Prevalence Of Peptic Ulcer In Patients Of Liver Cirrhosis Presenting With Upper Gi Bleed

BACKGROUND:  Although major cause of upper GI bleed in patients of liver cirrhosis is variceal bleed. However a significant proportion also presents with non-variceal bleeding (NVB). AIM: The aim of study is to determine the frequency of peptic ulcers in patients of liver cirrhosis presenting with upper GI bleed. METHODS: This descriptive cross sectional study was conducted in Gastroenterology section of medicine department at Benazir Bhutto Hospital from April 2017 to December 2018 . 672 patients of liver cirrhosis presenting with upper GI bleed were enrolled in study through non probability consecutive sampling. Upper GI endoscopy of all patients was performed by consultant Gastroenterologist and findings were documented on standardized Performa. RESULTS: 672 patients were included in study with mean age of 54.68 ±11.15. Among these 370 (55.1%) were males and 302 (44.9%) were females. 92 patients (13.1%) had peptic ulcer as cause of upper GI bleed. 112 patients (16.6%) had both peptic ulcer and variceal bleed as cause of Upper GI Bleed and endoscopic findings of remaining 468 patients (69.6 %) showed varices (oesophageal + gastric) as prime source of bleeding. CONCLUSIONS: In this study, peptic ulcer accounted for 13.1 % of all cases of UGI bleeding. Keywords: Peptic Ulcer, Variceal bleeding, Upper GI bleed, Cirrhosis

Comparison of risk factors and survival of type 1 and type II endometrial cancers

Objective: To compare risk factors and progression free survival of type 1 & 2 endometrial cancers.Methods: A retrospective analysis of 149 patients with early stage endometrial carcinoma treated between 1997 and 2012 in Aga Khan University Hospital, Karachi was performed.Results: A total of 149 patients were analyzed. Type I tumors accounted for 92% of cases in the study while 8% were type II tumors. The mean age, BMI, parity, co-morbidities (hypertension & Diabetes), family history and history of polycystic disease were comparable in both groups. Overall better survival (113 Vs 24 months) was observed for type I endometrial cancer.Conclusion: Both types of endometrial cancer may share common etiologic factors. Despite the limitation of small numbers in one group this study confirms better survival in type 1 endometrial cancer

Obstetric patients in intensive care unit: Perspective from a teaching hospital in Pakistan

Objective: Review of obstetric cases admitted to the intensive care unit.Design: Ten year retrospective review of individual patients\u27 medical records.Participants: Records of obstetric patients admitted from 2005-2014.Setting: Aga Khan University Hospital Karachi.Main outcome Measures: Diagnosis at the time of admission, associated risk factors, and intervention required aspects of management and rate of mortality.Findings: A total of 194 obstetric patients were admitted out of which 86.2% of patients had ventilator support. Mortality was not seen to be significantly associated with parity and antenatal/postnatal status. The median age of patients was 34 years, minimum length of stay was 24 hours and maximum stay was 53 days. Sixty one percent of patients were admitted to with organ system failure. The overall mortality rate was 21.64% (42/194). The mortality rate was five times more likely in patients who had gastro-intestinal complication {Odds Ratio=4.87; 95%CI: 1.65-14.36}. The largest group of patients {28.4%} presented with hematological diagnosis.Conclusion: When the intensive care unit admission became essential, primary diagnosis included: postpartum hemorrhage, hypertensive disorders, sepsis and infectious diseases. An increased vigilance of high-risk pregnant women and a stabilization of their condition before intervention is administered, improves the outcome of these women

