Congenital L-Transposition of the Great Arteries in a 12-Year-Old: A Case Report

Levo-transposition of the great arteries, L-TGA, also known as congenitally corrected transposition, cc-TGA is a rare anomaly and accounts for less than 1% of all congenital heart diseases. It is characterized by both atrioventricular and ventriculoarterial discordance . It is considered a congenitally corrected transposition because the circulation is from right atrium to left ventricle leading to the pulmonary vasculature. The lungs then pump blood into the left atrium to the right ventricle and eventually to the systemic circulation via the aorta

THE UNDERUSE OF SPIROMETERY IN ROUTINE MEDICAL PRACTICE FOR DIAGNOSIS AND MANAGEMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS IN KARACHI, PAKISTAN

Introduction: Spirometry is important in the diagnosis and management of chronic obstructive pulmonary disease (COPD), yet it is a common clinical observation that it is underused though the extent is unclear. This survey aims to examine the use of spirometry in the diagnosis and management of COPD patients in districts of, Karachi. Material and Methods: It is a cross-sectional survey involving four clinic settings: hospital-based respiratory specialist clinic, hospital-based mixed medical specialist clinic, general outpatient clinic (primary care), and tuberculosis and chest clinic. Thirty physician-diagnosed COPD patients were randomly selected from each of the four clinic groups. All of them had a forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) ratio less than 0.70 and had been followed up at the participating clinic for at least 6 months for COPD treatment. Results: Of the 120 COPD patients, there were 111 males and mean post-bronchodilator FEV1 was 46.2% predicted. Only 22 patients (18.3%) had spirometry done during diagnostic workup, and 64 patients (53.3%) had spirometry done ever. Conclusion: We conclude that spirometry is underused in general but especially by non-respiratory physicians and family physicians in the management of COPD patients. More effort at educating the medical community is urgently needed. KEYWORDS: Pulmonary function tests; Specialist; Forced expiratory volume in 1 second (FEV1); Forced vital capacity (FVC)

THE UNDERUSE OF SPIROMETERY IN ROUTINE MEDICAL PRACTICE FOR DIAGNOSIS AND MANAGEMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS IN KARACHI, PAKISTAN

Introduction: Spirometry is important in the diagnosis and management of chronic obstructive pulmonary disease (COPD), yet it is a common clinical observation that it is underused though the extent is unclear. This survey aims to examine the use of spirometry in the diagnosis and management of COPD patients in districts of, Karachi. Material and Methods: It is a cross-sectional survey involving four clinic settings: hospital-based respiratory specialist clinic, hospital-based mixed medical specialist clinic, general outpatient clinic (primary care), and tuberculosis and chest clinic. Thirty physician-diagnosed COPD patients were randomly selected from each of the four clinic groups. All of them had a forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) ratio less than 0.70 and had been followed up at the participating clinic for at least 6 months for COPD treatment. Results: Of the 120 COPD patients, there were 111 males and mean post-bronchodilator FEV1 was 46.2% predicted. Only 22 patients (18.3%) had spirometry done during diagnostic workup, and 64 patients (53.3%) had spirometry done ever. Conclusion: We conclude that spirometry is underused in general but especially by non-respiratory physicians and family physicians in the management of COPD patients. More effort at educating the medical community is urgently needed. KEYWORDS: Pulmonary function tests; Specialist; Forced expiratory volume in 1 second (FEV1); Forced vital capacity (FVC)

A Design for Proprioceptive Force in 3D Agility Robot Through Use of AI

For robots to be considered effective, they should be able to maneuver through 3D environments. To achieve such mobility, robots needs to be designed in such a way that would span various topographies. So, artificial intelligence algorithms have been developed to ensure agility of the robots when walking on murky topographies. In the current state of the art legged robots, there is still much progress need to be made in research to turn them into automobiles with great agility to be used in the real world utility and provide mobility in rough. GOAT leg as a means of artificial intelligence is still a new phenomenon. There still exists a number of preliminary tests that need to be done in accessing and in the characterization of the leg’s current performance and its implications in the future. This study seeks to develop and agility model which would be useful in ensuring that the robots remain agile in such complex environments. To do this, a simulation has been through Matlab analysis. Results of the current study showed that, 3-RSR was designed to ensure that a high fidelity proprioceptive force control would enable legs with the mechanically spring stiffness. Implications and future recommendations also discussed

