Correlation of Atrial Fibrillation with Left Atrial Volume in Patients with Mitral Stenosis. a Single Centre Study From Pakistan

Background: Rheumatic heart disease has a strong association with mitral valve stenosis. Atrial fibrillation is one of the most common complications of this condition and is a poor prognostic factor. Early detection and prompt management of atrial fibrillation can help to improve the quality of life and increase the life expectancy of the patients. We carried out this study to investigate the significance of left atrial volumetric changes in mitral stenosis and its correlation with atrial fibrillation. Methodology: We audited the data of 60 patients of rheumatic heart disease who had mitral valve stenosis. The patients were randomized into atrial fibrillation (Group A) and normal sinus rhythm (Group B). We conducted this cross-sectional analytical study at Cardiology Department, Mayo Hospital, Lahore, from 1st February 2017 to 31st January 2018. We only included those patients who consented to be a part of this study and fulfilled our predefined inclusion criteria. Left atrial volume was measured by prolate ellipse method and biplane methods on echocardiography. The Data was analyzed on SPSS v20. Results: Sixty patients were included in the study. Among the subjects, thirty-six (60%) were males, and twenty-four (40%) were females. Atrial fibrillation was noted in 43.33% of the patients of mitral valve stenosis. There was a marked difference in the mean volume of the left atrium among the two groups. We observed that the mean area of the mitral valve for Group A patients was larger than that of patients in Group B. Our study showed an inverse correlation between left atrial volume and mitral valve area among Group A patients. Conclusion: Patients of mitral stenosis are at an increased risk of developing atrial fibrillation if the left atrial volume is increasing. All patients with mitral stenosis should have routine echocardiography & measurement of left atrial volumes, so that proper treatment can be started if the left atrial volume is increasing, to prevent atrial fibrillation

A whole-health-economy approach to antimicrobial stewardship: Analysis of current models and future direction.

Antimicrobial stewardship (AMS) strategies are widely implemented in single healthcare sectors and organisations; however, the extent and impact of integrated AMS initiatives across the whole health economy are unknown. Assessing degree of integration of AMS across the whole health economy and its impact is essential if we are to achieve a ‘One Health’ approach to addressing antimicrobial resistance (AMR), and therefore we searched systematically for and analysed published examples of integrated AMS initiatives to address this gap. Application of a system-level framework to analyse integration of AMS initiatives across and within healthcare sectors shows that integration is emerging but needs strengthening. Findings from a small number of evaluations in high-income countries suggest that antimicrobial prescribing and healthcare-associated infections can be reduced using a multisectoral integrated AMS approach. More robust research designs to evaluate and understand the impact of multisectoral integrated AMS are needed, particularly with respect to differing health systems in different countries and local organisational contexts. Our analysis highlights a number of challenges and ways forward for enhancing the delivery of AMS through an integrated approach

A novel green antenna phase-shift system with data acquisition boards

A novel green phase shifter system is proposed in this research. The system is developed by a combination of reconfigurable beam steering antennas and data acquisition (DAQ) boards. A combination of two reconfigurable beam steering antennas, located side-by-side, forms a spatial configuration structure with a fabricated ‘green’ element plank of rice husk placed in between. The concept of a spatial configuration technique has been ‘mutated’ by shifting the structure of spiral feed line and aperture slots of first beam steering antenna by as much as 45 ◦ . The PIN diode switches connected to the DAQ boards enable the intelligent capability of the spatial antennas. The activation of certain degree radiation patterns of either the first beam steering antenna or the second beam steering antenna depends on the memory of the DAQ boards — Beam Manager. When an intruder comes from the cardinal angles of 0◦/ 360◦, 90◦, 180◦, or 270◦, its range and angles’ location will be automatically detected by the first antenna through the output ports of the 1st DAQ: P1.0, P1.1, P1.2, and P1.3. The second antenna is then activated by the output ports of the 2nd DAQ: P2.0 up to P2.3, to adaptively maneuver the beam towards four different ordinal directions of 45◦, 135◦, 225◦, and 315◦

Indigenous uses of economically important flora of Margallah Hills National Park, Islamabad, Pakistan

Informal interviews provided data about 245 useful plants of 77 families of 55 trees, 54 shrubs, 105 herbs, 15 climber, 10 grasses and 6 crops recorded from the Margallah Hills National Park, Islamabad.Two hundred and fifteen local/ vernacular names were noted of total plants. The inhabitants of the park have for a long time been dependent on surrounding plant resources for their food, health care, fodder,fuel wood and other cultural purposes. A list of plant species along with their local name, plant part/s used, popular uses (or troubles treated) are given. The pastoral nomads of the area make use of 159(64.89%) as native medicine, 79 (32.24%) as fodder for their livestock, 47(19.18%) as fuelwood, 33 (13.46%) as food (fruits), 18 (7.34%) as vegetables, 14 (5.71%) as timber, 6 (2.44%) as industrial, 4 (1.63%) as tannin, 3 (1.22%) as gum and 2 (0.81%) as fiber. Medicinal uses of the 126 plant species have also been described. This information will serve as reference for the benefit of pharmacists, researchers, Hakims (herbalist), veterinarians and public at large

Variasi Spasio-temporal Jenis Makanan Ikan Motan, Thynnichthys Polylepis Di Rawa Banjiran Sungai Kampar Kiri, Riau [Spatio-temporal Variation in the Diet of Thynnichtys Polylepis in Floodplain River of Kampar Kiri, Riau]

