Frequency of cryptosporidium infection in children under five years of age having diarrhea in the North West of Pakistan

Cryptosporidium species are minute, coccidian protozoan parasites that have been associated withenterocolitis. It has worldwide distribution and has emerged as an important cause of diarrhea,particularly in children less than 5 years of age and in immunocompromised individuals. Waterbornetransmission is particularly troublesome because Cryptosporidium parvum oocysts are not eliminatedby chlorination or domestic disinfectants. In the present study, single stool specimens from youngchildren (< 5 years) presented with diarrhea were collected in Khyber teaching hospital, Peshawar,Pakistan. Wet mount preparation and modified Ziehl-Neelsen staining were used for identification ofoocysts in stool specimens. Cryptosporidium oocysts were found in 18 (9.0%) out of 200 childrensuffering from diarrhea. Infection was common in children between 1 - 24 months of age and associatedwith abdominal cramps (50%), vomiting (61.1%) and prolonged duration of diarrhea (88.9%). Direct andindirect contact with animals was present in most of C. parvum infected children (83.3%). Most of C.parvum infected children were consumers of well water (77.8%). Cryptosporidium spp. are highlyinfectious causes of diarrheal illness around the world. It is an important cause of diarrhea in children.Clinician and laboratories should be encouraged to include C. parvum diagnostic techniques whiledealing with diarrheal stool samples of young children

Multi-objective optimisation for minimum quantity lubrication assisted milling process based on hybrid response surface methodology and multi-objective genetic algorithm

© 2019 by SAGE Publications Ltd.Parametric modelling and optimisation play an important role in choosing the best or optimal cutting conditions and parameters during machining to achieve the desirable results. However, analysis of optimisation of minimum quantity lubrication–assisted milling process has not been addressed in detail. Minimum quantity lubrication method is very effective for cost reduction and promotes green machining. Hence, this article focuses on minimum quantity lubrication–assisted milling machining parameters on AISI 1045 material surface roughness and power consumption. A novel low-cost power measurement system is developed to measure the power consumption. A predictive mathematical model is developed for surface roughness and power consumption. The effects of minimum quantity lubrication and machining parameters are examined to determine the optimum conditions with minimum surface roughness and minimum power consumption. Empirical models are developed to predict surface roughness and power of machine tool effectively and accurately using response surface methodology and multi-objective optimisation genetic algorithm. Comparison of results obtained from response surface methodology and multi-objective optimisation genetic algorithm depict that both measured and predicted values have a close agreement. This model could be helpful to select the best combination of end-milling machining parameters to save power consumption and time, consequently, increasing both productivity and profitability.Peer reviewedFinal Published versio

Granulomatous gastritis: a diagnostic dilemma?

Granulomatous inflammation of the gastrointestinal tract is an uncommon entity, an aetiopathogenic diagnosis can be reached only by combining the morphological examination with clinical and laboratory investigations. We report two cases of granulomatous gastritis: a 27-year-old woman presenting with weight loss and a 55-year-old woman presenting with epigastric pain and vomiting. Upper oesophagastroduodenoscopy in these cases showed antral hyperaemia and histopathology showed non-caseating gastric granulomatous inflammation. Both the cases were extensively worked-up for possible tuberculosis (TB) as the Patients lived in an endemic area, before starting steroids for the possibility of Crohn\u27s disease (CD). The first Patient improved but the second Patient had a flare of underlying undiagnosed TB. Granulomatous gastritis present a diagnostic challenge for treating physicians because of similar clinical, laboratory and endoscopical features between CD and intestinal TB

Local experts finding using user comments in location-based social networks

The opinions of local experts in the location-based social network are of great significance to the collection and dissemination of local information. In this paper, we investigated in-depth how the user comments can be used to identify the local expert over social networks. We first illustrate the existences of potential local experts in a social network using a scored model by considering the personal profiles, comments, friend relationship, and location preferences. Then, a multi-dimensional model is proposed to evaluate the local expert candidates and a local expert discovery algorithm is proposed to identify local experts. Meanwhile, a scoring algorithm is proposed to train the weights in the model. Finally, an expert recommendation list can be given based on the score ranks of the candidates. Experimental results demonstrate that effectiveness of proposed model and algorithm

Images in Clinical Urology: Complex open pyeloplasty in a pelvic kidney

A pelvic kidney occurs in between 1 in 2200 and 1 in 3000 people,1 due to failure of ascent during development. It is commonly asymptomatic and usually functions normally. Pelvic ureteral junction obstruction can either be congenital or acquired, and is characterized by intrinsic stenosis or extrinsic compression of the ureter at the junction with the pelvicalyceal renal system. This can cause symptomatic or asymptomatic hydronephrosis. We describe the complex case and management of a patient with a massive pelvic ureteral junction obstruction in a pelvic kidney

Maternal deaths in Pakistan : intersection of gender, class and social exclusion.