Testing for explosivity in US-Pak Exchange Rate via Sequential ADF Procedures

Global Financial Crises (GFC) of 2007-08 has disclosed the fact that economists and policymakers were unable to foresee bubble in housing prices in the US and other countries that consequently triggered the economic downturn. However, serious attempts have been made afterwards by researchers towards early identification of asset price bubbles, so that necessary policy measures could be taken to avoid any future mishap. Current study is conducted in similar vein to identify bubbles in nominal Dollar to Pakistani Rs exchange rate, from January 1982 to May 2020. Whether any identified bubble in nominal exchange rate is a rational bubble or otherwise generated by fundamentals, nominal exchange rate is adjusted for traded goods price differential and non-traded goods price differential in two countries as there is growing trend to take underlying fundamentals into account while studying asset prices to get accurate results on bubble detection (Bettendorf and Chen, 2013; Jiang et al., 2015 and Hu & Oxley, 2017). Further to explore whether nature of bubble changes with regime switching from managed floating to flexible floating in Pakistan is an addition of the study. Results of Generalized sup Augmented Dicky-Fuller (GSADF) test show that traded goods fundamental fully explain the movements in exchange rates even when non-traded goods are taken into account. Exchange rates were volatile both in managed floating and flexible floating regimes. However, volatility in only managed floating regime can be attributed to traded goods price difference. Various explosive episodes have been observed during flexible floating regime, which are either collapse or collapse and recovery phases

Ecological niche model comparison under different climate scenarios: a case study of Olea spp. in Asia

Ecological niche modeling (and the related species distribution modeling) has been used as a tool with which to assess potential impacts of climate change processes on geographic distributions of species. However, the factors introducing variation into niche modeling outcomes are not well understood: To this end, we used seven algorithms to develop models (Maxent, GARP, BIOCLIM, artificial neural networks, support‐vector machines, climate envelope, and environmental distance) to estimate the potential geographic distribution of olives (Olea europaea sensu lato, including Olea ferruginea) under two climatic data sets (current 2000 and future 2050). Five general circulation models and two representative concentration pathway scenarios were used as predictor variables in future projections of the geographic potential of this species; models were fit at global extents (10′ spatial resolution) but transferred and interpreted for a region of particular interest in Central Asia, which largely avoids problems with truncation of niche estimates. We found marked differences among approaches in predicted distributions and model performance, as well as in the future distributional pattern reconstructed, from one algorithm to another. These general approaches, when model‐to‐model variation is managed appropriately, appear promising in predicting the potential geographic distribution of O. europaea sensu lato and thus can be an effective tool in restoration and conservation planning for wild populations, as well as possible commercial plantations of this species

Estimation of Genetic Divergence in 40 Elite Cotton Germplasm

Background: Identification and development of superior cotton genotypes and their further improvement has been one of the primitive aims of plant breeding programmers. Therefore, necessity of analyzing the agro-morphological and yield attributes of advanced lines of cotton is doubtless.Methods: Mean performance and correlation between ten different morphological, yield and fiber related attributes of forty cotton genotypes from all over the Pakistan under National Coordinated Varietal Trial were studied at Central Cotton Research Institute of Multan. Selected traits included several sympodial and monopodial branches, plant height, number of bolls per plant, staple length, seed cotton yield, boll weight, fiber strength, percentage ginning out turn and micronaire value.Results: Statistical analysis of variance disclosed highly significant (p<0.01) differences among all cotton genotypes for majority of the characteristics. Basic descriptive statistical analysis of selected agronomic traits revealed the presence of substantial genetic variation among 40 genotypes of cotton for 10 selected traits. The correlation coefficient was determined both at p<0.05 and p<0.01 levels and the observations demonstrated that some of the characteristics exhibited positive correlation, while others displayed negative correlation with each other. Micronaire showed highly significant positive association with percentage ginning out turn (0.3412) and boll weight (0.2421 g) as well as highly significant negative association with fiber strength (-0.5973).Conclusion: Convincingly, mean performances and correlation of different traits with one another can be utilized in cotton breeding programs in future to improve the yield of cotton seed and to select fiber related attributes with desired characteristics.Keywords: Gossypium hirsutum; Morphological agronomic traits; Statistical analysi

Impacts of climate change on Capparis spinosa L. based on ecological niche modeling

Recent changes in climate are transforming the situation of life on Earth, including impacting the conservation status of many plant and animal species. This study aims to evaluate potential impacts of climate change on a medicinal plant that is known to be heat-tolerant, Capparis spinosa L. We used ecological niche modeling to estimate current and future potential distributions for the species, considering two emissions scenarios and five climate models for two time periods (2050 and 2070). The results in terms of areal coverage at different suitability levels in the future were closely similar to its present-day distribution; indeed, only minor differences existed in highly suitable area, with increases of only 0.2–0.3% in suitable area for 2050 and 2070 under representative concentration pathway 4.5. Given that climate-mediated range shifts in the species are expected to be minor, conservation attention to this species can focus on minimizing local effects of anthropogenic activity

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy