66 research outputs found

    Comparison of clinical and CSF profiles in children with tuberculous and pyogenic meningitis; role of CSF protein: Glucose ratio as diagnostic marker of tuberculous meningitis

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    Objectives: To compare the clinical and laboratory features of tuberculous meningitis with bacterial meningitis and to determine if protein glucose ratio in the cerebrospinal fluid can be predictive of the condition.Methods: It was a retrospective descriptive study at the Paediatric Ward of Aga Khan University Hospital, Karachi, for which records of 46 patients with tuberculous meningitis and 33 with bacterial meningitis were reviewed. All records related to the study period that was from January 2005 to October 2010. The records were retrieved in December 2010. Tuberculous meningitis was defined as illness \u3e or = 14 days, basal enhancement or tuberculoma on computerised tomography scan and response to anti-tuberculous therapy. Pyogenic meningitis was defined by the presence of a pathogenic isolate inthe cerebrospinal fluid (bacterial culture) or by positive latex particle agglutination or a pathogen on cerebrospinal fluid gram stain and clinical improvement with antibiotics. Logistic regression was used to model the probability of having tuberculous meningitis. To define the optimal protein-glucose ratio, cutoff point for the diagnosis of tuberculous meningitis, a receiver operating characteristic curve was applied. All analysis were done using SPSS 16.Results: Features predictive of a diagnosis of tuberculous meningitis were protein:glucose ratio of \u3e or = 2 (OR 21 95% CI 4.7-93); cerebrospinal fluid total leukocyte count \u3c 800 (OR 58, 95% CI 5-649); and the presence of hydrocephalus (OR 19, 95% CI 3.3-109).Conclusion: A set of simple clinical, laboratory and radiological criteria can help in predicting tuberculous meningitis. The value of cerebrospinal fluid protein:glucose ratio needs to be validated in larger studies with bacteriologically-confirmed cases of tuberculous meningitis

    School health education program in Pakistan (SHEPP)-A threefold health education feasibility trial in schoolchildren from a lower-middle-income country

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    Background: The school environment plays an essential role in promoting health education and physical activity for children and adolescence, and they are more likely to adapt it into their adulthood. School health education program has been endorsed and emphasized by the World Health Organization has not been implemented in true spirit in Pakistan yet. We aim to test feasibility of threefold health education program in children and its potential efficacy on physical activity and diet and cardiometabolic risk factors by including BP, BMI, and waist circumference.Methods: It is a parallel-group feasibility intervention trial. It is being conducted in two schools from lower to middle-income areas, at different locations but having the same school curriculum under the Aga Khan Education Service, Pakistan (AKESP). All children aged 9-11 years enrolled from the schools mentioned above were included. Children with any physical disability were excluded. One school received threefold intervention (focused on children, parents, and teachers) of school health education program in Pakistan (SHEPP) while the other school continued routine activity. Intervention of SHEPP is directed towards educating children, parents, and teachers about healthy behaviors. Children will receive interactive educational sessions and specially designed physical activity sessions. A 3-h health education session focusing on same healthy behaviors as for children will be conducted for both parents and teachers. Primary outcome is feasibility of SHEPP in terms of recruitment, retention, and treatment fidelity. Secondary outcomes are physical activity levels, dietary intake (of fruits, vegetable), and cardiometabolic risk factors (blood pressure, BMI, and waist circumference (WC)). The total number of children recruited were 982 (82.5 %); 505 from school A and 477 from school B and 496 (50.5) were boys.Conclusion: SHEPP is a unique health education program for children as it focuses on children while involving the parents and teachers in the behavior change process. If found feasible and demonstrating potential efficacy on physical activity, dietary behaviors, and cardiometabolic parameters, we will be able to replicate this on a larger scale in public sector schools also

    Assessment of macronutrients consumption in the diet of adolescent school children in four seasons: A longitudinal study from an urban city in Pakistan

