Spectrum of Different Spinal Disorders Presenting to Neurosurgical Department of Public Sector Tertiary Care Hospitals of Peshawar

Objectives: To assess the spectrum of different spinal disorders presenting to the Neurosurgical department of public sector tertiary care hospitals of Peshawar.Materials and Methods: This was a retrospective study carried out in the Neurosurgery departments of two public sector tertiary care hospitals in district Peshawar from January 2012 to December 2018. Our inclusion criteria comprised of all those patients who were having spinal abnormalities irrespective of age and gender, admitted either via emergency or OPD. We excluded those patients who were dead on arrival or whose data was lacking including those who did not do their follow up and those who were not given consent for the study.Results: Out of total 5,579 patients, male to female ratio was 1:1.7. The age range was from 6 days to 78 years. Elective cases were 63.61% (n = 3,549) and emergency were 36.37% (n = 2,030). TSCI were 35.01% (n = 1,953) and NTSCI were 3,626 (n = 64.99%). Out of all patients, 91.03% (n = 5,079) were treated surgically. About 79% (n = 4,406) had a good outcome.Conclusion: We collected data and made a survey of the spectrum of different spinal abnormalities resulting from various etiologies focused over the last 6 years. We found a variety of cases presenting to our departments of neurosurgery. Non traumatic spinal injuries are more frequent as compared to traumatic ones

Patterns of Motorbike Accidents Related Head Injuries in Patients Presenting to a Tertiary Care Hospital of Peshawar

Objective: To determine the different patterns of motorbike related head injuries in patients presenting to a tertiary care hospital of Peshawar.Materials and Methods: It was a prospective (observational) study, which was conducted at the Neurotrauma ward of Neurosurgery department, Lady Reading Hospital, Peshawar from January 2016 to June 2016. Total number of patients were 246. We included those patients who were having impaired Glasgow Coma Scale (GCS), danger signs and having some abnormal findings on CT brain. We excluded those patients who were having GCS 15/15 and those patients of head injury having associated co-morbid conditions.Results: There were 230 (93.49%) males and 16 (6.5%) females. Age range was 1 to 80 years. Majority of pati-ents were drivers (55.28%). Only 6 (2.43%) drivers used helmet. Ninety patients (36.58%) had an ICU stay of more than one week. Seventy six (30.89%) patients were operated and 170 (69.1%) patients were treated con-servatively. Mortality was 14.63% in our study.Conclusion: Majority were males in our study, most of the patients who sustained head injury in motorbike accidents were drivers. Thirty six percent of the patients needed ICU stay of more than 1 week. Maximum of the patients needed conservative treatment

SYNTHESIS AND CHARACTERIZATION OF Mg-Al ALLOYS FOR HYDROGEN STORAGE APPLICATIONS

Mg-Al system and 2mol% Ni additive nano catalyst in the particle size range of 30-45 nm were synthesized at relatively low temperature by thermal decomposition of co- 4 and [Ni(Bipy

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2–4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

Memaksimalkan Fitur Breaking Rooms Zoom Meeting pada Pendidikan Anak Usia Dini di Masa Pandemi Covid-19

Penelitian ini bertujuan untuk menyusun panduan settingBreakout Room untuk guru dalam memaksimalkan pemanfaatan aplikasi Zoom Meeting, dan melakukan uji kelayakannya. Penelitian ini didasari oleh merebaknya pandemi COVID-19, menjadikan transisi digitalisasi pendidikan berlaku lebih cepat. Oleh karenanya, sekolah, guru, orangtua, dan anak didik dipaksa untuk beradaptasi, menyelenggarakan pembelajaran yang adaptif dengan menggunakan media belajar daring. Dengan menerapkan prosedur penelitian R D, peneliti mere-konstruksi konsep Sugiono menjadi semi R D (tanpa diseminasimodel).Penelitian ini menyimpulkan bahwa: panduan settingbreakout rooms disusun untuk membantu guru memaksimalkan penggunaan aplikasi zoom meeting untuk mendukung pembelajaran di masa pandemi Covid-19. Berdasarkan uji kelayakan produk, ditemukan jika panduan tersebut, berkualifikasi baik sekali dengan keputusan sangat layak. Untuk memaksimalkan pemanfaatannya, guru harus pro-aktif secara mandiri mengembangkan keterampilan mereka. Di samping itu, administrator sekolah (kepala sekolah, manajer) juga perlu menginisiasi program-program dan mengikutsertakan guru-gurunya pada berbagai pelatihan-pelatihan pengembangan kecakapan diri guru, baik itu kecakapan pedagogis, sosial, kepribadian, profesional, dan pengetahuan terkini (teknologi)

COVID-19: An Emerging Culprit of Inflammatory Arthritis

Arthralgia is one of the most common symptoms that occur in patients with COVID-19. About 15% of patients present with arthralgia at some point. Although COVID-19 seems to attack the musculoskeletal system (muscles and joints) in its infective and postinfective stage causing inflammatory arthritis, not much is known about the rheumatic manifestations of this infection. In this case series of 5 patients, we discuss the occurrence of bilaterally symmetrical polyarthritis in patients, previously free from any rheumatic disease, after encountering COVID-19 infection. The musculoskeletal manifestations in these patients phenotypically resembled rheumatoid arthritis. These patients were treated successfully with low-dose glucocorticoids and disease-modifying antirheumatic drugs (DMARDs)

A robust multivariate Shewhart chart for contaminated normal environments

Lately, the multivariate setup of control charts, especially the memory-less chart has received less attention of researchers as compared to the univariate setup. However, the multivariate setup is of paramount importance in this big-data era. In this research work, we study the multivariate Shewhart chart for monitoring location parameter by examining the robustness of this scheme with the mean estimator. We also explored the scheme with some other robust parametric estimators in different process environments. The multivariate estimators such as median, midrange, tri-mean (TM), and Hodges–Lehmann (HL) estimators were examined under uncontaminated, location contaminated, variance contaminated, and both location–variance contaminated normal environments. Through a synthetic Monte Carlo simulation and application of the schemes on a real-life dataset, the findings suggest that the proposed estimators outperform the default estimator of the multivariate scheme (mean). The performance measures of comparing these estimators through the charts are the average run length, standard deviation run length, extra-quadratic loss, and relative average run length. The charts resulting from applying the schemes on real-life dataset recorded from glass manufacturing process also buttresses the simulation findings

Permanent pacemaker implantation: our initial experience with Two cases reported

Permanent pacemaker implantation is a lifesaving procedure. Complete heart block is one of the most common indications in our environment. Diagnosis is often missed and treatment is not readily available. These reasons account for the low turnover of cases. Two cases were successfully conducted in our center using the VVIR type of pacemaker, and no significant complications were recorded afterword. All patients presented with typical symptoms of complete heart block and were symptoms free after the procedure