Occurrence of severe cognitive impairment in elderly individuals with poor glycemic control Vs elderly individuals with good glycemic control or no DM: a case control study”

ABSTRACT: Background: There is substantiatial corroboration that diabetes (both T1DM and T2DM) plays an essential role in predisposition to cognitive decline thus leading to dementia in both human and animal studies. (1,2,3). Hypoglycemia has been associated with the increased risk of developing cognitive impairment. (4). There is lack of data from our community to support this. We aim to observe occurrence of cognitive impairment in individuals aged 65 or above with poor glycemic control and compare it with similar age group individuals with no DM or good glycemic control. Frailty independently contributes to the cognitive decline. We also assessed frailty index and incorporated it into our result interpretation. Methods: We conducted a case control study in the primary health care center of Ziauddin University from 1st December 2021 to 30th June 2022. Cases included 83 individuals 65yrs with HbA1c =7 and above and controls included 91 individuals 65yrs and above with HbA1c <7. Both groups were assessed for cognitive decline using MMSE score and CFS score determined their dependency status. Results: Moderately uncontrolled Diabetes had highest association with severe cognitive decline(50%) p-value 0.000 and those who could not manage to do IADLS were severely dementic in our study( p-value 0.046). We also found DM to be associated with high frailty scores. Severely uncontrolled DM was associated with CFS of 5 meaning those who were dependent on others for instrumental activities of daily living. Those who managed well independently was associated with Pre DM in our study.( p-value 0.041) Conclusion: Severe cognitive decline has high association with uncontrolled glycemic control. Keywords: IADLS (instrumental activities of daily living), CFS (chronic frailty scale), MCI (Mild Cognitive Impairment

Prevalence of Polycystic Ovarian Syndrome, Its Associated Conditions And Complications: an Experience from a Low Socio-Economic Population of Sikandrabad, Karachi, Pakistan

OBJECTIVES To study the prevalence of polycystic ovary syndrome, its associated conditions and complications in the low socio-economic population of Sikandrabad, Karachi. METHODOLOGY This cross-sectional study was conducted in a primary health care centre of Ziauddin University, Sikandrabad-Karachi, Pakistan, from January-June 2021. The ethical committee of the university approved this study. All female patients with gynaecological complaints having an age between 18 to 49 years were included. Females with a history of unilateral oophorectomy, uterine abnormality and abnormal karyotype or known malignancies were excluded from the study. A sample size of 118 was calculated using open-epi software. A performed questionnaire was used to collect data from females with gynaecological complaints. PCOS was diagnosed using Rotterdam criteria. Routine examination tests were done at the Primary Health Care Clinic (PHCC) of Ziauddin Hospital, and obesity was labelled through BMI calculation. RESULTSOf 118 females in the reproductive age group screened, 55.93% reported PCOS as a major gynaecological problem, followed by endometriosis at 16.94%, uterine fibroid at 14.46% and urinary tract infections at 9.32% respectively. Patients had infertility as a major complaint, with 54.54% cases followed by menstrual abnormalities at 21.21%, obesity at 16.66% and others at 7.57%. Most patients (38%) were obese, and 34% were overweight. CONCLUSION PCOS is a prevalent complicated endocrine disorder in women in the reproductive age group, and it presents with varying gynaecological complications like infertility, menstrual disturbances, hirsutism, and acne. Obesity, hormonal imbalance and poor dietary intake affect the disease outcomes further. More multi-centred studies are needed to know the exact prevalence and causal relations

Normal Adrenal Versus Adrenal in Acute Abdomen on MDCT

Background: Knowledge of the range of normal size and morphology is useful for adequate interpretation of computed tomography (CT) scans in patients with suspected adrenal pathology.Objective: To compare the size of normal adrenal glands with the cases of acute abdomen on Multidetector CT.Methods: A total of 256 Contrast enhanced CT scans of abdomen where observed. 108 of them were for evaluation of acute abdomen and the rest were reported as normal scans. Adrenal gland measurements were taken at body (at the level of maximum thickness of body), lateral limb and medial limb (a line perpendicular the limb) in both the cases and normal patients.Results: The mean maximum thickness (in mm) of the right adrenal gland body, medial limb, and lateral limb were 5.9 ± 1.6, 4.4 ± 1.4, and 4.8 ± 1.3, respectively, and the mean maximum thickness (in mm) of the left adrenal gland body, medial limb, and lateral limb were 6.7 ± 1.9, 4.9 ± 1.5, and 5.1 ± 1.6, respectively. In cases with acute abdomen mean maximum thickness (in mm) of the right adrenal gland body, medial limb, and lateral limb were 6.2 ± 1.5, 4.2 ± 1.3, and 4.9 ± 1.7, respectively, and the mean maximum thickness (in mm) of the left adrenal gland body, medial limb, and lateral limb were 7.1 ± 1.9, 4.9 ± 1.5, and 5.1 ± 1.9, respectively.Conclusion: There is no significant statistical difference between various measurements of adrenals of normal and cases with acute abdomen

