Spectrum of Spinal Dysraphism in Pediatric Patients in a Tertiary Care Hospital

Objectives:  To report the spectrum of spinal dysraphism presenting in pediatric patients admitted to the Department of Neurosurgery Lady reading hospital Peshawar. Material & Methods:  A descriptive case series was conducted and total of 89 patients (age between 2 months to 12 years) were included who underwent the surgical treatment. All patients were examined for clinical and radiological diagnosis of spinal dysraphism. Results:  The average age at treatment was 23 ± 39.77 months. The most recurring (52.8%) presenting symptom was the swelling on the back followed by lower limb weakness. Meningocele was reported in 11.2%, myelomeningocele in 47.2%, myelomeningocele & hydrocephalus in 12.4%, tethered cord syndrome in 25.8%, and diastematomyelia 3.4% of patients. Excision combined with the repair was done in 58.4%, release & repair done in 29.2% and endoscopic third ventriculostomy/ventriculoperitoneal shunts with the repair were done in 12.4% patients. Cerebrospinal fluid leak was reported in 3.7%, wound infection in 4.5% and mortality was reported in 3.4% patients. Conclusion:  Overall, a good outcome was reported in the majority of our patients. Surgical procedures like myelomeningocele’s excision & repair, tethered cord’s release & repair, and ETV/VP shunt in patients with hydrocephalus can lead to satisfactory clinical outcomes

Positivity of Lumbar Puncture for Acute Bacterial Meningitis among Children Presenting with First Febrile Seizure

OBJECTIVES: To determine the frequency of lumber puncture-proven acute bacterial meningitis among children with fever and seizures of first onset.METHODOLOGY From March 2020 to March 2021, a hospital-based descriptive cross-sectional study was conducted at the paediatrics department of Hayatabad Medical Complex Peshawar. The sample size for a total of 342 people was estimated using WHO software. The study included all children who had first-onset febrile seizures through OPD and the emergency department. All children underwent lumber punctures using a stringent aseptic procedure, and the hospital laboratory received the samples to look for bacterial meningitis. On a pre-made Proforma, details including name, age, and gender were entered. The gathered data were input into the computer for additional SPSS analysis (version 23).RESULTS Most individuals were male and were lies in the 21-40 months of age group. Mean weight and length/height were evaluated, respectively. The majority had a history of 6-10 days of disease duration. Bacterial meningitis was found significantly (p<0.05) associated with age, gender and neurological deficit, while non-significantly (p>0.05) associated with the duration of diseases.CONCLUSION All children between the ages of 6 months and 60 months who presented with episodes of fever and seizures were found to have a statistically significant (p<0.05) association found among bacterial meningitis and age groups

Ki-67 expression in astrocytomas

Objective: To apply immunohistochemical marker Ki-67 and to check it’s expression in various types of Astrocytomas according to their grades. Methodology: The cross sectional study was conducted in Pathology department, Federal Government Services Hospital (Polyclinic), Islamabad  from July to December 2015. All patients having diagnosis of astrocytomas grade II, III and IV on histopathology were included in the study. Microscopic examinations were carried out for accurate diagnosis and grading of astrocytomas. Immunohistochemical staining for Ki-67 was done and the percentage of cells with positive Ki-67 nuclear staining was determined. Quotients (positively stained tumor cells/totally counted tumor cells) were calculated as percentage and rounded to nearest integer. Result: A total of 212 patients were included in the study. The mean age of the patients was 40.16 ± 12.763 years (Range 20 to 76 years). Majority of the patients (32%) were in age range of 30-40 years. In this study, 110 of 212 patients (51.9%) were males while 102 patients (48.1%) were females. Among the three types of Astrocytomas, Glioblastoma multiforme (WHO grade IV) was the most common variant. Overall Ki-67 staining was positive in 168 of 212 specimens (79.2%) and most commonly was in Glioblastoma multiforme WHO grade IV being 96.3%.  Stratification of Ki-67 expression in tumors was also done according to age and gender of cases. P-value was found significant after stratification (P <0.05) Conclusion: Ki-67 staining was positive in 79.2% cases of Astrocytomas and most commonly (96.3%) positivity was in Glioblastoma multiforme WHO grade IV. Increasing values of Ki-67 are associated with increasing grade of malignancy

A prospective hospital based study of relation between carotid artery intimal medial thickness in patients with type 1 diabetes

Background: The aim of this study was to found association between Type 1 Diabetes Mellitus and Carotid Arterial Intimal Thickness (CIMT).Methods: Study design: It was a prospective case control hospital-based study. One hundred type 1 diabetes patient between the age group 3-36 years were taken. The association between type 1 diabetes with CIMT was studied. All the measurements were standardized. 50 age and sex matched controls were taken for comparison.Results: There is positive correlation between type 1 diabetes and CIMT (p<0.0001). The correlation further extends between duration of diabetes, glycemic control, age of onset, frequency and severity of diabetic related complication with CIMT.Conclusions: Carotid atherosclerosis as measured by CIMT has definite association with type 1 diabetes

The Challenges Experienced during Data Collection on Pensioners’ Time Use in Bahawalpur Division, Pakistan

