Fulminant hemolysis in glucose-6-phosphate dehydrogenase deficiency

Key Clinical MessageGlucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked disorder affecting some 400 million people worldwide. Though clinically silent, it may result in hemolysis on oxidative stress induced by drugs or infections. Viral hepatitis A with coexisting G6PD deficiencycan be devastating associated with severe hemolysis, anemia, renal failure, and hepatic encephalopathy

Selection principles: s-Menger and s-Rothberger-bounded groups

[EN] In this paper, selection principles are defined and studied in the realm of irresolute topological groups. Especially, s-Menger-bounded and s-Rothberger-bounded type covering properties are introduced and studied.Iqbal, MA.; Khan, MUD. (2022). Selection principles: s-Menger and s-Rothberger-bounded groups. Applied General Topology. 23(1):189-199. https://doi.org/10.4995/agt.2022.14846OJS18919923

Improved shear strength prediction model of steel fiber reinforced concrete beams by adopting gene expression programming

In this study, an artificial intelligence tool called gene expression programming (GEP) has been successfully applied to develop an empirical model that can predict the shear strength of steel fiber reinforced concrete beams. The proposed genetic model incorporates all the influencing parameters such as the geometric properties of the beam, the concrete compressive strength, the shear span-to-depth ratio, and the mechanical and material properties of steel fiber. Existing empirical models ignore the tensile strength of steel fibers, which exercise a strong influence on the crack propagation of concrete matrix, thereby affecting the beam shear strength. To overcome this limitation, an improved and robust empirical model is proposed herein that incorporates the fiber tensile strength along with the other influencing factors. For this purpose, an extensive experimental database subjected to four-point loading is constructed comprising results of 488 tests drawn from the literature. The data are divided based on different shapes (hooked or straight fiber) and the tensile strength of steel fiber. The empirical model is developed using this experimental database and statistically compared with previously established empirical equations. This comparison indicates that the proposed model shows significant improvement in predicting the shear strength of steel fiber reinforced concrete beams, thus substantiating the important role of fiber tensile strength.National University of Science and Technolog

Impressions and attitudes of adult residents of Karachi towards a possible public health insurance scheme

Objective: To gauge the general population\u27s knowledge and attitude towards a possible public health insurance scheme.Methods: This descriptive, cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from April to May 2015, and comprised permanent residents of the city. Convenience sampling was used. Data was collected via questionnaires. SPSS 22 was used for data analysis.Results: There were 340 participants in the study with an overall mean age of 32.9±12.4 years. Besides, 159(46.8%) participants were aware of the concept of medical insurance while the correct definition was identified by 160(50.5%) respondents. Overall, 256(75.3%) participants were willing to join a theoretical public health insurance scheme. Of all the respondents, 107(31.5%) had faced a catastrophic event in the past and consequently were more willing to join. Of those unsure or not willing to join, 33(37.9%) respondents identified lack of trust in government programmes as the main reason for their choice.CONCLUSIONS: A large majority of adults had a favourable attitude towards the implementation of a possible public health insurance scheme

Gene Expression Programming for Estimating Shear Strength of RC Squat Wall

The flanged, barbell, and rectangular squat reinforced concrete (RC) walls are broadly used in low-rise commercial and highway under and overpasses. The shear strength of squat walls is the major design consideration because of their smaller aspect ratio. Most of the current design codes or available published literature provide separate sets of shear capacity equations for flanged, barbell, and rectangular walls. Also, a substantial scatter exists in the predicted shear capacity due to a large discrepancy in the test data. Thus, this study aims to develop a single gene expression programming (GEP) expression that can be used for predicting the shear strength of these three cross-sectional shapes based on a dataset of 646 experiments. A total of thirteen influencing parameters are identified to contrive this efficient empirical compared to several shear capacity equations. Owing to the larger database, the proposed model shows better performance based on the database analysis results and compared with 9 available empirical models

Predicting the Response of RC Beam from a Drop-Weight Using Gene Expression Programming

For structures and load-bearing beams under extreme impact loading, the prediction of the transmitted peak impact force is the most challenging task. Available numerical and soft computing-based methods for finding peak impact force are not very accurate. Therefore, a simple and user-friendly predictive model is constructed from a database containing 126 impact force experiments of the simply supported RC beams. The proposed model is developed using gene expression programming (GEP) that includes the effect of the impact velocity and the impactor weight. Also identified are other influencing factors that have been overlooked in the existing soft computing models, such as concrete compressive strength, the shear span to depth ratio, and the tensile reinforcement quantity and strength. This allows the proposed model to overcome several inconsistencies and difficulties residing in the existing models. A statistical study has been conducted to examine the adequacy of the proposed model compared to existing models. Additionally, a numerical confirmation of the empirical model of the peak impact force is obtained by reference to 3D finite element simulation in ABAQUS. Finally, the proposed model is employed to predict the dynamic shear force and bending moment diagrams, thus rendering it ideal for practical application

