Importance of measuring non-HDL cholesterol in type 2 diabetes patients.

OBJECTIVE: To study the correlation between Non-high-density lipoprotein and low-density lipoprotein cholesterol in patients with Type 2diabetes mellitus and the proportion of patients achieving Adult Treatment Panel III recommended goals. METHODS: The cross sectional study was conducted at the Diabetic Clinic, Aga Khan University Hospital, Karachi. Data of Type 2 diabetesmellitus patients who attended the clinic bewteen 2007 and 2011 was reviewed. All Type 2 diabetic patients of either gender with fasting lipid profile irrespective of taking lipid lowering therapy were included.Type-1 DM, gestational diabetes, type 2 diabetes patients with pregnancy and those with incomplete data were excluded. Correlation between the low-density lipoprotein and Non-high-density lipoprotein was assessed by applying Cramer V and phi. Proportion of patients achieving Adult Treatment Panel III recommended goals was checked. Multivariable regression was done to identify common factors associated with elevated Non-high-density lipoprotein cholesterol. RESULTS: A total of 1352 patients fulfilling the eligibility criteria were included in the study. Mean age of the patients was 54.5 +/- 11.3 years; 797 (59%) were males; 1122 (83%) had Body Mass Index above 25; and 1016 (75%) had HbA1c \u3e or = 7%. Mean Non-high-density lipoprotein cholesterol was 129 +/- 42 mg/dl. Mean low-density lipoprotein cholesterol was 100 +/- 37 mg/dl. Both low-density lipoprotein \u3c or = 100 and Non-HDL \u3c or = 130 mg/dl was achieved in 645 (48%) patients. It is important to note that although 728 (53.8%) patients achieved target LDL cholesterol of \u3c or = 100 mg/dl, among them 83 (11.4%) had Non-high-density lipoprotein cholesterol still above the target \u3e 130 mg/dl (p \u3c 0.05). Out of 752 patients with Non-high-density lipoprotein cholesterol \u3c or = 130 mg/dl, 645 (86%) had low-density lipoprotein cholesterol below 100 mg/dl. Cramer V and Phi showed that correlation between Non-high-density lipoprotein and low-density lipoprotein cholesterol was 0.71 (p value \u3c 0.01). After adjusting for other covariates, low-density lipoprotein cholesterol \u3e 100 mg/dl was independently associated with having Non-high-density lipoprotein cholesterol \u3e 130 mg/dl (Adjusted Odds Ratio 38.6; 95% Confidance Interval = 28.1-53.1). Similarly, age \u3c or = 60 years was 60% more likely to have Non-high-density lipoprotein cholesterol \u3e 130 mg/dl (Adjusted Odds Ratio 1.6; 95% Confidance Interval = 1.01 - 2.3). Whereas having obesity Body Mass Index \u3e 25 was 3.6 times more associated to have Non-high-density lipoprotein \u3e 130 mg/dl (Adjusted Odds Ratio 3.6; 95% Confidance Interval = 1.6-7.7). In patients with coronary artery disease, combined goal achievement of low-density lipoprotein \u3c or = 70 mg/dl and Non-high-density lipoprotein cholesterol \u3c or = 100 mg/dl was seen in 59 (35%). Among patients with high-density lipoprotein \u3c or = 70 mg/dl, 8 (10%) had Non-high-density lipoprotein \u3e 100 mg/dl (p \u3c 0.05). CONCLUSION: The study showed a correlation between Non-high-density lipoprotein and low-density lipoprotein cholesterol. As measuringNon-high-density lipoprotein cholesterol in Type 2 DM patients is simple, cost-effective and convenient because it does not require 12-hour fasting which may be a risk for hypoglycaemia in these patients, clinicians may choose Non-high-density lipoprotein as a routine measure in everyday practice

Surgical management of traumatic extra dural hematoma in children: Experiences and analysis from 24 consecutively treated patients in a developing country

Background: Children with epidural hematoma (EDH) present differently thanadults. The outcome of treatment is also different. We aim to report our experiences with EDH in pediatric age group in terms of mode of injury, presenting features, management, and outcomes. We also aim to identify different prognostic indicators in pediatric patients with EDH. Methods: We prospectively collected data from 24 consecutively surgically treated pediatric patients. The data collected included presenting features, radiological imaging, details of management, and outcomes. Descriptive analysis was performed and different variables were tested for any statistical significance with Glasgow Outcome Score (GOS). Results: There were 19 male and 5 female patients. The mean GlasgowComa Scale (GCS) score at presentation was 9.3 ± 4.4. Falls were the mostcommon cause of EDH. Outcome assessment was done at 3 month follow up.A total of 15 patients had a GOS score of 5, 4 patients had a GOS score of4, 2 patients had a GOS score of 3, while 3 patients had a GOS score of 1.On univariate analysis, admitting GCS score, patient’s age, the time frominjury to admission and injury to surgery, anisocoric pupils at presentation andeffacement of basal cisterns were significantly associated with the outcome ofGOS score. Conclusion: Falls are the most common mode of injury leading to EDH inchildren. Lower GCS at presentation, younger age at trauma, increased timesince trauma to surgery and admission, anisocoria and effacement of basalcisterns are statistically significant variables in surgically treated pediatric patients of EDH that confer a poorer prognosis. A timely surgical intervention can result in excellent outcomes

Ependymal tumors with oligodendroglioma like clear cells: Experience from a tertiary care hospital in Pakistan

Background: Ependymal tumors with oligodendroglioma like clear cells have never been reported from Pakistan. We aimed to see the features and outcomes of this rare entity.Methods: It was retrospective cohort conducted at the Department of Neurosurgery, Aga Khan University from 2003 to 2013. The medical records and radiology of patients with proven histopathology were reviewed. Analysis was done on SPSS 20.Results: Eleven cases of ependymal tumors with clear cells were found, which equated to 1.5% of the total tumor burden in 11 years. The median age was 49 years. Most common presenting symptom was headache 54.5%. Out of 11 patients, 9 patients had a supratentorial tumor. Magnetic resonance imaging showed hypointense signals on T1 and hyperintense signals on T2-weighted images in all cases. Contrast enhancement was found in 9 patients (77.8%), necrosis and hemorrhage was found in 4 (36%) and 3 (27%) patients, respectively. Immunohistochemistry showed glial fibrillary acidic protein and epithelial membrane antigen positivity in all cases. Ki-67 showed high proliferative index in 6 patients. According to the World Health Organization grading of ependymal tumors, 2 patients had Grade II tumors, and 9 patients had Grade III tumors with clear cells. Gross total resection was achieved in 6 (54.5%) and subtotal resection in 5 patients (45.4%). Recurrence was observed in 9 patients. Six patients died of the disease. Median progression-free survival and overall survival was 8 months and 10 months, respectively.Conclusion: Ependymal tumors with clear cells presented more commonly in Grade III lesions and were more aggressive in behavior with poorer outcome compared to similar studies

Enhancement of real-time multi-patient monitoring system based on wireless sensor networks

Portable patient monitoring device has become increasingly important in Hospital wards to record realtime data during normal activity for better treatment. However, the current quality and reliability have not been satisfactory due to the size, weight, distance of coverage and also high power consumption. This paper provides several solutions for enhancing the reliability and improving the power management of the real-time multi-patient monitoring system (MPMS). A reliable wireless personal area networks (WPANs) based on digital signal processing (DSP) was introduced and developed, which consists of twenty remote nodes and a central node with pc-based graphic user interface. Sleep strategy and other techniques (dynamic voltage, frequency scaling) have been used to achieve low power management and assisted power control. Results indicate that, multiple WPANs approach outperformed the single one in respect of efficiency and reliability

Statistical model and prediction of pineapple plant weight

In the Great Giant Pineapples Company, the problem of prediction of weight of fruits at harvest has become a long critical problem for the planning, cannery and marketing. The company has been trying for a long time to find the best method to predict the production of pineapple weight per hectare by using the information of plant weight. It is well known that the fruit weight has linear relationship with the pineapples plant weight. In this study, the modeling and prediction of pineapples plant weight will be discussed based on some factors. The experiment have been conducted in four difference locations and cultivar classes and varieties, namely location 094D with cultivar class Medium Crown and variety GP1, location 126C with cultivar class Medium Crown and variety GP1, location 158H with cultivar class Small Crown and variety GP1and in location 576D with cultivar class Medium Crown and variety GP1. The age of plants are 15 months of age. From each location 40 data has been taken by method of systematic random sampling. Than from each datum the plant weight (W) in kg, number of perfect leaves (NPL), the length of the longest leaf (LLL) in cm, and the width of the longest leaf (WLL) in cm are measured. From the analysis the plant weight best predicted by using variables NPL, LLL, and WLL in all locations

Big data storage, collection, & protection with Islamic perspective

The paper examines the concept of Big Data storage, collection and protection and its Islamic perspective. It also supports the idea of scholars with evidence from the Noble Quran in terms of use. The paper asserts that Big Data in ICT is view in different aspects. These aspects were extensively dwelled with supportive verses from the Holy Quran. The paper concludes by ensuring proper back up is done by all and promoting the good use of Big Data