Some Differentials in Infant and Child Mortality Risks in Pakistan 1962 - 1986

In Pakistan the history of alternative sampling approaches to collect demographic data for direct and indirect estimation of population parameters extends back for three decades. The sources which provided directly usable statistical data for estimating fertility and mortality rates, are the 1962- 65 Population Growth Estimation (PGE), the 1968- 71 and 1976- 79 Population Grwoth Surveys (PGS), and the 1984- 86 Pakistan Demographic Surveys (PDS). Since these surveys yielded series of data which could be directly used for working out estimates which are in accordance with the conventional concepts, their results are being given a prior consideration in this paper. The second series of demographic surveys in Pakistan consists of the one-time retrospective surveys, which provided data to which indirect techniques could be applied for working out the estimates of fertility and mortality. The three most prominent of such surveys are: the 1975 Pakistan Fertility Surveys (PFS), the 1979-80 Population, Labour Force and Migration Survey (PLM) and the 1984-85 Pakistan Contraceptive Prevalence Survey (PCPS). The objective of this paper is to provide some direct and indirect estimates of infant and child mortality risks from these sources with a view to examining differentials and trends in these estimates

Comparison of Dexamethasone Plus Metoclopramide, with Dexamethasone Alone in The Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Elective Craniotomy

Objective:  To compare the efficacy of combination of dexamethasone plus metoclopramide with dexamethasone alone for control of postoperative nausea and vomiting in patients undergoing elective craniotomy. Study Design:  Double blinded randomized controlled clinical trial. Material and Methods:  One hundred ASA I – II patients listed for elective craniotomy were randomized to two groups of 50 patients each. Group A received dexamethasone 8 mg (2 ml) plus metoclopramide 10 mg (2 ml) pre-pared in two different syringes, and group B received dexamethasone 8 mg (2 ml) and normal saline (2 ml), pre-pared in two separate received syringes just before induction of anaesthesia. Anaesthesia was standardized. All episodes of Postoperative Nausea and Vomiting (PONV) during the first 24 hours postoperatively were evaluated at 3 time periods : 2, 4, and 24 hours. The presence or absence of nausea and vomiting (by simply yes or no) was assessed by research nurses aware of the study but blinded to the group to which the patient belonged.  Results:  The frequency of nausea and vomiting was clinically and statistically lower in dexamethasone plus metoclopramide group as compared to dexamethasone alone p-value 0.032 and 0.028 for nausea and vomiting respectively. Conclusion:  Combination of dexamethasone plus metoclopramide is more effective in preventing postoperative nausea and vomiting than dexamethasone alone when used for prophylaxis of Post-operative Nausea and Vomiting (PONV) before the induction of anaesthesia in patients undergoing elective craniotomy

Neuroimmunology diagnostics

Neuroimmunology has led to advanced diagnostics of previously cryptic disorders, using autoantibody testing against neurological targets. Neuropsychiatric syndromes and autoimmune encephalitis can now be routinely diagnosed using specialized antibody tests such as immunofluorescence and immunoblot assays in specialized laboratories. This helps in early and accurate diagnosis, leading to favorable patient prognosis. Here, we briefly review the diagnostics for Neuroimmunologic and related disorders including autoimmune encephalitis, demyelinating diseases, neuropathies, paraneoplastic syndromes, stiffperson syndrome, inflammatory myopathies as well as Alzheimer’s disease

Dyslipidemia and mean lipid profile in patients with liver cirrhosis

Background: Patients with liver disorders are often found to have deranged lipid profile. Clear decline is observed in the levels of cholesterol as well as TG among individuals having severe hepatitis and liver failure as synthesis of lipoprotein is reduced. This study was done to determine the frequency of dyslipidemia and the mean lipid profile values in patients of liver cirrhosis.Methods: A cross sectional, descriptive study, done at the Department of Medicine, Medical Unit-1, Bahawal Victoria Hospital, Bahawalpur, from July to December 2019. A total of 246 patients presented with cirrhosis of liver of age 20-60 years and both genders were included. Analysis for serum total cholesterol (TC) level, serum triglycerides level, low density lipoprotein (LDL) and high density lipoprotein (HDL) were done and findings were noted.Results: Mean age was 51.67±6.21 years. Out of the 246 patients, 153 (62.20%) were male and 93 (37.80%) were females with male to female ratio of 1.6:1. Mean values of lipid were, LDL cholesterol 95.76±29.65 mg/dl, HDL 43.37±11.46 mg/dl, TC 147.51±42.69 mg/dl and TG 101.29±21.59 mg/dl. Dyslipidemia was found in 59 (23.98%) patients, whereas there was no dyslipidemia in 187 (76.02%) patients.Conclusions: Frequency of dyslipidemia in cirrhotic patients is high. Evaluating patients of liver cirrhosis, dyslipidemia need to be considered for early recognition and analysis

Population study of 1311 C/T polymorphism of Glucose 6 Phosphate Dehydrogenase gene in Pakistan – an analysis of 715 X-chromosomes

