Should Carotid Endarterectomy be performed for Symptomatic Carotid Stenosis Pakistan?

Objective: The risk of stroke and death associated with carotid endarterctomy is operator dependant. Data regarding risks of this procedure are not available in Pakistan and therefore it is difficult to make accurate risk benefit analysis for individual patients. Our objective was to determine safety of carotid endarterectomy at an academic tertiary care center in Pakistan. Methods: Patients who underwent carotid endarterectomy (CEA) at our hospital during a ten-year period were identified through ICD-9 coding system of the hospital medical records. Demographic features. associated medical problems and immediate postoperative complications were recorded and analyzed. Results: Sixty-three carotid endarterectomies were performed on 59 patients. Ages range from 43 to 80 (mean 61±8) years; 53 were male and 10 were female. Common associated diseases among these patients were hypertension; 38 (64.4°/x), ischemic heart disease; 26 (44%), diabetes mellitus: 24 (40.7%); dyslipidemia; 19 (32.2%) and renal insufficiency; 13 (22%). Most common complication was neuropraxia (transient neuropathy) 5 (7.9%), followed by pneumonia and stroke; each in 3 (4.8%) patients. None of the strokes related to the surgical procedure were disabling. Two of the patients who had stroke, recovered fully within 17 weeks and one recovered partly but was independent in all daily activities of living (ADLs). One patient died following simultaneous coronary artery bypass graft (CABG) and CEA. The risk of stroke or death for patients undergoing CEA was high with simultaneous CABG (3/11, 27%) and low for patients undergoing CEA alone (1/52, 2%). Conclusion: Carotid endarterectomy is a safe procedure in patients with symptomatic carotid stenosis at our hospital and should be performed, when indicated. (JPMA 53:589;2003)

Bosonic Reduction of Susy Generalized Harry Dym Equation

In this paper we construct the two component supersymmetric generalized Harry Dym equation which is integrable and study various properties of this model in the bosonic limit. In particular, in the bosonic limit we obtain a new integrable system which, under a hodograph transformation, reduces to a coupled three component system. We show how the Hamiltonian structure transforms under a hodograph transformation and study the properties of the model under a further reduction to a two component system. We find a third Hamiltonian structure for this system (which has been shown earlier to be a bi-Hamiltonian system) making this a genuinely tri-Hamiltonian system. The connection of this system to the modified dispersive water wave equation is clarified. We also study various properties in the dispersionless limit of our model.Comment: 21 page

Real Time Wireless Air Pollution Monitoring system

Air pollution has significant influence on the concentration of constituents in the atmosphere leading to effects like global warming and acid rains. To avoid such adverse imbalances in the nature, an air pollution monitoring system is utmost important. This paper attempts to develop an effective solution for pollution monitoring using wireless sensor networks (WSN) on a real time basis namely real time wireless air pollution monitoring system. Commercially available discrete gas sensors for sensing concentration of gases l ike CO 2 , NO 2, CO and O 2 are calibrated using appropriate calibration technologies. These pre - calibrated gas sensors are then integrated with the wireless sensor motes for field deployment at the campus and the Hyderabad city using multi hop data aggregatio n algorithm. A light weight middleware and a web interface to view the live pollution data in the form of numbers and charts from the test beds was developed and made available from anywhere on the internet. Other parameters like temperature and humidity w ere also sensed along with gas concentrations to enable data analysis through data fusion techniques. Experimentation carried out using the developed wireless air pollution monitoring system under different physical conditions show that the system collects reliable source of real time fine - grain pollution data

Prevalence of Muscle Dysmorphia and Associated Health Activities in Male Medical Students in Karachi, Pakistan

