Comparison between Mesh Hernioplasty and Simple Suture Repair in the treatment of Paraumbilical Hernias at Bahawalpur Hospitals

To compare the rate of recurrence between mesh hernioplasty and simple suture repair in the management of paraumbilical hernias. Total 215 patients were selected in medical ward of Bahawal Victoria Hospital Bahawalpur. They were subdivided into three groups. Group A 112 patients were repaired in traditional way and group B 88 patients underwent mesh repair and the in third group C 15 patients undergone other ways of repair which we did not covered in our study. And the patients who showed the recurrence of hernia were selected and those were subject of interest. A comparison was made between two groups in terms of, complications and rate of recurrence. In Group A, 12(10.71%) patients had recurrence which was quite high compared to the group B which had only 2(2.27%) patients. Rate of infection was higher in group B (12%). There were incidences of postoperative hematomas and seromas formation in group A but none in group B. Mesh hernioplasty significantly reduced the recurrence rate as compared to the traditional suture repair. Unlike results of the other studies, infection rate was not high in mesh group. Keywords: Paraumbilical hernia, Mesh repair, Simple suture repair

Potential and prospects of biomass as a source of renewable energy in Pakistan

In an agricultural country like Pakistan, producing affordable and clean energy can be a challenging task. However, Pakistan has the potential to utilize various biomass feedstocks to generate renewable energy and tackle climate change while promoting sustainable development. Wheat, rice, sugarcane, and corn are the four main crops that yield a significant amount of residue, totaling 112.1 million tons per year. These residues have the potential to produce 3,050 kWh/ton of energy, which can meet 14% of the energy demand in Pakistan, equivalent to 9.85TW, starting in 2022. Gasification technology is a versatile option that efficiently converts biomass into energy while reducing negative environmental impacts. The current research explores the feasibility of generating clean energy from crop residues with low emissions, addressing the country’s energy needs, and supporting policymakers in promoting the use of biomass for energy production. According to this study, rice husk, corn cobs, wheat straw, and sugar bagasse all produce hydrogen at rates of 6.9 wt.%, 6.4 wt.%, 5.69 wt.%, and 5.35 wt.%, respectively. Therefore, our study demonstrates that corn cobs have a significant potential for energy production

Co-combustion of blends of coal and underutilised biomass residues for environmental friendly electrical energy production

This study investigated the co-combustion of the blends of coal and biomass residues from poplar sawdust, rice husk, pine nut shells, and sunflower residues for ecofriendly energy production. Proximate and ultimate analyses and calorific values of the coal and biomass residues were also carried out to evaluate the properties of the coal and biomass residues. The volatile matter in coal was reported as 43.38 wt% and ranged from 56.76 wt% to 80.95 wt% in the biomass residues. The ultimate analysis reported the carbon and sulfur content of coal as 68.7 wt% and 5.5 wt%, respectively. The coal and biomass blends were prepared using different ratios on the thermal basis of coal and biomass given as 100:0, 90:10, 80:20, 70:30, 60:40, and 50:50 by weight percentage. The consequent stoichiometric air requirements for all the blends were also calculated. The results revealed that the combustion of 60:40 of coal and sunflower residue blend was the most efficient blend, resulting in less emission of NOx, SOx, and CO2 in the flue gas compared to the combustion of pure coal. The study revealed a great perspective of the selected biomass residues to blend with coal for environmentally friendly and sustainable energy production

