Haemodynamics during Percutaneous Nephrolithotomy in Spinal Anaesthesia with Two Doses of Hyperbaric Bupivacaine (0.75%)

To compare variation in haemodynamics during percutaneous nephrolithotomy in spinal anaesthesia with two doses of hyperbaric bupivacaine (0.75%). Methods: In this randomized comparative study 60 patients, undergoing percutaneous nephrolithotomy, were included. It was done to compare the variation in haemodynamic parameters after spinal anaesthesia using two different doses of local anaesthetic before and after keeping patients in prone position. Patients were divided into two groups: Group A(n=30) (22.5 mg hyperbaric Bupivacaine 0.75%) and Group B (n=30)(30 mg hyperbaric Bupivacaine 0.75%). Spinal block was performed in sitting position. Hemodynamic measurements were carried out at different time points while patients were in supine and prone position.Results: Decrease in heart rate was significant in Group B than in Group A after 10 minutes of spinal block while in supine position (p<0.001) and the drop in heart rate was significant statistically in Group B when patients were turned to prone position (p<0.001).Systolic and diastolic blood pressures decreased in Group B at 5 and 10 minutes in supine position which further decreased following prone positioning and the decrease was highly significant statistically(p=<0.001).Conclusion: 22.5 mg of injection hyperbaric Bupivacaine is haemodynamically safer as compared to 30 mg of the same drug during spinal anaesthesia in percutaneous nephrolithotomy

Safety Evaluation of Stay Cables of Cable-Stayed and Extradosed Bridges via Deterministic and Non-deterministic Methods

Cable-stayed and extradosed bridges are thought to be identical structures because both bridges use stay cables for reinforcement. However, the safety factors of their stay cables are stipulated differently in many international standards, i.e., Japanese specifications suggest the safety factors of 2.5 and 1.67 for the design of cable-stayed and extradosed bridges, respectively. In this chapter, a parametric study is carried out for the evaluation of safety factors of stay cables by employing the deterministic and nondeterministic methods at limit states. As a result, it is found that the safety factors in the range of 2.3–2.5 and 1.67 are indispensable for the safe design of cable-stayed and extradosed bridges, respectively, to satisfy the conditions of limit states and target reliability index

Radiological and Clinical Outcome of Volar Barton Distal Radius Fractures Treated by Variable Angle Volar Locking- Plates (Chinese Version)

Background: To evaluate the functional and radiological results of treating volar Barton fractures of the distal radius with the variable Angle Volar Locking Plates (Chinese version). Methods: In this prospective study patients(n=50), of volar Barton fractures, which were fixed with Variable Angle Volar Locking Plates (Chinese version) were evaluated. Short arm back splint was applied . Volar approach was used for distal radius. After sweeping away the FPL muscle belly and retracting it ulnarly, pronator quadratus was exposed and released from its radial attachment in L shaped fashion using scalpel. Under direct visualization and with the aid of fluoroscopy, the fracture was then reduced. Plate was initially secured proximally with a 3.5-mm cortical screw in the oval hole of plate. Distal fixation with locking screws was then performed while maintaining the reduction. Radiological outcome (residual dorsal angulation, radial shortening and loss of radial inclination) was assessed according to Lidstorm criteria and clinical outcome was done using Mayo score . Results: Forty five cases were caused by road traffic accident and five cases were of domestic fall. Majority (n=28) sustained B3.1. Majority of the patients were operated within the first week of injury (60%). Mean time for radiological union was 08 weeks (6-12 weeks).Duration of hospital stay ranged from 2 to 3 days. Forty-six patients had excellent functional score at the end of six months. Forty-three patients (86%)had volar tilt in the range of 6-11 degrees and 2 patients (4%) had volar tilt in the range of 11-15 degree.Radiologically 96% patients had excellent to good results. Conclusion: Volar Barton fracture are best treated with osteosynthesis using variable angle volar locking plate

Self-reported academic performance in relation to health behaviours among Bahria University students

Objective: To find an association between self-reported academic performance with different socio-demographic factors, health behaviours and mental health amongst university students.Methods: This cross-sectional study was conducted at Bahria University, Karachi, from January 2012 to December 2013, and comprised university students of different disciplines. An anonymous, self-reported questionnaire was distributed among the subjects. Convenient sampling technique was used. Demographic information, including age, gender and field of study, were obtained. Depresion was evaluated via Centre for Epidemiological Studies Depression Scale. SPSS 22 was used to analyse data.Results: Of the 813 respondents, 334(41.1%) were males and 479(58.9%) females. The mean age was 19.9±1.8 years. Overall, 126(15.5%) subjects reported excellent, 242(29.8%) very good, 310(38.1%) good, 100(12.3%) satisfactory and 35(4.3%) not satisfactory academic performance. Residential status of students played a significant role on their academic performance (p=0.011). Breakfast eating behaviour depicted a significant association with the academic performance (p=0.04).The proportion of unsatisfactory academic performances among students having severe sleep disorder was the highest, followed by mild/moderate (p=0.01). The depression scale\u27s item \u27troubling in mind\u27 was highly associated with academic performance (p\u3c0.05).Conclusions: A constructive association existed among healthy behaviours and academic performance.

