Hallervorden spatz disease – a rare clinicoradiological diagnosis

Hallervorden Spatz disease, also known as pantothenate kinase associated neuro-degeneration, is a rare, progressive neurological disorder usually seen in first decade of life. It is associated with extrapyramidal effects, dysarthria and dementia. Hallervorden Spatz Disease is also associated with psychiatric symptoms, depression and behavioral changes. Affected patients are disabled predominantly by dystonia. MRI, in later stage of the disease, shows “eye of the tiger’ appearance which is fairly diagnostic of Hallervorden Spatz Disease. Response to drugs is often poor and of limited value to these patients. This report highlights a classical case of Hallervorden Spatz disease that presented as an outpatient with dystonia and psychotic symptoms and was diagnosed on the basis of clinical and radiological evidence

Is it really transverse myelitis? Acute flaccid Myelitis a rare entity.

Acute Flaccid Myelitis is a relatively new and rare disease entity which was recognized for the first time in United States in 20121. Usually children below 18 years of age present with sudden onset rapidly progressive flaccid paralysis sometimes following upper respiratory tract infection. To date no cases have been reported from Afghanistan and Pakistan. We are reporting case of a young girl who presented with sudden onset flaccid paralysis and respiratory distress. Her MRI Cervical spine showed longitudinally extensive transverse myelitis. One year after the onset of disease flaccid paraparesis continued despite various treatments. It is important to report cases of acute flaccid myelitis as it is a new disease with poor prognosis. People including clinicians are not aware of it

Antibacterial Potentials of Human Urine at Acidic pH 5

To identify factors determining susceptibility of individuals to urinary tract infections (UTIs).Methods: In this descriptive study , 55 hospitalized patients' urine samples were analyzed. Presence of red blood cells , pus cells, epithelial cells, casts and crystals were observed and counted under per high power field (HPF) by microscopy. While pH, specific gravity, protein, leukocytes, nitrites, glucose, ketones, urobilinogen, blood and bilirubin, were analyzed using dipstick method. All the samples were streaked on CLED agar for isolation of bacteria; and SDA for yeast.Results: Twenty urine samples were found culture positive, of which 15 were from females and 5 from males. Cultures were isolated and identified as E. coli (11), Enterococcus (4), Klebsiella (3), Pseudomonas (1) and yeast (1). Interestingly, organisms were mainly isolated from urine samples having pH >5.5. In all the culture positive samples, pus cells were >20-40 /HPF. No patient with culture negative had urine pH 6.5 or above in the present study.Conclusion: The probability of bacteriuria (UTI) and pyuria (increase pus cells in urine) increases with rise in urine pH. Persons with urine pH5 are generally protected from UTIs. Thus mechanism/s needs to be elucidated

Active slip control of a vehicle using fuzzy control and active suspension

This paper presents an active slip control system (ASCS) for a four-wheel drive electric vehicle (EV) using an active suspension of the vehicle. The integrated control mechanism is designed using a combination of a fuzzy controller and a nonlinear back-stepping controller to control the slip of the individual wheels with the help of the active suspension of the vehicle. In this research, the presented control mechanism is implemented in two steps. In the first step, based on the friction coefficient calculated from a nonlinear tire model, the fuzzy controller will generate the vehicle roll and pitch angles required to reduce the slipping of the individual wheels by changing the vertical load of the individual wheel. In the second step, a nonlinear back-stepping controller is used to track the required roll and pitch angles using the active suspension of the vehicle. A linear seven degree of freedom (DOF) vertical mathematical model is used for the design of the nonlinear back-stepping controller, while the rules of the fuzzy controller are interpreted from the friction coefficients of the tyre model. The performance of the presented control mechanism is verified using a 14-DOF nonlinear model with nonlinear tyre dynamics. The simulations using a nonlinear vehicle model show that the presented controller can successfully improve vehicle stability by reducing the slipping of the individual wheel

Intubation in emergency department of a tertiary care hospital in a low-income

Objective: To study the indications, method, success rate and complications of intubation at the Emergency Department of a private, tertiary care hospital in Karachi, Pakistan.Methods: The case series involved 278 patients above 14 years of age who underwent emergency intubation at the Emergency Department of Aga Khan University Hospital, Karachi between 1998 and 2003. Descriptive statistics were used to compare rapid sequence intubation with crash intubation. The level of significance was p\u3c0.05.Results: Of the total 278 intubations performed, 37 (13.3%) had to be left out for incomplete information. The study population remaining for inferential analysis comprised of 241 patients. Of the total 278 patients, 174 (63%) were males. Rapid sequence intubation was the commonest type (n=185, 67%) of intubation and was performed mostly by anaesthetists (n=236, 85%). Cardiogenic pulmonary oedema and head injury were commonly seen in these patients. The success on first attempt of intubation was 98% (n=181) in rapid sequence intubation, and 85% (n=48) in crash intubation. Overall, 15 (5.3%) complications were seen in these intubations.Conclusion: Study showed a satisfactory success rate in both rapid sequence and crash intubations

