A Sustainable Indoor Air Quality Monitoring Approach through Potable Living Wall for Closed Confined Spaces: A Way Forward to Fight Covid19

The COVID-19 pandemic has greatly influenced various aspects of life, part of which has consequently paved the way toward improvements in building design criteria, especially for closed confined spaces. The closed confined spaces are directly proportional to the quantity and quality of the volatile organic compounds (VOCs) present in the atmosphere, from which human beings breathe. In managing the impact produced by VOCs, a practical, sustainable, economical and environmentally friendly concept of indoor living walls has become a prominent feature for improving the indoor air quality (IAQ) of closed confined spaces to efficiently reduce sick building syndrome (SBS) factors. In modification of common practice of ventilation systems, living wall technology leverages the natural ability of plants to purify indoor air quality by reducing air pollutants and allows the recycling of indoor air and the creation of a productive and inspiring environment. In this paper, the concept of a portable living wall through the use of a native plant species locally available in Sindh, Pakistan is introduced. Herein, the portable living concept was assessed by means of the design, construction, and data collection (testing and monitoring) of various environmental parameters carried out before and after the installation of the living wall. The study was monitored for 90 days, and analyses for various types of air pollutants were carried out in the environmental laboratory. During the monitoring period, the parameters humidity, VOCs, hazardous chemicals of concern (HCOC), CO2 and CO showed reductions in their values, with changes observed ranging from 61.5 to 58%, 0.66 to 0.01 ppm, 0.2 to 0.01 ppm, 1070 to 528 ppm and 0.2 to 0.01 ppm, respectively. The outcomes showed noticeable changes in air pollutants coupled with reductions in heating, ventilation and air conditioning (HVAC) energy consumption by up to 25%, mainly due to limited air requirements for ventilation

Iatrogenic trauma following percutaneous and minimally invasive surgical interventions

Technological progress has changed the landscape of surgical practice. Minimally invasive surgery (MIS) and percutaneous interventions (PC) are constantly replacing open procedures. This reduces hospital stay and allows quicker recovery. The application of MIS should follow the good medical practice dictum by Hippocrates i.e. First do no harm . To remain abreast with new procedures, the medical personnel are required to update and enhance their knowledge and skill. To ensure safety, the innovations are rigorously tested and tried. The learning curve of MIS is shortened by simulator training and proctorship. Credentialing processes are in place to enhance safe delivery of care. Despite of all these measures MIS and PCI are associated with adverse effects. The purpose of this article is to overview the iatrogenic trauma associated with MIS and PCI in major surgical subspecialties

Memory and cognitive flexibility in physical therapy students of Karachi

Memory allows us to remember the skills that we have learnt and retrieve valuable information stored in the brain. Physical therapy is a multidimensional profession which demands efficient cognitive flexibility and decision-making skills with an excellent memory to help the therapist to multi-task

Ionomic profiling of pericardial fluid in ischemic heart disease

Metals are essential cofactors that play a crucial role in heart function at the cell and tissue level. Information regarding the role of metals in the pericardial fluid and its ionome in ischemic heart disease (IHD) is limited. We aimed to determine the association of elements in pericardial fluid and serum samples of IHD patients and their correlation with systolic and diastolic function. IHD patients have been studied with systolic and diastolic dysfunction categorized on the basis of echocardiographic parameters. We measured concentrations of sixteen elements in the pericardial fluid and serum of 46 patients obtained during open heart surgery with IHD by ICP-MS. The levels of chromium and nickel in pericardial fluid were significantly higher as compared with serum samples of IHD patients (p \u3c 0.05). The chromium, nickel and manganese levels in pericardial fluid were lower in patients with ejection fraction (EF) \u3c 45% as compared to EF \u3e 45% (p \u3c 0.05). There was no significant difference in pericardial concentrations of elements in diastolic dysfunction grade 0–1 with 2 in IHD patients. We also found that decreased concentration of these elements in pericardial fluid is associated with decreased systolic function. These results suggest that pericardial fluid concentrations of these metals may reflect the extent of ischemic heart disease. These findings are hypothesis generating with regards to a role in the pathogenesis of the disorder

Accuracy of procalcitonin levels for diagnosis of culture-positive sepsis in critically ill trauma patients: A retrospective analysis

