Comparison of intravenous magnesium sulphate versus placebo in the management of women with severe pre-eclampsia.

Objective: To investigate the effectiveness of prophylactic intravenous magnesium sulphate in management of pre-eclemptia in terms of prevention from convulsions and developemrnt of eclempsia. Methodology: This prospective randomised trial was conducted in the department of Obtetrical and gynaecology Bahawal Vctoria Hospital, Bahawalpur. From September 2016 to September 2017. Information was entered in SPSS computer software version 23.1 and analyzed for possible results. Mean and SD was calculated and presented for quantitative data like maternal age, Gestational age, Parity and Blood pressure. Frequency (percentages) were calculated and presented for qualitative data such as gender protienurea (Yes/No), C-section, development of eclempsia and maternal death. Post stratification statistical chi square test was used to see effect modification. P value ≤ 0.05 was considered as significant. Results: In this study, a total number of 100% (n=318) patients were included, divided into two equal groups, 159 in each i.e. magnesium sulphate group and placebo group The outcomes were observed as Convulsions 2.5% (n=4) and 8.2% (n=13), maternal death1.3% (n=2) and 6.3% (n=10), adverse reaction 0.6% (n=1) and 8.2% (n=13), anti-hypertensive therapy 73.6% (n=117) and 81.8% (n=130), caesarean Section 59.7% (n=95) and 48.4% (n=77), live births 88.1% (n=140) and 97.5% (n=155) and stillbirths 21.4% (n=34) and 12.6% (n=20) for magnesium sulphate group and placebo group respectively. In Mgso4 group 95% patients have good efficacy and placebo group have 84.3% good efficacy. Conclusion: Relative small incidence of convulsions (2.5%) was found in Mgso4 group, so administration of Magnesium sulphate should considered in management of pre-eclempsia

How do Companies Promote Luxury Brands in United Arab Emirates?

Luxury – a word most brands would want to be characterized as. Being a social marker, luxury brands play a key role in the creation of human identity – it influences how they dress and enables them to signify a certain lifestyle. In the past it was fairly easy to brand luxury, as competition was moderate and consumers were quite easy to define and the tendency of consumers to remain loyal and uncritical towards a single-brand.[1] Keeping the above in view, the study was designed to analyze the promotional strategies of three well known automotive brands present in United Arab Emirates. The study indicated that the companies used almost the same modes and mediums for promoting their respective brands. [1] Reference: Kapferer & Bastien, 2009, p. 18 & Okonkwo, 2007, p. 3, 6

Overexpression of EGFR in oral premalignant lesions and OSCC and its impact on survival and recurrence

Introduction: Oral squamous cell carcinoma (OSCC) the sixth leading cancer worldwide ranks as the most common cancer in males, and the third most common in females in Pakistan. It is influenced by risk factors which are widely consumed in our population. The epidermal growth factor receptor (EGFR) is a tyrosine kinase receptor that is imperative for cell signalling, growth and differentiation. It is mutated and overexpressed in a variety of cancers, while in OSCC it has been linked to poor patient survival; premalignant to malignant transformation and recurrence. This study investigates the use of EGFR as a prognostic factor for OSCC.Materials and Methods: Premalignant (n=29) and OSCC (n=100) formalin-fixed paraffin-embedded tissues were retrieved from the surgical archives of Aga Khan University Hospital (AKUH). Immunohistochemistry for EGFR overexpression was performed using monoclonal antibody on both groups. EGFR expression was correlated with habits of risk factor consumption, clinicopathologic features and 5-year survival and recurrence.Results: 15/29 premalignant and 67/100 OSCC patients had overexpressed EGFR. The upper/lower lip had the highest EGFR positivity among all premalignant sites of lesion (p=0.041). In OSCC patients, those who had EGFR overexpression had worse 5-year survival (univariate: p=0.048, multivariate: p=0.056) and higher chances of recurrence (univariate: p=0.01, multivariate: p=0.004) as compared to EGFR negative patients.Conclusion: EGFR is a viable candidate for an OSCC prognostic marker since its overexpression leads to poor survival and markedly increases the chances of recurrence

Herbal remedies used for the management of urolithiasis in Abbottabad, Northern Pakistan