N,N′-[1,3-Phenylenebis(methyl­ene)]dibenzene­sulfonamide

The complete mol­ecule of the title compound, C20H20N2O4S2, is generated by crystallographic twofold symmetry, with two C atoms lying on the rotation axis. The dihedral angle between the central benzene ring and the pendant ring is 68.42 (6)° and the dihedral angle between the pendant rings is 45.11 (5)°. The torsion angles for the C—S—N—C and S—N—C—C fragments are −73.22 (15) and −150.45 (13)°, respectively. In the crystal, mol­ecules are linked by N—H⋯O hydrogen bonds, generating corrugated (001) sheets. Aromatic π–π stacking [centroid–centroid separation = 3.8925 (12) and 3.9777 (12) Å] and weak C—H⋯O inter­actions also occur

Efficacy of fungicides, plant extracts and biocontrol agents against Ascochyta blight (Ascochyta rabiei) of chickpea (Cicer arietinum L.) under field conditions

Two fungicides, Aliette and ThiovitJet @ 0.15%, containing Aluminum tris (O-ethyl phosphonate) and sulphur compounds, respectively; two plant extracts, Melia azedarach and Azadirachta indica @ 8% and one biocontrol agent, Trichoderma harzianum @ 107 conidia ml-1 were investigated against ascochyta blight of chickpea under field conditions. Treatments were evaluated on three varieties susceptible to chickpea blight. Field trial revealed that Aliette and ThiovitJet significantly decreased disease severity to 17 and 23% respectively, followed by M. azedarach and A. indica which decreased severity to 50 and 56% respectively, compared to control with 75% disease severity. T. harzianum, with a severity of 63%, was significantly less effective than fungicides and both plant extracts in controlling blight disease. The current research revealed that systemic and sulphur containing fungicides, both plant extracts and the biocontrol agent have the potential to control ascochyta blight of chickpea

Diagnostic Value of Immature-to-Total Neutrophil Ratio in Neonatal Sepsis

Background: Neonatal sepsis is the third most common reason of neonatal mortality in Pakistan. Blood culture, the gold standard test for diagnosis of neonatal sepsis, is time consuming. Therefore, rapid diagnostic tests with good specificity and sensitivity is needed for accurate and early diagnosis of this condition. The objective of this study was to determine the diagnostic value of abnormal (≥ 0.2) immature-to-total-neutrophil ratio in neonatal sepsis.Material and Methods: This cross-sectional study was carried out on 288 neonates, aged 0-28 days, admitted with suspected sepsis. Detailed history of the neonates was recorded including gender, age, birth weight, maternal age, gestational age and clinical features. Blood culture and Peripheral blood films were done in each case. Differential leucocyte counts, total Polymorphoneutrophil count (PMN), immature neutrophil count, mature neutrophil count and calculation of I/T ratio was carried out in the Pathology Department of PIMS, Islamabad. The study outcome was divided into three groups on the basis of positive or negative blood culture and I/T ratio as normal, probable sepsis and proven sepsis group. Data was analyzed by SPSS version 21.0. Diagnostic value of I/T ratio was determined in NS by calculating values of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) by considering the blood culture as the gold standard test of NS.Results: The mean age and weight of the neonates at the time of admission was 1.1 (± 0.6) days and 2.51 (± 0.40) kg, respectively. About 60% of the neonates were males and 118(41%) neonates had I/T ratio of ≥ 0.2. On the basis of positive or negative blood culture and I/T ratio, 82 (28.5%) neonates were diagnosed as proven sepsis, 43 (14.9%) neonates had probable sepsis and remaining 163 (56.6%) neonates were declared as normal. Out of 82 neonates with positive blood cultures, 75 (91.5%) had I/T ratio ≥ 0.2, while 7 (8.5%) had I/T ratio ≤ 0.2. The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of abnormal I/T ratio to diagnose neonatal sepsis was 91%, 79%, 64%, 96% and 83%, respectively.Conclusions: Due to substantially high diagnostic accuracy of I/T ratio ≥ 0.2, we recommend it as a useful, rapid and cost-effective tool in accurate diagnosis of neonatal sepsis

An Investigation of the Major Wheat Weeds in Different Zones of Dera Ismail Khan

On account of huge yield losses, weed infestation is a serious threat in wheat crops throughout the country. A comprehensive survey to find out the major weeds in wheat in Dera Ismail Khan was carried out during the crop season of 2012-13. Wheat fields at seed farms of Rakhmanghan, RakhZandani, Rata Kulachi and adjacent farmer’s fields to each seed farm were investigated. Data was collected at the peak growth stage of weeds and the quadratic method was used to record relative density (RD), relative frequency (RF), relative crowding coefficient (RCC) and importance value index (IVI). The results revealed that the major and most problematic weed of wheat at all the locations was Avena fatua (wild oat) on account of having maximum IVI at Rakh Manghan (78.51 & 77.44), Rata Kulachi (77.82 & 77.54) and Rakh Zandani (77.51 & 77.53) seed Farms and Farmer’s fields respectively. Rumex dentatus (dock) and Convolvulus arvensis (Lehli) were the second and third abundantly occurring weeds at almost all the seed farms and farmer fields on account of having the second and third highest IVI values at all the locations. Therefore Avena fatua (wildoat), Rumex dentatus (dock) and Convolvulus arvensis (lehli) seed were collected to find out the yield losses through further experimentation