Correlation of Cervical Vertebral Maturation and Tooth Mineralization of Mandibular Second Molar

OBJECTIVES To determine the correlation between skeletal maturity and mandibular second molar calcification. METHODOLOGY A descriptive cross-sectional study was conducted at the Saidu College of Dentistry from 15th January to 30th October 2022. One hundred participants of Pakistani descent, aged 8-16 years (both genders), with ANB greater than 50 and presence of all permanent teeth excluding 3rd  molars, were included. Medically compromised, syndromic patients, those who had undergone previous orthodontic treatment, and cases with extracted permanent teeth were excluded. Skeletal maturity was determined by analyzing the cervical vertebrae maturation index (CVMI) on lateral cephalogram according to Baccetti et al. and mandibular second molar calcification according to the Demijian Index from panoramic radiographs. The Spearman correlation test was run for correlation assessment.RESULTSThe mean age was 11.81±1.62 years. There were 49 (49%) males and 51 (51%) females. A perfect correlation (100%) was found between CVM stage I and dental stage C. The concordance between CVM stage II and dental stage D was found in 21 (91.30%). The correlation between tooth mineralization and CVM stages was very high and statistically significant (r=0.97, p<0.001). Similarly, the correlation between CVM and chronological age was also high and statistically significant (r=0.8, p<0.001). The correlation was also significantly increased in males and females (r=0.97, p<0.001). CONCLUSION The tooth mineralization stages of the mandibular second molar can be used to assess growth as an alternative to cervical maturation staging

