Prevalence and impact of chronic widespread pain in the Bangladeshi and White populations of Tower Hamlets, East London

The prevalence and impact of chronic pain differ between ethnic groups. We report a study of the comparative prevalence and impact of chronic pain in Bangladeshi, British Bangladeshi and White British/Irish people. We posted a short questionnaire to a random sample of 4,480 patients registered with 16 general practices in the London Borough of Tower Hamlets and conducted a longer questionnaire with patients in the waiting areas at those practices. We distinguished between Bangladeshi participants who were born in the UK or had arrived in the UK at the age of 14 or under (British Bangladeshi) and those who arrived in UK at the age of over 14 (Bangladeshi). We obtained 1,223/4,480 (27 %) responses to the short survey and 600/637 (94 %) to the long survey. From the former, the prevalence of chronic pain in the White, British Bangladeshi and Bangladeshi groups was 55, 54 and 72 %, respectively. The corresponding figures from the long survey were 49, 45 and 70 %. Chronic widespread pain was commoner in the Bangladeshi (16 %) than in the White (10 %) or British Bangladeshi (9 %) groups. People with chronic pain experienced poorer quality of life (odds ratio for scoring best possible health vs. good health (or good vs. poor health) 5.6 (95 % confidence interval 3.4 to 9.8)), but we found no evidence of differences between ethnic groups in the impact of chronic pain on the quality of life. Chronic pain is commoner and, of greater severity, in Bangladeshis than in Whites. On most measures in this study, British Bangladeshis resembled the Whites more than the Bangladeshis

Methotrexate in rheumatoid arthritis: a 2 year experience at a university hospital in Pakistan

In this study we report our two years experience of methotrexate (MTX) in the management of rheumatoid arthritis (RA) at the Aga Khan University Hospital, Karachi. We studied the clinical course of 124 RA patients. The mean age was 44 +/- 11 years (range 19-72) and mean duration of RA was 5 +/- 4 years (range 0.3-25). Female to male ratio was 10:2.4 (100F:24M). All of them were diagnosed according to the criteria set by American Rheumatism Association. The mean value of ESR was 60 +/- 30 (Range 3-128). Fifty one percent had severe disease (\u3e 10 joints involved and evidence of erosions and deformities). Twenty-one patients had extra-articular manifestations. None of them had received MTX previously. Their kidney and liver functions were assessed to be normal. Patients were divided into two groups. One group (n = 92) received MTX (7.5-10 mg/week) as initial treatment, while the other group (n = 32) was given other disease modifying anti-rheumatic drugs (penicillamine, salazopyrin, gold, or chloroquine) followed by MTX. Assessment of the treatment outcome and development of any adverse reactions was carried out at 3-month interval over an average period of 1 year. Assessment of the treatment outcome in the group which received MTX as initial drug revealed the response to be excellent in 13%, good in 70%, fair in 11% and variable in 4%. In the group which received MTX as second-line of therapy, 59% of the patients had the response from good to excellent, while 25% of the patients exhibited poor to fair response. Regarding side-effects of MTX treatment, 57% exhibited none, while 35% had nausea and vomiting. Alopecia was the next common toxicity in these patients. Two individuals had abnormal liver function tests (value twice more than normal), while one developed lung fibrosis. MTX despite its adverse effects in some of the patients is still an effective, well tolerated and inexpensive disease modifying drug in RA

Minimization of total harmonic distortions of cascaded H-bridge multilevel inverter by utilizing bio inspired AI algorithm

Minimizing total harmonic distortion (THD) with less system complexity and computation time is a stringent constraint for many power systems. The multilevel inverter can have low THD when switching angles are selected at the fundamental frequency. For low-order harmonic minimization, selective harmonic elimination (SHE) is the most adopted and proficient technique but it involves the non-linear transcendental equations which are very difficult to solve analytically and numerically. This paper proposes a genetic algorithm (GA)-based optimization technique to minimize the THD of cascaded H-bridge multilevel inverter. The GA is the finest approach for solving such complex equations by obtaining optimized switching angles. The switching angles are calculated by the genetic algorithm by solving the nonlinear transcendental equations. This paper has modeled and simulated a five-level inverter in MATLAB Simulink. The THD comparison is carried out between step modulation method and optimization method. The results reveal that THD has been reduced from 17.88 to 16.74% while third and fifth harmonics have been reduced from 3.24%, 3.7% to 0.84% and 3.3%, respectively. The optimization method along with LC filter significantly improves the power quality providing a complete sinusoidal signal for varying load

The effect of Cyclophosphamide on spermatogenesis in rats

This study aimed to evaluate the effects of cyclophosphamide on spermatogenesis; we used three doses with variable time interval to determine the effect of the low and high doses of cyclophosphamide. The results showed that low doses for long time interval caused a considerable increase in the percentage of sperm head abnormalities (Tertatospermia), without any significant changes in tissue sections, the percentage of sperm head abnormalities was increased to 20.72% with the dose 5mg/Kg, while high doses caused a significant tissue changes in testes, and epididymis as well as head sperm abnormalities but less than the 5mg/Kg dose. The percentage of head sperm abnormalities were 14.75 and 13.19 for the doses 15mg/Kg and 10mg/Kg respectively

A new eight switch seven level boost active neutral point clamped (8S-7L-BaNPC) inverter

