not all asymptomatic carotid plaques are equal: some require intervention

Ischemic stroke represents a major health hazard around the world, which has a severe impact on society and the health-care systems. Roughly, 15% of all strokes can be attributed to significant atherosclerotic disease of the carotid arteries. Some patients presenting with disabling strokes for the first time cannot benefit from carotid revascularization having lost the opportunity of prevention. We know that all symptomatic patients were once asymptomatic. Hence, after identifying high risk carotid plaques and patient’s characteristics suitable for interventions, they should be offered carotid revascularization at specialized centers (with low perioperative stroke and death rates) to prevent stroke and cognitive function decline in long term

Cerebral embolism: distal subclavian disease as a rare etiology

Subclavian artery occlusive disease is usually secondary to persistent compression caused by thoracic outlet syndrome (TOS) and rarely due to focal atherosclerosis. Emboli from diseased vessel can flow retrograde to the vertebral or carotid arteries to produce ischemic infarct with or without neurological deficit. We are reporting two cases of distal subclavian artery disease presenting with cerebral embolization, an unusual manifestation. Such surgically correctable lesions producing cerebral emboli and stroke needs consideration while evaluating patients with unusual presentation to prevent further occurrence of stroke

Future Time Orientation and Moral Self-image: An Analysis of Adolescents in Private and Government Schools in Punjab Pakistan

The purpose of the present research was to investigate future time orientation and moral self-image in the adolescents of government and private schools. A sample of 300 adolescents was studied from the government and private schools of Kharian, Pakistan by using simple random sampling technique. The construct of future time orientation was measured by using Time Orientation Scale (Zimbardo & Boyd 1999) whereas moral self-image was measured by using Moral Self Image Scale (Jordan, Leliveld, & Tenbrunsel, 2015). The data was analyzed by using simple regression and independent sample t-test. The results revealed that future time orientation was the significant predictor of moral-self-image [R²=.168; F (1, 298) = 60.103, p<.01]. Further, there was difference in the future time orientation of adolescents of government and private school (t (298) = 3.40, p<.05) and difference in moral self-image was not significant (t (298) = 1.02, p>.05). Whereas on gender there was a non-significant difference persist in the future time orientation (t (298) = .62, p>.05) and significant difference identified on moral self-image (t (298) = -2.1, p<.05). It was explored that future time orientation was the significant predicator of the moral self-image. Moreover, there was difference in the future time orientation of government and private school adolescents and no difference on the moral self-image. Moreover, no gender difference was established on future time orientation and a gender difference existed on the moral self-image

Genotypic Characterization of Macrolides Resistance in Clinical Isolates of Staphylococcus Aureus from Rawalpindi, Pakistan

Objective: To determine the patterns of resistance among different macrolides and to detect macrolide resistance genes in Staphylococcus aureus collected from different clinical samples. Study Design: Cross-sectional observational study. Place and Duration of Study: The clinical samples sourced from the Pathology Labs of Railway Hospital, Tehsil Head Quarter (THQ) Hospital Taxila and Wah General Hospital Wah Cantt, Pakistan was collected from 01August 2017 to 01 February 2018. Materials and Methods: One hundred non-repetitive clinical isolates were obtained from different clinical samples (pus, urine, sputum and blood). Each Staphylococcus aureus isolate was obtained from only one sample, to avoid repetition of strain. They were selected on the criteria of their growth with bright yellow color colony formation on mannitol salt agar (MSA) media along with the color change of media from red to yellow and coagulase positive results. Kirbey-Baur disk diffusion test was followed for the detection of antimicrobial sensitivity, whereas genotypic resistance drift was determined using PCR. Results: Highest frequency of Staphylococcus aureus was observed in pus samples i.e. 45 (40.2%). Out of 100, 34 isolates of Staphylococcus aureus were resistant to macrolides group. Among 34 resistant isolates the frequency of ermC gene was 25 and msrAwas 14 respectively, whereas all isolates were negative for ermAgene. Maximum resistance was observed against erythromycin, n=33 (29.5%) and minimum against clarithromycin, n=26 (23.3%). The highest susceptibility trend was seen against Azithromycin, n=62 (55%). Conclusion: Resistance of Staphylococcus aureus may vary with different antibiotics within the same group. A high frequency of erythromycin resistance was seen in this study. The most predominant resistance was for ermC, among the resistance genes in isolates

Height and Self-Esteem as the Determinants of Psychological Adjustment in Students in Punjab, Pakistan

The purpose of the present research was to investigate height and self-esteem as the determinants of psychological adjustment in students. A sample of 300 students was recruited from University of Gujrat, Pakistan by using convenient sampling technique. The construct of self-esteem was measured using Rosenberg Self-esteem Scale whereas psychological adjustment was measured by using and Scale of Adjustment . The data was analyzed using neural network analysis. Among the 300 students, the results revealed that height and self-esteem predicted psychological adjustment. Further, the importance of each variable was also explored through the analysis.  It indicated that the height of the students (.562 with 100% normalized importance) was more important in predicting the psychological adjustment as compare to self-esteem (.438 with 77.9% normalized importance). It was concluded that height and self-esteem was the determinant of psychological adjustment in students. Further, height plays a more vital role in hindering the psychological adjustment as compare to self-esteem. Keywords: Height, Self-esteem, Psychological Adjustment, Neural Network Analysis, Students DOI: 10.7176/JEP/10-36-10 Publication date: December 31st 201

