Risk Factors for Hypertension in Patients with Stroke Presenting to Tertiary Care Hospital

OBJECTIVES To determine the risk factors for hypertension in stroke patients presenting to the tertiary care hospital of Peshawar, Pakistan. METHODOLOGY This cross-sectional descriptive study was conducted in the Department of Medicine at Khyber Teaching Hospital, Peshawar. This study spanned months and included 225 patients of either gender who had stroke symptoms within the preceding 72 hours. Detailed information was documented in age (in years), residence, gender, educational qualification, family history of hypertension, smoking, diabetes mellitus, obesity, dyslipidemia, hypertension, and duration. SPSS version 26.0 was used.RESULTSThe age range of the participants were from 41 to 80 years, with a mean age of 61.004±6.69. The mean duration of hypertension was 3.052±0.85 years. Hypertension was seen in 42.2% of patients. Factors leading to hypertension in stroke patients were age 40.8%, urban area 42%, illiteracy 36.2%, positive family history 61.9%, diabetes mellitus 65.2%, smoking 33.3%, obesity 85.3%, and dyslipidemia 71.8%. CONCLUSION Significant risk factors for stroke include hypertension, diabetes mellitus, hypercholesterolemia, smoking, obesity, and positive family history

Comparison of Single-Stage Reverse Sural Artery Flap Versus Two-Staged Interpolated Flap in Distal Lower Limb Injuries

Background and Objective: Plastic surgeons face challenging conditions when dealing with soft tissue injuries or defects involving the lower part of the leg and the proximal part of the foot. The objective of the current study is to compare single-staged reverse sural artery flaps with two-staged interpolated flaps in distal lower limb injuries. Methods: It was a prospective study carried out at the Department of Plastic Surgery, Allama Iqbal Memorial Teaching Hospital, Sialkot, Pakistan, over 5 years from 2015 to 2020. Sixty-eight (n = 68) patients with distal lower limb soft-tissue defects were enrolled and randomly allotted a two-stage interpolated flap design (group A) or single-stage reverse sural artery flap design (group B). The measured outcomes included the frequency of flap-tip necrosis, epidermolysis, partial or total flap loss, and additional procedures needed for managing these complications. Results: Out of all the patients, 72% were of male gender and 28% were females with a mean age of 38.38 &plusmn; 10.76 years. In group A, there were 6% of the cases where tip necrosis was the only impediment as compared to 17% in group B. In patients of group A, epidermolysis was seen in 12% as compared to 35% in group B whereas only 6% of patients in group A required secondary procedures for flap tip necrosis as compared to group B (47%). Paired t-test was used to calculate the statistical significance of the outcome between the two groups (p-value of 0.0491). Conclusion: The two-staged interpolated flap procedure results in fewer complications as compared to a single-staged reverse sural artery flap procedure. However, the shorter hospital stay in single-staged flap design is satisfying for the patients who did not report any complications with this procedure.</p

Hydrogeochemical Mechanism Associated with Land Use Land Cover Indices Using Geospatial, Remote Sensing Techniques, and Health Risks Model

Land is a vital component of nature around the world and is essential for humans, terrestrial plants, and animals. However, urbanization is growing worldwide and the groundwater quality in urban areas is declining due to rapid development, industrialization, and pollution. Hence, it is important to determine the hydrogeochemistry and changes concerning land use and land cover (LULC). This study was conducted to investigate the hydrogeochemical mechanism of Sargodha, one of Pakistan’s fastest-growing cities, during 2015 and 2021 under two different LULC indices named normalized difference vegetation index (NDVI) and normalized difference built-up index (NDBI). Forty-eight groundwater samples were collected in 2015 and 2021 to assess groundwater quality for domestic use and irrigation. The Piper diagram revealed that (Ca2++Mg2+–HCO3−+CO32−) and (Na++K+–SO42−+Cl−) were the main components of hydrogeochemistry in both years. The Gibbs plot and silicate weathering of groundwater samples indicated that rock dominance and silicate weathering played a major role in aquifers. Additionally, the results showed that 4% of the groundwater in 2015 and 21% of the groundwater samples in 2021 were unfit for human consumption. However, 37% and 40% of samples were considered not fit for irrigation in 2015 and 2021, respectively. The LULC, NDVI, and NDBI clearly revealed higher urban areas in 2021 compared to 2015. The relationship between groundwater parameters and land use land cover indices (NDVI and NDBI) explained that none had a major relationship. The non-carcinogenic risk showed health quotient HQ 3−) exposure in the city. The current study suggests conducting future investigations considering a larger scale to recommend efficient management strategies, urbanization planning, and ensuring safe irrigation and drinking water to prevent groundwater pollution

Hydrogeochemical Mechanism Associated with Land Use Land Cover Indices Using Geospatial, Remote Sensing Techniques, and Health Risks Model

Land is a vital component of nature around the world and is essential for humans, terrestrial plants, and animals. However, urbanization is growing worldwide and the groundwater quality in urban areas is declining due to rapid development, industrialization, and pollution. Hence, it is important to determine the hydrogeochemistry and changes concerning land use and land cover (LULC). This study was conducted to investigate the hydrogeochemical mechanism of Sargodha, one of Pakistan&rsquo;s fastest-growing cities, during 2015 and 2021 under two different LULC indices named normalized difference vegetation index (NDVI) and normalized difference built-up index (NDBI). Forty-eight groundwater samples were collected in 2015 and 2021 to assess groundwater quality for domestic use and irrigation. The Piper diagram revealed that (Ca2++Mg2+&ndash;HCO3&minus;+CO32&minus;) and (Na++K+&ndash;SO42&minus;+Cl&minus;) were the main components of hydrogeochemistry in both years. The Gibbs plot and silicate weathering of groundwater samples indicated that rock dominance and silicate weathering played a major role in aquifers. Additionally, the results showed that 4% of the groundwater in 2015 and 21% of the groundwater samples in 2021 were unfit for human consumption. However, 37% and 40% of samples were considered not fit for irrigation in 2015 and 2021, respectively. The LULC, NDVI, and NDBI clearly revealed higher urban areas in 2021 compared to 2015. The relationship between groundwater parameters and land use land cover indices (NDVI and NDBI) explained that none had a major relationship. The non-carcinogenic risk showed health quotient HQ &lt; 1, indicating no severe health risk due to nitrate (NO3&minus;) exposure in the city. The current study suggests conducting future investigations considering a larger scale to recommend efficient management strategies, urbanization planning, and ensuring safe irrigation and drinking water to prevent groundwater pollution