The research aimed to describe diet composition of Thynnichthyes polylepis. The diet compositions of population from two sites (Mentulik and Simalinyang) in floodplain river of Kampar Kiri, were compared according to the month. Fishes were captured using experimental gillnet and trap. For food habits analysis, the index of preponderance method was used. The collections were performed monthly from July to December 2008, where the stomach contents of 479 specimens were assessed. Prey items of T. polylepis were basically composed of phytoplankton and zooplankton, especially Cocconeis, Nitzschia, Navicula, Cyclotella, Pleurotaenium, and Testudinella. At site Mentulik, the most common items were Cocconeis, Nitzschia, and Navicula. Conversely, at site Simalinyang, Cocconeis, Pleurotaenium, and Nitzschia more representative. In general, main food of fish origin showed the highest index values at Mentulik, whereas at Simalinyang. The composition of items varied monthly, especially at Simalinyang. Food habits of fish may be flexible according to resource availability in spatial and temporal variation

A novel Multi-permittivity Cylindrical Dielectric Resonator Antenna for Wideband Applications

In this paper, a novel multi-permittivity cylindrical dielectric resonator antenna for wideband application is presented. The multi-permittivity cylinder is formed by combining two different permittivity material sectors in such a way that each sector (with constant permittivity) is 90 degree apart. A direct microstrip line coupling terminated with T-stub at the open end is used to excite the multi-permittivity cylindrical dielectric resonator. The angular position of the multi sector dielectric resonator with respect to the longitudinal axis of the microstrip line and length of the additional strip at the open end of the feeding circuit is key parameters for wideband operation of the antenna. By optimizing all parameters of the proposed antenna, wideband impedance bandwidth of 56% (12.1 GHz - 21.65 GHz) is achieved. The average gain of the antenna throughout the bandwidth is 5.9 dB with good radiation properties in both E-plane and H-plane. A well matched simulation and experimental results show that the antenna is suitable for wideband applications

The establishment of minimum luminous range for existing lighthouses in the age of global navigation satellite system by limiting the luminous range within geographical range

Long range marine aids to navigation is not required by current marine navigational practice, therefore luminous range of lighthouses should be reduced. The objective of this study is to determine a minimum luminous range for major lighthouses. The minimum luminous ranges is determined by conducting two steps, namely by modifying the existing geographical range formula and determine a strong linear correlation between light intensity and luminous range with the lowest gradient as possible in a linear graph. The application of minimum luminous range would eliminate the loom of light beyond the lighthouse's geographical range, which is not necessary for current navigational practice. This method is applied to seven major lighthouses in Peninsular Malaysia, which resulted minimum luminous range that ranging from 12.2 nm to 14 nm. The existing luminous ranges of these lighthouses are ranging from 18 nm to 25 nm. These new minimum luminous ranges are sufficient for mariners who primarily rely on GNSS, reduce service provider operational cost and may sustain lighthouses operation in the future

Kesan penggunaan koswer multimedia animasi visual terhadap pencapaian pelajar dalam mata pelajaran matematik

Ramai pelajar yang bermasalah dalam topik Pelan dan Dongakan. Ini kerana pelajar sukar untuk membayangkan objek yang tersembunyi melalui proses pengajaran dan pembelajaran (P&P) secara konvensional. Penyelidik telah membangunkan satu koswer multimedia animasi visual dalam topik Pelan dan Dongakan dengan menerapkan kesemua elemen-elemen yang dapat membantu meningkatkan kemahiran visual iaitu elemen animasi, video, audio, grafik dan teks. Seterusnya, kajian kuasi eksperimental ini turut dijalankan bertujuan untuk mengetahui kesan penggunaan koswer multimedia animasi visual terhadap pencapaian pelajar bagi mata pelajaran Matematik di sekolah menengah. Ujian Pra dan Ujian Pos digunakan untuk melihat perbezaan pencapaian yang signifikan selepas menggunakan koswer multimedia animasi visual yang menggunakan teori Kognitif Visual Wiley. Responden yang terlibat dalam kajian ini ialah seramai 40 orang pelajar Tingkatan Lima yang dibahagikan kepada dua kumpulan iaitu kumpulan rawatan dan kumpulan kawalan yang dipilih daripada sebuah sekolah di daerah Batu Pahat, Johor. Hasil analisis menunjukkan peningkatan skor min markah bagi pelajar kumpulan rawatan. Hasil analisis ujian-t (paired-sample-t-test) membuktikan bahawa wujudnya perbezaan skor min markah yang signifikan di antara markah ujian pra dan markah ujian pos bagi kumpulan rawatan. Oleh itu, terdapat perbezaan yang signifikan di antara skor min markah ujian pra dan ujian pos bagi pelajar kumpulan rawatan selepas menggunakan koswer multimedia animasi visual. Manakala instrumen soal selidik yang digunakan untuk melihat tahap penerimaan pelajar selepas menggunakan koswer multimedia animasi visual berdasarkan tiga aspek iaitu aspek isi kandungan, aspek interaksi dan aspek persembahan telah memeperolehi skor min yang tinggi bagi ketiga-tiga aspek tersebut. Dapatan kajian ini menggambarkan penggunaan koswer multimedia animasi visual dapat membantu meningkatkan pencapaian Matematik di dalam bilik darjah terutama yang tidak melibatkan pengiraan