Molecular detection of antimicrobial resistance in local isolates of Staphylococcus epidermidis from urinary tract infections in Faisalabad region of Pakistan

Staphylococci are one of the foremost causes of urinary tract infections (UTIs) in humans. The emergence of multiple drug resistance (MDR) among Staphylococci poses serious challenges in antimicrobial therapy for UTIs. Most work has been done on S. aureus while coagulase negative Staphylococci (mainly S. epidermidis) are often neglected. This study was conducted to establish a baseline profile of drug resistance in local S. epidermidis isolates from UTIs. Eighty urine samples were collected from suspected UTIs cases and screened for S. epidermidis. Twenty isolates were suspected as S. epidermidis based on colony morphology and Gram staining. Molecular detection by polymerase chain reaction (PCR) confirmed 13 isolates as S. epidermidis. Using disc diffusion method, phenotypic drug resistance of the isolates was observed towards erythromycin (100 %), gentamycin, azithromycin and tetracycline (92.3 %), ampicillin and oxytetracyclin (84.6 %), amikacin and srteptomycin (76.9 %), methicillin (69.2 %), cephradine, cefaclor and cefazolin (53.8 %) and vancomycin (15.3 %). Eighteen most commonly reported genes responsible for conferring resistance towards these drugs were targeted by PCR: among these tetM gene was found most prevalent (46.1 %) followed by tetK (30.7 %), aac(6’)/aph(2”) (30.7 %), aacA-aphD (23 %), ermA (23 %), blaZ (23 %), mecA (23 %) blaTEM-1 (23 %), MeccA (23 %) and mecA (15.3 %). No gene fragment for vancomycin resistance was detected. The salient finding was that all S. epidermidis isolates were multiple drugs resistant as they showed resistance against at least three structurally different antimicrobial agents. It is concluded that in addition to the mostly used antimicrobial agent vancomycin, the cephalosporins including cephradine, cefaclor and cefazolin are also the drugs of choice against UTIs caused by S. epidermidis

Synthesis, Characterization, Antibacterial, Antifungal and Irritant Activities of Organometalic(ll) Complexes of O-Nitro N,N-Dimethylbenzylamine Derivatives

A series of Transition metal  complexes have been  synthesized by reacting with newly prepared  biological active Schiff base ligand .The ligand was prepared by reacting N-bromosuccinimide with O-nitro toluene and reflux for 8hours ,resulting mixture was filtered ,filtrate was o-nitro benzyl bromide which on reaction with dimethyl ammine produce o-nitro N,N-dimethylbenzylamine and characterized by elemental analysis, molar conductivity ,thermal analysis ,X-ray diffraction,IR,UV-Vis spectroscopy and mass spectra. Analytical data confirms the ratio between metal and ligand that is 1:2with octahedral geometry. The IRspectra suggests that ligand behaves as basic bidenate ligand. Molar conductance values suggests non electrolytic nature of metal complexes ,thermal behavior shows more ordered activated state in complex form.Antibacterial and Anti fungal activities were performed by using new strains of bacteriaBacillussubtilis,Bacilluspumilus,Sarcinalutea,Streptococcusfaecalis,Staphlococcusaureus,Borditellabronchiseptica and fungal strains used were Trichophyton longiusus, Candida albicans, Aspergillus flavis,Microsporum canis, Fusarium solani, Candida glabrata.The biological activities data showed that complexes of Copper, Chromium, Manganese and zinc exhibited more antimicrobial activities than their parent ligand. Maximum antibacterial activity was exhibited by zinc complex. Moderate antibacterial activity exhibited by copper complex and the minimum antibacterial response was reported with manganese .

Middle East in Crisis

In the contemporary times, Middle East is engulfed in multiple crises ranging from contention amongst rival states to the terrorism. In addition to that, insurgencies, civil wars and proxies, a very active role of non-state actors as well as extra regional players have become a constant feature while defining Middle Eastern politics. This research study would analyze these conflicts from multiple perspectives that include economic, social and demographic structures that contributed in ignition of the crises in Middle East. Furthermore, the incongruence amongst various actors in Middle East severed and aggravated the crises that Middle East is facing in current era. This research study argues that a comprehensive and multilateral approach is required to resolve these issues, which are affecting Middle East

Acute limb ischemia due to ergotism

Acute ischemia of an extremity potentially threatens limb loss and occasionally the life of the patient. We are reporting two cases of extremity ischemia secondary to ergot poisoning. The first patient was a 60 years old woman, who presented with a 15 days history of ischemia of the left arm with gangrene of the fingers and pain in the resting right hand for one day. Right brachial artery catheterization showed severe spasm of the artery which was resolved by passage of the inflated balloon catheter. She underwent amputation for gangrene of the left hand. The second patient presented with bilateral symmetrical ischemia of the lower extremities which improved upon withdrawal of the ergot containing medicine. She responded to nifedipine