Prevalence of non-communicable diseases and their risk factors at a semi-urban community, Pakistan

Introduction: Pakistan is currently facing the double burden of communicable (38%) and non- communicable diseases (49%) according to WHO NCD Country Profiles 2014. About 50% of all deaths are attributed to NCD's. The objective of this study was to determine the burden of noncommunicable diseases in semi urban community of Islamabad. Methods: We carried a cross sectional study to estimate the burden of noncommunicable diseases in an urban setting, a community based cross sectional survey covering 1210 households was carried out over a period of three months. Households were selected through consecutive non-probability sampling, among which adult females and males who were permanent resident of the community were interviewed through a structured questionnaire in urdu language. SPSS version 21 was used to analyze the data. Descriptive statistics were calculated. Results: About 38.7% individuals had High BP / IHD, 34.4% had oro-dental health problems, 24.3% were physically disabled and 14.6% had diabetes. Among the risk factors, 48.2% were tobacco user, 13.60% were drug abuser and 1.8% alcoholics. Conclusion: We conclude that the prevalence of non-communicable diseases is quite high in the above setting as compared to the National indicators, which demands timely intervention to curtail the existing burden of NCD.Pan African Medical Journal 2016; 2

Atypical Presentation of Esophageal Squamous Cell Carcinoma Masquerading as Diffuse Severe Esophagitis

Esophagitis is described as an inflammation of the esophagus and can result from multiple etiologies. Esophageal squamous cell carcinoma (ESCC), presenting as diffuse esophagitis in the absence of a mass or lesion, is rare. We present a case of a 61-year-old man who presented to the gastroenterology clinic for dysphagia and heartburn of 3 months duration. The patient had lost about 15 pounds unintentionally over 6 months. The patient underwent esophagogastroduodenoscopy, which revealed significant diffuse Grade 4 esophagitis without any overt bleeding. Random biopsies were taken with cold forceps from proximal, middle, and distal esophageal segments because of the striking endoscopic appearance. Histopathology revealed high-grade dysplasia and carcinoma in situ. The patient underwent endoscopic ultrasound (EUS) of the esophagus, which revealed a focal lesion. EUS-guided fine-needle aspiration showed squamous cell carcinoma of the esophagus. ESCC usually presents as a mass or a gross lesion seen on endoscopy. However, it rarely presents as severe diffuse esophagitis seen on routine endoscopy. From our observation, it would be reasonable for physicians to bear this unusual endoscopic presentation in mind and perform multiple random biopsies if encountered with such a case to rule out the possibility of any underlying malignancy

Millisecond-Timescale Local Network Coding in the Rat Primary Somatosensory Cortex

Correlation among neocortical neurons is thought to play an indispensable role in mediating sensory processing of external stimuli. The role of temporal precision in this correlation has been hypothesized to enhance information flow along sensory pathways. Its role in mediating the integration of information at the output of these pathways, however, remains poorly understood. Here, we examined spike timing correlation between simultaneously recorded layer V neurons within and across columns of the primary somatosensory cortex of anesthetized rats during unilateral whisker stimulation. We used Bayesian statistics and information theory to quantify the causal influence between the recorded cells with millisecond precision. For each stimulated whisker, we inferred stable, whisker-specific, dynamic Bayesian networks over many repeated trials, with network similarity of 83.3±6% within whisker, compared to only 50.3±18% across whiskers. These networks further provided information about whisker identity that was approximately 6 times higher than what was provided by the latency to first spike and 13 times higher than what was provided by the spike count of individual neurons examined separately. Furthermore, prediction of individual neurons' precise firing conditioned on knowledge of putative pre-synaptic cell firing was 3 times higher than predictions conditioned on stimulus onset alone. Taken together, these results suggest the presence of a temporally precise network coding mechanism that integrates information across neighboring columns within layer V about vibrissa position and whisking kinetics to mediate whisker movement by motor areas innervated by layer V

Role of different factors as preoperative predictors of conversion of laparoscopic cholecystectomy to open cholecystectomy

Aim: Laparoscopic cholecystectomy has become the gold standard for the treatment of gallstones. Background: The objective of our study was to identify the preoperative predictors of conversion of laparoscopic cholecystectomy into open cholecystectomy. Materials and Methods: We carried out a cross-sectional study in the Surgical Unit 1, Holy Family Hospital, Rawalpindi, from September 2016 to February 2017. All patients undergoing laparoscopic cholecystectomy were included in the study. Patients undergoing open cholecystectomy due to the presence of contraindication to laparoscopic cholecystectomy or patients in which laparoscopic cholecystectomy was a part of some other laparoscopic intervention were not included in the study. SPSS version 21 was used to analyze the data. Results: The overall mean age of the patients was 43.67 ± 13.54 years. The male patients were significantly older as compared to the female patients. The conversion rate was higher in patients who had an elevated total leukocyte count and alanine aminotransferase before the operation (P < 0.05). The rate of conversion was significantly higher in male patients aged ≥50 years (P < 0.05). Difficulty in the dissection of the triangle of Calot, difficulty in dissecting the gallbladder fossa, bleeding in gallbladder fossa, presence of duodenal fistula, and autolyzed gangrenous gallbladder were the reasons for the conversion to open cholecystectomy. Conclusion: The rate of conversion of laparoscopic cholecystectomy to open cholecystectomy was found to be 5%. Male patients aged ≥50 years, acalculous acute cholecystitis, acute cholecystitis, elevated preoperative total leukocyte count, and alanine aminotransferase levels were found to be significant predictors of conversion to open cholecystectomy