A new boost Active-Neutral-Clamped (ANPC) voltage boosting inverters are appealing for low dc-link voltage demand. Recent boost ANPC topology has demonstrated a 1.5 times voltage gain, but the number of switches has a higher number. This paper proposed an improved boost ANPC topology with 1.5 voltage gain using the least number of switches. Further, the number of conducting switches has been reduced remarkably which enhances the system efficiency. The seven-level (7L) output voltage levels are achieved using a floating capacitor with self-voltage balancing capability. The proposed topology has been analyzed and compared to the ANPC topologies proposed in recent years. For the validation of the theoretical aspect of the proposed topology, the experimental findings have been compiled in the paper.This work was supported by the Qatar University-Marubeni Concept to Prototype Development Research grant # [MCTP-CENG-2020-2] from the Qatar University and the publication charges is paid by the Qatar National Library, Doha, Qatar.Scopu

Mechanical and thermal properties of montmorillonite-reinforced polypropylene/rice husk hybrid nanocomposites

© 2019 by the authors. In recent years, there has been considerable interest in the use of natural fibers as potential reinforcing fillers in polymer composites despite their hydrophilicity, which limits their widespread commercial application. The present study explored the fabrication of nanocomposites by melt mixing, using an internal mixer followed by a compression molding technique, and incorporating rice husk (RH) as a renewable natural filler, montmorillonite (MMT) nanoclay as water-resistant reinforcing nanoparticles, and polypropylene-grafted maleic anhydride (PP-g-MAH) as a compatibilizing agent. To correlate the effect ofMMTdelamination andMMT/RHdispersion in the composites, the mechanical and thermal properties of the composites were studied. XRD analysis revealed delamination of MMT platelets due to an increase in their interlayer spacing, and SEM micrographs indicated improved dispersion of the filler(s) from the use of compatibilizers. The mechanical properties were improved by the incorporation of MMT into the PP/RH system and the reinforcing effect was remarkable as a result of the use of compatibilizing agent. Prolonged water exposure of the prepared samples decreased their tensile and flexural properties. Interestingly, the maximum decrease was observed for PP/RH composites and the minimum was for MMT-reinforced and PP-g-MAH-compatibilized PP/RH composites. DSC results revealed an increase in crystallinity with the addition of filler(s), while the melting and crystallization temperatures remained unaltered. TGA revealed that MMT addition and its delamination in the composite systems improved the thermal stability of the developed nanocomposites. Overall, we conclude that MMT nanoclay is an effective water-resistant reinforcing nanoparticle that enhances the durability, mechanical properties, and thermal stability of composites

Locked-in Syndrome in a Young Patient Due to SARS-CoV-2: A Case Report

© Copyright © 2020 Sattar, Iqbal, Haider, Zia, Niazi, Hanif, Ali and Khan. Coronavirus disease 2019 (COVID-19), apart from commonly involving the respiratory system, has its impact on the central nervous system, with a wide spectrum of clinical presentations ranging from headaches to ischemic strokes. The ongoing research regarding this novel disease has found that there is a very high prevalence of thrombotic episodes especially in critically ill patients when compared to severe presentation of other viral illnesses. This COVID-19-associated coagulopathy has a very complex etiology with the ability to form thrombus in arteries, veins, and microvasculatures of different organs. We present a unique case of a young woman with underlying COVID-19 who unfortunately developed locked-in syndrome due to bilateral pontine infarction during the course of her illness

Microbial Metabolism of (+)-Cycloisolongifol-5β-ol

Microbial transformation of a cyclic sesquiterpene, (+)-cycloisolongifol-5β -ol (1), was carried out with the fungus Cunninghamella elegans, resulting in three new metabolites, cycloisolongifol-3β , 5β -diol (2), cycloisolongifol-5β -ol-11-one (3), and cycloisolongifol-3β , 5β , 11α-triol (4). The structures of new compounds were deduced on the basis of spectroscopic evidences

Post partum anxiety and depression in peri-urban communities of Karachi, Pakistan: a quasi-experimental study

<p>Abstract</p> <p>Background</p> <p>Postpartum anxiety and depression is a major public health concern because of its adverse effects on the cognitive and social development of the infant. Globally postpartum depression has been widely investigated but as anxiety is a more prominent feature of postpartum depression we assessed the prevalence of anxiety and depression and their associated factors in post partum women.</p> <p>Methods</p> <p>A quasi-experimental study investigating the impact of postpartum anxiety and depression on child growth and development was conducted in two peri-urban, multiethnic, communities of Karachi, a mega city of Pakistan. A house to house questionnaire based survey was done by trained field workers; 420 consenting pregnant women were identified and data for socio-demographic, home environment and family relationship variables was collected between 36 weeks of pregnancy and within 10 days of childbirth. Mother's levels of anxiety and depression were assessed after one month, two months, six months and twelve months of childbirth; this was two step process: initially an indigenous, validated screening instrument Aga Khan University Anxiety and Depression Scale was used and diagnostic confirmation was done through a psychologist's interview based on DSM IV criteria. Women found to be anxious and depressed at least once out of four assessments were considered for the computation of overall prevalence of postpartum anxiety and depression as well as its risk factors. However, point prevalence's of postpartum anxiety and depression were also reported at each assessment time. Two sixty seven women could be followed for one year. Data was analyzed using SPSS. Chi-square test, simple and multiple logistic regression were used to see the association of different factors.</p> <p>Results</p> <p>The overall prevalence of postpartum anxiety and depression was found to be 28.8 percent. Domestic violence, difficulty in breast feeding at birth and unplanned current pregnancy were found to be significantly associated with postpartum anxiety and depression.</p> <p>Conclusion</p> <p>Domestic violence and not having the right to plan pregnancy are related to the patriarchal culture and lack of empowerment of women. The association with difficulties in breast feeding needs to be further explored in future studies</p