SCEIP: Analysis Study for Deploying Cloud Services in Educational Institutions of Pakistan

For underdeveloped countries like Pakistan, education is very important to be at par with the developed countries. Education plays a vital role in the development and prosperity of the country. Cloud computing has been an essential part of education during the last few years. We have conducted a cost benefit analysis on cloud deployment in government institutions. Our focus is to evaluate the costs and benefits of moving educational institutions data to cloud. We intend to investigate the cost required to implement cloud based structure in an institution and what benefits it will bring to it. We will be considering some specific universities for each sector: public and private. We have compared the cost of traditional system being followed in institutions and SAAS system which will be helpful for educational sector. We conducted a survey to investigate barriers involved in implementing cloud facilities in public institutions. The comparison shows the benefits of implementing SAAS model in institutions

DIAGNOSTIC ACCURACY OF FNAC IN DETECTION OF THYROID CARCINOMA

Background; Thyroid nodules are quite common and different imaging techniques are now used for diagnosis of thyroid nodules like radionucleotide scanning, high-resolution ultrasonography, etc. However, FNAC is still regarded as the single most accurate and cost-effective procedure, particularly if ultrasound is used as a guide for better sample collection, especially for cystic lesions. The current study was done to ascertain diagnostic accuracy of FNAC using histopathology as gold standard. Objective: To determine the diagnostic accuracy of FNAC in detection of thyroid carcinoma in patients with thyroid nodules using histopathology as gold standard. Material and Methods; A total of 120 patients were taken in this study. Both genders with thyroid nodules › 2 months aged more than 18 years were enrolled in our study. Patients receiving chemotherapy or radiotherapy, confirmed cases of thyroid carcinoma and previous history of any type of thyroid surgery were excluded from our study. Sample size was 120 specimens fulfilling the inclusion criteria received at the department of histopathology, Nishtar Hospital Multan. Results; Of these 120 study cases, 28 (23.3%) were male patients while 92 (76.7%) were female patients. Mean age of our study cases was 42.31 ± 8.40 years. Of these 120 study cases 104 (86.7%) were married while 16 (13.3%) were un-married. Mean disease duration was 8.34 ± 3.91 months while 76 (63.3%) had disease duration more than 6 months and 66 (55%) had more than 10 cm size of nodule. Only 8 (6.7%) of these patients were using Iodine in their diet while remaining 93.3 % were not using Iodine supplemented diet. FNAC results revealed that thyroid carcinoma was present in 39 (32.5%) while histopathology documented thyroid carcinoma was present in 31 (25.8%) of our study cases. Sensitivity of FNAC was 87 %, specificity was 86.51 %, diagnostic accuracy was 86.66 %, positive predictive value was 69.23 % and negative predictive value was noted to be 95.06 %. Conclusion; Fine needle aspiration cytology (FNAC) is a sensitive, specific, and accurate initial diagnostic test for the evaluation of patients with thyroid swellings. It is highly reliable, easy to perform, cost-effective and accurate tool to differentiate a malignant lesion from a benign one with high accuracy. Keywords; Thyroid nodules, thyroid carcinoma, FNAC

