Biomarker research in thromboembolic stroke

Introduction Stroke is a leading cause of death and disability worldwide. Approximately one quarter of all strokes are secondary to carotid atherosclerosis. There is a clinical need to improve risk stratification of carotid atherosclerosis, to better target surgical or interventional therapy and prevent stroke. This study aimed to determine diagnostic biomarkers of high-risk carotid atherosclerosis, and ensure the validity of such markers in the presence of alternative phenotypes of atherosclerotic disease. Methods 150 patients were recruited according to the following criteria: Group 1: Symptomatic >50% carotid stenosis Group 2: Non-carotid stroke/TIA Group 3: Asymptomatic >50% carotid stenosis Group 4: Asymptomatic controls with <50% carotid stenosis Group 5: Abdominal aortic aneurysm Group 6: Intermittent claudication Disease groups were matched for age, gender, cardiovascular risk factors, haematological parameters, renal function and lipid status. Blood and urine was collected from all patients and analysed through global metabolic profiling (1H-NMR Spectroscopy, HILIC-Mass Spectrometry and Lipid Profiling-Mass Spectrometry). Acquired spectra were compared across groups using computational multivariate data analysis to determine markers of high-risk carotid atherosclerosis. Results Statistical models derived from urinary spectra proved stronger than serum datasets, in particular with HILIC-Mass Spectrometry (positive ionisation mode). Application of computational OPLS DA resulted in discrimination of symptomatic carotid atherosclerosis from asymptomatic disease, aneurysmal disease, and intermittent claudication. Differentiating metabolites span a vast array of compounds including lipid derivatives, amino acid derivatives and nucleotide derivatives. Conclusion This is the first study to identify urinary metabolic biomarkers of high-risk carotid atherosclerosis, differentiating symptomatic carotid atherosclerosis from asymptomatic disease, and aneurysmal and peripheral arterial disease. Targeted temporal studies are now required for clinical validation and to determine the variation of acute biomarkers with time.Open Acces

Aberrant Presentation of the Gallbladder During Laparoscopic Cholecystectomy

A left aberrant gallbladder is a rare presentation that requires awareness of biliary anatomy and selective use of intraoperative cholangiography to assist in safe laparoscopic gallbladder resection

Acute disseminated encephalomyelitis in a middle age female

Acute disseminated encephalomyelitis (ADEM) is an autoimmune condition that predominately involve demyelination of the white matter of the brain and spinal cord. It resembles other acute demyelinating syndromes like multiple sclerosis and most often presents in childhood.This is a case of a 52-year woman, presented with lower limb weakness, confusion and spasticity throughout the body with no preceding illness. CSF showed increased proteins with no oligoclonal bands. MRI Brain showed abnormal high intensity areas in bilateral parietal, periventricular region, with no contrast enhancement. She was given 1gram iv methylprednisolone based on the diagnosis of ADEM and responded well

Monetary Policy Shifts and Central Bank Independence

Why does low central bank independence generate high macroeconomic instability? A government may periodically appoint a subservient central bank chairman to exploit the inflation-output trade-off, which may generate instability. In a New Keynesian framework, time-varying monetary policy is connected with a “chairman effect.” To identify departures from full independence, I classify chairmen based on tenure (premature exits), and the type of successor (whether the replacement is a government ally). Bayesian estimation using cross-country data confirms the relationship between policy shifts and central bank independence, explaining approximately 25 (15) percent of inflation volatility in developing (advanced) economies. Theoretical analyses reveal a novel propagation mechanism of the policy shock

Monetary Policy Shifts and Central Bank Independence

Why does low central bank independence generate high macroeconomic instability? A government may periodically appoint a subservient central bank chairman to exploit the inflation-output trade-off, which may generate instability. In a New Keynesian framework, time-varying monetary policy is connected with a “chairman effect.” To identify departures from full independence, I classify chairmen based on tenure (premature exits), and the type of successor (whether the replacement is a government ally). Bayesian estimation using cross-country data confirms the relationship between policy shifts and central bank independence, explaining approximately 25 (15) percent of inflation volatility in developing (advanced) economies. Theoretical analyses reveal a novel propagation mechanism of the policy shock

What are monetary policy shocks?

I decompose deviations of the Federal funds rate from a Taylor type monetary policy rule into exogenous monetary policy shocks and a time-varying inflation target. I show that the role of exogenous shocks may be exaggerated in a fixed inflation target model, and a large fraction of business cycle fluctuations attributed to them may actually be due to changes in the inflation target. A time-varying inflation target explains approximately half of the volatility normally attributed to these deviations, and consequently more than a quarter of the fluctuations in the business cycle. This contributes approximately 39% additional inflation volatility during the Great Inflation. I show that shocks to the inflation target imply a lower sacrifice ratio compared to exogenous changes in the interest rate and therefore propose a gradual adjustment of the inflation target in order to achieve monetary policy objectives

Histopathological Effects and Element Concentration Of Body Tissues Of Ranid Frog Inhabiting Polluted Water Sites

Freshwater or wetlands are being polluted on regular basis due to the release of domestic sewage and most importantly industrial effluents that include chemicals, organic pollutants and heavy metals, and run-off from land-based activities containing leached fertilizers. Pollutants are such substances that reduce quality of water that effect directly and indirectly. The present study was carried out on Korang River Islamabad/Rawalpindi. Two different locations were selected along the Korang River. The data were collected two times during the current study period; March 2012, and October 2012. Ranid frogs (n=10) were captured from all selected sites, which were dissected to collect blood and body tissue samples. During the month of March and October the concentration of heavy metals in water samples increase and decrease significantly at both sites of Korang River. The continuous leaching of contaminants may cause abnormal tissue damage in amphibians making them more vulnerable to predation and competition and also decreased reproductive success

Diagnostic Accuracy of Sonographic Septations in Tuberculous and Malignant Pleural Effusions

Background: Discrimination between tuberculous (TB) and malignant pleural effusions is a real practical challenge because both exist as exudative lymphocytic type. Transthoracic ultrasonography not only identifies and quantifies pleural effusion but also displays sonographic septations, which are frequently seen in TB pleural effusions and can help in differentiation between tuberculosis and malignancy successfully, without any invasive procedure. We designed this study to determine the diagnostic usefulness of these septations for tuberculous and malignant pleural effusions. Material and Methods: This prospective study was conducted in the OPD of Gulab Devi Chest Hospital Lahore, Pakistan, a 1500 bedded tertiary care hospital, from November 2016 to February 2018. Total of 339 consecutive cases, aged 14-83 years with radiological evidence of pleural effusion were included in the study. After detailed history, thorough physical examination, radiological, haematological and biochemical findings were recorded. Pleural fluid macroscopic, cytological, microbiologic and biochemical analysis results were also recorded. Ultrasonography was done, septated and non-septated pleural effusions identified and findings were noted. SPSS-16 was used for statistical evaluation. Fisher Exact test was utilized for comparison between TB and malignant cases with P-value &lt; 0.05 taken as significant. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy and positive likelihood ratio were calculated. Results: Out of total 339 cases, 49 (14.45%) were malignant and 290 (85.55%) were non-malignant. In the malignant group, only 03 cases (6.12%) showed sonographic septations. In the non-malignant group, 259/290 (89.31%) cases showed tuberculous etiology and 187/259 (72.20%) of these cases displayed sonographic septations. By considering septations as predictor of TB, statistical analysis revealed a sensitivity of 79.23%, specificity of 92.85%, PPV of 98.42%, NPV of 44.31% and diagnostic accuracy of 81.29%, respectively. Conclusions: Sonographic septations can be a valuable predictor of tuberculosis, in a population with high prevalence of the disease. We found it to be a useful feature in differentiating between a malignant and tuberculous etiology, in exudative lymphocytic pleural effusions. It can be used with confidence in patients who are unfit for interventional procedures

Reconfiguration of speech recognizers through layered-grammar structure to provide ease of navigation and recognition accuracy in speech-web.

Developing speech interfaces to large knowledge bases is a new and challenging problem. There is a need for a solution to provide access to large knowledge bases and high recognition accuracy. A partial solution to this problem is to distribute the knowledge base into a network of speech-accessible units of knowledge. But as the number of such units increases the recognition accuracy decreases and navigation among these units becomes difficult. In this thesis, a new technique is investigated. The new technique is based on a layered grammar structure and modification of the unit\u27s input language to provide high recognition accuracy with ease of navigation among units. This technique is a step towards a solution for high recognition accuracy and distribution transparency with ease of navigation for large knowledge bases. A prototype has been implemented to demonstrate the efficiency of the layered grammar based approach. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis2000 .Q74. Source: Masters Abstracts International, Volume: 40-03, page: 0727. Adviser: Richard Frost. Thesis (M.Sc.)--University of Windsor (Canada), 2001