Case-Control Study on Fetal Outcomes in Isolated Oligohydramnios in Third Trimester

Background: Oligohydramnios is defined as a condition with low volume of amniotic fluid relative to gestational age. Long-term oligohydramnios can result in pulmonary hypoplasia, intra uterine growth retardation, Potter’s syndrome, club hand & foot and dislocation of hip. This study was conducted to assess feto-maternal outcome in isolated oligohydramnios and factors associated with poor outcome. Methodology: This case-control study was conducted from January to December 2020 in the Gynecology & Obstetrics and Radiology departments of HBS General Hospital, Islamabad. Total 300 patients with isolated oligohydramnios fulfilling the criterion were included. For cases, patients with singleton intrauterine pregnancy with AFI <5, of any age or parity with gestational age of more than 34 weeks were included. 300 controls were also taken. Patients with increased amount of amniotic fluid, diabetics, hypertensive and cardiac patients were excluded. Patient were followed up till delivery. Mode of delivery was checked out. Fetal APGAR score at 1 minute and at 5 minutes were observed. New born weight and  NICU admissions were recorded. Data was  analyzed via SPSS v26. Results: Forty six percent (n=138) patients underwent caesarean section while fifty four percent (n=162) had normal vaginal delivery. Significant association (OR=1.85, P<0.001) was found between caesarean section in mothers with oligohydramnios compared to controls. Thirty eight percent (n=114) of neonates among cases had low APGAR score. Significant association (OR=3.29, P<0.001) was found between low APGAR score and mothers with oligohydramnios compare3d to controls. Thirty percent (n=90) required NICU  admission. There were 6 still births. Mother’s with oligohydramnios have double risk of still birth and NICU admission compared to women with normal fluid levels. Conclusion: Neonate born with mothers having oligohydramnios have low birth weight, lower APGAR scores and high rate of NICU admissions. Delivery at 37-39 weeks in oligohydramnios is associated with higher rate of still births

Evaluation of prescription pattern and compliance in kashmiri women with polycystic ovarian syndrome

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine system disorder affecting women of reproductive age. As there are a few studies with inconsistent data available in the literature regarding the prescription pattern and compliance of drugs in patients with PCOS, both within and outside India, the present study was undertaken to generate some valid and useful data regarding these parameters. Objective: Evaluation of drug utilization and assessment of prescribing patterns and patient compliance among Kashmiri women with polycystic ovary syndrome. Materials and Methods: This study was a prospective, observational and cross-sectional study, which was carried out on Kashmiri females diagnosed with PCOS as per Rotterdam criteria of 2003. Patients attending Srinagar based hospitals and clinics over a period of nine months. Information was collected through personal interviews using a pre-validated, self-administered data collection tool. The prescribing patterns of drugs were evaluated by comparison with Endocrine Society Clinical Practice Guidelines. Patient compliance with prescribed medicines was assessed using modified Morisky 8-Item Medication Adherence Questionnaire. Results: Drugs prescribed to the study patients included oral contraceptive pills (OCPs) 57(46.34%), insulin sensitizers 75 (60.97%), anti-androgen 37 (30.08%), anti-estrogens 1 (0.81%), progestins 10 (8.13%), dopaminergic agonists 7 (5.69%), steroids 2 (1.62%) and statins 1(0.81%). 50 (40.65%) patients were highly adherent to their prescribed medications. Conclusion: The study revealed that nature of drugs prescribed to the study population was in consonance with the established standard guidelines. Most of the women were highly adherent to their prescribed medications. Keywords: PCOS, prescription, drug adherence. &nbsp

COMBINATORIAL EFFECT OF LEPTIN, TUMOR NECROSIS FACTOR-ΑLPHA, AND VITAMIN D IN PROGRESSION OF TYPE 2 DIABETES IN KASHMIRI POPULATION

Objectives: Type 2 diabetes mellitus (T2DM) is a metabolic disorder usually characterized by hyperglycemia. Adipose tissue secretes bioactive substances known as adipocytokines including leptin, tumor necrosis factor-alpha (TNF-α), and adiponectin. These are considered as a bridge connecting obesity and insulin resistance. There is considerable epidemiological evidence to suggest a role of Vitamin D deficiency in the etiology of T2DM. This study was performed to evaluate and compare serum Vitamin D and adipocytokine levels in T2DM patients and healthy controls of Jammu and Kashmir region of India.Methods: A total of 200 T2DM patients and normal 200 healthy controls were considered for the study. Enzyme-linked immunosorbent assay was used to measure serum leptin and TNF-α levels. The Vitamin D levels were measured by chemiluminescent microparticle immunoassay method. Biochemical parameters were measured by the enzymatic method.Results: Our results concluded that basic metabolic parameters, TNF-α and leptin levels were significantly higher in cases than controls. The serum Vitamin D levels were found significantly lower among T2DM patients. No correlation of Vitamin D with leptin was observed in cases and controls. However, a positive correlation between leptin and TNF-α was noted in T2DM subjects as well as in controls with statistical significance being higher in females (r=0.500; p=0.001) as compared to males (r=0.298; p=0.036) in T2DM subjects as well as in controls (r=0.659; p=0.001; r=0.621; p=001).Conclusion: These results concluded that lowering of Vitamin D levels and upregulation of leptin and TNF-α altogether play an important role in the development of T2DM, and from correlation analysis, it could be predicted that leptin and TNF-α act in a synergistic manner toward the development of T2DM

Association of a Chromosomal Susceptibility Locus to Bipolar Affective Disorder (BPAD): A case-control study in Kashmir

The etiology of bipolar disorder (BPAD) is still unknown, but family, twin, and adoption studies strongly suggest the involvement of genetic risk factors. Linkage studies have revealed a number of loci to be linked with BPAD. Of those, several investigators confirmed 18p11 as one of the susceptibility loci for BPAD. Thus, chromosome 18p11 is one of the targets of the genetic association study of BPAD. The aim of our study was to investigate whether the tandem repeat polymorphism in D18S452 microsatellite marker at locus 18p11.2 is a risk factor for the development of BPAD in Kashmiri population. The repeat polymorphism in D18S452 was evaluated in 74 patients with BPAD and 74 control (age, sex and region matched) individuals. The repeat polymorphism was evaluated by PCR analysis of DNA obtained from the blood of the subjects. We observed that the tandem repeat (300bp*) allele frequency was found to be 1.35 % in the controls and 8.108% in cases. The tandem repeat (250bp*) allele frequency was found to be in 91.89% in cases and 98.65% in controls. The 252bp/252bp genotype was found to be present in 89.18% of the cases and 98.64% of the controls, the 300bp/300bp genotype in 5.40% of cases and 1.35% of controls and the 252bp/300bp variant in 5.40% of the cases and none among the controls. It was observed that although the proportion of patients homozygous for the tandem repeat (300bp/300bp) was higher in cases than in controls, the difference was not statistically significant when using 252bp/252bp genotype as a reference (OR= 4.4242; 95% CI, 0.4822-40.5924); P = 0.1529). However, it was observed that the frequency of the heterozygous genotype (252bp/300bp) when compared with 252bp/252bp showed statistical significance (OR=8.0603; 95% CI, 1.1112-58.4646; P = 0.0383). Chromosome 18 harbors many candidate genes that are involved in the pathophysiology of BPAD. It may be possible that this marker is directly or indirectly involved in the regulation of neighboring genes. It is also possible that this locus may be in linkage disequilibrium with other genes. Although, this is the first study reporting the association of the marker D18S452 in heterozygous condition (252bp/300bp) with BPAD. Yet, it would be too early to associate this genotype with the predisposition to BPAD. Therefore, further studies with larger sample size should be carried to validate the result, taking into account the various disease phenotypes, endophenotypes and environmental conditions

IoT-Based COVID-19 Diagnosing and Monitoring Systems: A Survey

To date, the novel Coronavirus (SARS-CoV-2) has infected millions and has caused the deaths of thousands of people around the world. At the moment, five antibodies, two from China, two from the U.S., and one from the UK, have already been widely utilized and numerous vaccines are under the trail process. In order to reach herd immunity, around 70% of the population would need to be inoculated. It may take several years to hinder the spread of SARS-CoV-2. Governments and concerned authorities have taken stringent measurements such as enforcing partial, complete, or smart lockdowns, building temporary medical facilities, advocating social distancing, and mandating masks in public as well as setting up awareness campaigns. Furthermore, there have been massive efforts in various research areas and a wide variety of tools, technologies and techniques have been explored and developed to combat the war against this pandemic. Interestingly, machine learning (ML) algorithms and internet of Things (IoTs) technology are the pioneers in this race. Up till now, several real-time and intelligent IoT-based COVID-19 diagnosing, and monitoring systems have been proposed to tackle the pandemic. In this article we have analyzed a wide range of IoTs technologies which can be used in diagnosing and monitoring the infected individuals and hotspot areas. Furthermore, we identify the challenges and also provide our vision about the future research on COVID-19

Comparative evaluation of procoagulant and proinflammatory markers in drug naive versus oral contraceptive pill’s (OCP’s) treated Polycystic Ovary Syndrome (PCOS) women.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of young women. There is a spectacular increase in the prevalence of PCOS all over world especially in Asia. The condition seems to be on rise in Kashmir valley although systemic studies on the subject are underway. First line of treatment is often the oral contraceptive pills (OCP’s) as most of these women attend to various gynaecologists and they desire menstrual regulation. Since there is plethora of data that PCOS women have evidence of enhanced markers of inflammation and indicators of coagulation. Therefore treatment with OCP’s may worsen the metabolic, inflammatory and coagulation parameters in this population. We undertook this study to investigate the effect of OCP treatment procoagulant and proinflammatory markers in women with PCOS. The results may therefore translate in to the clinical practice

Physicochemical and pathological assessment of groundwater quality from Sargodha, Pakistan using hybrid multi-layer slow sand filter: pre and post treatment analysis

One of the main issues confronting humanity in the twenty-first century is the lack of potable water availability. Around half of the world’s consumers face drinking water scarcity. Industrially rich areas have a high population and high-water contamination risk factors. Modern technologies that are quite effective for water purification, present economical limitations that impede their usefulness in developing countries. Conventional methods involving low energy, low chemical demand, and prevention of water-borne disease are therefore significant for water purification in developing countries like Pakistan. These limitations have led to improvising the conventional method for facile water purification. Herein we report the water purification assembly based on allow sand filtration; involving the raw materials grass, clay, sand, silt, pebbles, gravel and coal/ fly ash carbon to obtain clean and quality-controlled water treatment. Ground water samples collected from various areas of Sargodha city were subjected to the developed design Hybrid Multi-Layer Slow Sand Filter (HMLSSF). Based on pre- and post-treatment water analysis, it was determined that the filtration assembly was quite effective at reducing pH, turbidity, dissolved and suspended solids, hardness, and heavy metals percent removal by 87%, 77.7%, 91.3%, 95.4%, 84.4%, and to promising levels, respectively. Moreover, 99 % biological contamination such as total coliform was also removed by this method

A Co-relational Study of Community Midwife and Maternal Health Care System: A Questionnaire Survey in Rural Areas of Pakistan

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Design Optimization of an Efficient Bicolor LED Driving System

There are some challenges involved in the design of a multicolor LED driver, such as the precise control of color consistency, i.e., maintaining the correlated color temperature (CCT) and luminous intensity. CCT deviation causes a color shift of composite light. This paper approaches the method of nonlinear optimization of the LED currents of two LED sources to achieve the desired CCT. A bicolor blended-shade white LED system is formed by using a warm color LED source of 1000 K CCT and a cool color LED source of 6500 K CCT. By using a nonlinear optimization methodology, the reduced deviation of the blended CCT and optimum LED currents are obtained. The optimized currents in the two LED strings are maintained by the control circuit of the single-ended primary inductor converter (SEPIC). The obtained reduced deviation of the CCT is 43 K, and the precision is 99.15%. Again, harmonics in the input current hamper power quality, i.e., reduce the power factor and increase power loss. This paper proposes the harmonic reduction technique to achieve the lowest value of total harmonic distortion (THD) through the nonlinear parametric optimization of the SEPIC. Measured THD = 4.37%; PF = 0.96; and efficiency = 92.8%. The system stability was determined and found to be satisfactory