The current study was performed to evaluate the ethnobotanical uses of medicinal plants to treat and prevent kidney diseases, especially urolithiasis in the Abbottabad region, Northern Pakistan. Field surveys were conducted from 2014–2016 in various rural and tribally dwelled hilly areas like Ayubia National Park, Sherwan and Thandiani. Ethnobotanical information about the medicinal plants employed to treat urinary ailments was obtained from well-informed sources like local healers (hakims) and residents (men/women), who had vast knowledge of local plants uses. The questionnaire method was adopted to record the information and queries were made to verify the information. Informed consent was obtained from each informant before conducting the interview process. Quantitative ethnobotanical indices were calculated for each recorded species. Correlation analysis between the RFC, UV and FL% was tested by Pearson’s correlation, SPSS (ver. 16). A total of 38 plant species belonging to 27 families were being used in the study area to treat Urolithiasis or kidney stone diseases. Asteraceae was the most dominant family with 5 species. Local people used different methods of preparation for different plant parts; among them, decoction was the popular and dominant way of preparation (52.6%), followed by powder (18.4%), extracts (15.7%), juice (7.8%) and cooked (5.2%). The highest UV was recorded for Rumex acetosa L. (1.14) followed by Agrimonia eupatoria L. (1.1), Equisetum ramosissimum Desf. (1.05), Aerva lanata L. (1.04), Eclipta alba Hassak. (1.03). Moreover, twenty-three species were recoded with above 50% Fidelity level. It was found that most of the plant species (16 species) were explicitly used to remove kidney stones. All the obtained data about the ethnomedicinal uses of plants to treat urinary tract ailments are alphabetically categorized to their botanical name/family, local name, phytoconstituents, dosage and route of administration, along with quantitative indices value. All the collected ethnomedicinal plants require a thorough scientific investigation for isolation, identification, biochemical assays, toxicities and evaluation of pharmacological activities of the phytoconstituents, especially of the plants recorded with a high-fidelity level before their usage in clinics

Analysis of collaborative wireless vehicular technologies under realistic conditions

Abstract Reliable communications are essential to provide intelligent services to connected cars. For operational services, connected vehicles in VANET (Vehicle Ad hoc Networks) regularly transfer large amounts of data related to vehicular safety. Similarly, V2X (Vehicle-to-Everything) communications include vehicles exchanging information with each other and with infrastructure that is, Vehicle-to-Infrastructure (V2I) and Vehicle-to-Vehicle (V2V). This paper has analyzed the performance of IEEE 802.11p and 5G test network in a collaborative manner under realistic conditions. For performance analysis the exchange of safety-critical road weather and traffic information has been performed to enhance the traffic safety and traffic efficiency in the domain of intelligent transportation system (ITS). The vehicular connectivity is provided in V2V and V2I scenarios by utilizing short-range IEEE 802.11 standard or cellular approaches, such as the 5G network. Here, we consider combining these technologies in a cooperative manner to exploit jointly their advantages. In this cooperative heterogeneous network, the IEEE 802.11p supports safety-related pilot use cases while the provision of non-safety-related pilot use cases are supported by the 5G test network. The performance analysis revealed that the IEEE 802.11p performs quite reasonably well with restricted mobility in contrast of 5G test network in a collaborative manner to avoid road accidents

Cause of death in under 5 children in a demographic surveillance site in Pakistan

ObjectiveTo identify Cause of deaths among children below age of 5yearsfrom a prospective cohort of women in one urban and four peri-urbansettings of Karachi, PakistanIntroductionPakistan ranks 26th in Childhood mortality rates, globally. Pakistan,with other 4 countries is responsible for about half of the deaths ofchildren age under 5. Despite such burden vital registration systemis not well established, health facilities are not easily accessible andmostly deaths occur at home, making identification of cause of death(COD) difficultMethodsFrom Jan 2007-Dec 2012 under-5 mortality was identifiedby CHWs during their 3-monthly visits. A Research Assistantconducted Verbal Autopsies (VA). Each VA form was analyzed by2 physicians, independently, and assigned a cause. VA is analyzedby a third physician in case two physicians do not agree on a cause.Cause Specific Mortality Fractions (CSMF) were calculated for eachidentified COD.Results833(58%) neonatal deaths and 591(42%) Under-5 deaths (excludingneonates) were identified. Among neonates most common CODswere perinatal asphyxia(30.4%), neonatal sepsis/meningitis(28%),pre-term birth complication(11%) and neonatal pneumonia(6%).For Post-neonatal deaths most common CODs were sepsis (19%),diarrheal disease (17%), Pneumonia (17%) and meningitis (8%).ConclusionsWe describe the CSMF for different CODs among neonated andchildren under 5. Strategies for prevention of most common causesand making health facilities easily accessible will decrease thisburden