Association between perioperative hypothermia and surgical site infection after elective abdominal surgery: A prospective cohort study

Introduction: Surgical site infections (SSIs) account for 14-16% of nosocomial infections and are one of the major causes of increased morbidity, hospital stay, cost of care, and even mortality. Hypothermia as a risk factor for SSI is debated but there is lack of conclusive evidence. The present study explores the association of hypothermia with SSI.Methodology: This is a prospective cohort study conducted on adult patients who underwent elective laparotomy. Patients were divided into two cohorts, the Hypothermia Cohort and the Normothermia Cohort, based upon episodes of hypothermia of \u3c360C in the perioperative period. SSI was diagnosed based upon criteria defined by the Center for Disease Control and Prevention (CDC). Postoperative follow-up to detect SSI was done until 30 days after the operation.Results: A total of 183 patients met the selection criteria and were included in the study. Ninety patients (49%) had perioperative hypothermia and were followed in the Hypothermia Cohort, while 93 patients (51%) who remained normothermic in the perioperative period were followed in the Normothermia Cohort. Mean age of the patients was 49.77 +/- 14.82 years. Almost two-thirds of the participants were females (63.9%). Patients who developed hypothermia were significantly older and had lower BMI. Also the proportion of female patients was significantly higher in the Normothermic Cohort.Rate of SSI was similar in both groups (10% versus 10.8%) with p-value of 0.867. Multivariable regression analysis also failed to show any significant association between hypothermia and SSI.Conclusion: Our study failed to show any statistically significant association between hypothermia and surgical site infection

MRI-based cartilage changes and clinical effectiveness of autologous intra-articular platelet-rich plasma injections in symptomatic patients with moderate osteoarthritis of the knee

Abstract Background An autologous blood product containing a high percentage of various growth factors, cytokines, and modulating factors such as platelet-rich plasma (PRP) is thought to play a role in chondral remodeling by promoting the production of cartilage matrix molecules and repairing and regenerating articular cartilage. In symptomatic patients with moderate osteoarthritis (OA) of the knee, we aimed to investigate MRI-based cartilage changes and the clinical efficacy of autologous intra-articular PRP injections. Results Thirty-three patients with grades 2 and 3 OA of knees as per Kellgren and Lawrence OA classification underwent three consecutive PRP injections at monthly intervals. These patients were followed up monthly for the first 3 months, and then after every 3 months at 6 months, 9 months, and 12 months. There was statistically significant improvement in joint pain and functionality with the visual analogue scale (VAS) scores showing a reduction from 7 ± 2 at baseline to 2.76 ± 1.34 at 12 months and Western Ontario and McMaster Universities Osteoarthritis Index Score (WOMAC) scores declining from 77.91 ± 1 1.6 at baseline to 23.61 ± 19.1 at 12 months (p  0.05)]. Conclusions PRP had a positive effect on pain alleviation and patient functioning, but there was no significant change in articular cartilage as measured by MRI

Dyeing of Wool with Sappan Wood Natural Dye Using Metal Salts for Enhancement in Color and Fastness Properties

In this study, we explore the dyeing properties of the extract of sappan wood natural dye for coloration of wool yarn to find the potential use of natural dyed wool yarn in the development of eco-friendly textiles. Different characterizations were used to know the chemistry of sappan wood dye and its interaction with metal salts and wool. Interestingly, we found that metal salts, which are called as mordants in reference to unmordanted dyed sample, play an important role in fixing the dye molecule on wool as well as in creating different shades with a variety of hues and tones. The typical color of fabric dyed with extracts of sappan wood without mordant varies from yellowish to red. Light yellowish shades were obtained in case of aluminum sulfate-mordanted samples, whereas yellowish shades were obtained in case of ferrous sulfate mordant. Light colorfastness of the premordanted dyed samples was relatively better than that of the unmordanted dyed samples. The wash fastness of all samples mordanted as well as unmordanted shows color change fairly good to good level, whereas the color staining on wool and cotton was found to be negligible