Background: A key aim of countries with high maternal mortality rates is to increase availability of competent maternal health care during pregnancy and childbirth. Yet, despite significant investment, countries with the highest burdens have not reduced their rates to the expected levels. We argue, taking Pakistan as a case study, that improving physical availability of services is necessary but not sufficient for reducing maternal mortality because gender inequities interact with caste and poverty to socially exclude certain groups of women from health services that are otherwise physically available. Methods: Using a critical ethnographic approach, two case studies of women who died during childbirth were pieced together from information gathered during the first six months of fieldwork in a village in Northern Punjab, Pakistan. Findings: Shida did not receive the necessary medical care because her heavily indebted family could not afford it. Zainab, a victim of domestic violence, did not receive any medical care because her martial family could not afford it, nor did they think she deserved it. Both women belonged to lower caste households, which are materially poor households and socially constructed as inferior. Conclusions: The stories of Shida and Zainab illustrate how a rigidly structured caste hierarchy, the gendered devaluing of females, and the reinforced lack of control that many impoverished women experience conspire to keep women from lifesaving health services that are physically available and should be at their disposal

SDN-Sim: Integrating System Level Simulator with Software Defined Network

© 2020 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works. With the introduction of diverse technology paradigms in next-generation cellular and vehicular networks, design and structural complexity are skyrocketing. The beyond- 5G use cases such as mobile broadband, 5G-V2X and UAV communications require support for ultra-low latency and high throughput and reliability with limited operational complexity and cost. These use cases are being explored in 3GPP Release 16 and 17. To facilitate end-to-end performance evaluation for these applications, we propose SDN-Sim - an integration of a System Level Simulator (SLS) with a Software Defined Network (SDN) infrastructure. While the SLS models the communication channel and evaluates system performance on the physical and data link layers, the SDN performs network and application tasks such as routing, load balancing, etc. The proposed architecture replicates the SLS-defined topology into an SDN emulator for offloading control operations. It uses link and node information calculated by the SLS to compute routes in SDN and feeds the results back to the SLS. Along with the architecture, data modeling and processing, replication and route calculation frameworks are proposed

Interactive virtual 3D image reconstruction to assist renal surgery in patients with fusion anomalies of the kidney

Objective: Renal fusion anomalies are rare and usually present as horseshoe kidneys or crossed fusion ectopia. The complex renal anatomy seen in patients with these anomalies can present a challenge. Pre-operative planning is therefore paramount in the surgical management of these cases. Herein we report the use of interactive virtual three-dimensional (3D) reconstruction to aid renal surgery in patients with fusion anomalies of the kidney. / Materials and Methods: A total of seven cases were performed between May 2016 and October 2020. 3D reconstruction was rendered by Innersight Labs using pre-operative computed tomography (CT) scans. / Results: Five patients had malignant disease and two patients had benign pathology. Robotic and open operations were performed in four and three patients, respectively. / Conclusion: The use of 3D reconstruction in the cases reported in this series allowed for the identification of variations in renal vasculature, and this informed the choice of operative approach. / Oxford Centre for Evidence-Based Medicine Evidence Level: 4

Behind the counter: pharmacies and dispensing patterns of pharmacy attendants in Karachi.

BACKGROUND: There is little literature available on dispensing patterns and unsupervised sale of medicines from pharmacies in developing countries. OBJECTIVE: This study obtained background information on pharmacies assessed the level of training, knowledge and dispensing patterns of pharmacy attendants in Karachi. METHODOLOGY: This is a descriptive cross sectional study with convenient sampling. A structured questionnaire was used to interview pharmacy attendants. RESULTS: Of the 219 pharmacies surveyed, 62% reported more than 50 customers daily and 20% also sold items of general provision. Mean operating hours were 13. Only 24 (11%) had a visible license. On an average 3 attendants were employed per pharmacy. We interviewed one in each. Amongst the 219 interviewed, 77 (35%) were intermediate qualified and only 26 (12%) pharmacologically trained. Correct frequency of ORS administration was not known by 167 (76%) and 21% incorrectly suggested an anti-diarrhoeal preparation for viral diarrhoea in children. The knowledge of those with pharmacological training was significantly better. For respiratory tract infection in children approximately 60% did not know the correct dose of Paracetamol and Amoxicillin. Only 13 (6%) knew that Propanalol was contraindicated in hypertensive asthamatics. For Cotrimoxazole, metronidazole and lomotil only 40%, 21% and 15% respectively, were aware that these could not be dispensed without prescription. CONCLUSION: In the absence of trained pharmacists existing pharmacy attendants should be trained to improve drug-dispensing patterns