Functional salvage of a mangled lower limb using custom-made endoprosthetic replacement

Functional salvage of a severely injured extremity is a challenge for the patient and the treating surgeon. We report a case of a woman presenting with severely injured lower limb and bone loss, which was managed using a custom-made endoprosthetic replacement for successful functional outcome. Despite being complicated by bone loss, nerve injury and infection; a planned staged surgical treatment and rehabilitation have resulted in satisfactory outcome. At 3-year follow-up, the functional score according to the Musculoskeletal Tumor Society-International Symposium on Limb Salvage System was 70% and the Toronto Extremity Salvage Score was 62%. Endoprosthetic replacements may have a limited role in managing selected patients with mangled extremity and can lead to a good functional outcome to these patients

The Estimation ofAggregate Consumption Function for High Income Countries

Aggregate Real Private Consumption (ARPC) is one of the major components of the Gross Domestic Product (GDP)that contributes to specify any economy’s long term living standards. The contribution of ARPC stands on an average around 55%. It is therefore important to understand the components of the consumption which is almost more than half of the aggregate economic expenditure. The study is an attempt to make a case for developing countries to bring policy level changes in order to determine the consumption pattern of developing countries’ GDP. Using appropriate empirical model the study investigates the validity of Permanent Income Hypothesis (PIH) and Absolute Income Hypothesis (AIH)on ARPC for selected developed economies. The results of the study reveals that the important determinants of ARPC in the long-run are real GDP and wealth, while in the short-run they are real interest rate and unemployment rate

The Prevalence of Hypomagnesemia in Critically Ill Patients Admitted in Medically Intensive Care Unit

Background Magnesium is the fourth most abundant cation in the human body. Hypomagnesemia can result from decreased intake, redistribution of magnesium from the extracellular to the intracellular space, or increased renal or gastrointestinal loss. Hypomagnesemia can cause severe outcomes in ill patients. So, we conducted this study to determine the frequency of hypomagnesemia in critically ill medical patients. Methods This is a Descriptive cross-sectional study involving 120 patients admitted in the medical intensive care unit (MICU) of the Holy Family Hospital, Rawalpindi, Pakistan. The study was conducted from July 2020 to September 2021. About 1 ml sample of blood was taken from each patient included and sent to the hospital laboratory for evaluation of serum magnesium levels. All the collected data was entered and analyzed on SPSS v. 23. A p-value of ≤ 0.05 was taken significant. Results In our study, the mean age of the patients was 42.76±12.77 years, and the male-to-female ratio of the patients was 1:1. The mean value of the APACHE II score of the patients was 29.68±2.571. Hypomagnesemia was found in 28 (23.33%) patients. Conclusion According to our study, the frequency of hypomagnesemia in critically ill medical patients was 23.33% (28 patients)

Evidence-based discussion increases childhood vaccination uptake : a randomised cluster controlled trial of knowledge translation in Pakistan

Other authors: Ari Ho Foster, Bev Shea, George A Wells, and José Legorreta SoberanisThe relatively low-cost knowledge translation intervention applied in this study significantly increased vaccine uptake, without relying on improved services, in a poor district (Lasbela, Pakistan) with limited access to services. The study results prove relevant towards better vaccination coverage in developing countries. The intervention comprised three structured discussions separately with male and female groups in each cluster. Adjusting for baseline differences between intervention and control clusters with generalized estimating equations, the intervention doubled the odds of measles vaccination in the intervention communities (OR 2.20, 95% CI 1.24-3.88). It trebled the odds of full DPT vaccination (OR 3.36, 95% CI 2.03-5.56)

CLINICAL PROFILE OF PATIENTS WITH SEPTICEMIA

OBJECTIVE: To evaluate the clinical profile of patients with septicemia. PATIENTS AND METHODS: This cross sectional case series study of six months was conducted at tertiary care teaching hospital Hyderabad. The admitted patients of age ≥18 years, either gender diagnosed as sepsis were recruited. The diagnosis of sepsis was made by the detail clinical history and examination and relevant investigations. The clinical parameters include fever, hypothermia or hyperthermia, tachycardia, tachypnea, leucocytosis or leucopenia, acute altered mental status, thrombocytopenia, hypotension. The etiological diagnosis requires isolation of pathogen from the blood or local site of infection. The Gram staining and culture of the specimen from the site of infection for microbial study was taken. Other relevant laboratory investigations depending upon the requirement were advised accordingly. RESULTS: During six months study period total fifty individuals with sepsis were recruited and studied for detecting the focus of infection. The mean age ±SD for whole population was 55.83±8.95 with male gender predominance 37 (74%). The male gender was predominant 37 (74%), Common co-morbidities observed were diabetes 7(14%), hypertension 5(10%) and chronic liver disease 3(6%). The common source of infection detected were respiratory infection 10(20%), urinary tract infection 8(16%) and wound infection 06(12%). Forty two (84%) patients were recovered while eight (16%) were expired. CONCLUSION: Respiratory and urinary tract infection and wound infections were the most common source of sepsis. KEYWORDS: Septicemia, Infections, Sepsi

Extrapulmonary tuberculosis in Pakistan- A nation-wide multicenter retrospective study