Background: Muscle Dysmorphia (MD) is a subtype of body dysmorphic disorder (BDD) and is currently classified under anxiety disorders (subheading: Obsessive-compulsive disorder) in DSM 5. MD is hypothesized to affect the self-esteem and social outlook of the younger generation. MD shows a higher rate in males and may influence their self-confidence rendering them more prone towards using steroids, supplementary proteins and other drugs to alter their physical outlooks as shown in previous studies. This problem has been on the rise lately due to revolutionary advancement in the media and film industry and the abrupt changes about the standards of physical good looks and body shapes. With the lack of studies done in our population, our study will be helpful to consider the prevalence of the disease in our setting and increase awareness in the general public and clinicians. We hope to help clinicians/ therapists find better options in managing the disease. Materials: We performed a cross-sectional study with a sample size of 246 medical school students in Karachi to collect data through self-administered questionnaires. We used the DSM 5 criteria for the diagnosis of BDD and additional questions on the presence of MD. Nutritional habits, exercise routines, use of supplements and drugs were also obtained for exploratory analysis. Results: Our study predicted the prevalence of MD to be 25%. Other main findings included statistical significant associations between MD and the thoughts and practice of steroid use for muscularity. Conclusion: MD is an underdiagnosed and often unrecognized disease that we believe has significant consequences for the young male population. Further work is needed on this in our part of the world. Our research, we believe, can be a stepping stone for further studies that would incorporate wider populations

Validation of fibre stress utilization model for modified ring spun yarns

To model the fibre stress utilization in modified ring spun yarns, we developed an analytical formula from the experimental data. The development of empirical formulae is carried out by using two different techniques, i.e., Cubic Spline and Artificial Neural Network methods. The experimental data of stress-strain curves of fibre and yarn has a large variation. To cope this variability, we used the smoothing spline technique to find the best-fit curve with respect to a reasonable smoothness. The best nonlinear smooth fitting can be used to extrapolate the experimental data beyond the breaking point. The modified ring spun yarns (compact, SIRO and SIRO-compact) with 20/1, 30/1 and 40/1 English count, produced from viscose staple fibre, were used to predict fibre stress utilization up to the yarn break by extrapolating the mean stress-strain curves of fibre and yarn by using the artificial neural network. Moreover, a new distribution function of fibre distribution in yarn has been proposed and successfully implemented for the prediction of fibre stress utilization in yarn. The new formulation helps to compute the fibre stress utilization in the yarn analytically. The validation of the proposed methodology is presented by comparing the numerical results with the experimental data. The predicted fibre stress utilization was in good agreement with the experimental fibre stress utilization for all types of modified ring spun yarns. It has been observed that SIRO-compact yarn exhibits improved fibre stress utilization as compared to SIRO and compact yarns. Moreover, the new distribution functions Gamma and Gaussian distribution were introduced in parallel with the Dirac delta function. In previous similar studies on ring, rotor and air-jet spun yarns, the proposed model can only predict the fibre stress utilization before the breakage point whereas the modified model, in this study, can predict the fibre stress utilization up to the breaking point

Psychosocial associations of emotion-regulation strategies in young adults residing in the United Arab Emirates.

This is the peer reviewed version of the following article: Azhar, H. , Baig, Z. , Koleth, S. , Mohammad, K. and Petkari, E. (2019), Psychosocial associations of emotion‐regulation strategies in young adults residing in the United Arab Emirates. Psych J. doi:10.1002/pchj.272, which has been published in final form at https://doi.org/10.1002/pchj.272 This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived VersionsThe management and expression of emotions can have a positive impact on psychological health and overall functioning. Thus, it is crucial to focus on the study of emotion regulation and the strategies young adults employ to achieve it, namely cognitive reappraisal and expressive suppression, as well as their associations with the long neglected psychosocial factors. The current study aimed at exploring the associations between psychosocial factors and the two emotion-regulation strategies, after controlling for potential sociodemographic confounders. This study used a sample of 136 participants from the Indian subcontinent living in Dubai, United Arab Emirates, aged 18-25 years, who completed instruments measuring social anxiety, social support, and parenting styles (authoritative, authoritarian, permissive) as well as the use of the emotion-regulation strategies of suppression and reappraisal. The results indicated that having experienced authoritarian parenting and perceiving low social support were associated with the use of suppression, while having experienced authoritative parenting and low levels of social anxiety were associated with the use of emotional reappraisal. Our study provides evidence on the importance of psychosocial factors for the use of emotion-regulation strategies and suggests their modification for the promotion of adaptive ways of managing emotions