Ca(2+) influx shutdown in neutrophils induced by Fas (CD95) cross-linking

In neutrophils, as in most other cell types, Ca(2+) signalling is important for a number of cellular activities. Although inositol(1,4,5)trisphosphate-mediated release of Ca(2+) from intracellular stores is a necessary prelude, it is the Ca(2+) influx that is responsible for many of the neutrophil responses. We report here that although elevations of cytosolic Ca(2+) do not accompany Fas-mediated apoptosis in neutrophils, the Ca(2+) influx component of the response to N-formyl-methionyl-leucyl-phenylalanine (FMLP) becomes selectively inactived as the neutrophils progress towards accelerated apoptosis induced by Fas (CD95) cross-linking. After 4 hr incubation at 37°, untreated neutrophils display an exaggerated Ca(2+) influx phase in response to FMLP. This was absent in neutrophils that had been Fas-activated at the same time. No Ca(2+) influx component was demonstrable by the removal of extracellular Ca(2+) or by Ca(2+) channel blockade with Ni(2+) and no Mn(2+) influx was detectable. The defect could not be attributed to a decrease in receptor sensitivity, receptor coupling or receptor number because the release of stored Ca(2+) remained constant during incubation and was unaffected by Fas activation. Ca(2+) influx became uncoupled from store release before detectable gross morphological changes or phosphatidyl serine externalization and was also insensitive to caspase 3 and 8 inhibitors. These results suggest a mechanism other than caspase-mediated proteolytic damage to components important for Ca(2+) influx

Anatomical Snuff Box Arteriovenous Fistulas for Haemodialysis

Background: To evaluate snuffbox fistulas in patients with end stage chronic renal failure and to describe the complications and patency rates of snuff box fistulas.Methods: This descriptive study enrolled patients with end stage renal chronic renal failure, in whom anatomical snuff box fistulas were created. All the patients had adequate caliber vessels (greater than 2mm diameter cephalic vein and radial artery) in an end to side configuration. Presence of a palpable thrill or bruit on auscultation was considered a successful fistula. Fistulas which never provide vascular access whether due to poor vein maturation, thrombosis or any other reason were designated primary failure. Fistulas that failed after a period of use were designated secondary failures. Complications and failure rates were determined at 1 month, 3 months, 6 months and 12 months.Results:A total of 71 AV fistulas were created over a period of 8 years. Sixteen patients (22.53%) developed fistula failure over a follow up of one year. Thrombosis was the commonest cause of primary failure and Juxta anastamotic stenosis was the commonest cause of secondary failure . Overall patency was 66 % at one year. Both primary and secondary failures were higher in females and diabetics.Conclusion: Anatomical snuff box arteriovenous fistulas have several advantages over the more commonly performed Brescia-Cimino radiocephalic fistulas at the distal forearm. Snuff-box fistulas have satisfactory outcome and patency rate and advantage of preservation of more proximal sites for any future fistula construction in case of failure

Can blood glucose levels predict biochemical and hematological abnormalities in Covid -19 patients - Experience from a tertiary care hospital in Balochistan

Objective: To find out the association between poor glycaemic levels and biochemical and haematological abnormalities in patients of coronovairus disease-2019. Methods: The prospective, observational, cohort study was conducted at the Combined Military Hospital, Quetta, Pakistan, from September 2020 to February 2021, and comprised all patients who tested positive for coronavirus disease-2019 on polymerase chain reaction test and were subsequently admitted. The patients were divided into two groups on the basis of random blood glucose level at the time of admission; 11.1mmol/l (206mg/dl) in group A, and 4-11.1mmol (74-206mg/dl) in group B. Association between categorical variables was evaluated and hazard ratio was measured. Data was analysed using SPSS 21. Results: Of the 349 patients, there were 56(16%) in group A; 40(71.4%) males and 16(28.6%) females with age range 39-61 years. There were 293(84%) subjects in group B; 239(81.5%) males and 54(18.5%) females with age range 27-53 years. Overall, 75(21.4%) patients were known type 2 diabetics. A significant association was found between poor glycaemic control and raised levels of C-reactive protein, lactate dehydrogenase, ferritin, erythrocyte sedimentation rate, troponin, creatine kinase, reatine kinase-MB, alanine aminotransferase, creatinine and D-dimers (p<0.05). Inter-group differences were significant for acute kidney injury, acute liver injury, Intensive care unit admission for coagulation abnormalities and for overall mortality (p<0.05). Conclusion: Poor glycaemic control was found to be a risk factor for developing multisystem complications in patients of coronavirus disease-2019. Key Words: Biochemical, Covid-19, Hyperglycaemia

Mean Rise in Hemoglobin After Intravenous Iron Therapy in Children with Iron Deficiency Anemia