Implementation of an Intelligent Exam Supervision System Using Deep Learning Algorithms

Examination cheating activities like whispering, head movements, hand movements, or hand contact are extensively involved, and the rectitude and worthiness of fair and unbiased examination are prohibited by such cheating activities. The aim of this research is to develop a model to supervise or control unethical activities in real-time examinations. Exam supervision is fallible due to limited human abilities and capacity to handle students in examination centers, and these errors can be reduced with the help of the Automatic Invigilation System. This work presents an automated system for exams invigilation using deep learning approaches i.e., Faster Regional Convolution Neural Network (RCNN). Faster RCNN is an object detection algorithm that is implemented to detect the suspicious activities of students during examinations based on their head movements, and for student identification, MTCNN (Multi-task Cascaded Convolutional Neural Networks) is used for face detection and recognition. The training accuracy of the proposed model is 99.5% and the testing accuracy is 98.5%. The model is fully efficient in detecting and monitoring more than 100 students in one frame during examinations. Different real-time scenarios are considered to evaluate the performance of the Automatic Invigilation System. The proposed invigilation model can be implemented in colleges, universities, and schools to detect and monitor student suspicious activities. Hopefully, through the implementation of the proposed invigilation system, we can prevent and solve the problem of cheating because it is unethical

‘Immune-inflammatory markers & clinical characteristics for outcomes in hospitalized SARS-CoV-2 infected patients of Pakistan: a retrospective analysis’

ABSTRACTObjective Accumulating evidence suggests the role of immune-inflammatory markers in early risk stratification and prognostication of COVID-19 patients. We aimed to evaluate their association with severity and the development of diagnostic scores with optimal thresholds in critical patients.Setting and participants This retrospective case study includes hospitalized COVID-19 patients from March 2019 to March, 2022, in the developing area teaching hospital in Pakistan. Polymerase chain reaction (PCR) positive patients, n = 467 were investigated for clinical outcomes, comorbidities and disease prognosis. The plasma levels of Interleukin-6 (IL-6), Lactate dehydrogenase (LDH), C-reactive protein (CRP), Procalcitonin (PCT), ferritin and Complete blood count markers were measured.Results Majority were males (58.8%) and patients with comorbidities had more severe disease. Hypertension and diabetes mellitus were the commonest comorbidities. Shortness of breath, myalgia and cough were the main symptoms. The hematological markers NLR, as well as the plasma levels of immune-inflammatory variables, IL-6, LDH, Procalcitonin, Erythrocyte sedimentation rate, Ferritin were markedly raised in severe and critical patients (p 90% of patients in terms of COVID-19 severity (AUC = 0.93, 91.7%, se; 90.3%sp). Furthermore, positive correlation with all other markers including NLR with cut-off = 2.99 (AUC = 0.87, se = 89.8%, sp = 88.4%), CRP with cut-offs at 42.9 mg/l, (AUC = 0.883, se = 89.3% and sp = 78.6%), LDH cut-off at 267μg/L, evidenced in >80% patients (AUC = 0.834 se = 84% and sp = 80%). Additionally, ESR and ferritin have the corresponding AUC 0.81 and 0.813 with cut-off at 55 mm/hr and 370, respectively.Conclusion Investigating the immune-inflammatory markers can assist physicians in providing prompt treatment and ICU admission in terms of COVID-19 severity. As a result, which may reduce the overall mortality of COVID-19 patients

Detoxifying the heavy metals: a multipronged study of tolerance strategies against heavy metals toxicity in plants

Heavy metal concentrations exceeding permissible limits threaten human life, plant life, and all other life forms. Different natural and anthropogenic activities emit toxic heavy metals in the soil, air, and water. Plants consume toxic heavy metals from their roots and foliar part inside the plant. Heavy metals may interfere with various aspects of the plants, such as biochemistry, bio-molecules, and physiological processes, which usually translate into morphological and anatomical changes. They use various strategies to deal with the toxic effects of heavy metal contamination. Some of these strategies include restricting heavy metals to the cell wall, vascular sequestration, and synthesis of various biochemical compounds, such as phyto-chelators and organic acids, to bind the free moving heavy metal ions so that the toxic effects are minimized. This review focuses on several aspects of genetics, molecular, and cell signaling levels, which integrate to produce a coordinated response to heavy metal toxicity and interpret the exact strategies behind the tolerance of heavy metals stress. It is suggested that various aspects of some model plant species must be thoroughly studied to comprehend the approaches of heavy metal tolerance to put that knowledge into practical use