Appropriateness and clinical outcome of chest computed tomography without intravenous contrast: a study conducted in Pakistan

Background: Chest computed tomography (CT), including high-resolution CT (HRCT), has become an integral part of modern healthcare. It enables the physician to arrive at a diagnosis using a noninvasive approach. Our practice has shown that various chest CT scans without intravenous (IV) contrast, including HRCT, have no proper clinical indication. For the same reason, we have assessed the appropriateness of chest CT without IV contrast based on the evidence-based American College of Radiology (ACR) appropriateness criteria. Methods: Chest CT scans without IV contrast were reviewed to evaluate if the examination was based upon the evidence-based ACR appropriateness criteria. All clinical indications, positive physical examination findings, laboratory test findings, and radiological records submitted at the time of chest CT were reviewed. Results: Of 1205 CT scans, 538 (44.6%) were considered “inappropriate,” 367 (30.4%) were considered “appropriate,” and 300 (24.8%) were considered “may be appropriate.” CT scans were performed on 241 (20.0%) patients with no clinical history, whereas 148 (12.3%) examinations in patients aged < 40 years were performed with no positive physical finding. Positive results that affected the management were 4.43 times more likely to be considered appropriate than inappropriate (adjusted odds ratio, 4.43; 95% confidence interval, 1.81–10.87). Conclusions: This study showed a high percentage of chest CT scans without IV contrast examinations not meeting the ACR appropriateness criteria. Chest CT is a valuable tool for evaluation of chest diseases only in the presence of adequate detailed history and physical examination

A novel integration of face-recognition algorithms with a soft voting scheme for efficiently tracking missing person in challenging large-gathering scenarios

The probability of losing vulnerable companions, such as children or older ones, in large gatherings is high, and their tracking is challenging. We proposed a novel integration of face-recognition algorithms with a soft voting scheme, which was applied, on low-resolution cropped images of detected faces, in order to locate missing persons in a challenging large-crowd gathering. We considered the large-crowd gathering scenarios at Al Nabvi mosque Madinah. It is a highly uncontrolled environment with a low-resolution-images data set gathered from moving cameras. The proposed model first performs real-time face-detection from camera-captured images, and then it uses the missing person’s profile face image and applies well-known face-recognition algorithms for personal identification, and their predictions are further combined to obtain more mature prediction. The presence of a missing person is determined by a small set of consecutive frames. The novelty of this work lies in using several recognition algorithms in parallel and combining their predictions by a unique soft-voting scheme, which in return not only provides a mature prediction with spatio-temporal values but also mitigates the false results of individual recognition algorithms. The experimental results of our model showed reasonably good accuracy of missing person’s identification in an extremely challenging large-gathering scenario

The Influence of Leadership Styles on Employees Performance under Perceptions of Organizational Politics: A Study of Telecom Sector in Pakistan: Kashif Rathore, Chaudhry Abdul Khaliq, Nauman Aslam

The purpose of this study is to investigate the relationship of leadership styles and employee performance. In addition to that, this study also examines the mediation effect of perceived organizational politics between leadership styles and employee performance in the telecom sector of Lahore, Pakistan. Positivism research paradigm and deductive research approach has been adopted. Survey research method and focus group interviews have been triangulated in order to validate the findings of the research. Random sampling technique has been used in which 360 questionnaires has been distributed in the selected telecom companies of Lahore, Pakistan and 249 valid questionnaire were received at a response rate of 69%. Results of this study indicated that transformational leadership is insignificantly related with employee performance while transactional leadership significantly related with the employee performance. This findings of this study also indicated that perceived organizational politics fully mediate the relationship of transformational leadership and employee performance. Moreover, perceived organizational politics partially mediate the relationship of transactional leadership and employee performance. Future implications and limitations are also discussed

Effects of heat and mass transfer on unsteady boundary layer flow of a chemical reacting Casson fluid

In this study, an endeavor is to observe the unsteady two-dimensional boundary layer flow with heat and mass transfer behavior of Casson fluid past a stretching sheet in presence of wall mass transfer by ignoring the effects of viscous dissipation. Chemical reaction of linear order is also invoked here. Similarity transformation have been applied to reduce the governing equations of momentum, energy and mass into non-linear ordinary differential equations; then Homotopy analysis method (HAM) is applied to solve these equations. Numerical work is done carefully with a well-known software MATHEMATICA for the examination of non-dimensional velocity, temperature, and concentration profiles, and then results are presented graphically. The skin friction (viscous drag), local Nusselt number (rate of heat transfer) and Sherwood number (rate of mass transfer) are discussed and presented in tabular form for several factors which are monitoring the flow model. Keywords: HAM, Casson fluid, Stretching sheet, Similarity transform, Heat source, Chemical reactio

Successful pregnancy in a kidney transplant recipient with chronic hepatitis B virus infection

Overall success rate of pregnancies in kidney transplant recipients is higher than 90% if pregnancy goes beyond the 1st trimester. Risks to mother include hypertension, preeclampsia, infections, and worsening proteinuria, and those to the fetus are prematurity, intrauterine growth retardation, and low birth weight. Hepatitis B infection is associated with progressive liver disease and diminished survival in kidney transplant recipients. A 32-year-old woman had undergone living unrelated donor kidney transplant. Two years after transplantation, she presented with live gestation of 6 weeks. She was also found positive for hepatitis B surface antigen and extracellular antigen. Liver enzymes were normal and ultrasonography findings were normal. Cyclosporine dose was reduced and lamivudine was started. She was monitored closely until 33 weeks, when she gave birth to a healthy female baby through spontaneous vaginal delivery. The newborn received vaccination and immunoglobulins for hepatitis B virus. Mother\u27s kidney allograft function remained stable throughout pregnancy

