PAKistan Study of prEmature coronary atHerosclerosis in young AdulTs (PAK-SEHAT): A prospective longitudinal study protocol investigating the prevalence, severity and determinants of atherosclerotic cardiovascular disease in the young adult Pakistani population

Introduction: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity, mortality and health expenditures worldwide. Despite having higher ASCVD in the Pakistani population, data on subclinical coronary atherosclerosis in young Pakistanis remain scarce. The PAKistan Study of prEmature coronary atHerosclerosis in young AdulTs (PAK-SEHAT) aims to assess the prevalence, severity and determinants of subclinical coronary atherosclerosis among Pakistani men (35-60 years) and women (35-65 years) free of clinically symptomatic ASCVD and will assess 5-year rates of ASCVD events.Methods and analysis: PAK-SEHAT is an ongoing prospective cohort study with 2000 participants from all provinces of Pakistan who will be interviewed at the baseline along with phlebotomy, measurement of carotid intima-media thickness (CIMT) and coronary CT angiography (CCTA). Phlebotomy will be repeated at 2.5 years, whereas CIMT and CCTA will be repeated at 5 years. We will report the frequency of maximal coronary stenosis ≥50% and ≥70%, number of coronary vessels with plaque and the number of coronary segments affected per participant on CCTA. We will use Cox proportional hazards regression models to evaluate the association between baseline characteristics and incident ASCVD events during follow-up. These associations will be presented as HRs with 95% CIs.Ethics and dissemination: The study protocol was approved by the Tabba Heart Institute Institutional Review Board (THI/IRB/FQ/22-09-2021/016). All study procedures are consistent with the principles of the Declaration of Helsinki. Findings of the study will be disseminated via peer-reviewed publications and conference presentations.Trial registration number: NCT05156736

Pakistan study of premature coronary atherosclerosis in young adults (pak-sehat): A prospective longitudinal study protocol investigating the prevalence, severity and determinants of atherosclerotic cardiovascular disease in the young adult pakistani population

Introduction Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity, mortality and health expenditures worldwide. Despite having higher ASCVD in the Pakistani population, data on subclinical coronary atherosclerosis in young Pakistanis remain scarce. The Pakistan Study of prematurely coronary atherosclerosis in young Adults (PAK-SEHAT) aims to assess the prevalence, severity and determinants of subclinical coronary atherosclerosis among Pakistani men (35–60 years) and women (35–65 years) free of clinically symptomatic ASCVD and will assess 5-year rates of ASCVD eventMethods and analysis PAK-SEHAT is an ongoing prospective cohort study with 2000 participants from all provinces of Pakistan who will be interviewed at the baseline along with phlebotomy, measurement of carotid intima-media thickness (CIMT) and coronary CT angiography (CCTA). Phlebotomy will be repeated at 2.5 years, whereas CIMT and CCTA will be repeated at 5 years. We will report the frequency of maximal coronary stenosis ≥50% and ≥70%, number of coronary vessels with plaque and the number of coronary segments affected per participant on CCTA. We will use Cox proportional hazards regression models to evaluate the association between baseline characteristics and incident ASCVD events during follow-up. These associations will be presented as HRs with 95% CIs.Ethics and dissemination The study protocol was approved by the Tabba Heart Institute Institutional Review Board (THI/IRB/FQ/22-09-2021/016). All study procedures are consistent with the principles of the Declaration of Helsinki. Findings of the study will be disseminated via peer-reviewed publications and conference presentations

Life is beautiful: gay representation, moral panics, and South Korean television drama beyond Hallyu