Bioaccumulation of hexavalent chromium in commercially edible fish grass carp, Ctenopharyngodon idella

The current research was conducted with the aim to investigate the rate of chromium accumulation in various tissues of commercially valuable freshwater fish, Grass Carp, Ctenopharyngodon idella. Investigation included various tissues of skin, muscles, liver, swim bladder, intestine, and gills in fish. For this purpose, the fish were exposed to sub lethal concentration of hexavalent chromium in the form of potassium dichromate with a dose of 120 mg/L for 40, 20 days and 10 mg/L for 7, 25, 40 and 60 days. Forty fish of the same weight and length (70.45±2.91 g and 7.32±0.16 inches) were used in the present research. Chromium was estimated after acid digestion of the sample tissues and further analyzed through atomic absorption spectrophotometer (Spectra AA6300 China). The results showed that in all the experiments intestine remained the highly accumulative tissue and the accumulation of chromium in the intestine increased with the increase in exposure time i.e., 0.63±0.21 after 7 days, 0.83±0.35 after 25 and 1.63±0.44 after 60 days. Finding of this research work supports that the route of metal uptake was mainly oral instead of absorption by gills or skin

Management of Chili leaf curl disease (ChiLCD) through resistant germplasm and Nutrients in relation to Environmental Factors

Chili (Capsicum annuum L.) is an important commercial spicy crop grown in many regions across the world. Six chili varieties such as Zinia F1, Desi (Jalalpuri), Desi (Jalalpuri 2), Wonder Hot, Summer Queen F1, and Faisalabad Selection was evaluated against the most devastating and catastrophic Chili’s leaf curl disease caused by Begomovirus Chili leaf curl virus (ChiLCV). Out of all six varieties, Wonder Hot and Summer Queen F1 showed moderately resistant (MR) response whereas three varieties including Zinia F1, Desi (Jalalpuri) and Desi (Jalalpuri 2) had a moderately susceptible (MS) response, and only one variety namely Faisalabad Selection, expressed resistant (R) response. Four varieties; Desi (Jalalpuri), Desi (Jalalpuri 2), Zinia F1, and Wonder Hot, were used for management purposes with four micronutrients in combinations, namely T1 (ZnSO4 + CuSO4), T2 (MnSO4 + CuSO4), T3 (Boric Acid + CuSO4) and T4 (ZnSO4 + CuSO4 + MnSO4 + Boric Acid). When compared to control (58.14%), only T4 demonstrated minimum disease severity (11.63%). In the case of disease incidence, T4 gave the best results with minimum disease incidence (35.65%) as compared to control (92.59%). Treatments were able to decrease the disease progression even in the existing of favorable environmental factors.There was significant (p˂0.05) but positive correlation between wind speed and disease severity. Wind speed was highly correlated with the disease severity of variety Wonder Hot (r=0.91). We concluded that the application of micronutrient activate the plant defense system and at the same time suppress the vector populations

A situational analysis of HIV and AIDS in Pakistan

HIV (Human immunodeficiency virus) transmission has been reduced by protected sex and screening of blood products and other body fluids in the developed countries. It has been reported that Pakistan is at high risk of HIV/AIDS infection but presently the prevalence rate is considerably low. The number of reported cases of HIV/AIDS in Pakistan has been continuously increasing since 1987. By 2010 the total number of registered cases has reached to 6000 and this figure is on the rise with the passage of time. Some serious strategies must be implemented to control this deadly disease

Formulation development and characterization of quercetin loaded poly caprolactone nanoparticles for tumors

Cancer is a formidable health obstacle, characterized by its bleak outlook. Considerable scientific investigation has shed light on the capacity to modify the dispersion of anticancer medications at various levels within tissues and cells by enclosing them within submicronic colloidal systems, often known as nanoparticles. This approach is based on the goal of enhancing the therapeutic effectiveness of these medications while minimizing adverse effects on the entire body. Moreover, the theragnostic characteristics of these nanoparticles are widely acknowledged, hence enhancing their therapeutic potential. The current study is centered on exploring the potential anti-tumor effects of quercetin by utilizing its antioxidant capabilities. The quercetin nanoparticles are synthesized with great precision utilizing the nanoprecipitation approach, in which poly(caprolactone) is utilized as the polymer matrix. Following synthesis, the nanoparticles are extracted for further analysis. Further attempts are undertaken to enhance the drug loading process, and the resultant nanoparticles undergo a thorough analysis, including the examination of their morphology using scanning electron microscopy, and the evaluation of drug-polymer interactions using Fourier transform infrared spectroscopy and differential scanning calorimetry. The remarkable efficacy of quercetin's envelopment can be attributed to its lipophilic nature, reaching a maximum of 81%. The utilization of scanning electron microscopy allows for the observation of nanoparticles with varying forms. Conversely, the absence of noticeable interactions in Fourier-transform infrared analysis indicates the stability of poly(caprolactone) nanoparticles loaded with quercetin

