794 Evaluating disability in adult burn injury patients treated at a tertiary-care burn unit in Karachi, Pakistan: a longitudinal study using who disability assessment schedule II

Abstract Background Disability after burn injury is not assessed in the context of Pakistan. This study assesses disability among adult burn injury patients presenting to a burn unit in Karachi, Pakistan. Methods This longitudinal study was conducted at a burn centre is Karachi, Pakistan. Adult patients(\u3e18 years) who were discharge after 24-hour admission were enrolled from August 2014–March 2015. Baseline assessment before discharge and follow-up at 2,6 and 12 weeks after discharge via telephone was done using 12-item WHODAS 2.0 (5 -point likert-scale; 1 = none; 2 = mild; 3 = moderate; 4 = severe; and 5 = extreme) related to cognition, mobility, self-care, getting along, life activities and participation. The score range was 12–60 with higher score being worse. Ethical approval was taken from collaborating and participating sites. Results Of the 59 eligible patients, 53 completed all follow-ups. There were 69.8% males. Mean age of all patients was 36.8 ± 14.0 years, 71.7% were married and 17.0% had no/informal education. About half the patients were breadwinners. More than half of burn incidents occurred at home. Flame burns (50.9%) and scalds (17%) were the most common type of burns. The average surface area burnt was 43.0 ± 14.2%. The mean-scores for all patients at baseline, 2-week, 6-week and 12-week were 13.9 ± 4.9, 35.3 ± 13.8, 26.8 ± 11.9 and 20.1 ± 9.1, respectively. The mean-scores for males were lower than that of females for the four assessments (Males: 13.5 ± 1.8, 34.2 ± 14.1, 25.3 ± 10.7, 19.2 ± 8.4 and females: 16.1 ± 8.5, 37.3 ± 13.3, 30.5 ± 14.4, 22.1 ± 10.6). The two-week score was higher for those with \u3e15% burn(36.7 ± 13.9) compared to those with ≤15% burn(34.6 ± 14.2) while the score were similar at 12-week follow-up. Conclusions This analysis shows that the burn injury patients tend to recover from their injury over a period of 12 weeks after discharge. Future work should focus on larger group of patients and long term follow-up at one and two years after burn injury

THERAPEUTIC DRUG MONITORING OF BROAD SPECTRUM ANTIFUNGAL, VORICONAZOLE- A REVIEW

Voriconazole is a broad-spectrum antifungal drug. It belongs to triazole group, and is available in market as oral as well as intravenous (IV) forms. It is highly effective against a number of clinically important fungi causing invasive infections. Its pharmacokinetic profile is non-linear with extensive inter-individual and intra-individual variability. Various factors contribute towards this variability including age, race, gender, genotype, hepatic functions, administration with or without food, and concomitant administration of other drugs causing drug interactions. Variability in plasma concentrations of the drug, arising from these factors, may result in variations in efficacy of the drug or may contribute towards potential toxicity. Voriconazole therapeutic drug monitoring is mandatory considering bad prognosis of patients suffering from invasive fungal infections, especially ones who are immunosuppressed, and prolonged period of treatment needed, in order to optimize antifungal treatment and to prevent the adverse events.&nbsp

COMPARISON AND EVALUATION OF ONE-STEP REVERSE TRANSCRIPTASE-POLYMERASE CHAIN REACTION (RT-PCR) AND REVERSE TRANSCRIPTASE LOOP-MEDIATED ISOTHERMAL AMPLIFICATION ASSAY(RT-LAMP) FOR RAPID DETECTION OF FOOT-AND-MOUTH DISEASE VIRUS (FMDV)

Foot-and-mouth disease (FMD) is endemic in Pakistan and cause severe economic losses. Serotype O, A and Asia 1 is prevalent and their rapid detection for Pakistaniisolates is needed to determine the serotype prevalence in different areas of the country. One step reversetranscriptase-polymerase chain reaction (RT-PCR) and reverse transcriptase loop-mediated isothermal amplification (RT- LAMP) was compared for the rapid and sensitive detection of FMDV genome. FMDV genome was confirmed in 19/25clinically affected animals by sequencing. These positive samples (n=19) were also confirmed in both RT-PCR and RT-LAMP consensus assay.In theserotyping assay, RT-PCR detection rate was16.67%, 80%, and 50% and RT-LAMP detection rate was 50%, 60% and 50%for serotype Asia 1, O and type A respectively. In general detection of FMDV, RT-PCR assay and the RT-LAMP assay showed high concordance (k = 1.0). However, in serotype detection, RT-LAMP was found more sensitive as compared to RT-PCR for the detection of the FMDV serotype Asia1 and Vice Versa in the detection of serotype O. To the best of the author’s knowledge, this is thefirst document on thecomparison of RT-LAMP and one-step RT- PCR for FMDV using ESE-Quant Tube Scanner in Pakistan.The RT-LAMP assay has the potential for early and rapid clinical diagnosis, surveillance and serotyping of FMDV infection in endemic countries