Critical attention on Korean popular culture, particularly outside of Korea, has focused upon the Hallyu cultural phenomenon at the expense of sectors of the Korean creative industries that have sought to actively engage with their social and cultural environment and challenge the status quo. Politically charged, countercultural or just distinctive and/or original, non-Hallyu cultural artifacts have been and continue to be born out of a desire to be creative, to comment on or to create social change. This article focuses upon one such critically overlooked South Korean cultural artifact, the audacious and genuinely groundbreaking television drama "Life is Beautiful" (SBS 2010), which motivated an immense amount of critical and social reaction within Korea and yet has barely featured in English language analysis of Korean drama because it has not been classified as Hallyu. This is in spite of it being a finely produced and performed series and one written by the most prolific, longest serving and commercially successful of all Korean writers of Hallyu drama, Kim Soo-hyeon. In addition to its impressive production credentials, "Life is Beautiful" is also notable for being hugely controversial at the time of its broadcast due to its boldness in tackling the subject of Korean prejudice towards homosexuality

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Etiological and clinical profile of acute renal failure in children attending SKIMS Srinagar

Background: Acute renal failure is an important problem in childhood in hospital practice. It is a catastrophic and life threatening event. Objectives: The present study focuses on the “etiological and clinical profile of ARF in children attending SKIMS”. Study designed: Prospective study. Material & Methods: This study was conducted over a period of 2 ½ years from 2006 – 08. 100 cases of children upto the age 18 years with ARF who were admitted in SKIMS were studied. Results: Out of 100 cases of ARF, 51 (51%) were girls and 49 (49%) were boys; 36% of patients were 10 years of age. Sepsis was the commonest cause of ARF (18%) followed by acute gastroenteritis (15%) and post streptococcal glomerulonephritis (12%). The commonest clinical presentation was oliguria (60%) followed by edema (45%), vomiting (39%), and breathlessness (26%). Anuria was present in 13% of patients. Convulsions were the most common major systemic complications. The treatment modality was conservative in 80%, renal replacement therapy (RRT) in the form of peritoneal and hemodialysis was performed in 20% of the patients. The overall mortality rate was 20%. Mortality was highest in patients with sepsis and rapidly progressive glomerulonephritis. Outcome data at 3 months showed normal renal function in 72 (90%), and CKD in 5 (6.3%). Three (3.8%) patients lost followup. Conclusions: ARF is fairly common in children with a mortality rate of 20% in our study. Even today, sepsis is the most common cause of ARF followed by acute gastroenteritis. If these conditions are treated early and promptly, the occurrence of ARF can be prevented. If the patient develops ARF, an early referral to a specialized center with dialysis facilities can significantly improve the final outcome

Real-Time Nitrogen Application of Rice Varieties Based on Leaf Colour Chart under System of Rice Intensification in Temperate Climate

Increasing nitrogen use efficiency in rice intensification (SRI) is pivotal to achieving high crop yield and reducing nitrogen losses. To find the critical value of the leaf color chart (LCC) for real-time nitrogen (N) application in rice varieties under SRI, a field experiment was laid at the Research Farm, Faculty of Agriculture, Wadura, SKAUST-Kashmir in Kharif between 2019 and 2020. The experiment comprised two cultivars (SR-3 and SR-4) and eight LCC-based nitrogen managements (control, recommended dose of nitrogen (RDF), and three LCC scores (≤3, ≤4, ≤5 each with 20 and 30 kg N ha−1). SR-4 produced significantly higher values for growth and yield parameters, producing higher grain yield (7.02 and 6.86 t ha−1) compared to SR-3 (6.49 and 6.36 t ha−1) between 2019 and 2020, respectively. An LCC value of 5 with 30 kg N ha−1 produced maximum grain yield (7.84 and 7.70 t ha−1) in 2019 and 2020, respectively, which were statistically at par with the LCC value of 5 with 20 kg Nha−1. Pooled data revealed that the highest B: C ratio of 1.55 was recorded in cultivar SR-4 with an LCC value of 5 with 30 kg N ha−1. Furthermore, agronomic and recovery efficiency of nitrogen remained maximum in LCC 5 with 20 kg N ha−1 for both years. Grain yield recorded in LCC 3 20 kg N ha−1 was similar to recommended nitrogen. The present study highlighted the need-based N application through LCC and proved effective in increasing the N-use efficiency and yield in rice