Security and Efficiency Analysis of the Hamming Distance Computation Protocol Based on Oblivious Transfer

open access articleBringer et al. proposed two cryptographic protocols for the computation of Hamming distance. Their first scheme uses Oblivious Transfer and provides security in the semi-honest model. The other scheme uses Committed Oblivious Transfer and is claimed to provide full security in the malicious case. The proposed protocols have direct implications to biometric authentication schemes between a prover and a verifier where the verifier has biometric data of the users in plain form. In this paper, we show that their protocol is not actually fully secure against malicious adversaries. More precisely, our attack breaks the soundness property of their protocol where a malicious user can compute a Hamming distance which is different from the actual value. For biometric authentication systems, this attack allows a malicious adversary to pass the authentication without knowledge of the honest user's input with at most $O(n)$ complexity instead of $O(2^n)$, where $n$ is the input length. We propose an enhanced version of their protocol where this attack is eliminated. The security of our modified protocol is proven using the simulation-based paradigm. Furthermore, as for efficiency concerns, the modified protocol utilizes Verifiable Oblivious Transfer which does not require the commitments to outputs which improves its efficiency significantly

Collective vs local measurements in qubit mixed state estimation

We discuss the problem of estimating a general (mixed) qubit state. We give the optimal guess that can be inferred from any given set of measurements. For collective measurements and for a large number $N$ of copies, we show that the error in the estimation goes as 1/N. For local measurements we focus on the simpler case of states lying on the equatorial plane of the Bloch sphere. We show that standard tomographic techniques lead to an error proportional to $1/N^{1/4}$, while with our optimal data processing it is proportional to $1/N^{3/4}$.Comment: 4 pages, 1 figure, minor style changes, refs. adde

Evolution and Population Dynamics of Clonal Complex 152 Community-Associated Methicillin-Resistant Staphylococcus aureus

Since the late 1990s, changes in the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) were recognized with the emergence of community-associated MRSA (CA-MRSA). CA-MRSA belonging to clonal complex 152 (CC152), carrying the small staphylococcal cassette chromosome mec (SCCmec) type V and encoding the Panton-Valentine leukocidin (PVL), has been observed in Europe. The aim of this study was to investigate its origin, evolution, and dissemination. Whole-genome sequencing was performed on a global collection of 149 CC152 isolates spanning 20 years (93 methicillin-susceptible S. aureus [MSSA] and 56 MRSA isolates). Core genome phylogeny, Bayesian inference, in silico resistance analyses, and genomic characterization were applied. Phylogenetic analysis revealed two major distinct clades, one dominated by MSSA and the other populated only by MRSA. The MSSA isolates were predominately from sub-Saharan Africa, whereas MRSA was almost exclusively from Europe. The European MRSA isolates all harbored an SCCmec type V (5C2&5) element, whereas other SCCmec elements were sporadically detected in MRSA from the otherwise MSSA-dominated clade, including SCCmec types IV (2B), V (5C2), and XIII (9A). In total, 93% of the studied CC152 isolates were PVL positive. Bayesian coalescent inference suggests an emergence of the European CC152-MRSA in the 1990s, while the CC152 lineage dates back to the 1970s. The CA-MRSA CC152 clone mimics the European CC80 CA-MRSA lineage by its emergence from a PVL-positive MSSA ancestor from North Africa or Europe. The CC152 lineage has acquired SCCmec several times, but acquisition of SCCmec type V (5C2&5) seems associated with expansion of MRSA CC152 in Europe. IMPORTANCE Understanding the evolution of CA-MRSA is important in light of the increasing importance of this reservoir in the dissemination of MRSA. Here, we highlight the story of the CA-MRSA CC152 lineage using whole-genome sequencing on an international collection of CC152. We show that the evolution of this lineage is novel and that antibiotic usage may have the potential to select for the phage-encoded Panton-Valentine leukocidin. The diversity of the strains correlated highly to geography, with higher level of resistance observed among the European MRSA isolates. The mobility of the SCCmec element is mandatory for the emergence of novel MRSA lineages, and we show here distinct acquisitions, one of which is linked to the successful clone found throughout Europe today