Essential medicines management during emergencies in Pakistan

This paper illustrates the experiences of essential medicine management in providing cure and care to victims of Pakistan\u27s 2005 earthquake in a safe, rational and effective mode. The health interventions assured access to essential medicine, sustained supply, inventory control through a computerized logistic support system and rational use of medicines. World Health Organization Pakistan outlined modalities for acceptance of donated medicines, assisted in speedy procurement of medicines and designed customized kits. Proper storage of medicines at controlled temperature was ensured in warehousing facilities in 12 locations. A steady supply of medicines and their consumption without stock-outs in the 56 first-level care facilities of calamity-hit areas helped to ascertain the average consumption and cost of essential medicines and supplies for the catchment population. Tools for quantification and forecasting of medicines and supplies were developed and shared. Medicines and medical supplies were efficiently used resulting in minimum wastage

Dynamic Fine-grained SLA Management for 6G eMBB-plus Slice using mDNN & Smart Contracts

The advent of 6G networks promises revolutionary advances in dynamism, intelligence, and decentralization. Realizing the full potential of 6G requires adaptable service level agreements (SLAs) that can optimize performance based on dynamic network conditions. In this paper, we suggested a method based on the Hyperledger Sawtooth blockchain's smart contract with the Reptile meta-learning algorithm to solve the rigidity of static SLA and centralization problems. In order to sustain the quality of service in the radio access network and core network domain of 6G networks, this work focuses on SLA management for efficient resource allocation for the eMBB-plus slice. Our approach entails breaking down static SLAs into finer-grained components, transferring those components onto Hyperledger Sawtooth smart contracts, and using the Reptile meta-learning algorithm to forecast SLA metrics and resource requirements. A dynamic tariff model, also proposed within the smart contract, handles increased user demands. We evaluate the solution by analyzing Reptile performance, resource allocation, and SLA violations under dynamic demands. Results demonstrate the efficiency of this AI-driven, blockchain-based approach for automated, optimized 6G eMBB-plus resource management adhering to dynamic fine-grained SLAs. This work highlights the synergistic potential of AI and blockchain for trusted and intelligent 6G service delivery

Use of B2O3 films grown by plasma-assisted atomic layer deposition for shallow boron doping in silicon

Plasma-assisted atomic layer deposition (PALD) was carried for growing thin boron oxide films onto silicon aiming at the formation of dopant sources for shallow boron doping of silicon by rapid thermal annealing (RTA). A remote capacitively coupled plasma source powered by GaN microwave oscillators was used for generating oxygen plasma in the PALD process with tris(dimethylamido)borane as boron containing precursor. ALD type growth was obtained; growth per cycle was highest with 0.13 nm at room temperature and decreased with higher temperature. The as-deposited films were highly unstable in ambient air and could be protected by capping with in-situ PALD grown antimony oxide films. After 16 weeks of storage in air, degradation of the film stack was observed in an electron microscope. The instability of the boron oxide, caused by moisture uptake, suggests the application of this film for testing moisture barrier properties of capping materials particularly for those grown by ALD. Boron doping of silicon was demonstrated using the uncapped PALD B2O3 films for RTA processes without exposing them to air. The boron concentration in the silicon could be varied depending on the source layer thickness for very thin films, which favors the application of ALD for semiconductor doping processes.Investment Bank Berlin and EFR

Incidence of shoulder dystocia and its relation to brachial plexus palsy: a 10 year retrospective review at King Abdulaziz University Hospital

Background: Objective of the study was to determine the incidence of shoulder dystocia (SD) in King Abdulaziz University Hospital (KAUH), with a focus on Brachial Plexus Palsy (BPP) and the accompanying risk factors.Methods: We conducted a retrospective study of all vaginal deliveries between 2005 and 2014. Out of 29,199 vaginal deliveries, 236 cases where diagnosed with SD at KAUH in Jeddah, KSA. The following maternal and perinatal variables were reviewed by the patients' medical records: (booking status, maternal age, gestational age, maternal Body Mass Index (BMI), presence of diabetes, previous history of SD, instrumental delivery, Birth weight, Erb's and Klumpke's palsies).Results: A total of 236 cases had SD with an incidence of (0.8%). Only 55 cases among all had BPP. The Erb's palsy was found in 54 cases (30.7%) while Klumpke's palsy was found only in one case (0.6%). There were 121 (68.8%) cases with no BPP and a remaining of 60 unknown BPP outcomes. From the total number of cases with SD, mothers with overweight and obesity were found in 93% of the cases.Conclusions: Most of clinically diagnosed SD cases did not give the consequence of BPP. However, this complication in addition to other complications of SD mandates extra caution in cases with risk factors

Comparative study on calcium, magnesium and cobalt in diabetic and non diabetic patients (males) in Punjab, Pakistan

Minerals are very important because of their important role in the maintenance of human health. Our study was aimed at assessing and comparing the levels of Ca, Mg and Co in the blood samples of diabetic and non diabetic persons (males) of five age groups between one and 75 years. For this purpose, fasting blood samples of diabetic and non diabetic males of selected age groups were collected. The blood samples were centrifuged to get serum. The mineral elements in the serum were analyzed by using atomic absorption spectrophotometer. The results depicted that the diabetic patients had higher mean concentration of Ca (141.47 ppm), Mg (18 ppm) and Co (0.057 ppm) while non diabetic persons had higher mean concentration of Ca (201.33 ppm), Mg (36.15 ppm) and Co (0.047 ppm). Statistical analysis was done by applying Student’s T-test. It can be concluded from the study that the diabetic patients of all five age groups are deficient of Ca, Mg, whereas the concentration of Co is higher in diabetic patients. In the further study physiological parameters along with other inorganic cofactors are being taken into consideration.Key words: Diabetes mellitus, blood serum, Ca, Mg, Co