Shear Strength Prediction Model for RC Exterior Joints Using Gene Expression Programming

Predictive models were developed to effectively estimate the RC exterior joint’s shear strength using gene expression programming (GEP). Two separate models are proposed for the exterior joints: the first with shear reinforcement and the second without shear reinforcement. Experimental results of the relevant input parameters using 253 tests were extracted from the literature to carry out a knowledge analysis of GEP. The database was further divided into two portions: 152 exterior joint experiments with joint transverse reinforcements and 101 unreinforced joint specimens. Moreover, the effects of different material and geometric factors (usually ignored in the available models) were incorporated into the proposed models. These factors are beam and column geometries, concrete and steel material properties, longitudinal and shear reinforcements, and column axial loads. Statistical analysis and comparisons with previously proposed analytical and empirical models indicate a high degree of accuracy of the proposed models, rendering them ideal for practical application

Association of factor V Leiden G1691A and prothrombin gene G20210A mutations with adverse pregnancy outcomes

Objective: To determine the association of Factor V Leiden / prothrombin gene mutation in Pakistani women with adverse pregnancy outcomes. Method: The prospective study was conducted at the Aga Khan University Hospital, Karachi, from January 1 to December 31, 2016, and comprised females ?40 years having history of two or more foetal losses with no apparent aetiology. Restriction fragment length polymorphism- Polymerase chain reaction was performed using MnlI and HindIII restriction enzymes for factor V Leiden G1691A and prothrombin gene mutation G20210A. Females with two or more consecutive normal pregnancies were enrolled as the control group. Data was analysed using SPSS 19. Results: Of the 172 participants with a mean age of 29.3±5.9 years (range: 19-38 years). 86(50%) each were healthy controls and those with recurrent pregnancy loss. There were 238 livebirths among the controls compared to 13 in the other group. Factor V Leiden G1691A was identified in 2(2.3%) women, and prothrombin gene mutation G20210A in 1(1.2%) woman in the patient group, while no mutation was identified in the control group. Conclusion: The prevalence of Factor V Leiden / prothrombin gene mutation in women with recurrent pregnancy loss was found to be very low. Continuous...

Association of factor V leiden G1691A and prothrombin gene G20210A mutation with adverse pregnancy outcomes

Background: Familial defects and polymorphisms of clotting cascade proteins protein S, protein C, factor V Leiden G1691A and factor II G20210A are linked with increased risk of thromboembolism which is better known as inherited thrombophilia. Thrombophilia causes deep venous thrombosis, pulmonary embolism and is strongly associated with poor pregnancy outcomes. Pathophysiology of these outcomes is thought to involve thrombosis in uteroplacental blood flow hence, anticoagulation therapy can potentially improve obstetric outcome in females with thrombophilias. To date, there is local limited data on the role of these genetic abnormalities causing adverse pregnancy outcomes. Objective: Determine the association of factor V Leiden G1691A and prothrombin gene G20210A mutation with adverse pregnancy outcomes. Methods: It is a case control study, conducted at clinical laboratory, section of haematology, and PCR-RFLP technique is used at multi-disciplinary laboratory, AKUH. Females with adverse pregnancy outcomes coming to obstetrical clinic are included in the study as cases. Control samples are selected from females with ≥ 2 consecutive normal pregnancies. Calculated sample size is 172 which comprise of 86 cases and 86 controls. Results: The mean age of cases was 29.3 (±5.17) years while that of controls was 31.8 years (±6.23). 34% of cases had previous live births. One case (2/86) had heterozygous mutation of factor V Leiden G1691A and while none was identified in control arm (0/86). Heterozygous prothrombin gene mutation was identified in one case (1/86) while none of the controls (0/20) exhibited this mutation. Conclusion: Overall, this study does not support a significant association between inherited thrombophilia mutations and adverse pregnancy outcomes. The apparent lack of association may be reconciled by the low numbers of subjects recruited. Keywords: Factor V Leiden G1691A, factor II G20210A, adverse pregnancy outcomes, inherited thrombophili