ASSOCIATION OF POSITIVE FAMILY HISTORY WITH BREAST CANCER IN YOUNG FEMALES WITH BREAST LUMPS.

Background; Breast cancer is most frequently diagnosed cancer in females. It has a major impact on health of women. According to a World Health Organization [WHO] estimate, more than 1.2 million people are diagnosed with breast cancer worldwide every year. This study was conducted to determine the frequency of breast cancer in patients presenting with breast lumps in our population. OBJECTIVE; To determine frequency of breast cancer among young females presenting with breast lumps at a tertiary care hospital. Material and Methods; Consecutive 160 young ladies presenting with breast lumps were taken.  Young females with breast lumps were taken and diagnosed for breast cancer. All the data was entered and analyzed using SPSS-20. Results; Of these 160 study cases, 98 (61.2 %) were un-married female patients while 62 (38.8 %) were married female patients. Mean age of our study cases was 23.23 ± 3.85 years (with minimum age of our study cases was 18 years while maximum age was 32 years). Our study results have indicated that majority of our study cases i.e. 123 (76.9 %) were aged up to 25 years. Mean body mass index of our study cases was 26.23 ± 1.92 kg/m2 and obesity was present in 48 (30.0 %). Mean disease duration was 2.98 ± 2.54 months and 111 (69.4%) had duration of illness up to 3 months. Breast cancer was noted in 40 (25.0%) of our study cases. Conclusion; High frequency of breast cancer was noted in our study among young females presenting with breast lumps. Breast cancer was significantly associated with marital status, increasing age, residential status, socioeconomic status and family history of breast cancer. These findings suggest that females at every age group with breast lumps need specialized care for diagnosis and management. Keywords; Breast Cancer, Breast Lumps, Young Females. DOI: 10.7176/JMPB/54-18 Publication date: April 30th 201

Frequency of puerperal infection with meconium stained amniotic fluid.

Objective: To determine the association of meconium stained amniotic fluid with puerperal infection. Material, place and method: A Cohort Study was conducted from 1stjanuary 2018 to 30th June 2018 in department of obstetrics & gynecology, Nishtar hospital, Multan. A total of 66 women with singleton pregnancy, gestational age 37-41 weeks of any parity undergoing elective caesarean section were eligible in study. Patients with rupture of membranes for more than 6 hours on history, diabetic patients, preterm delivery and post term delivery were excluded. During elective caesarean section, after rupture of membranes women were divided in two equal groups. 33 (50%) patients with meconium stained liquor in exposed group and 33 patients (50%) with clear liquor in un-exposed group were divided. Puerperal infection was noted when temperature of 38°C and higher on any two of first ten days postpartum excluding of first 24 hours. The data was analyzed using statistical analysis program to compare proportions between these two groups. Frequency, percentage and mean ±SD were presented for variables. Chi-square test was applied to compare puerperal infection in both groups taken p ≤0.05 as significant. Results: Age range in this study was from 18 to 35 years with mean age of 28.000± 2.27 years in Exposed Group while 26.212± 3.06 years in Unexposed Group. Mean gestational age was 38.848±1.12 weeks in exposed group while 39.060±1.11 weeks in unexposed group. Puerperal infection was seen in 63.64% patients in exposed Group as compare to 12.1% in unexposed Group (p=0.005). Conclusion: Recognition of the increased risk of infection in women with meconium stained fluid improves the perinatal outcome. Keywords: Meconium stained amniotic fluid, Puerperal infection, Association, cohort study. DOI: 10.7176/JMPB/54-17 Publication date: April 30th 201

DIAMOnDS - DIstributed Agents for MObile & Dynamic Services

Distributed Services Architecture with support for mobile agents between services, offer significantly improved communication and computational flexibility. The uses of agents allow execution of complex operations that involve large amounts of data to be processed effectively using distributed resources. The prototype system Distributed Agents for Mobile and Dynamic Services (DIAMOnDS), allows a service to send agents on its behalf, to other services, to perform data manipulation and processing. Agents have been implemented as mobile services that are discovered using the Jini Lookup mechanism and used by other services for task management and communication. Agents provide proxies for interaction with other services as well as specific GUI to monitor and control the agent activity. Thus agents acting on behalf of one service cooperate with other services to carry out a job, providing inter-operation of loosely coupled services in a semi-autonomous way. Remote file system access functionality has been incorporated by the agent framework and allows services to dynamically share and browse the file system resources of hosts, running the services. Generic database access functionality has been implemented in the mobile agent framework that allows performing complex data mining and processing operations efficiently in distributed system. A basic data searching agent is also implemented that performs a query based search in a file system. The testing of the framework was carried out on WAN by moving Connectivity Test agents between AgentStations in CERN, Switzerland and NUST, Pakistan.Comment: 7 pages, 4 figures, CHEP03, La Jolla, California, March 24-28, 200

