Thromboembolic disease of the venous and the arterial system : two different entities or two different sides of the same coin?

In this thesis, special attention was paid to renal disease as different components of the renal disease were previously linked to either VTE (venous thromboembolis) and arterial thromboembolis (ATE). Whereas the association between overt proteinuria and VTE was known for decades, for the first we described the association between tiny amount of albumin in the urine (i.e. microalbuminuria) and VTE. Moreover, for the first time we described that treatment of overt proteinuria with losartan partially reverses the prothrombotic state. Except for overweight or obesity other major cardiovascular risk factors such as elevated blood pressure, elevated cholesterol, diabetes and smoking are probably not risk factors for VTE. On the other hand, deficiencies of the natural anticoagulant protein S or protein C, which are known strong risk factors for VTE, predisposed one also to ATE. Finally, history of VTE itself is a risk factor for subsequent ATE.

Increasing rate of weighted product of partial quotients in continued fractions

Let $[a_1(x),a_2(x),\cdots,a_n(x),\cdots]$ be the continued fraction expansion of $x\in[0,1)$. In this paper, we study the increasing rate of the weighted product $a^{t_0}_n(x)a^{t_1}_{n+1}(x)\cdots a^{t_m}_{n+m}(x)$ ,where $t_i\in \mathbb{R}_+\ (0\leq i \leq m)$ are weights. More precisely, let $\varphi:\mathbb{N}\to\mathbb{R}_+$ be a function with $\varphi(n)/n\to \infty$ as $n\to \infty$. For any $(t_0,\cdots,t_m)\in \mathbb{R}^{m+1}_+$ with $t_i\geq 0$ and at least one $t_i\neq0 \ (0\leq i\leq m)$, the Hausdorff dimension of the set $$\underline{E}(\{t_i\}_{i=0}^m,\varphi)=\left\{x\in[0,1):\liminf\limits_{n\to \infty}\dfrac{\log \left(a^{t_0}_n(x)a^{t_1}_{n+1}(x)\cdots a^{t_m}_{n+m}(x)\right)}{\varphi(n)}=1\right\}$$ is obtained. Under the condition that $(t_0,\cdots,t_m)\in \mathbb{R}^{m+1}_+$ with $0<t_0\leq t_1\leq \cdots \leq t_m$, we also obtain the Hausdorff dimension of the set \begin{equation*} \overline{E}(\{t_i\}_{i=0}^m,\varphi)=\left\{x\in[0,1):\limsup\limits_{n\to \infty}\dfrac{\log \left(a^{t_0}_n(x)a^{t_1}_{n+1}(x)\cdots a^{t_m}_{n+m}(x)\right)}{\varphi(n)}=1\right\}.\end{equation*

Insulin Refusal Among Type-2 Diabetics: Healthcare Provider’s Perspective

Objective: Aim of this study is to determine frequency of patients with type-2 diabetes mellitus who refuse to take insulin therapyDesign &amp; duration: This is a cross sectional study completed in six months duration.Setting: Study was conducted in medical out-patient door of Bahawal Victoria Hospital Bahawalpur.Patients &amp; methods: Patients presenting to out-patient door of medical department having type-2 diabetes taking oral anti diabetics and having poor glycemic control. When these patients were advised to take insulin therapy their response was documented on a performa. Who refused they were asked about its reason and their perspective which was noted down. Consent was taken from all cases in study group. Permission was taken from ethical committee of the institution. Patients of either sex and of any age were included in the study. Confidence level. Confidence interval was 95% with 5% margin of error.Results: Total 200 cases were studied including 62% female and 38% male patients. When these patients were advised to take insulin therapy, 5.5% agreed while 94.5% refused. Main cause of refusal was fear of injection pain in 41.3% cases and fear of addiction was in 27% cases. Mean age of patients was 40.3±8.5 years. Conclusion:  Majority of type-2 diabetic people on oral antidiabetics have fear to use insulin therapy. Injection site pain or fear of addition are main causes of refusa

Estimation of Technical Efficiency of Open Shed Broiler Farmers in Punjab, Pakistan: A Stochastic Frontier Analysis

This study was conducted to estimate the level of technical efficiency of open shed broiler farmers in Punjab, Pakistan. Data was randomly collected from 60 broiler farmers using multistage sampling technique during January-February, 2014. Stochastic frontier Cobb-Douglas production function was used for analysis of data. Maximum likelihood estimation technique was employed for estimation. The analysis revealed that the mean technical efficiency of open shed broiler farmers was 0.880 ranging from 0.440 to 0.985.  This means that if the average broiler farmer in the sample was to achieve the technical efficiency level of its most efficient counterpart than the average farmer could realize 10.50 per cent cost savings. In other words, with the same available resources and technology, an average broiler farmer could increase broiler production by 10.50 per cent. Similarly the most technically inefficient broiler farmer could reveal cost savings of 54.50 per cent. Results further showed that number of day old chicks, feed and labor positively and significantly affected broiler production while the effect of vaccination was negative and that of capacity of shed was positive but statistically insignificant. Results of technical inefficiency effect model revealed that with the increase in age, education and membership with association, technical efficiency of broiler farmers increased. Based upon these findings it is suggested that government and extension workers should educate open shed broiler farmers to use high quality day old chicks and feed for highest possible output and cost savings. Education programs for awareness among broiler farmers to use vaccinated day old chicks and quality resources for enhancing broiler production in the country is also a good policy option. Keywords:Open Shed Broiler Farmers, Technical Efficiency, Stochastic Frontier, Cobb-Douglas Production Function, MLE, Punjab, Pakista

Incidence of Atrial Fibrillation in Acute St-Elevation Myocardial Infarction

Objective: of our study was to evaluate the incidence of acute fibrillation developing in the context of acute myocardial infarction population. Methodology: This cross sectional study was carried out in department Cardiology Nishtar Hospital, Multan under supervision of senior cardiologists. Patients who were presented with acute myocardial infarction selected for study, duration April 2018 to February 2019. Data was entered and analyzed by using SPSS software, mean and SD representation was done for continuous data like age and frequency (percentages %) representation were done for categorical variables like gender, hypertension, DM, onset of old AF and new AF. chi square test was applied to see association between variables. P value less than or equal to 0.05 was considered as significant.  Results: A total of 214 patients were enrolled in this study. There was association between new onset of AF and age (p=0.000). Old AF found in 7.9% (n=17) in patients. The main outcome of this study was new outset AF, in our study, it was found in 18.7% (n=40) patients. Conclusion: New onset of atrial fibrillation is a common type of Arrhythmia which is highly associated with ST segment elevation mayocardial infarction or acute mayocardial infarction. Keywords: Acute myocardial infarction, atrial fibrillation, prognosis, ST segment elevation. DOI: 10.7176/JMPB/52-1