Collecting data is a crucial part of the research process. In this article we highlight the problems and challenges we encountered while collecting data for the time use of pensioners in Pakistan, a developing country. We faced some anticipated as well as unanticipated problems and challenges while conducting interviews with pensioners for our research. The unforeseen challenges included inappropriate conduct of data providers with a female researcher, lack of funds, time management issues, a decline in response, and security issues in the field. We end the article with the recommendations to overcome those challenges and hence improving the data collection procedure and providing guidelines for societal data collection not only in rural Punjab, Pakistan, but indeed for those working in any underdeveloped and rural society

Chemical Profiling and Bioactivities of Selective Organic Compounds from Fruits of Olea ferruginea and its Comparison with Olea europaea

This study evaluate the chemical profiling and bioactivities of selective organic compounds from fruits of Olea ferruginea and its comparison with Olea europaea from three unexplored locations of Pakistan. The oil was characterized into fatty acids by GC-MS and FT-IR. Antioxidant activities were detected by DPPH, ABTS and H₂O₂ scavenging bioassays. For cytotoxicity, Brine-Shrimp-Cytotoxicity-Bioassay was tested. The extracted oil was checked against five bacterial strains. Higher quantity of phytochemicals and yields of oil were present in fruit of Olea ferruginea collected from Malakand as compared to other locations. Prominent inhibitory activity against E.coli and S.aureus was observed during antibacterial assay. Good quality oil with antioxidant properties obtained from fruit of Olea ferruginea from Malakand. The comparative studies revealed the same qualitative composition of both species but Olea europaea showed greater oil-yield than Olea ferruginea. In consequence, the wild species Olea ferruginea was found to be economical, wild and drought tolerant. This work is licensed under a Creative Commons Attribution 4.0 International License

Nosocomial Transmission of SARS CoV-2 in a Tertiary Care Hospital in Peshawar, Pakistan

Objective The study aimed to determine the frequency of nosocomial transmission of severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) in a tertiary care hospital in Peshawar, Pakistan. Methodology This cross sectional, analytical study was carried out in Hayatabad Medical Complex, Peshawar, Pakistan from 1st June 2021 to 31st August 2021. Consecutive patients aged 18 years and above admitted for conditions other than COVID-19 with a negative rapid antigen test for COVID-19 at admission were included. Patients with respiratory symptoms or those who were hospitalized for any reason in the preceding six weeks in any health care facility were excluded. The study protocol was completed by 90.9% of participants. The rapid antigen test was repeated for participants at the time of discharge or symptoms suggestive of COVID-19. Patients with a positive rapid antigen test for COVID-19 either at the time of discharge or symptom onset were considered to have acquired nosocomial SARS-CoV-2 infection. Statistical Package for the Social Sciences version 21 for Windows was used for data analysis. Results The frequency of nosocomial transmission of SARS-CoV-2 was 2.7% (13/482). Patients with nosocomial COVID-19 stayed longer in the hospital than those who tested negative (7.5±4.0 versus 4.8±3.6 days; p=0.006). Age (p=0.796), gender (p=0.453), department of inpatient stay (p=0.943), major surgery (p=0.678), minor surgery (p=0.576), and visit to the radiology department (p=0.707) did not affect nosocomial spread of SARS-CoV-2. Conclusion Nosocomial transmission of COVID-19 was infrequent, accounting for 2.7% of participants in this study

Predictors of Outcome of Bronchiolitis in Children Using Children Hospital of Wisconsin Respiratory Score: An Experience of a Tertiary Care Hospital

Objective: To study the correlation of CHWR score and its various clinical markers with the length of stay in hospital bronchiolitis. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Pediatrics Combined Military Hospital, Lahore Pakistan, from Nov 2018 to Apr 2019. Methodology: This study included children aged 2 to 24 months, clinically diagnosed with bronchiolitis. The Receiver Operator Characteristic (ROC) was used to determine the discriminative validity of the CHWR score in predicting the length of stay. Results: One hundred thirty-eight children of either gender were enrolled in the study. The median age of the study population was 10.8 (9) months. ROC curve showed significant discriminate validity of CHWR score and its component criterion on admission. CHWR score of >10.5 predicted a longer stay (>24 hours) in ICU. Pearson correlation showed a statistically significant positive correlation between CHWR score at admission and length of stay (r=0.831, p=<0.001). Conclusion: CHWR scoring system on admission is an easy, safe and effective way to classify bronchiolitis severity and thus help predict the length of stay

A Taxonomy of Text Mining

With a rapid increase in the volume of textual data on the Internet, extracting useful information through innovative text mining techniques has become crucial. In this context, terminology jargon in the literature related to text-mining creates ambiguity and has made it very difficult for researchers to focus in a specific direction and bring innovation. For example, review mining and opinion mining may have different applications, however, from a technical perspective, they are very similar. In this paper, we propose a classification of the text mining terminologies from the perspectives of technical and text-mining processes. The classification is based on a comprehensive literature survey and analysis. This research study presents a clear classification of text mining terminologies based on technical and text mining processes to resolve the issue of terminology jargon. By utilizing the proposed classification, researchers will be able to easily choose a specific direction instead of diverging amongst similar research problems, thereby, driving innovation. Further, the proposed classification will help advance and improve the overall research progress in all text-mining related fields