Effective strategies for increasing the uptake of modern methods of family planning in South Asia: a systematic review and meta-analysis

Background: Family planning (FP) interventions have improved the use of modern contraceptives, yet a high unmet need for contraception still exists in South Asia. This systematic review of existing research was conducted to identify effective FP interventions that led to an increase in the uptake of modern methods of contraception in South Asia. Methods: Five electronic databases were searched for relevant studies published between January 1st, 2000 and May 4, 2023. Experimental studies that reported data on the impact of FP interventions on modern contraceptive use among women of reproductive age (15–49 years) in the South Asian region were included. A random-effects Inverse Variance weighted model was employed to pool the adjusted odds ratio (OR) on modern contraceptive use and unmet need for contraception. In addition, we computed subgroup meta-estimates based on intervention type and the urban-rural divide. Results: Among 643 studies identified, 21 met the inclusion criteria. The overall pooled odds ratio for modern contraceptive use was significantly higher (OR 1.51; 95% CI 1.35–1.70; heterogeneity; I2 = 81%) for FP interventions with a significant reduction in unmet need for contraception (OR 0.86; 95% CI 0.78–0.94, I2 = 50%). The subgroup analysis revealed demand-generation (OR 1.61; 95% CI 1.32–1.96), health system integrated (OR 1.53; 95% CI 1.07–2.20), and franchised FP clinic interventions (OR 1.32; 95% CI 1.21–1.44) had promoted the modern contraceptive uptake. Further, FP interventions implemented in urban settings showed a higher increase in modern contraceptive use (OR 1.73; 95% CI 1.44–2.07) compared to rural settings (OR 1.46; 95% CI 1.28–1.66). Given the considerable heterogeneity observed across studies and the low degree of certainty indicated by the GRADE summary for the primary outcome, caution is advised when interpreting the results. Conclusion: The review collated experimentally evaluated FP interventions that increased modern contraception use and reduced the unmet need in South Asia. The demand generation interventions were the most effective in increasing the uptake of modern contraceptive methods. Furthermore, the urban environment provides a conducive environment for interventions to improve contraceptive usage. However, further studies should assess which aspects were most effective on attitudes towards contraception, selection of more effective methods, and contraceptive behaviors

ROLE OF SONOELASTOGRAPHY IN THE EVALUATION OF THYROID NODULES

Thyroid nodular disease is one of the most common endocrine disorder. B mode ultrasound provides useful characteristic information about thyroid nodules but it has noticeably low accuracy to differentiate benign from malignant. Fine needle aspiration is widely been used in differentiation of benign and malignant thyroid nodules but it is an invasive procedure. Sonoelastography is a newly developed non- invasive technique which uses ultrasound and gives information about the stiffness of tissue. It estimates the hardness of thyroid lesions in association with adjacent tissues and assists in the differentiation of benign from malignant nodules.Objective:The objective of this study was to evaluate the role sonoelastography in the evaluation of thyroid nodules. Methods:This study was conducted on 72 Patients of age between 18-80 years of either gender at Institute of Nuclear Medicine and Oncology Lahore (INMOL) Pakistan, from 25 March 2019 to 23 August 2019 for duration of five months. Elastography was performed using Toshiba Aplio 500.  Patient having one or more solid nodules in thyroid on conventional ultrasound examination were included in the study and the sonoelastography of nodules was confirmed with histopathological findings of nodules. Results: A total 72 participants were included in our study. The mean age of participants was 42.11 years. Gender distribution shows that 51.4% (n=37) were male and 48.6% (n=35) were female. Sonoelastographic strain ratio of 55.6% nodules (n=40) was more than 2.1(malignant feature) and 44.4% nodules (n=32) have less than 2.1 (benign). Histopathology showed 56.9% of participants (n=41) have malignant nodules and 43.1% (n=31) have benign nodules. The comparison of sonoelastography and histopathology in reference with nodules shows that the results of histopathology and sonoelastography were same and support each other. Conclusion: Sonoelastography is non-invasive and cost-effective imaging technique to diagnose thyroid nodules either benign or malignant. Keywords: Ultrasound Elastography, Thyroid Nodules, Benign, Malignant, Fine Needle Aspiration. DOI: 10.7176/JHMN/66-08 Publication date:September 30th 201