Analysis of VANET wireless networking technologies in realistic environments

Abstract Communication is essential to provide an intelligent services to connected cars. For operational services, connected vehicles in VANET (Vehicle Ad hoc Networks) regularly try to transfer large amounts of data for vehicular safety. Similarly, V2x (Vehicle-to-Everything) communication includes vehicles transferring information with each other and with infrastructure i.e., Vehicle-to-Infrastructure (V2I) and Vehicle-to-Vehicle (V2V) are proven to increase traffic safety and security as well as to enhance the efficiency of intelligent transportation system (ITS). Vehicular connectivity is provided using short-range technologies such as the IEEE 802.110 standard or cellular approaches, such as the 5G network. In this article, we consider combining these technologies in a cooperative manner and aiming at exploiting jointly their advantages. In this cooperative heterogeneous network, the IEEE 802.11p supports safety-related pilot use cases while the provision of non-safety-related pilot use cases are supported by the 5G test network

Cause of death in under 5 children in a demographic surveillance site in Pakistan

ObjectiveTo identify Cause of deaths among children below age of 5yearsfrom a prospective cohort of women in one urban and four peri-urbansettings of Karachi, PakistanIntroductionPakistan ranks 26th in Childhood mortality rates, globally. Pakistan,with other 4 countries is responsible for about half of the deaths ofchildren age under 5. Despite such burden vital registration systemis not well established, health facilities are not easily accessible andmostly deaths occur at home, making identification of cause of death(COD) difficultMethodsFrom Jan 2007-Dec 2012 under-5 mortality was identifiedby CHWs during their 3-monthly visits. A Research Assistantconducted Verbal Autopsies (VA). Each VA form was analyzed by2 physicians, independently, and assigned a cause. VA is analyzedby a third physician in case two physicians do not agree on a cause.Cause Specific Mortality Fractions (CSMF) were calculated for eachidentified COD.Results833(58%) neonatal deaths and 591(42%) Under-5 deaths (excludingneonates) were identified. Among neonates most common CODswere perinatal asphyxia(30.4%), neonatal sepsis/meningitis(28%),pre-term birth complication(11%) and neonatal pneumonia(6%).For Post-neonatal deaths most common CODs were sepsis (19%),diarrheal disease (17%), Pneumonia (17%) and meningitis (8%).ConclusionsWe describe the CSMF for different CODs among neonated andchildren under 5. Strategies for prevention of most common causesand making health facilities easily accessible will decrease thisburden

Rates and causes of stillbirth in a demographic surveillance site in Karachi, Pakistan

ObjectiveTo determine burden, timing and causes of stillbirths in aprospective cohort of pregnant from a low income community settingin peri urban KarachiIntroductionStillbirth remained a neglected issue absent from mention inMillennium Development Goals. An estimated 2.6 million babies arestillborn every year withhighest rate in Pakistan, 43.1 stillbirths/1000births. There is lack of good quality prospective population based datain Pakistanregarding burden, timing and causes of stillbirthsMethodsFrom Jan – Dec 2012, Community Helath Workers (CHWs)identified pregnant women through 3 monthly household visits.Pregnant women were then followed up till end of their pregnancy.In case of a stillbirth, a detailed verbal autopsy (VA) interview wasundertaken 2 weeks after the outcome by a research assistant. VAforms were then reviewed by 2 independent Physicians who assigneda cause for stillbirth. In case of disagreement, VA form was reviewedby a third physician. A consensus between two physicians wasrequired for a definitive cause.ResultsThere were a total of 273 stillbirths (3.04%) reported. Stillbirthrate was 30.7/1000 births. Distribution of antepartum and intrapartumstillbirths was 83% and 17%. Three most common causes of stillbirthsincluded pregnancy induced Hypertension(37%), antepartumhemorrhage (10%) and obstructed labor(6%) (fig. 1).ConclusionsWe have reported a high burden of stillbirths that take placeduring the intrapartum period. This reemphasizes need for goodquality antenatal care in these settings. Appropriate measure needsto be taken targeting most common causes of stillbirths, focusing onimproved antepartum health care facilitie