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    Background: A healthy diet in the adolescence period is essential for physical, mental, and immunological development. We aimed to assess macronutrient consumption in the diet of adolescent school children using 24 h recalls in four seasons of the year.Method: This was a longitudinal study conducted from February 2014 to June 2015. The study population included 155 school children aged 7-14 years from an urban school in Karachi. 24HR recall was conducted on 4 random days of the 4 main seasons. A food composition table was developed where the weight, calories, carbohydrate, fat, and protein content of the food items were listed. Macronutrients quantification was calculated by using proportional weight from the food composition table. Food groups were also assigned to each food item including vegetables, fruits, grains, protein foods, dairy products, and oils.Results: A total of 155 adolescent children aged between 7 and 14 years were approached. Out of the 155 preadolescents and adolescents, 150 (96.7%) agreed to participate. The mean (SD) age of the children was 11.31 (1.6) years, and 59% of all the children were males. Overall mean (SD) daily intake for all seasons was 195.31 (86.87) grams of carbohydrates, 94.77 (71.87) grams of proteins, and 55.87 (30.79) grams of fats. Carbohydrates formed 48.16%, protein 21.92%, and fat 29.93% of the total caloric intake. The mean (SD) daily caloric intake was 1517 (644) grams. Overall, the highest source of calories was from carbohydrate 781 (347) Kilocalories (Kcal), followed by fat 502 (277) Kcal and protein 379 (287). The Carbohydrate intake in 24 h was highest in the autumn; 212.81 (85.37), and there was a significant difference in carbohydrate intake in all seasons (p value 0.003). Consumption of discretionary food group was high (31.3%), and consumption of fruits and vegetables was low (29%).Conclusion: The study reports a suboptimal caloric intake of fewer than 2000 cal/day among the adolescents from school. The highest source of calories was from carbohydrates.The highest consumption of food was in autumn and the least in summer. Fruits and vegetable intake was low, and discretionary food intake was high

    COMPARISON OF SELF-REPORTED PHYSICAL ACTIVITY AND WEARABLE DEVICE-XIAOMI MI2 BAND IN PREADOLESCENT SCHOOL CHILDREN-A PILOT CROSSESCTIONAL STUDY

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    International Journal of Exercise Science 17(7): 565-575, 2024. The purpose of this study is to compare physical activity measured by the wearable device Xiaomi Mi2 Band and self-reported physical activity by YPAQ in preadolescent school children. A pilot cross-sectional study was performed on a subsample (5%=n=60) of preadolescent children within a parallel-group feasibility intervention trial (n=1000). All children aged 9-11 years enrolled in the schools were included in the study and children with any physical disability were excluded. Self-reported physical activity was recorded through the modified version of the Youth Physical Activity Questionnaire (YPAQ) and automatic physical activity was measured by the Xiaomi Mi2 band over 7 days. Data from the Xiaomi Mi2 band was synchronized with its mobile application from where data was transferred to an excel sheet. Data on 7-day total physical activity in minutes and 7-day total step count were recorded by the Xiaomi Mi2 band. Student’s t-tests were used to determine whether significant differences were present between self-reported physical activity and by Xiaomi Mi2 band. A Bland-Altman method was also used to assess the degree of agreement between the two methods of measuring physical activity. Mean ± SD age of the children was 9.6 (± 1.0) years and 31 (51.7 %) were boys. The mean ± SD time spent in physical activity reported by YPAQ was 457.5 (± 136) minutes and by the Xiaomi Mi2 band was 594.7 (± 183) minutes. The Bland-Altman plot identified a mean bias between the methods (YPAQ and Xiaomi Mi2 band) of -157.6 (95% CI: 296.3, -611.0) minutes of 7-day physical activity. Physical activity measured by a wearable device, the Xiaomi Mi2 band can give overestimated values of physical activity compared to self-reported physical activity in preadolescent school children. However, when PA is measured through step counts by the Xiaomi Mi2 band converted to minutes, it is comparable to PA measured by YPAQ

    Description of Sivalhippus (Equidae: Perissodactyla) from the Late Miocene Siwalik Sub-Group of Pakistan

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    New fossil mandible as well as isolated upper and lower dentitions of the late Miocene Hipparionine species, have been discovered from a locality of Chakwal, Punjab, Pakistan. By using morphometric and morphologic analysis, we have deduced that these specimens belong to Sivalhippus theobaldi. The body size of this species was intermediate between Sivalhippus perimensis and Hipparion antilopinum while its hypsodonty indicates that this species was a grazer to a larger extent which existed in mosaic of woodland and grassland in the Latest Miocene. However, the comparison with the recent horse (Equus caballus) mandible indicates some differences in dental and jaw lengths. The recent horse tends to have bigger and longer molars (higher hypsodonty indices) which may be attributed to a response towards changing vegetation, started at the end of the Miocene (ca. 6-7 Ma) strengthening the hypothesis that adaptive physiologies are a response towards a changing climate

    Enhancing hydrogen production from steam electrolysis in molten hydroxides via selection of non-precious metal electrodes