Dimensions of Women Empowerment: A case study of Pakistan

Introduction Over the last three decades, gender equality and empowerment debates are being focused. It has been realized that policies and projects without concerning the female position in the society have adverse impact on development. United NationsInternational Conference on Women in 1995, held in Beijing, stressed on the need to reduce gender inequality and to increase women empowerment. The third target of Millennium Development Goal is regarding gender equality and women empowerment.Numerous countries, regions and International Development Organizationsmade commitments to reduce gender equality as a key for sustainable economic development. The term women empowerment has different connotation which depends on social, economical, and political context in which it is used. World Bank (2001) defines “the expansion of the freedom of choices and action, which could increase women authority and control over resources and decision regarding their life.”Similarly, Women empowerment is a process through which women achieve the ability to control, take ownership over resources and make strategies of life choices(Kabeer 2001). However, the process itself depends on women, through education, capacity building, skills and trainings and changes in legal and structural framework. Women empowerment covers many dimensions including social,economic, cultural, political, legal and psychological (Malhotra et al. 2002). This explains a broad variation in the concept of women empowerment.  Although, these definitions are clear but there are some constraints to measure women empowerment due to lack of standardized ways. Moreover, many researchers  tried to construct set of specific questions based on Population Based Primary Survey for measuring empowerment at individual level, (Kishor and Subaiya 2008). Women empowerment is preferred not only for the development of a country but also required to minimize poverty and promotes economic growth. (Chaudryet al.2012). According to United Nations Women Policy Division (2013), women empowerment need to be focused and all the development projects and policies need to be gender sensitize. In most of the developing countries, due to early marriages, high female unemploymentrate along with limited investment in them comply females to depend on men. Early marriage is one of the crucial reasons of lower participation of females in the labor marketcompared as to developed nations [ (World Bank 2007) , (Doepke et al. 2012)]. Plethora of literature demonstrates that women empowerment are directly associated with contraceptive use, lower fertility, and longer birth intervals[( Gwako 1997), (Schuler et al. 1997), (Balk 1994), (Woldemicael 2009), (Upadhyay and Hindin 2005)]. Furthermore, education is one of the determinants of empowerment of women which also lowers the fertility rate and improves the earnings. (Jejeebhoy1995), ( Mason 1987)]. For political empowerment, education plays a crucialrole as  well educated women are better informed about their legal rights and they can actively participatein political decision making process[ (Moghadam 2003), (Rihani et al. 2006)]. In a patriarchal society like Pakistan, women empowerment is also very difficult to achieve as societies and communities are governed by strictly social and cultural norms. In a traditional society like Pakistan, the entire major as well as the minor decisions related to inside and outside the house are taken by the men. The worse situation has been reported for Pakistan in terms of gender equality and women empowerment.  According to MDG Report (2013), Pakistan is still far away from the targets of 2015 MDGs in terms of access to education, gender equality and women empowerment which are reflected by child mortality, maternal health and nutrition (Government of Pakistan 2013). Pakistan ranks 121st as overall in the Gender Gap Index (GGI) 2014 out of 142 counties, and 146th out of 187 countries in Human Development Index (HDI) 2014,Furthermore,it stands141stfor economic participation and opportunity for women, ineducation attainmentit ranks 132nd, in terms of health and survival 119th and 85th in terms of political empowerment in 2014. Pakistan,Inequality Human Development Index(IHDI) value for 2013 is 0.375, Human Inequality coefficient was 28.7%, Inequality in Life Expectancy at Birth is 29.9% ,Inequality in Education was 45.2%  andInequality in income is 11% .Pakistan GII value is 0.562 and rank is 126th out of 149 countries in the 2013 index. The Maternal Mortality Ratio is 260 per women 100,000 lives birth, Adolescent birth rate is 27.3,and female seats in parliament are 19.7%. Population with at leastSecondary education for male is 46.3% and for female is 19.3%. The impediments of low level of women empowerment in Pakistan is due to regional disparities, social values, cultural norms and traditions, ethnic and political issues (Sustainable Development Policy Institute, 2008). Furthermore, the women’s status and position is also different in terms of rural and urban. Pakistan Bureau of Statistics (2012), reports female literacy rate is lower and unequal as compared to men in rural and urban areas. However, women in rural areas spend more hours at work as compared to females in urban areas. Mostly in developing countries like Pakistan, women are restricted to domestic activities like doing household chores and raisings children (Mollel and Metenga ,2000) and women have less access to enjoy the opportunities, decision making, and basic resources. There is strong need of women empowerment especially on economics ground. The reason is that women are the majority of the population and represent majority of the poor. Moreover, the economic empowerment has significant impact on the livelihood of women, children at the household, but also at the community and national level(Singh(2006) , Ogato(2013). According to Awan (2012) cultural issues have more or less same impact on women regarding upper or lower classes. She further explained that the upper class women are more educated with strong financial support and available resources. However, in some tribal areas women are the victims of injustice. The status and position of women in marginalized segment or unprivileged segment of population are vulnerable. Because they don’t have any chance or resources against unfair treatment, especially domestic violence. Even these women are not aware regarding their basic rights. Pakistani women are bounded in a trap of dependency and subordination due to low economic, political and social position in the society. Moreover, majority of them suffers from all kinds of poverty (Social Policy Development Centre,2009). In rural areas, women are expected to perform household choresas well as agriculture and farming activities, however their contribution is hardly appreciated and mostly taken as for granted because they are the unpaid family workers. Later, when women become old then they are able to control over some domestic decision making, the situation is much better in urban areas due to exposure of education, electronic media. However, it cannot be stated that women are empowered in urban areas as the magnitude of women discrimination is different in urban and rural areas. Although political empowerment condition is better in Pakistan as compared to china , India, and Iran, and its represent 22.2% seats in national assembly and In the Senate, women have 17 per cent of the parliamentary seat ,however its cannot explained overall women empowerment on household and community level. These women are needs to be more active for taking part in laws in order to raise women status in the society in reality they are not as much as active as they should be. This paper comprises of IV sections. Section I is introduction followed by review of literature II. Section III highlights the data sources and methodology. Section IV identifies the different dimensions of women empowerment and the last section is the conclusion and policy options