Impact of insulin pump on quality of life of diabetic patients

Aim: Diabetes is an emerging health problem, both in developing and developed countries and has an enormous economic and social impact. The objective of our study was to find the impact of insulin pump on the quality of life of patients with type 2 diabetes (T2D) and compare it to the quality of life of patients with T2D using an insulin pen. Subjects and Methods: This is a case–control study which was conducted among patients with T2D presenting between November 2014 and November 2015. A total of 83 patients with T2D, using insulin pump were enrolled in the study as cases and 322 patients with T2D not using insulin pump but using insulin pens were enrolled as controls. Short form-36 quality of life questionnaire was used for data collection. Results: Mean age of patients using insulin pump was 52.49 ± 9.28 while the mean age of patients not using insulin pump was 54.72 ± 16.87. Mean score of all domains in the questionnaire was found to be higher in patients using insulin pump as compared to patients not using insulin pumps (P < 0.05). In 81.1% of the patients, the insulin pump decreased the frequency of hypoglycemic episodes. Conclusion: Insulin pump has significantly improved the quality of life of patients in terms of better self-esteem, decreased stress, and better mood. It has resulted in improved physical health, meal time flexibility, and ease of travel. It allows patient to have more active participation in social and recreational activities improving their personal and family life

Ruptured Gastroduodenal Artery Pseudoaneurysms as a Complication of Pancreatitis

Visceral artery pseudoaneurysms is a known vascular complication of pancreatitis that can lead to life-threatening hemorrhages with a high mortality rate if left untreated. We present a case of ruptured gastroduodenal artery pseudoaneurysm in a 68-year-old male with acute pancreatitis presenting with fatal gastrointestinal and retroperitoneal bleeding that was successfully managed with endovascular coil embolization of the involved vasculature. Patients with hemorrhagic pancreatitis or those presenting with unexplained retroperitoneal or gastrointestinal bleeding in the setting of pancreatitis with an unexplained drop in hematocrit or sudden expansion of pancreatic fluid collection should be screened in a timely manner for pseudoaneurysm using CT angiogram of the abdomen, which is the gold standard imaging modality to identify pseudoaneurysms. Once pseudoaneurysm is diagnosed, it should be treated immediately. Endovascular treatment options are now favored over surgical options in most cases

Effect of Students Attitude Towards Mathematics on their Mathematical Achievement at Secondary School Level

The effect of student’s attitude on mathematical achievement has gathered tremendous attention from various researchers. However, there is a degree of inconsistency in the findings regarding these effects. The aim of the study was to find out the effect of students’ attitude towards Mathematics on their mathematical achievement at secondary schools in AJ&amp;K. The objectives of the study were; to analyze students’ attitude in Mathematics at secondary level, to compare students’ attitude and academic achievement in Mathematics (gender wise) in AJ&amp;K and to find out the effect of students’ attitude on Mathematical achievement at secondary level in AJ&amp;K. The research was descriptive and quantitative in nature  and cross-sectional survey was used to collect the data. All the students of 10th class of Govt. Secondary Schools in District Bagh AJ&amp;K were the population of the study. There were 1076 students (458 boys and 618 girls) studying in 10th class in Government Secondary Schools of District Bagh. Sample was taken using Stratified random sampling technique. The researcher selected 444 students (192 male and 252 female) using proportionate stratified random sampling technique. The researcher developed five-point Likert scale questionnaire to collect the data. It was concluded that attitude had an impact on the mathematical achievements of the students. Parents’ education, qualification and social status had positive effect on academic achievements of students. It is recommended that students may be encouraged to achieve mathematical goals

Facile, polyherbal drug-mediated green synthesis of CuO nanoparticles and their potent biological applications

Copper oxide nanoparticles (CuO NPs) were synthesized using ayurvedic medicine septilin. The septilin-mediated CuO NPs were characterized using UV–Vis, fourier-transform infrared spectroscopy, X-ray diffraction (XRD), scanning electron microscope (SEM), and transmission electron microscope (TEM). The average particle size of CuO NPs was 8 nm as evident from TEM. Minimum inhibitory concentration of CuO NPs against Escherichia coli, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), and Candida albicans was found in the range of 1–2.5 mg·mL−1. CuO NPs dose-dependently decreased the biofilm formation from 0.0315 to 2 mg·mL−1, at the highest dose of 2 mg·mL−1 of CuO NPs; 92.91%, 79.84%, and 71.57% decrease in biofilm was observed for P. aeruginosa, MRSA, and C. albicans, respectively. Down-regulation of biofilm upon treatment with nanoparticles (NPs) was also observed by SEM analysis. SEM analysis also showed the change in morphological structure, and deformities in bacterial and fungal cells upon treatment of NPs. Furthermore, the anticancer efficacy of NPs was assessed using colon cancer (HCT-116). The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay clearly showed the anticancer potential of NPs, as the concentration of CuO NPs increased, the number of viable cells decreased. The produced CuO NPs have promise for future investigations in many biological and therapeutic domains, including the treatment of microbial biofilm infections, as well as the inhibition of cancer cell growth