ROLE OF GLYCEMIC CONTROL IN DEVELOPMENT OF DIABETIC RETINOPATHY

Background; Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM) and is considered the leading cause of visual impairment in working-aged adults worldwide. The duration of DM and hyperglycemia have been associated with DR, so this study was done to ascertain role of glycemic control in the development of diabetic retinopathy. Objective; To compare the frequency of DR in in type II diabetes having controlled and un-controlled diabetes. Subjects and Methods; A total of 175 type 2 diabetic patients presenting in Diabetes OPD aged 35 – 65 years were selected in this cross-sectional study from Diabetes outdoor clinic of Nishtar Hospital Multan. Patients underwent any form of retinal surgery / laser therapy, on ACE-inhibitors or ARBs, having cataract were excluded from our study. All patients had undergone retinal imaging using Non Mydriatic Fundus Camera (NIDEK® Model # AFC-330) and collected data was analyzed by SPSS version 22. Results; Of these 178 study cases, 73 (41.0 %) were male patients while 105 (59.0 %) were female patients. Mean age of our study cases was 50.39 ± 8.25 years. Mean age of the male patients was noted to be 57.36 ± 5.25 years while that female patients was 45.54 ± 6.24 years (p=0.000). Mean body mass index of our study cases was 26.12 ± 1.85 kg/m2 and obesity was present in 45 (25.3 %) of our study cases. Mean disease duration was 6.23 ± 3.28 years and 92 (51.7%) had duration of illness more than 5 years. Of these 178 study cases, 112 (62.9%) were illiterate and 66 (37.1%) were literate. Diabetes was controlled in 79 (44.4%) while it was un-controlled in 99 (55.6%) of our study cases. Diabetic Retinopathy was noted in 69 (38.8%) of our study cases. Diabetic retinopathy was 22.8% patients with controlled diabetes and 51.5% in patients with un – controlled diabetes. Conclusion; Very high frequency of diabetic retinopathy was noted in our study among diabetic patients having un-controlled diabetes as compared with those having controlled diabetes. Diabetic retinopathy was significantly associated with control of diabetes, residential status and prolonged disease duration. National health authorities must launch a mega awareness campaign at national level for awareness of diabetic patients leading to good glycemic control which will protect them from future hardships. Keywords; Diabetic retinopathy, controlled diabetes, frequency

Efficacy of the muscle energy technique versus the strain-counter strain technique on immediate deactivation of myofascial trigger points in upper trapezius muscle

Aims and objectives: Thisstudy aimed to check the comparative efficacy of the Muscle EnergyTechnique versus the Strain-Counter Strain technique on immediate deactivation ofmyofascial trigger points in the upper trapezius muscle. Study design: The study comprised acomparative analytical design to compare and contrast the two study interventions. Place andduration of the study: The research was conducted in the Department of Physical therapy,Allied hospital Faisalabad for 6 months. Patients and methods: Based on inclusion andexclusion criteria, 40 subjects were enrolled in the study using the convenient samplingmethod. The subjects were divided into two groups; group A (n=20) received a single sessionof baseline treatment with themuscle energy technique, while group B (n=20)received a singlesession of baseline treatment with the strain-counter strain technique. The subjects wereevaluated through the pressure-pain threshold (algometer), Numeric Pain Rating Scale, andModified Bournemouth Questionnaire as pre-intervention and post-intervention measuringtools for pain and functional status. Results: The data was analyzed using SPSS version 17.Within group analysis showed a significant difference between pre- values and post values ofpressure-pain threshold, Numeric Pain Rating Scale and Modified BournemouthQuestionnaire in both groups (P<0.05). Between group analysis was done using independentsample t test. It also showed significant difference (P<0.05) in post mean values between thetwo group subjects in all three outcomes. The post-mean values for the strain-counter straingroup were slightly more improved than the Muscle Energy Technique group. Conclusion:The strain-counter strain technique is found more effective than the Muscle Energy Techniquefor immediate deactivation of myofascial trigger points in the upper trapezius muscle

Association of APOA1-75G/A and +83C/T polymorphic variation with acute coronary syndrome patients in Kashmir (India)

Introduction: Acute coronary syndrome (ACS) comes under the ambit of cardiovascular disease.APOA-1 gene plays a vital role in lipid metabolism and has been observed to have plausible role in ACS. This cross sectional case-control study was conducted to evaluate association between APOA1-75G/A(rs1799837), +83C/T (rs5069) genotypes and risk for ACS. Methods: The current case-control study that included confirmed 90 ACS cases and 150 healthy controls were genotyped for APOA1-75 G/A and +83 C/T by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLF) method. Results: APOA1-75G/A distribution of genotypes/alleles among cases and controls was seen proportionally same with no association to ACS (P = 0.5). APOA1+83 C/T variants showed protective effect with ACS where variant TT genotype presented more in controls (12%) than cases (1.6%) (P = 0.004) and likewise variant ‘T’ allele was found more in controls than ACS cases (9.4% vs.28.5% respectively: P < 0.05). Further, significantly high difference of CT genotype was seen among cases and controls 15% vs. 33% respectively (P = 0.002). The overall distribution of different haplotypes showed a marked difference in GT when compared with GC between cases and controls (P = 0.0001). Conclusion: The study shows that TT genotype and variant T allele of APOA1 +83 C/T depicted a protective role with respect to ACS whereas APOA1-75G>A showed no relation. Haplotype GT was observed to significantly over-represent in controls with its protective effect in ACS as against wild type haplotype GC