HLA-DQA1*05 carriage associated with development of anti-drug antibodies to infliximab and adalimumab in patients with Crohn's Disease

Anti-tumor necrosis factor (anti-TNF) therapies are the most widely used biologic drugs for treating immune-mediated diseases, but repeated administration can induce the formation of anti-drug antibodies. The ability to identify patients at increased risk for development of anti-drug antibodies would facilitate selection of therapy and use of preventative strategies.This article is freely available via Open Access. Click on Publisher URL to access the full-text

Impact of open access endoscopy on early diagnosis, treatment and gastrointestinal radiology service

The objective is to compare the endoscopic findings before and after initiation of open access and its effect on gastrointestinal radiology services. The data of endoscopic findings before open access endoscopy (July, 1989-June, 1992) and after open access endoscopy (July, 1992-June, 1995) was collected from the records of the endoscopy unit. Similarly, data of barium meals for the same periods was collected from the radiology department. An X 2 test was used to compare the endoscopic findings before and after open access policy. It is found that open access endoscopy increased the workload in the endoscopy unit but at the same time reduced the number of gastrointestinal radiological procedures. It reduced the waiting period for endoscopy and this helped in making early diagnosis and initiation of appropriate treatment

Genetic variability in beta-tubulin-1 in benzimidazole resistant haemonchus contortus from sheep in North-East Punjab, Pakistan

Benzimidazole is a synthetic anthelmintic against which nematode resistance especially in Haemonchus contortus, is emerging at a alarming speed. The mechanism of benzimidazole resistance appears to involve mutations in the gene encoding β-tubulin isotype 1 (β-tubulin-1). The present study was carried out to find out the variation existing in β-tubulin-1 which is directly involved with drug binding capacity involving microtubules polymerization. DNA of adult nematode H. contortus was extracted, amplified and sequenced. Out of 50 worms investigated, 37 showed benzimidazole susceptible gene while 13 were resistant indicating single nucleotide mutation at amino acid 200 TTC/TAC. In addition, 12 worms showed several regions of consistent difference indicating single nucleotide polymorphism (SNPs) at various positions in coding region. It has been concluded that resistant alleles conferring anthelmintic resistance is prevalent in the local population of H. contortus of north-east Punjab, Pakistan

Solar Energy Harvesting and Management in Wireless Sensor Networks

Wireless networks comprise of small devices that are typically deployed in environments where paucity of energy seriously restricts essential operations. The energy source of these devices decreases very quickly during continuous operation and it is pivotal to replace or recharge frequently the power sources. Sometimes, it is very difficult to perform these functions through conventional methods. One attractive solution to this problem is the use of the energy, scattered around us in the environment. The availability of energy from the environment is random and uncertain. In this paper, we present a model, schematically and analytically, for solar energy harvesting with appropriate energy management. We provide analysis and simulations for a solar cell for standard and different irradiance levels. The power of the storage device is also simulated for different times of the day. The proposed model not only scavenges the energy but also assures the connectivity of the network by optimizing the energy consumption

Deep Learning Approach Based on Residual Neural Network and SVM Classifier for Driver’s Distraction Detection

In the last decade, distraction detection of a driver gained a lot of significance due to increases in the number of accidents. Many solutions, such as feature based, statistical, holistic, etc., have been proposed to solve this problem. With the advent of high processing power at cheaper costs, deep learning-based driver distraction detection techniques have shown promising results. The study proposes ReSVM, an approach combining deep features of ResNet-50 with the SVM classifier, for distraction detection of a driver. ReSVM is compared with six state-of-the-art approaches on four datasets, namely: State Farm Distracted Driver Detection, Boston University, DrivFace, and FT-UMT. Experiments demonstrate that ReSVM outperforms the existing approaches and achieves a classification accuracy as high as 95.5%. The study also compares ReSVM with its variants on the aforementioned datasets

Tri-Primer ARMS-PCR Gel Pattern of IL17-F Gene, a) IL-17F rs2397084 Genotypes, b) IL-17F <i>rs</i>11465553 Genotypes, and c) IL-17F rs763780 Genotypes.

Tri-Primer ARMS-PCR Gel Pattern of IL17-F Gene, a) IL-17F rs2397084 Genotypes, b) IL-17F rs11465553 Genotypes, and c) IL-17F rs763780 Genotypes.</p