Analyzing the Knock-on Impacts of 2022 Floods on Rabi 2023 Using Remote Sensing and Field Surveys

While the world's attention is focused on immediate relief and rescue operations for the affectees of the current floods in Pakistan, knock-on effects are expected to play further havoc with the country's economy and food security in the coming months. Significant crop yield losses had already occurred for Winter (Rabi) 2021-22 due to a heatwave earlier in the year and estimates for the Summer (Kharif) 2022 crop damage due to flood inundation have already been determined to be very high. With the next sowing season already upon the flood affectees, there is a big question mark over the resumption of agricultural activity in disaster-struck districts. This study is aimed at analyzing the range of influences of the 2022 floods on the upcoming winter (Rabi) crop. Satellite-based remote sensing data, state-of-the-art Earth system models, and field observations will be leveraged to estimate the impacts of the flood on the resumption of agricultural activity in the most impacted districts of Southern Punjab, Sindh, and Baluchistan. The field surveys are conducted during multiple visits to the study area to maximize the monitoring of on-ground conditions and provide a larger validation dataset for the satellite-based inundation and crop classification maps. The project leverages on the expertise and previous experiences of the LUMS team in performing satellite-based land/crop classification, estimation of soil moisture levels for irrigation activity, and determining changes in land-use patterns for detecting key agricultural activities. Delays in the sowing of the winter crop and its effects on crop-yield were analyzed through this study

Echocardiographic Findings and Their Impact on Outcomes of Critically Ill Patients with AIDS in the Era of HAART

Objective. To describe the echocardiographic findings in critically ill patients with AIDS and their impact on clinical outcome. Design. A retrospective chart review of consecutive AIDS patients over 18 years of age, who had a trans-thoracic echocardiogram performed during the course of intensive care unit stay over the course of 2 years at a tertiary care hospital. Main outcome measures. The prevalence of echocardiogram abnormalities in this population and its impact on ICU mortality, ICU length of stay, hospital mortality, hospital length of stay and 60 day survival. Results. Among 107 patients who met the inclusion criteria, an admission echocardiogram was performed in 62 (58%). The prevalence of cardiac abnormalities was 60%. The most common admission diagnosis was respiratory failure n = 27 (43%). The most common finding on echocardiogram was left ventricular (LV) dysfunction n = 31 (50%) followed by pulmonary hypertension n = 25 (40%). None of these findings had a significant impact on clinical outcomes. There was trend toward reduced 60 day survival among patients with depressed LV function. Conclusions. Although echocardiogram abnormalities were prevalent among this population none of these findings had a significant impact on ICU mortality or hospital mortality and ICU length of stay or hospital length of stay

Retrosternal abscess after trigger point injections in a pregnant woman: a case report

<p>Abstract</p> <p>Introduction</p> <p>Although retrosternal abscess is a well known complication of sternotomy and intravenous drug abuse, to date it has not been described as a consequence of trigger point injections. There are reported cases of serious complications as a result of this procedure including epidural abscess, necrotizing fasciitis, osteomyelitis and gas gangrene.</p> <p>Case presentation</p> <p>A 37-year-old African-American woman, who was 20 weeks pregnant, presented to our emergency room with complaints of progressively worsening chest pain and shortness of breath over the course of the last two months. She was undergoing trigger point injections at multiple different sites including the sternoclavicular joint for chest pain and dystonia. Two years previously she had developed a left-sided pneumothorax as a result of this procedure, requiring chest tube placement and subsequent pleurodesis. Her vital signs in our emergency room were normal except for resting tachycardia, with a pulse of 100 beats per minute. A physical examination revealed swelling and tenderness of the sternal notch with tenderness to palpation over the left sternoclavicular joint. Laboratory data was significant for a white blood count of 13.3 × 10⁹/L with 82% granulocytes. A chest radiograph revealed left basilar scarring with blunting of the left costophrenic angle. A computed tomography angiogram showed a 4.7 cm abscess in the retrosternal region behind the manubrium with associated sclerosis and cortical irregularity of the manubrium and left clavicle.</p> <p>Conclusion</p> <p>Trigger point injection is generally considered very safe. However, there are reported cases of serious complications as a result of this procedure. A computed tomography scan of the chest should strongly be considered in the evaluation of chest pain and shortness of breath of unclear etiology in patients with even a remote history of trigger point injections.</p

Approach to acute exacerbation of idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial pneumonia with a median survival of 3 years after diagnosis. Acute exacerbation of IPF (AE-IPF) is now identified as a life-threatening complication. It presents as worsening dyspnea with new ground glass opacities superimposed upon a radiographic usual interstitial pneumonia (UIP) pattern. It is a diagnosis of exclusion. The prognosis of AE-IPF is poor and treatment strategies lack standardization. In order to rule out any reversible etiology for an acute decompensation of a previously stable IPF patient diagnostic modalities include computerized tomographic angiogram (CTA) coupled with high-resolution computerized tomography (HRCT) imaging of the chest, bronchoalveolar lavage (BAL) and echocardiogram with bubble study. Avoiding risk factors, identifying underlying causes and supportive care are the mainstays of treatment. Anti-inflammatory and immunosuppressant medications have not shown to improve survival in AE-IPF. Most of the patients are managed in a critical care setting with mechanical ventilation. Lung transplantation is a promising option but most institutions are not equipped and not every patient is a candidate

Impact of a ‘Research in pharmacy’ course on students’ self-reported competence and confidence to conduct research: findings from a Malaysian university

Objective: To evaluate the impact of a ‘Research in Pharmacy’ course on students’ self-reported competence and confidence to plan and conduct pharmacy practice research. Method: This is a pre- and post-intervention study conducted among third year pharmacy undergraduate students in a public university in Malaysia using an online questionnaire. A ‘Research in pharmacy’ course which encompassed lectures, tutorials, and practical sessions was delivered over a 14-week period. The students were divided into groups and assigned a project supervisor to guide them in planning and conducting a research project that was completed in one term. Result: Of the 109 students, 69 and 62 completed the questionnaire in the pre- and postintervention periods, respectively. Students’ interest in conducting research and their interest in learning about research was similar in both periods. However, self-reported ability to conduct research increased significantly. Self-reported competence and confidence to conduct most components of research improved significantly (p < 0.05), although, extreme/very competent or confidence level was lower than 50% for most items. Overall, median total competence score (66.0 versus 74.0, p < 0.001) and median total confidence score (66.0 versus 71.5, p < 0.001) increased significantly after the course. Most students were very satisfied/satisfied with the online lectures (54.8%) and online project supervision (64.6%). Lack of time (61.3%) was the major challenge students encountered during the course. Conclusion: A ‘Research in pharmacy' course with both didactic and experiential components improved self-reported competence and confidence to plan and conduct research among pharmacy undergraduate students. Future studies should investigate the facilitators and barriers to students’ interest in pharmacy practice research