Measuring Extent of Autonomy in Teaching Hospitals of Punjab: A Case of Services Hospital, Lahore

This study examined ‘to what extent’ hospital autonomy has affected the internal management of Services Hospital Lahore (SHL). It is a case study and semi-structured interview guide was used for in-depth interviews. Doctors, administrative staff and Para medical staff were included in the sample. Findings of this this study showed that Hospital Autonomy Reforms could not achieve its claimed objectives. Most of the powers still lie with the bureaucracy and there is no significant impact on the hospital management due to autonomy as all decisions are still finalized at secretariat through health and finance department. Key words: autonomy, hospital, reforms, health secto

Non-compliance to social distancing during COVID-19 pandemic: A comparative cross-sectional study between the developed and developing countries

Background: Despite mass vaccination campaigns, the world has seen a steady rise in the number of SARS-CoV-2 cases, with 178,765,626 cases and 3,869,994 COVID-19 related deaths by June 19th, 2021. Therefore, it is important to enforce social distancing to control its spread. With the variation observed in the severity of the pandemic in different countries, it is also imperative to study the social distancing behaviors amongst the population in developed and developing countries. Design and Methods: In this cross-sectional study, a total of 384 participants from 14 different countries were surveyed via an online REDCap form. Results: In this study, it was highlighted that despite adequate knowledge, the overall compliance to COVID-19 related preventive measures remains poor, the lowest being in the senior age group (≥ 65 years), and the highest being in adults aged between 25-64 years (p-value =0.003). Population from the developing countries were more compliant to all preventative measures against COVID-19 spread, except for handwashing, where the difference between the two populations remained insignificant (p-value = 0.038, \u3c0.001, 0.016). Socioeconomic status, prior history of COVID-19 infection, or presence of comorbidities did not significantly affect compliance rates, however, participants with no prior history of this infection were found to be more compliant to donning a mask in public as compared to those with a positive history (p-value = 0.044). Conclusions: Since compliance remains subpar in both the developing and the developed countries, mass campaigns about COVID-19 related preventive measures remain essential in controlling the disease spread

Development and optimization of erythromycin-loaded lipid-based gel by Taguchi design: In vitro characterization and antimicrobial evaluation

The foremost aim of the current research was to prolong and sustain the release of erythromycin (ERY) by preparing a solid lipid nanoparticles (SLNs)-based gel formulation for the safe and effective treatment of acne. ERY-loaded SLNs were developed, and various process variables were optimized with respect to particle size, zeta potential, and entrapment efficiency using the Taguchi model. The average particle size, PDI, zeta potential, drug entrapment efficiency, and drug loading of optimized SLN (F4) were found to be 176.2±1.82 nm, 0.275±0.011, -34.0±0.84, 73.56%, and 69.74% respectively. The optimized SLN (F4) was successfully incorporated into the carbopol-based hydrogel. The in vitro release of ERY from the SLN gel and plain gel were compared and found to be 90.94% and 87.94% respectively. In vitro study of ERY-loaded SLN gel showed sustained delivery of drug from formulation thus enhancing the antimicrobial activity after 30 hours when compared to ERY plain gel

Alterations in Quality Parameters of Mastitic Milk

Quality milk production in modern dairy systems is facing many challenges. Salient in them is mastitis which is responsible for decline in milk production, altered milk composition and compromised udder health. The malaise consists of multiple bacterial etiologies which can be broadly classified into contagious pathogens and environmental pathogens S. aureus is being isolated invariably in all epidemiological studies, followed by E. coli. Pathogenic virulence in mastitis is often accounted due to microbial ability of producing wide array of virulence factors that enhances pathogenicity and sustainment potential in the epithelial linings of udder. Mastitis affects quality parameters of milk i.e. constitutional as well as mineral profile due to local damage and inflammatory mediators. It decreases the lactose secretion because of oxidative stress generated due to the formation of free radicals in the milk. In mastitic milk, IgG2 becomes the predominant antibody which is thought to be the main opsonin supporting neutrophil phagocytosis in the bovine mammary gland. Therefore, it plays a significant role in the battle against mastitis pathogens. Mastitis infected cow shows a notable elevated level of the sodium and chloride and demoted level of calcium, potassium and inorganic phosphorus. In micro minerals, mastitis effects are pretty much same as in most macro minerals i.e. lower down their concentration in milk secretion. Consistent preventive strategy alongside strict surveillance and biosecurity is recommended for combating this challenge

