtained. A reference FA value was obtained from the corresponding area on the contralateral side. Images were evaluated by a consultant neuroradiologist. Radiological findings were correlated with clinical findings. White matter morphology was described by a consultant neuroradiologist. All three cases included in the study had a history of haemorrhage in the past. Two patients had disruption of CST and presented with a significant neurological deficit. In one patient FA value of CST around the nidus was comparable to the contralateral side and did not show any neurological deficit. DTI integrated neuronavigation was used to plan the trajectory and complete resection of the AVM with excellent postoperative recovery

Role of Higher Education in Creation of Knowledge Economy in Punjab, Pakistan

Knowledge is working as an engine in achieving sustainable economic development goals for societies who are shifting from labor intensive economy to knowledge based economy like Pakistan. Education works like a backbone in knowledge based economies. Hence, the current research is planned to find out that is the educational institutions of Pakistan are contribution in production of new knowledge or not. Survey was the technique used by researcher for collection of information. Tool for gathering data was questionnaire and sample was selected from six public and private universities of Punjab Pakistan by applying simple random technique while the sample size was comprised of 606 respondents. Both descriptive and inferential statistical techniques were considered to analyze the data. Association found between the efforts made by higher educational institutions by providing access to knowledge, rich infrastructure, funds, incentives, research and development, human capital development, collaboration with industry and creation of knowledge economy

Comparison Of Naproxen And Diacerein In The Treatment Of Knee Joint Osteoarthritis

Background: Knee osteoarthritis is a common disease in older age. Pain and limitation of movement are the main symptoms of knee osteoarthritis. Many pharmacological options are available for symptomatic relief but NSAIDs are mostly prescribed. Diacerein is also prescribed for osteoarthritis but data regarding its efficacy is still controversial. Moreover, studies regarding the comparison of diacerein with NSAIDs are deficient in Pakistan. Objective: The objective of the study was to compare the clinical efficacy of naproxen (NSAID) with diacerein in treating knee osteoarthritis. Methodology: Patients fulfilling inclusion criteria were included in the study. After written informed consent 60 patients of knee osteoarthritis were included in the study. They were divided randomly into two groups. Group A (n=30) was prescribed with tablet naproxen 500mg twice daily and group B (n=30) was given capsule diacerein 50mg twice daily for 12 weeks. Baseline VAS and WOMAC scores of the patients were noted. These scores were compared with scores achieved 12 weeks after intervention. Intra-group comparison of the scores was also carried out. SPSS version 23.0 was used for statistical analysis. Results: WOMAC and VAS scores comparison of the two groups (A & B) before intervention showed an insignificant p-value that is 0.815 for the WOMAC score and  0.509 for the VAS score. After intervention means WOMAC score i.e.10.50 ± 2.46 of group A (treated with naproxen) was better than the mean 29.62 ± 7.03 of group B (treated with diacerein) showing significant p-value (< 0.001). Similarly mean VAS of group A 1.92 ± 0.58 improved more than the mean VAS of group B i.e 3.38 ± 0.75 with significant p-value (< 0.001). Intra-group comparison of the groups also showed a significant p-value. Conclusion: Clinical efficacy of naproxen is better than diacerein in treating knee osteoarthritis

Quality Of Life of Women, Pre- and Post-Operative Breast Cancer Surgery

Objective: To evaluate the Quality of Life (QoL) of women with breast cancer who came for treatment in surgery department before diagnosis and post-operative time period. Methodology: A prospective cohort study was conducted at General surgery Department, Islamabad Medical complex, NESCOM, from October 2021 to March 2022. Seventy four diagnosed breast cancer patients, above 18 years of age, who underwent surgical treatment (MRM and Axillary clearance), were selected. QoL was assessed with the help of EORTC QLQ C-30 and EORTC BR-23 questionnaire. Data was collected on opd follow up and through telephone. SPSS 20 was used to analyze the data and Wilcoxon test and Kruskal-Wallis test were performed. Results: The QoL assessed at pre and post operative stage showed positive results only in the future prospects and emotional function domain. Whereas, negative results were scored in rest of the domains, which are symptoms in the arm, body image, financial concerns, sexual pleasure, cognitive function and physical function. Conclusion: The need for a multidisciplinary approach for breast cancer patients is required regarding different dimensions that can improve their QoL

Association of Beta-2 Adrenoreceptor Single Nucleotide Polymorphism with Risk of Type II Diabetes Mellitus

Objective: To determine the genotype of Arg16Gly & Gln27Glu polymorphism in type-2 diabetes mellitus and to find possible association of ADRβ2with type-2 diabetes mellitus. Methodology: A case control study was designed and a total of 192 subjects (98 in each group) were included. After formal approval, subjects were recruited from North West General Hospital (NWGH) Peshawar. After taking consent blood samples were collected from the participants and DNA analysis was done using commercially available kits by salting out protocols, while other biochemical parameters were analyzed using normal laboratory protocols for respective tests. Results: The comparative analysis of SNP rs1042713 indicates that allele G/A was 42(49.4%) in diabetic and 43(50.6%) in non-diabetic subjects. While GG was more frequent 22(59.5%) in diabetic as compare to non-diabetic 15(40.5%). Among AA allele, 19 (65.5%) were non-diabetic while 10(34.5%) were diabetic. However the difference was not statistically significant (p=0.22). In case of “rs1042714” gene the commonest allele was C/C 80 (41.7%) out of which, 47(58.8%) was found in diabetic and 33(41.2%) were non-diabetic. Similarly CG was second common allele out of which diabetics were 27(44.3%) while non-diabetics were 34(55.7%). Allele G/G was found only among 11 subjects (p=0.085). Conclusion: Based on the result of the present study, it is concluded that polymorphism in ADRB2 genes rs1042713 (Arg16Gly) and rs1042714 (Gln27Glu) is associated with susceptibility of T2DM through alteration in BMI & HbA1c