Background Pakistan is fifth among high burden countries for tuberculosis. A steady increase is seen in extrapulmonary tuberculosis (EPTB), which now accounts for 20% of all notified TB cases. There is very limited information on the epidemiology of EPTB. This study was performed with the aim to describe the demographic characteristics, clinical manifestations and treatment outcomes of EPTB patients in Pakistan. Method We performed descriptive analysis on routinely collected data for cohorts of TB patients registered nationwide in 2016 at health facilities selected using stratified convenient sampling. Findings Altogether 54092 TB including 15790 (29.2%) EPTB cases were registered in 2016 at 50 study sites. The median age was 24 years for EPTB and 30 years for PTB patients. The crude prevalence of EPTB in females was 30.5% (95%CI; 29.9–31.0) compared to 27.9% (95%CI; 27.3–28.4) in males. The likelihood of having EPTB (OR), was 1.1 times greater for females, 2.0 times for children, and 3.3 times for residents of provinces in the North-West. The most common forms of EPTB were pleural (29.6%), lymphatic (22.7%) and abdominal TB (21.0%). Pleural TB was the most common clinical manifestation in adults (34.2%) and abdominal TB in children (38.4%). An increase in the prevalence of pleural and osteoarticular and decline in lymphatic and abdominal TB was observed with advancing age. Diversity in demography and clinical manifestations were noted between provinces. The treatment success rate for all type EPTB was significantly high compared to bacteriology confirmed PTB with the exception of EPTB affecting CNS with a high mortality rate. Conclusions The study provides an insight into demography, clinical manifestations and treatment outcomes of EPTB. Further studies are needed to explain significant diversities observed between provinces, specific risk factors and challenges concerning EPTB management.publishedVersio

Immobilization of lipase enzyme carbon nanotubes via adsorption

Lipase is an enzyme used widely in many major industries. Immobilization of enzymes will help to enhance its sustainability as enzymes are more resistance to changes in environment and can be reused. This experiment examines effects the immobilization of lipase with adsorption technique through carbon nanotubes. The paper investigates the enzyme activity and efficiency of immobilized enzyme lipase by using assay solution. It also presents the effects of pH on immobilized enzyme and the characterization of the immobilized enzyme lipase with FTIR spectrum and FESEM technique. The results showed that there are as enzyme concentration increases, the enzymatic activity increases too. However, this lowers the immobilization efficiency due to saturation of binding pores on functionalized MWCNTs. Meanwhile, the optimum pH for maximum immobilization activity of enzyme lipase is at pH 6. Based on the characterization by FTIR spectrum and FESEM, it is confirmed by the presence of functional group in FTIR spectrography. On the other side, FESEM also confirms that immobilization of enzyme has occurred

Multiwall carbon nanotube promising route for removal of chromium from wastewater via batch column mechanism

Water pollution regarding heavy metals issue keep lingering our days from time to time, and some problems even left unattended. The most crucial cause of this pollution is the industrial waste, especially waste water that had been released into the drainage system without being treated first. This activity had been done illegally and left a huge impact towards the environment also human. In this study multiwall carbon nanotubes (MWCNTs) are promising route for removal of chromium was investigated. Results revealed that the optimum conditions for highest removal (99.97%) of chromium are pH7,0.04g of MWCNTs dosage, and flowrate of 20.83 mL/s. Based on adsorption isotherm for this experiment, the amount of chromium adsorbed, qm calculated was 50.51 mg of chromium/gram of MWCNTs. From the results obtained, it had been proved that MWCNTs can be used as an effective adsorbent in chromium removal from aqueous solution due to high adsorption capacity

Turn on the Lights: Macroeconomic Factors Affecting Renewable in Pakistan

The objective of the study is to examine the relationship between macroeconomic factors (i.e., population growth; urbanization, industrialization, exchange rate, price level, food production index and live stock production index) and renewable energy in Pakistan over a period of 1975-2012. In addition, this study uses oil rent as an intervening variable to overcome the biasness of the single equation model. The results indicate that macroeconomic factors positively contributed to renewable energy consumption in Pakistan. The causality test indicate that there is a unidirectional causality running towards macroeconomic factors to renewable energy in Pakistan, however, renewable energy Granger cause oil rent but not via other route. In addition, there is bidirectional causality between exchange rate and live stock production in Pakistan. Variance decomposition analysis shows that economic growth has a major contribution to increase renewable energy in Pakistan

Turn on the Lights: Macroeconomic Factors Affecting Renewable in Pakistan

The objective of the study is to examine the relationship between macroeconomic factors (i.e., population growth; urbanization, industrialization, exchange rate, price level, food production index and live stock production index) and renewable energy in Pakistan over a period of 1975-2012. In addition, this study uses oil rent as an intervening variable to overcome the biasness of the single equation model. The results indicate that macroeconomic factors positively contributed to renewable energy consumption in Pakistan. The causality test indicate that there is a unidirectional causality running towards macroeconomic factors to renewable energy in Pakistan, however, renewable energy Granger cause oil rent but not via other route. In addition, there is bidirectional causality between exchange rate and live stock production in Pakistan. Variance decomposition analysis shows that economic growth has a major contribution to increase renewable energy in Pakistan