Perioperative glycemic control and its outcome in patients following open heart surgery

Background: Diabetes is not uncommon in patients requiring cardiac surgery. These patients have a higher incidence of morbidity and mortality. Subsequently, diabetes represents a major medico-economic problem in both developed and developing countries. This study was designed to observe the association between glycemic control and outcome of patients after open heart surgery in adult population.Materials and methods: Data was collected retrospectively in all patients who underwent open cardiac surgery (coronary artery bypass grafting, valve, or bypass grafting with valve surgery) and survived 72 hours postoperatively and had diabetes. The study was conducted from January 2015 to December 2016.Results: Of the 129 patients included in the study, male dominated 101 (78.3%). Most frequent surgery was coronary artery bypass grafting (CABG) 123 (95.3%), CABG plus aortic valve replacement 4 (3.1%), and CABG plus mitral valve replacement 2 (1.6%). Considering diabetes, only 3 (2.3%) were on diet control, 112 (86.8%) on oral hypoglycemic agents (OHA), whereas 9 (7%) had control on both insulin and OHA. Only 5 (3.9%) had type I diabetes. The mean fasting blood sugar (FBS) was 154.58 g/dl, and the mean duration of diabetic mellitus was observed 12.32 years. Microvascular and macrovascular complications were 26/129 (20.16%) and 17/129 (13.17%), respectively. Total 75 (58.1%) patients did not require insulin and 54 (41.9%) were treated with insulin intraoperatively to keep the blood glucose level less than 200 g/dl. Cardiac arrhythmias were frequent in the insulin group (P \u3c 0.05), which was also associated with increased stay in the cardiac intensive care unit.Conclusion: Inadequate glycemic control during open cardiac surgery can possibly lead to increased perioperative morbidity and mortality and with decreased long-term survival and recurrent ischemic events. Therefore, aiming for blood glucose levels around 140 mg/dl appears reasonable. Further studies are required to define specific glucose ranges for a clearer definition of recommended blood glucose goals in postoperative cardiac patients for the best outcomes in patients with diabetes mellitus

A Short Review on the Development of Salt Tolerant Cultivars in Rice

Rice is staple food for half of the world. With a population of almost 9.6 billion by the year 2050, there is a dire need of developing techniques to improve the crop plants, not only in terms of better yield but also to withstand harsh environmental conditions and stresses like drought, temperature, flood and salinity. Salinity is second to drought stress and hence it is very important to develop crops tolerant to salinity stress. This review discusses the mechanisms of salt tolerance and the recent developments in understanding the complex tolerance phenomena. One way to address the salinity issue is to develop tolerant rice varieties using conventional and modern breeding techniques for which screening the rice germplasm for the varieties with desired traits is critical. Conventional methods to develop tolerant rice varieties are discussed along with modern biotechnology techniques are also discussed. Quantitative Trait Loci (QTL) and Marker Assisted Selection (MAS) are promising techniques. In addition to these modern techniques, some recent developments in the fields of transgenic plants, haploid breeding and Somaclonal variations have also been discussed. The limited knowledge about molecular and genetic mechanisms to tolerate abiotic stresses, however is a barrier to efficiently develop tolerant cultivars. A combination of conventional and modern biotechnology techniques could possibly open up the new ways

A Robust Regression-Based Stock Exchange Forecasting and Determination of Correlation between Stock Markets

Knowledge-based decision support systems for financial management are an important part of investment plans. Investors are avoiding investing in traditional investment areas such as banks due to low return on investment. The stock exchange is one of the major areas for investment presently. Various non-linear and complex factors affect the stock exchange. A robust stock exchange forecasting system remains an important need. From this line of research, we evaluate the performance of a regression-based model to check the robustness over large datasets. We also evaluate the effect of top stock exchange markets on each other. We evaluate our proposed model on the top 4 stock exchanges—New York, London, NASDAQ and Karachi stock exchange. We also evaluate our model on the top 3 companies—Apple, Microsoft, and Google. A huge (Big Data) historical data is gathered from Yahoo finance consisting of 20 years. Such huge data creates a Big Data problem. The performance of our system is evaluated on a 1-step, 6-step, and 12-step forecast. The experiments show that the proposed system produces excellent results. The results are presented in terms of Mean Absolute Error (MAE) and Root Mean Square Error (RMSE)

Analysis of Metal Content of Samples of Gloriosa Superba L (Colchicaceae) Collected from Two Different Locations in Pakistan

Purpose: To determine the metallic content of different parts of Gloriosa superba collected from two different locations in Pakistan, and also to assess their nutritious values and toxic levels.Methods: The plant material and soil were collected from two different locations - polluted and unpolluted. Wet digestion method was used for the preparation of samples (whole plant and soil) followed by analysis using flame atomic absorption spectrophotometer (for micronutrients) and flame photometry (for macronutrients).Results: Of the detected micronutrients, high concentrations of Zn, Fe and Mn were noted for samples collected from both areas. These values were within permissible limits. Samples collected from the polluted area contained Cu (7.5 – 13.0 ppm), Cr (1.4 − 1.9 ppm) and Ni (0.3 − 2.0 ppm), all of which exceeded acceptable limits; the same nutrients were mostly within acceptable limits for samples collected from the unpolluted area. Significant presence of macronutrients - Ca, Na and K - were observed in samples obtained from both areas.Conclusion: Proper validation of medicinal plants used for therapeutic purposes should be mandatory on safety grounds to protect consumers from contaminants.Keywords: Gloriosa superba, Micronutrients, Macronutrients, Toxicity, Metal ions, Medicinal plant

Co-existing spinal intradural ependymal cyst and sacral tarlov cyst in adult-onset tethered cord syndrome with syringomyelia: Case report and literature review

Background: Synchronous spinal intradural ependymal cysts and sacral Tarlov cysts in adult onset tethered cord syndrome are extremely rare.Case description: A 23-year-old male presented with back pain radiating into both lower extremities, accompanied by acute onset of gait difficulty and sphincter dysfunction. Magnetic resonance imaging identified a low lying conus medullaris, syringomyelia with septations extending from T12 to S1, a tethered cord, and a thickened filum terminale with a sacral Tarlov cyst. The patient underwent a L3-4 laminectomy for decompression of syringomyelia and excision/biopsy of a space occupying lesion along with S1-2 laminectomy for cord untethering and Tarlov cyst fenestration. Postoperative histopathology confirmed that the lesion was an ependymal cyst. Clinically, patient showed marked improvement in the neurological status.Conclusion: Simultaneous decompressive laminectomy of L3-4 and S1-2 effectively decompressed the syringomyelia while allowing for excision/biopsy of a space occupying lesion at the former and untethering and Tarlov cyst fenestration at the latter levels