Implications of risk conferred by 5p15.33 loci genetic variants; human telomerase reverse transcriptase rs2736098 and rs2736100 in predisposition of bladder cancer

Background: The polymorphic variations of human telomerase reverse transcriptase (hTERT) gene play an important role in predisposition to carcinogenesis. The current study aimed to elucidate the genetic predisposition to bladder cancer in two important variants, rs2736098 and rs2736100 of hTERT gene. Materials and methods: Confirmed 130 patients of bladder cancer and 200 healthy controls were genotyped by PCR-RFLP to determine different variants of hTERT rs2736098 and rs2736100. Results: hTERT rs2736098 homozygous variant AA genotype frequency was observed to significantly differ 2-fold between cases and controls (26.15% vs. 13.5%) (p = 0.02). In addition, rare ‘A’ allele significantly differed among two groups (cases: 47% versus controls: 39%: p = 0.03). hTERT rs2736098 was observed to be presented significantly more in high stage tumors (p = 0.02). hTERT rs2736100 genotype AA or variant allele A showed no significant difference between cases and controls. Haplotype CA displayed significantly different pattern of frequency as 0.5 in cases as compared to 0.16 in controls (p < 0.0001). Combination of variant A/G haplotype frequency implicated more in cases than in controls (0.34 vs. 0.16, p = 0.001). Conclusions: It is concluded that hTERT rs2736098 polymorphic variant has a vital role to confer a strong risk to bladder cancer in our population. Further, hTERT haplotypes CA and AG inhTERT could prove to be a promising tool to screen the risk for bladder cancer

Relation of color doppler twinkling artifact and scale or pulse repetition frequency

Objective: The aim of this study is to determine the effect of scale/pulse repetition frequency (PRF) on the appearance of color Doppler twinkling artifact. Materials and Methods: We commenced this cross-sectional study for 20 months from November 2014 to July 2016. During routine ultrasound examination, we observed multiple case of twinkling artifact produced by renal stones, calcifications in the thyroid nodules, bony fragments and intestinal gases, etc., We observed twinkling artifact with low- and high-PRF settings in 500 different structures. A total of 500 other structures were included wherein there was no Doppler twinkling artifact produced by them, with usual optimum PRF settings. These structures were also evaluated with low- and high-PRF to determine the effect of PRF on twinkling artifact effectively. All the patients were examined according to the AIUM guideline for appropriate examination protocol. Data were collected from the observation of twinkling artifact with low- and high-PRF/scale and evaluated with the help of IBM SPSS 24 package, the results were summarized as follow. Results: Change in scale/PRF could not affect the twinkling artifact. The twinkling artifact observed with low-PRF was the same as seen with high-PRF. There was a significant agreement between low- and high-PRF in the production of color twinkling artifact. The kappa value of agreement was estimated as 0.96, whereas the Pearson's correlation was significant with the value of 0.001. Same twinkling artifact was created with low- and high-PRF, with no significant variation. Conclusion: Twinkling artifact is independent of PRF/Scale

Diagnostic accuracy of sonoelastography in different diseases

The objective of this study was to evaluate the diagnostic accuracy of sonoelastography in patients of primary and secondary health care settings. Google scholar, PubMed, Medline, Medscape, Wikipedia and NCBI were searched in October 2017 for all original studies and review articles to identify the relevant material. Two reviewers independently selected articles for evaluation of the diagnostic accuracy of sonoelastography in different diseases based on titles and abstracts retrieved by the literature search. The accuracy of sonoelastography in different diseases was used as the index text, while B-mode sonography, micro pure imaging, surgery and histological findings were used as reference texts. Superficial lymph nodes, neck nodules, malignancy in thyroid nodules, benign and malignant cervical lymph nodes, thyroid nodules, prostate carcinoma, benign and malignant breast abnormalities, liver diseases, parotid and salivary gland masses, pancreatic masses, musculoskeletal diseases and renal disorders were target conditions. The data extracted by the two reviewers concerning selected study characteristics and results were presented in tables and figures. In total, 46 studies were found for breast masses, lymph nodes, prostate carcinoma, liver diseases, salivary and parotid gland diseases, pancreatic masses, musculoskeletal diseases and renal diseases, and the overall sensitivity of sonoelastography in diagnosing all these diseases was 83.14% while specificity was 81.41%. This literature review demonstrates that sonoelastography is characterized by high sensitivity and specificity in diagnosing different disorders of the body

