Correlation of Atrial Fibrillation with Left Atrial Volume in Patients with Mitral Stenosis. a Single Centre Study From Pakistan

Background: Rheumatic heart disease has a strong association with mitral valve stenosis. Atrial fibrillation is one of the most common complications of this condition and is a poor prognostic factor. Early detection and prompt management of atrial fibrillation can help to improve the quality of life and increase the life expectancy of the patients. We carried out this study to investigate the significance of left atrial volumetric changes in mitral stenosis and its correlation with atrial fibrillation. Methodology: We audited the data of 60 patients of rheumatic heart disease who had mitral valve stenosis. The patients were randomized into atrial fibrillation (Group A) and normal sinus rhythm (Group B). We conducted this cross-sectional analytical study at Cardiology Department, Mayo Hospital, Lahore, from 1st February 2017 to 31st January 2018. We only included those patients who consented to be a part of this study and fulfilled our predefined inclusion criteria. Left atrial volume was measured by prolate ellipse method and biplane methods on echocardiography. The Data was analyzed on SPSS v20. Results: Sixty patients were included in the study. Among the subjects, thirty-six (60%) were males, and twenty-four (40%) were females. Atrial fibrillation was noted in 43.33% of the patients of mitral valve stenosis. There was a marked difference in the mean volume of the left atrium among the two groups. We observed that the mean area of the mitral valve for Group A patients was larger than that of patients in Group B. Our study showed an inverse correlation between left atrial volume and mitral valve area among Group A patients. Conclusion: Patients of mitral stenosis are at an increased risk of developing atrial fibrillation if the left atrial volume is increasing. All patients with mitral stenosis should have routine echocardiography & measurement of left atrial volumes, so that proper treatment can be started if the left atrial volume is increasing, to prevent atrial fibrillation

How to achieve Financial Gains with Corporate Social Responsibility in businesses

This research paper presents a conceptual framework for companies to manage their financial gains or profitability with the help of Corporate Social Responsibility initiatives and attempts. A case of Sharp electronics and Samsung will also be discussed that how these companies gain profits through implementing CSR in companies. And we will also do a graphical analysis of Asian countries involve in CSR activities. The results of the present study showed that an organization can increase its output by effectively using corporate social responsibility activities. Key words: Corporate Social Responsibility, Financial gains, Conceptual framewor

Indirect Rapid Molds for Prototype Lost-Foam Pattern Production 506

Lost-foam (also known as Expendable Pattern Casting, EPC) is an ever-growing metalmcasting technique, capable of producing complex metal components without parting lines. Mold preparation for lost-foam casting is typically accurate, but expensive and slow. The goal of this research was to develop a new approach for producing rapid lost-foam molds. With this new approach, patterns generated by SFF technology are used to form indirect composite lost-foam molds. Ultimately, our objective is to produce these molds quickly, accurately, and inexpensively. This new approach to lost-foam mold-making will be explained as well as the results of one trial.Mechanical Engineerin

using management information system to evaluate quality of care at tertiary care hospital’s stroke centre

To find out the average length of stay, the rate of I/V catheter cellulites, the rate of bed sores among patients in stroke centre and determine the mortality rates. Methodology: This is a descriptive study, carried out at a tertiary care hospital over the period of six months. Data was analyzed by SPSS version 15.0. Result: Total numbers of patients were 36 from January 1 to June 30, 2007 at Stroke Center Liaquat National Hospital. The mean length of stay was 8.17 ±5.81 days. Patients had cellulitis (intravenous) 97.2%, only 2.8% of patients did not develop. The rate of bed sore was 41.7%. Conclusion: By effective implementation of the Management Information System (MIS) in health care delivery system we can find patients clinical issues and can reduce their length of stay

Case Report: Sometimes a Cigar is just a Cigar

This unusual case underscores the need for psychiatrists to consider treatable and curable causes of acute behavior changes even when historical data are not easily available. This case presentation invites physicians of mind (and body) to utilize simple and common-sense approaches while evaluating their patients

Bacillus thuringiensis and its application in agriculture

Presently, a number of approaches to pest control via genetic engineering have been developed and genetically engineered crops expressing insecticidal characteristics are under cultivation for the last 15 years. Use of Bacillus thuringiensis genes encoding o̅ endotoxins with insecticidal characteristics is the major approach and a number of such B. thuringiensis genes have been expressed in crops with variable level of efficiency. It is very crucial to achieve adequate level of B. thuringiensis gene expression to have durable resistance against target insect pests. As with many aspects of genetic engineering, politics can impact on the success of a project involving the development of B. thuringiensis transgenic crops, irrespective of its apparent social, economic or environmental benefits. Public education will be essential to ensure the widespread adoption of genetic adoption technologies in agriculture, and scientists will have to play an active role in this process

Injection use in two districts of Pakistan: implications for disease prevention

Objective. To estimate the annual number of injections per person in Sindh province of Pakistan and to describe their distribution with regard to prescribers, settings, and safety. Design. A population-based cross-sectional study in July-September 2001. Setting. Lyari, an urban town in Karachi district; and Digri, a rural subdistrict in Mirpur Khas district. Study participants. We selected a population-based cluster sample of 1150 individuals aged ≥3 months. We interviewed one person per household for the number of encounters they had with health care providers, number and types of injections received, safety circumstances, and cost of injections during the past 3 months. Main outcome measure. The number of injections per person per year. Results. After adjusting for age and sex, 68% of participants had received at least one injection in the previous 3 months (13.6 injections/person/year). The majority of the respondents received injections at the clinics of qualified general practitioners (n = 571, 67%) by dispensers (644, 76%). Most of the injections (n = 3446, 96%) were for curative purposes. A freshly opened syringe was used for only 454 (53%) of the injections. The average fee for receiving an injection was Rs. 51 (US$0.8). Conclusion. Injections are overused in Pakistan's Sindh province and the ratios of injection per capita that we found are among the highest ever reported. Interventions are needed to substantially reduce injection prescription among private health care providers who prescribe most of the injections received by the populatio

Correlation of non alcoholic fatty liver disease in patients of coronary artery disease

Background: In NAFLD, increase in factor VIII and a reduction of protein C leads to the progression from steatosis to cirrhosi. The aim was to study the correlation of NAFLD with other associated risk factors of CAD.Methods: A total number of 100 patients of coronary artery disease were assessed for presence of NAFLD, dyslipidemia, metabolic syndrome & diabetes by various laboratory tests.Results: 46% of the CAD patients were found to have NAFLD. 69.6% patients of NAFLD were in the age group of 40-60 years. 21.7% were above 60 years. 91.1% of NAFLD patients were males. Half of the NAFLD patients were diabetic. 21.7% of NAFLD patients were found to have a total cholesterol level >200. Triglyceride level was also high among these patients (58.7%). All the NAFLD patients had LDL <100. 52.2% of them had metabolic syndrome.Conclusions: The study showed a direct correlation between NAFLD & CAD. Metabolic syndrome, diabetes, increased total cholesterol & triglyceride level were also associated with increased risk for CAD. However LDL level was not found to be associated with NAFLD risk