Antibacterial efficacy of indigenous Pakistani honey against extensively drug-resistant clinical isolates of Salmonella enterica serovar Typhi: an alternative option to combat antimicrobial resistance

Abstract Background Extensively drug-resistant (XDR) Salmonella enterica serovar Typhi (S. Typhi) poses a grave threat to public health due to increased mortality and morbidity caused by typhoid fever. Honey is a promising antibacterial agent, and we aimed to determine the antibacterial activity of honey against XDR S. Typhi. Methods We isolated 20 clinical isolates of XDR S. Typhi from pediatric septicemic patients and determined the minimum inhibitory concentrations (MICs) of diferent antibiotics against the pathogens using the VITEK 2 Compact system. Antimicrobial-resistant genes carried by the isolates were identifed using PCR. The antibacterial efcacy of fve Pakistani honeys was examined using agar well difusion assay, and their MICs and minimum bactericidal concentrations (MBCs) were determined with the broth microdilution method. Results All 20 isolates were confrmed as S. Typhi. The antibiogram phenotype was confrmed as XDR S. Typhi with resistance to ampicillin (≥32 µg/mL), ciprofoxacin (≥4 µg/mL), and ceftriaxone (≥4 µg/mL) and sensitivity to azithromycin (≤16 µg/mL) and carbapenems (≤1 µg/mL). Molecular conformation revealed the presence of blaTM-1, Sul1, qnrS, gyrA, gyrB, and blaCTX-M-15 genes in all isolates. Among the fve honeys, beri honey had the highest zone of inhibition of 7–15 mm and neem honey had a zone of inhibition of 7–12 mm. The MIC and MBC of beri honey against 3/20 (15%) XDR S. Typhi isolates were 3.125 and 6.25%, respectively, while the MIC and MBC of neem were 3.125 and 6.25%, respectively, against 3/20 (15%) isolates and 6.25 and 12.5%, respectively, against 7/20 (35%) isolates. Conclusion Indigenous honeys have an efective role in combating XDR S. Typhi. They are potential candidates for clinical trials as alternative therapeutic options against XDR S. Typhi isolates. Keywords Antimicrobial resistance, Natural antibiotics, XDR S. Typhi, MIC, Honey, Resistance gene

Influence of Sleeve Gastrectomy on NASH and Type 2 Diabetes Mellitus

Background. Nonalcoholic fatty liver disease is present in up to 85% of adipose patients and may proceed to nonalcoholic steatohepatitis (NASH). With insulin resistance and obesity being the main risk factors for NASH, the effect of isolated sleeve gastrectomy (ISG) on these parameters was examined. Methods. 236 patients underwent ISG with intraoperative liver biopsy from December 2002 to September 2009. Besides demographic data, pre-operative weight/BMI, HbA1c, AST, ALT, triglycerides, HDL and LDL levels were determined. Results. A significant correlation of NASH with higher HbA1c, AST and ALT and lower levels for HDL was observed (P < .05, <.0001, <.0001, <.01, resp.). Overall BMI decreased from 45.0 ± 6.8 to 29.7 ± 6.5 and 31.6 ± 4.4 kg/m2 at 1 and 3 years. An impaired weight loss was demonstrated for patients with NASH and patients with elevated HbA1c (plateau 28.08 kg/m2 versus 29.79 kg/m2 and 32.30 kg/m2 versus 28.79 kg/m2, resp.). Regarding NASH, a significant improvement of AST, ALT, triglyceride and HDL levels was shown (P < .0001 for all). A resolution of elevated HbA1c was observed in 21 of 23 patients. Summary. NASH patients showed a significant loss of body weight and amelioration of NASH status. ISG can be successfully performed in these patients and should be recommended for this subgroup

Scaling of the F_2 structure function in nuclei and quark distributions at x>1

We present new data on electron scattering from a range of nuclei taken in Hall C at Jefferson Lab. For heavy nuclei, we observe a rapid falloff in the cross section for $x>1$, which is sensitive to short range contributions to the nuclear wave-function, and in deep inelastic scattering corresponds to probing extremely high momentum quarks. This result agrees with higher energy muon scattering measurements, but is in sharp contrast to neutrino scattering measurements which suggested a dramatic enhancement in the distribution of the `super-fast' quarks probed at x>1. The falloff at x>1 is noticeably stronger in ^2H and ^3He, but nearly identical for all heavier nuclei.Comment: 5 pages, 4 figures, to be submitted to physical revie

New measurements of high-momentum nucleons and short-range structures in nuclei

We present new measurements of electron scattering from high-momentum nucleons in nuclei. These data allow an improved determination of the strength of two-nucleon correlations for several nuclei, including light nuclei where clustering effects can, for the first time, be examined. The data also include the kinematic region where three-nucleon correlations are expected to dominate.Comment: 5 pages, 3 figures. Results from JLab E02-01