Wartość diagnostyczna sonoelastografii w różnych jednostkach chorobowych

The objective of this study was to evaluate the diagnostic accuracy of sonoelastography in patients of primary and secondary health care settings. Google scholar, PubMed, Medline, Medscape, Wikipedia and NCBI were searched in October 2017 for all original studies and review articles to identify the relevant material. Two reviewers independently selected articles for evaluation of the diagnostic accuracy of sonoelastography in different diseases based on titles and abstracts retrieved by the literature search. The accuracy of sonoelastography in different diseases was used as the index text, while B-mode sonography, micro pure imaging, surgery and histological findings were used as reference texts. Superficial lymph nodes, neck nodules, malignancy in thyroid nodules, benign and malignant cervical lymph nodes, thyroid nodules, prostate carcinoma, benign and malignant breast abnormalities, liver diseases, parotid and salivary gland masses, pancreatic masses, musculoskeletal diseases and renal disorders were target conditions. The data extracted by the two reviewers concerning selected study characteristics and results were presented in tables and figures. In total, 46 studies were found for breast masses, lymph nodes, prostate carcinoma, liver diseases, salivary and parotid gland diseases, pancreatic masses, musculoskeletal diseases and renal diseases, and the overall sensitivity of sonoelastography in diagnosing all these diseases was 83.14% while specificity was 81.41%. This literature review demonstrates that sonoelastography is characterized by high sensitivity and specificity in diagnosing different disorders of the body.Celem badania była ocena dokładności diagnostycznej sonoelastografii u chorych leczonych w warunkach placówek podstawowej i specjalistycznej opieki zdrowotnej. W październiku 2017 roku dokonano przeglądu baz danych Google Scholar, PubMed, MEDLINE, Medscape, Wikipedia oraz NCBI w celu pozyskania prac oryginalnych i poglądowych, które stanowiły materiał do badania. Prace wybierało dwóch badaczy niezależnie. Oceniono dokładność sonoelastografii w diagnostyce różnych chorób na podstawie tytułów i streszczeń wyszukanych prac. Główny termin stanowiła „skuteczność sonoelastografii w diagnostyce różnych chorób”, a terminy „ultrasonografia w trybie B-mode”, „obrazowanie MicroPure”, „zabieg operacyjny” i „wynik badania histopatologicznego” stosowano jako terminy referencyjne. Badane patologie dotyczyły: powierzchownych węzłów chłonnych, guzków okolicy szyi, złośliwych guzów tarczycy, łagodnych i złośliwych zmian w węzłach chłonnych szyjnych, guzków tarczycy, raka gruczołu krokowego, łagodnych i złośliwych zmian w piersiach, chorób wątroby, zmian w śliniankach przyusznych i gruczołach ślinowych, zmian w trzustce, chorób układu mięśniowo-szkieletowego oraz chorób nerek. Pozyskane przez dwóch badaczy dane dotyczące charakterystyki ocenianych prac oraz wyniki analizy przedstawiają tabele i ryciny. W sumie wyszukano 46 badań dotyczących zmian w piersiach, węzłów chłonnych, raka gruczołu krokowego, chorób wątroby, chorób gruczołów ślinowych i ślinianek przyusznych, zmian w trzustce, chorób układu mięśniowo-szkieletowego i chorób nerek, a ogólna czułość i swoistość sonoelastografii w diagnostyce tych chorób wynosiły odpowiednio 83,14% i 81,41%. Niniejszy przegląd literatury wskazuje na wysoką czułość i swoistość sonoelastografii w diagnostyce różnych chorób. Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/index.php/issues/volume-18-no-7