Introduction: Iron deficiency anemia (IDA) is a significant public health issue in Pakistan, affecting up to 63% of children, as revealed by the Pakistan National Nutritional Survey 2018. While oral iron remains the primary choice, challenges in compliance have led to the consideration of intravenous (IV) iron therapy, particularly iron sucrose. The study discusses the safety and efficacy of IV iron therapy in Pakistani children and aims to broaden our understanding of treating IDA in resource-constrained regions. Aims & Objectives: To determine the average hemoglobin (Hb) increase in iron-deficient-anemic children aged 01 to 12 years after treatment with intravenous iron sucrose. Place and Duration of Study: A quasi-experimental study was undertaken at Fauji Foundation Hospital in Rawalpindi, spanning from September 2021 to September 2022. Material & Methods: The study focused on a cohort of pediatric patients aged between 1 and 12 years, all of whom were diagnosed with iron deficiency anemia and had previously encountered ineffective outcomes with oral iron therapy. In this investigation, the patients received treatment involving intravenous iron sucrose. Subsequently, their progress was diligently monitored after a period of 8 weeks. Improvement in hemoglobin level was assessed at the end of treatment to evaluate its efficacy.Data processing and statistical analysis were carried out using SPSS version 23,p-value of <0.05 indicated statistical significance. Results: Out of 150 study cases, 96 (64.0 %) were male, while 54 (36.0 %) were female. The mean age of our study cases was 05 ± 2.3 years of these 150 study cases, 74 (49.3 %) belonged to rural areas, and 76 (50.7 %) belonged to urban areas. Poor socioeconomic status was noted in 97 (64.7 %), and 53 (35.3%) were middle-income. A family history of iron deficiency anaemia was recorded in 16 (10.7%). Iron deficiency due to dietary iron insufficiency was reported in 67 (44.7%), Total Parentral Nutrition (TPN) dependencywas seen in 61 (40.7%) and 22 (14.7%) had chronic gastritis. The mean baseline (pretreatment) haemoglobin level was 7.71 ± 0.63 g/dl, while the mean post-treatment haemoglobin level was 10.68 ± 0.60 g / dl (p = 0.001). Conclusion: After intravenous iron sucrose, we noted a significant rise in paediatric patients' hemoglobin levels, emphasizing its effectiveness and safety. Statistically, we found correlations with age, family history, and causes. Healthcare practitioners should consider injectable iron treatments for better results and reduced health issues in this group

Use of optimized centroid and weighted centroid algorithms to locate a partial discharge source by using received signal strength

Received signal strength (RSS) based localization of a source is a simple but effective technique. In RSS based localization source location is estimated by converting obtained signal into distance. In this paper, centroid and weighted centroid algorithms has been utilized to locate a partial discharge (PD) source. An artificial PD signal was generated, and signals were captured using radio frequency (RF) sensors and hence the location of the source was estimated. The location of the source was estimated for three different positions. There were eight measurement sensors used and received signal was converted into dBm as input to the location algorithm

Analysis of genetic biomarkers, polymorphisms in ADME-related genes and their impact on pharmacotherapy for prostate cancer

Abstract Prostate cancer (PCa) is a non-cutaneous malignancy in males with wide variation in incidence rates across the globe. It is the second most reported cause of cancer death. Its etiology may have been linked to genetic polymorphisms, which are not only dominating cause of malignancy casualties but also exerts significant effects on pharmacotherapy outcomes. Although many therapeutic options are available, but suitable candidates identified by useful biomarkers can exhibit maximum therapeutic efficacy. The single-nucleotide polymorphisms (SNPs) reported in androgen receptor signaling genes influence the effectiveness of androgen receptor pathway inhibitors and androgen deprivation therapy. Furthermore, SNPs located in genes involved in transport, drug metabolism, and efflux pumps also influence the efficacy of pharmacotherapy. Hence, SNPs biomarkers provide the basis for individualized pharmacotherapy. The pharmacotherapeutic options for PCa include hormonal therapy, chemotherapy (Docetaxel, Mitoxantrone, Cabazitaxel, and Estramustine, etc.), and radiotherapy. Here, we overview the impact of SNPs reported in various genes on the pharmacotherapy for PCa and evaluate current genetic biomarkers with an emphasis on early diagnosis and individualized treatment strategy in PCa