Prevalence of Hepatitis B core antibodies with negative Hepatitis B surface antigen in dialysis and chronic kidney disease patients

Occult hepatitis B infection (OBI) is a potential cause of infection transmission in patients with chronic kidney disease (CKD) and dialysis-dependant patients. It is liable to be missed since the marker for OBI, hepatitis B core antibody (HBcAb), is not done routinely. We carried out a study to assess the prevalence of OBI in CKD Stage II–V or requiring renal replacement therapy. It was a cross-sectional study carried out at Fatima Memorial Hospital, Lahore, from May 2104 to May 2015. A total of 188 patients were included in this study, 124 were dialysis dependent and 64 had acute or CKD Stage II–V. About 17.55% (n = 33) of patients had isolated HBcAb positive. Nearly 33.5% (n = 63) of patients were found to have hepatitis B surface antigen positive, indicating development of immunity by exposure to virus. About 20.74% (n = 39) of patients were co-positive with HBcAb also. The prevalence of isolated HBcAb in dialysis and CKD patients is high; therefore, testing for HBcAb should be a routine part of screening in our CKD population to rule out OBI. Further confirmation with polymerase chain reaction analysis for HBV viral DNA is recommended. Considering our circumstances, a consensus statement from the hepatologists and nephrologists is needed to further plan for the management of such cases

Application of ultrasound-assisted cooking temperature for improving physicochemical and sensory properties of broiler meat

The current study investigates the effect of ultrasound-assisted cooking on broiler meat quality. The objective of this study was to explore the combined effect of ultrasound treatment (US) (40 kHz, 120 Wcm−2) at different cooking temperatures (50, 60, 70, 80 °C) on physicochemical and sensory attributes of broiler meat. Therefore, pH, cooking loss %, Thio-barbituric acid reactive substances (TBARS), shear force, color, and sensory properties were investigated and compared with the control group. The result showed that the ultrasound treatment had no significant effect on pH values compared to the control group. The cooking loss % decreased with the application of US treatment at higher temperatures, which implied a higher cooking yield. Furthermore, sonicated meat showed lower shear force values even at 80 °C cooking temperature, which indicates increased tenderness. In addition, lower TBARS values were recorded at 50 °C temperature in combination with ultrasound, but the other treatments were similar to the control group. The application of ultrasound increased the lightness of meat with a significant decrease in lightness and yellowness. Meat cooked at 80 °C with US showed a significantly higher sensory score (odor, flavor, tenderness, juiciness, overall acceptability) than other treatment groups. The treatment of ultrasound combined with temperature was considered a promising and efficient technique for processing as it increased the perception of tenderness with less cooking losses and higher sensory attributes

In-hospital mortality of patients with cardiogenic shock after acute myocardial infarction; impact of early revascularization

Abstract Objectives The purpose of this study was to determine the frequency of in-hospital mortality in 351 patients who developed cardiogenic shock after acute myocardial infarction and by determining this; we might find that how efficiently we could manage this serious condition in our population by knowing the factors which are associated with high mortality after cardiogenic shock. Moreover impact of early revascularization like thrombolytic therapy or angioplasty was also evaluated. Results Mean age was 65.41 ± 7.78 years in our study. In-hospital mortality with cardiogenic shock after acute myocardial infarction was found to be 44.73%. Significant association of in-hospital mortality was noted with age, hypertension, diabetes mellitus and BMI. Patients receiving early revascularization were noted to have lower in-hospital mortality compared to those in whom revascularization was not done due to delayed presentation. This study concluded that there is a high frequency (44.73%) of in-hospital mortality in patients with cardiogenic shock after acute myocardial in our population. So, we recommend that for achieving a good outcome and to reduce in-hospital mortality; in addition to rapid diagnosis of this condition, underlying risk factors like hypertension and diabetes should be evaluated and managed accordingly and early revascularization should be done when possible

Tracking missing person in large crowd gathering using intelligent video surveillance

Locating a missing child or elderly person in a large gathering through face recognition in videos is still challenging because of various dynamic factors. In this paper, we present an intelligent mechanism for tracking missing persons in an unconstrained large gathering scenario of Al-Nabawi Mosque, Madinah, KSA. The proposed mechanism in this paper is unique in two aspects. First, there are various proposals existing in the literature that deal with face detection and recognition in high-quality images of a large crowd but none of them tested tracking of a missing person in low resolution images of a large gathering scenario. Secondly, our proposed mechanism is unique in the sense that it employs four phases: (a) report missing person online through web and mobile app based on spatio-temporal features; (b) geo fence set estimation for reducing search space; (c) face detection using the fusion of Viola Jones cascades LBP, CART, and HAAR to optimize the results of the localization of face regions; and (d) face recognition to find a missing person based on the profile image of reported missing person. The overall results of our proposed intelligent tracking mechanism suggest good performance when tested on a challenging dataset of 2208 low resolution images of large crowd gathering