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

Dicarbonyl­dichlorido(N,N,N′,N′-tetra­methyl­ethylenediamine)­ruthenium(II)

In the title compound, [RuCl2(C6H16N2)(CO)2], the geometry around the RuII atom is a distorted RuC2N2Cl2 octa­hedron, with pairs of C and Cl atoms trans to each other and the N atoms of the bidentate ligand in a cis conformation. The five-membered chelate ring is puckered on the C—C bond

Degradation of atorvastatin: (1R,2S,4S,5S)-4-(4-fluoro­phen­yl)-2-hydro­peroxy-4-hydr­oxy-2-isopropyl-N,5-diphenyl-3,6-dioxabicyclo­[3.1.0]hexane-1-carboxamide

The degradation of atorvastatin calcium in methanol and hydrogen peroxide results in the crystallization of the title compound, C26H24FNO6, which shows several differences compared with the starting compound. In the crystal structure of the title compound, intra- and inter­molecular hydrogen bonding is found

Sufficient conditions to solve two systems of integral equations via fixed point results

Abstract The purpose of this paper is to study the solution of two systems of nonlinear integral equations via fixed point results in a complete dislocated b-metric space. Also the notion of graphic contractions on a closed set for two families of graph dominated multivalued mappings is introduced. Our results generalize some previous results in the existing literature

Novel VPS13B Mutations in Three Large Pakistani Cohen Syndrome Families Suggests a Baloch Variant with Autistic-Like Features.

BackgroundCohen Syndrome (COH1) is a rare autosomal recessive disorder, principally identified by ocular, neural and muscular deficits. We identified three large consanguineous Pakistani families with intellectual disability and in some cases with autistic traits.MethodsClinical assessments were performed in order to allow comparison of clinical features with other VPS13B mutations. Homozygosity mapping followed by whole exome sequencing and Sanger sequencing strategies were used to identify disease-related mutations.ResultsWe identified two novel homozygous deletion mutations in VPS13B, firstly a 1 bp deletion, NM_017890.4:c.6879delT; p.Phe2293Leufs*24, and secondly a deletion of exons 37-40, which co-segregate with affected status. In addition to COH1-related traits, autistic features were reported in a number of family members, contrasting with the "friendly" demeanour often associated with COH1. The c.6879delT mutation is present in two families from different regions of the country, but both from the Baloch sub-ethnic group, and with a shared haplotype, indicating a founder effect among the Baloch population.ConclusionWe suspect that the c.6879delT mutation may be a common cause of COH1 and similar phenotypes among the Baloch population. Additionally, most of the individuals with the c.6879delT mutation in these two families also present with autistic like traits, and suggests that this variant may lead to a distinct autistic-like COH1 subgroup

Frequency of Subdural and Epidural Hematoma in Brain Injury Via Computed Tomography in Trauma Center of DHQ Teaching Hospital Sargodha

At least 10 million TBIs serious enough to result in death or hospitalization occur annually. The mortality associated with acute subdural hematoma has been reported to range from 36-79%. Epidural hematoma occurs in approximately 2% of patients with head injuries and 5–15% of patients with fatal head injuries. Both can be caused by fall, motor vehicle crashes, assaults, blasts and sports activities. CT is best modality for diagnosis of brain injury. Objective:To measure the frequency of subdural and epidural hematoma in brain injury via computed tomography in trauma center of DHQ Teaching Hospital Sargodha.Methodology:In this descriptive study, among 137 patients of traumatic brain injury (TBIs) were selected with age and gender discrimination by convenient sampling, at Department of Radiology, DHQ Teaching Hospital Sargodha. Single slice Computed Tomography Toshiba asteion machine was used.Results:Out of 137 patients collected, 35 were females and 102 were males who visited emergency department due to brain Injury. It shows 25.5% were females and males were 74.5%.Out of 137 patients, 63.5% were injured with RTA and 35.8% came with the history of fall. 67.2% patients present with loss of consciousness, 67.9% patients with skull fractures and 73% with swelling. Out of 137 patients 85.4% develop SDH and 14.6% develop EDH. Conclusion:In this study we conclude that male develop larger number of brain injuries than females. Most patients with history of RTA had epidural hematoma. Females most likely develop subdural hematoma. Most patients with brain injury later develop subdural hematoma. Keywords: Subdural Hematoma, Epidural Hematoma, Traumatic Brain Injury(TBI), Road Traffic Accident(RTA) DOI: 10.7176/JHMN/71-01 Publication date: February 29th 202

Solving a fractional differential equation via θ-contractions in ℜ-complete metric spaces

In this manuscript, we introduce the notion of ℜα-θ-contractions and prove some fixed-point theorems in the sense of ℜ-complete metric spaces. These results generalize existing ones in the literature. Also, we provide some illustrative non-trivial examples and applications to a non-linear fractional differential equation

Variation of growth and proximate composition in Portunus pelagicus juveniles fed with selected feeds in recirculating aquaculture system (RAS)

Aim: The experiment was conducted to determine the suitability of using scad fish, Acetes shrimp and common squid for the direct and indirect application as diets for the juvenile rearing of the blue swimming crab Portunus pelagicus. Methodology: A total of 54 crab juveniles with an initial weight of 2.46 ±0.94 g were randomly stocked in triplicate at 6 crabs per 60 l tank (0.26 m²) experimental units and fed twice daily with three different types of feed namely scad fish, squid tissue and frozenAcetesshrimp foraperiodof31days. Results: At the end of the trail, ammonia and nitrite-nitrogen compound were significantly higher in Acetes shrimp fed group. It is found that final body weight (g) of P. pelagicus was significantly higher when fed with squid, however no significant differences were noticed between scad fish and Acetes shrimp fed groups. The whole body proximate composition was similar in all the diet fed individuals except the level of lipid which was higher in squid compared to scad fish and Acetes shrimp. Significantly (p<0.05) better food conversion ratio (FCR) was observed in juvenile crab fed with squid even though scad fish possessed the highest crude protein of 83.33%. Interpretation: Overall, the results suggested that squid meal could be recommended for P. pelagicus juvenile culture. Hence, squid meal may be incorporated in crab artificial diet as protein source to attain better survival and growth

Implementation and Evaluation of a Social Media-Based Communication Strategy to Enhance Employee Engagement: Experiences From a Children's Hospital, Pakistan

Social media can complement organizational communication strategy which is integral to employee engagement. However, successful case studies which can allow replication are limited. The objective of the study is to describe the design, implementation, and evaluation of a social media-based communication strategy in a tertiary care hospital in Pakistan. The leadership of the pediatric service line developed an intervention plan to engage the employees with the newly reframed vision to improve patient and family experience. An online communication platform—Facebook page—was created for all employees of the pediatric service line. The strategy to influence employees was based on Cialdini's six principles of persuasion. Implementation of the strategy between October 2017 and December 2019 was evaluated for reach, discussion themes, and outcomes using the framework by Murdough (2009). Quantitative indicators included total posts, mean comments, and reactions per post. Posts were qualitatively analyzed with an emergent approach for insights into the discussion. The analysis revealed a total of 9,085 posts, with mean reactions per post of 8.4, mean comments of 7.2, and active viewership by 90% members on average. In terms of post types, photos were the highest (4,779), while videos were the lowest (1,163). Qualitative analysis indicated 54% of the posts were of the theme “inspirational and thought provoking,” while the greatest engagement was generated on the theme “challenges and solution.” The authors conclude that the strategy was successfully implemented to maintain active membership, engage employees in meaningful conversations, and have them express intent to execute quality improvement projects.publishedVersio