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    © 2020 Hydrogen Energy Publications LLC There are still gaps in the field of reference electrode that is needed to assist electrolysis in high temperature electrolytes (e.g. molten hydroxides) for H2 gas production. This research aims to fill the gaps by preparing Ni/Ni(OH)2 reference electrode and more importantly testing its effectiveness against important performance factors including; ion conducting membrane (e.g. mullite tubes), internal electrolyte composition, working temperature and electrochemical control (e.g. potential scan rate). Then, this reference electrode was used to study the electrocatalytic activity various cheaper working electrode materials including; stainless steel (St.st), Ni, Mo and Ag in comparison with Pt by the means of chronoamperometry and voltammetry. The effect of introducing steam into electrolyte (eutectic mixture of NaOH and KOH) on the electrocatalytic activity of these working electrodes was also studied. It was observed that the potential of hydrogen evolution with different working electrodes followed an order as; Pt > Ni > St. st > Ag > Mo (positive to negative). The performance of each working electrode was confirmed through chronoamperometry for hydrogen evolution at a constant potential of −0.7 V. It was also found in cyclic voltammetry and confirmed by chronoamperometry that the introduction of steam was apparent as increasing the current density at cathodic limit for hydrogen evolution. This study could help to develop non-precious metal electrodes for the production of hydrogen fuel. In future, there will be a potential in the threshold concentration of steam for H2 gas production

    Electrochemical study of different membrane materials for the fabrication of stable, reproducible and reusable reference electrode

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    © 2020 Fabrication of stable, reproducible and reusable reference electrodes for low energy and high-temperature steam splitting is of great interest for hydrogen fuel production without anthropogenic carbon dioxide (CO2) emission. This study has been conducted for the detection of suitable material for the fabrication of novel reference electrode. In the present scenario, this research is designed to fabricate a novel nickel reference electrode by using operating conditions of eutectic molten hydroxide (NaOH-KOH, 49–51 mol%) at temperature 300 °C in an ion-conducting membrane of alumina and mullite tube. Afterwards, the designed nickel reference electrode has been examined for its reusability and stability by using electrochemical technique and cyclic voltammetry. Five scans of cyclic voltammetry are performed for both membrane fabricated reference electrode. A slight positive shift in oxidation peaks is observed for mullite membrane electrode (64 mV from scan 1 to 5). The stability measurements are noted by changing the scan rate between 50 and 150 mV s−1. Furthermore, the results show that the Ni/Ni(OH)2 reference electrode covered with a mullite membrane is stable and reusable at 300 °C temperature without any deterioration. The stability and reusability of prepared nickel reference electrode covered by mullite tube in the eutectic molten hydroxide were up to 9 days to carry out an electrochemical investigation, while for alumina tube reference electrode the stability and reliability were up to 3 days. The internal electrolytic material and ionic conductance can play an important role for future studies with this reference electrode along with optimisation of temperature and scan rate parameters

    Synthesis of 5-Fluorouracil Cocrystals with Novel Organic Acids as Coformers and Anticancer Evaluation against HCT-116 Colorectal Cell Lines

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    5-Fluorouracil (5-FU) being a mainstream anticancer drug is under keen and detailed investigation for prodrugs formulations in order to minimize the associated side effects. Cocrystallization of 5-FU is an innovative technique for the synthesis of 5-FU prodrugs to improve its anticancer effectiveness. The present study is based on the synthesis of 5-FU supramolecular synthons with four coformers: succinic acid, cinnamic acid, malic acid, and benzoic acid utilizing acetone as a solvent. Solid state grinding followed by a slow evaporation solution method was applied. Colorless clear crystals were obtained in all the cases. The cocrystal formation was supported with the help of Fourier transform infrared (FTIR) spectroscopy and powder X-ray diffraction (PXRD). Through FTIR, the main peaks of interest in the spectrum of 5-FU were N–H (3409.02 cm–1) and carbonyl group (1647.80 cm–1), which were prominently shifted in all spectra of the cocrystals demonstrating the replacement as well as the development of already present interactions with the new ones. For 5-FU–cinnamic acid cocrystals, the anticipated peaks were observed at 1673.13 cm–1 (−C═O) and 3566.89 cm–1 (N–H) manifesting a significant change in comparison to 5-FU. Furthermore, with the help of PXRD characterization, the representative peak of 5-FU was recorded at 2θ = 28.80°. The shifting of this specific peak and development of many new ones in the spectra of cocrystals proved the development of new structural entities. Finally, the anticancer activity of all cocrystals was evaluated in comparison to that of API. All cocrystals manifest significantly greater growth inhibition potential than the main active pharmaceutical ingredient. 5-FU–Cinnamic acid (3C) was the one that proved to be the most potent anticancer agent at all four concentrations: 4.82% (12 μg/mL), 34.21% (25 μg/mL), 55.08% (50 μg/mL), and 67.29% (100 μg/mL). In short, this study proved to be a true example to enhance the anticancer potential of 5-FU following fairly easy fabrication requirements of the cocrystallization phenomenon. After the successful synthesis of these supramolecular synthons and subsequent enhancement of growth inhibition potential of 5-FU, these cocrystals can further be evaluated for in vivo trials and membrane crossing potentials in the future
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