Chronic Kidney Disease and Mortality in Implantable Cardioverter-Defibrillator Recipients

Incidence of sudden cardiac death (SCD) in end-stage renal disease (ESRD) remains high. Limited data is available about whether implantable cardioverter-defibrillators (ICDs) can prevent arrhythmic death in patients with chronic kidney disease (CKD). The purpose of this retrospective study was to determine the impact of CKD on all-cause and sudden cardiac death in ICD recipients. We evaluated 441 consecutive patients who underwent ICD implantation at our center between 1994 and 2002. We found that mortality rate was higher in patients with eGFR <60 mL/min and those with ESRD on hemodialysis (43%, n = 69/162 and 54%, n = 12/22, resp.) than in patients with eGFR ≥60 mL/min (23%, n = 58/257; P < .0005). The SCD rate was also higher in the patients with ESRD (50%) than in CKD patients not on dialysis (10.2%; P < .0005). Mortality rate for single-chamber ICDs was 56.8% in comparison with dual-chamber ICDs (38.1%) and for biventricular ICDs (5.0%) (P < .0005)

Anaphylaxis: incidence, presentation, causes and outcome in patients in a tertiary care hospital in Karachi, Pakistan

Background: Anaphylaxis is a potentially fatal condition requiring immediate resuscitation. Data regarding the epidemiology of anaphylaxis are limited and inconsistent. A reason for the variability was unavailability of a universally acceptable case definition till 2005. We reviewed cases using this new definition Aim: To review the incidence, clinical presentation, cause and outcome of anaphylaxis at a tertiary care center in a low income country. Design: Retrospective, case series Methods: Chart review of all patients discharged from Aga Khan University Hospital between January 1988 - December 2012 (24 years) with anaphylaxis definition as per second National Institute of Allergy and Infection disease/Food Allergy and Anaphylaxis Network Symposium Results: Total of 129 cases were found with mean age of 41.6 years (SD 18.8). Majority of patients had cutaneous features (76.7 %), followed by respiratory (68.9 %), cardiac (64.3 %) and gastrointestinal (20.9 %) symptoms respectively. About 22.4 % of patients had positive history for allergens out of which 31% (n=9) were exposed to the same allergens. The common causes identified for anaphylaxis were drugs (60.5 %), food (16.3 %) and intravenous contrast (10.9 %) respectively. Only 22.5 % of cases received epinephrine as part of their initial management. In 4 patients (3.1 %) the cause of death was attributed to anaphylaxis. Conclusion: Anaphylaxis is a rare but life threatening condition. Though cutaneous features are most common, their absence does not exclude the diagnosis. Drugs were the most common cause and epinephrine was not commonly used as first line agent for its management

Features of mobile apps for people with autism in a post covid-19 scenario: current status and recommendations for apps using AI

The new ‘normal’ defined during the COVID-19 pandemic has forced us to re-assess how people with special needs thrive in these unprecedented conditions, such as those with Autism Spectrum Disorder (ASD). These changing/challenging conditions have instigated us to revisit the usage of telehealth services to improve the quality of life for people with ASD. This study aims to identify mobile applications that suit the needs of such individuals. This work focuses on identifying features of a number of highly-rated mobile applications (apps) that are designed to assist people with ASD, specifically those features that use Artificial Intelligence (AI) technologies. In this study, 250 mobile apps have been retrieved using keywords such as autism, autism AI, and autistic. Among 250 apps, 46 were identified after filtering out irrelevant apps based on defined elimination criteria such as ASD common users, medical staff, and non-medically trained people interacting with people with ASD. In order to review common functionalities and features, 25 apps were downloaded and analysed based on eye tracking, facial expression analysis, use of 3D cartoons, haptic feedback, engaging interface, text-to-speech, use of Applied Behaviour Analysis therapy, Augmentative and Alternative Communication techniques, among others were also deconstructed. As a result, software developers and healthcare professionals can consider the identified features in designing future support tools for autistic people. This study hypothesises that by studying these current features, further recommendations of how existing applications for ASD people could be enhanced using AI for (1) progress tracking, (2) personalised content delivery, (3) automated reasoning, (4) image recognition, and (5) Natural Language Processing (NLP). This paper follows the PRISMA methodology, which involves a set of recommendations for reporting systematic reviews and meta-analyses