<p>Abstract</p> <p>Background</p> <p>Nucleotide 1311 polymorphism at exon 11 of G6PD gene is widely prevalent in various populations of the world. The aim of the study was to evaluate 1311 polymorphism in subjects carrying G6PD Mediterranean gene and in general population living in Pakistan.</p> <p>Results</p> <p>Patients already known to be G6PD deficient were tested for 563C-T (G6PD Mediterranean) and 1311 C-T mutation through RFLP based PCR and gene sequencing. A control group not known to be G6PD deficient was tested for 1311C/T only.</p> <p>C-T transition at nt 1311 was detected in 60/234 X-chromosomes with 563 C-T mutation (gene frequency of 0.26) while in 130 of normal 402 X-chromosomes (gene frequency of 0.32).</p> <p>Conclusion</p> <p>We conclude that 1311 T is a frequent polymorphism both in general populations and in subjects with G6PD Mediterranean gene in Pakistan. The prevalence is higher compared to most of the populations of the world. The present study will help in understanding genetic basis of G6PD deficiency in Pakistani population and in developing ancestral links of its various ethnic groups.</p

A Comparative Analysis of Supportive Navigation on Movie Recommenders

This literature review covers the research and thought process that went into making a solution for the infinite scrolling problem faced in streaming services such as Netflix. Using the data collected, we have come to the conclusion that an alternate layout can somewhat alleviate the problems it takes in navigating a list of movies. We also found out by a comparative analysis that some layouts, the circular one in particular, is advantageous in certain settings making it an ideal candidate for a movie recommender system.Comment: This was an extensive survey and prototyping we did to purpose and alternative user interface for movie recommender systems like Netfli

Oral cancer: Clinicopathological features and associated risk factors in a high risk population presenting to a major tertiary care center in Pakistan

Oral squamous cell carcinoma (OSCC) has the highest prevalence in head and neck cancers and is the first and second most common cancer in males and females of Pakistan respectively. Major risk factors include peculiar chewing habits like areca nut, betel quid, and tobacco. The majority of OSCC presents at an advanced stage with poor prognosis. On the face of such a high burden of this preventable cancer, there is a relative lack of recent robust data and its association with known risk factors from Pakistan. The aim of this study was to identify the socioeconomic factors and clinicopathological features that may contribute to the development of OSCC. A total of 186 patients diagnosed and treated at a tertiary care hospital, Karachi Pakistan were recruited. Clinicopathological and socioeconomic information was obtained on a structured questionnaire. Descriptive analysis was done for demographics and socioeconomic status (SES) while regression analysis was performed to evaluate the association between SES and chewing habits, tumor site, and tumor stage. The majority of patients were males and the mean age of OSCC patients was 47.62±12.18 years. Most of the patients belonged to low SES (68.3%) and 77.4% were habitual of chewing. Gender (male) and SES were significantly associated with chewing habits (

Polymorphism of HLA-DR and HLA-DQ in rheumatoid arthritis patients and clinical response to methotrexate--a hospital-based study

Objective: To investigate the frequency and distribution of DRB1 and DQB1 alleles in Patients with rheumatoid arthritis (RA) and analyze the relationship between clinical response to methotrexate (MTX) and the HLA-DR and HLA-DQ genotypes in these patients.Methods: In this case-control study, the HLA-DRB1 and HLA-DQB1 polymorphism in 91 RA patients and 91 healthy controls was done using polymerase chain reaction and sequence specific primers.Results: There was no statistical difference in frequencies of HLA-DRB1*03, DRB1*04, DRB1*07, DRB1*10, DRB1*11, DRB1*12, DRB1*13, DRB1*14, DRB1*15 and DRB1*16 genotypes between patients and controls. However, DRB1*01 was found to be significantly more common (p=0.015) in RA patients compared to controls. HLA-DRB1*15 was more common in patients (43.5%) compared to controls (30.8%) but results were not significant. HLA-DRB1*08 and DRB1*09 were present in negligible number in patients as well as controls while HLA-DRB1*12 was conspicuously absent in controls. Similarly, DQB1*06 was also significantly more common (p = 0.01) among the patients compared to healthy control subjects, while there was no statistical difference in the frequencies of DQB1*02, DQB1*03, DQB1*04 and DQB1*05 among the cases and the controls. RA susceptibility in most patients appeared to be associated with the HLA-DRB1*01/DQB1 *06 genotype. Regarding association between HLA-DR or HLA-DQ genotype and clinical response to methotrexate (MTX), the data showed that with the exception of HLA-DRB1*03, there appears to be no association between the particular subtypes of HLA-DR and HLA-DQ. HLA-DRB1*03 was significantly-more common among non-responders to MTX alluding to the possibility that another genes responsible for MTX metabolism, might be in linkage disequilibrium with HLA-DRB1*03 in the Pakistani population, thereby making such individuals non-responsive to MTX-therapy.Conclusion: RA susceptibility in most Pakistani patients is associated with the HLA-DRB1*01/DQB1*06 genotype. HLA-DRB1*03 was found to be significantly more common among non-responders to MTX treatment suggesting that Pakistani patients with this genotype are less likely to benefit from MTX