Background: Abdominal trauma and intra-abdominal sepsis are associated with significant morbidity and mortality. Microcirculation in the gut is disrupted in hemorrhagic and septic shock leading to tissue hypoxia, and the damaged gut acts as a reservoir rich in inflammatory mediators and provides a continual source of inflammation to the systemic circulation leading to sepsis. Sepsis is defined as the presence (probable or documented) of infection together with a systemic inflammatory response to infection. Blood culture is commonly considered to be the preferred approach for diagnosing sepsis, although it is time-consuming, that is, reports are normally available only after 12-48 hours. Procalcitonin levels (PCT) have recently emerged as a promising biomarker in the diagnosis of sepsis. The aim of the present study is to determine the diagnostic accuracy of PCT levels in predicting sepsis in critically ill trauma patients.Methodology: This was designed as a validation study conducted in the Indoor Department of General Surgery, Liaquat National Hospital, Karachi. The sample size was calculated by taking the estimated frequency of sepsis in suspected patients at 62.13%, expected sensitivity of PCT at 70.83%, and specificity at 84.21% and the desired precision level of 12% for sensitivity; the calculated sample size was 96. The non-probability consecutive sampling method was used to recruit participants who were diagnosed with sepsis on clinical assessment. Blood culture samples were sent for the enrolled patients and a final diagnosis was made on the blood culture report. PCT levels were measured in these suspected patients on the same day of sending blood culture. Diagnostic accuracy of PCT size was measured using the receiver operating characteristic (ROC) curve. ROC curve was formulated for PCT levels against culture-proven sepsis to determine the ideal cut-off value of PCT levels. Two different cut-offs were determined to obtain the highest sensitivity and highest specificity accordingly.Results: A total of 97 individuals met the inclusion criteria with a mean age of 34.89 ± 10.52 years. Mean PCT levels were 0.96 ± 0.59, with a gender predilection towards females (p \u3c 0.001). No age difference was documented among gender (p = 0.655). The mean duration of intensive care unit stay was 11.73 ± 3.56 days. Culture-proven sepsis was identified in 67.0% of the study participants with a higher PCT level (p \u3c 0.001). Among the 52.6% males included in the study, half were reported to have culture-positive sepsis, but among the 47.4% females culture was positive in 87% (p \u3c 0.001). ROC revealed PCT was predictive for culture-positive sepsis at a cut-off value 0.47 ng/mL (p \u3c 0.001), with a sensitivity of 92.3%, specificity of 68.7%, positive predictive value (PPV) of 85.7%, and negative predictive value (NPV) of 81.5%. By increasing the cut-off value to 0.90 ng/mL at area under the curve of 0.816, the specificity increased to 81.3% and sensitivity became 66.2%, with a PPV of 87.8% and NPV of 54.2%.Conclusion: Our study determined two cut-values for PCT to predict sepsis, one with the highest sensitivity and the other with better specificity. Other than that, higher PCT levels were significant in female trauma patients. We conclude that PCT is a reliable marker for culture-proven diagnosis of sepsis and may aid physicians/surgeons to promptly manage patients accordingly

Current status of shrimp fishery in Pakistan: economic role, challenges, opportunities and strategies for aquaculture development

1743-1754The Shrimp fishery has an important role in society to meet current and future food, livelihood, employment, business and other economic needs. The capture fishery is one of the largest food-providing sector, whereas aquaculture has emerged as the fastest food-contributing sector globally. This research determines the socio-economic structure of shrimp fishery with a prime objective to expose an overview of shrimp fishery with economic perspective in Pakistan. In addition, further specifying the shrimp capture production, export earnings, farming and socio-impact in coastal region. Indus delta is the most favourable breeding ground for many fish and shrimp species, exhibiting highly rich in natural resources. There is a huge non-agricultural land available along the coast, which can be utilized for aquaculture. This study elucidates that the Shrimp fisheries is ‘Drowning’ in Pakistan. Hence, in order to sustainably develop shrimp aquaculture in Pakistan, this study aims to propose developmental strategies for authorities to establish an extension aquaculture in fisheries department all over the country. In addition, promoting shrimp farming initially at coastal regions to benefit and generate numerous opportunities for sustainable development in country’s livelihood

Ocular manifestations of dengue fever in Bangladesh during its out break

Dengue fever, borne by Aedes aegypti mosquito, is one of the most common and most prevalent forms of flavivirus infections in humans, endemic in tropics and warm temperate regions of the world. We report a spectrum of ocular manifestations of dengue fever along with its associated laboratory findings. To study the ocular manifestations associated with dengue fever. This study was conducted in 600 patients hospitalized with diagnosis of dengue fever over a period of 3 months from March 2019 to May 2019. All patients underwent complete evaluation with respect to systemic and ophthalmic examination in different institutions of Bangladesh. A total of 600 patients were diagnosed with dengue fever; of which, 375 (62.5%) were men and 225 (37.5%) were women. Mean age was 32 years (20–60 years). Only 195 patients (32.7%) had complaints of retrobulbar pain in the eyes. 10 patients (1.67%) had blurring of vision. Ocular findings were present in 340 patients (56.7%). Most common anterior segment findings were subconjunctival haemorrhage in 275 patients (45.8%). Posterior segment findings were present in 80 patients (13.3%); of which, 70 (87.5%) had retinal haemorrhages. Ocular changes had resolved in all the cases, which came for follow-up in 8–10 weeks. It was mostly attributed to the improving platelet count. The incidence of ocular complications in dengue fever is increasing, hence all patients with dengue should be referred to an ophthalmologist to prevent any sight-threatening BSMMU J 2022; 15(1): 16-1

Understanding of metals dysregulation in patients with systolic and diastolic dysfunction in ischemic heart disease

Ischemic heart disease (IHD) is the leading cause of death and chronic disability in the world. IHD affects both the systolic and diastolic function of the heart which progressively leads to heart failure; a structural and functional impairment of filling or ejection of blood from the heart. In this study, the progression of systolic and diastolic dysfunction characterized according to their echocardiographic parameters including left ventricular ejection fraction (EF), grades of diastolic dysfunction and ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e\u27), were correlated with differential regulation of various metals in patients sera samples (n = 62) using inductive coupled plasma-mass spectrometry (ICP-MS). Chromium, nickel and selenium were found significant (p \u3c 0.05) in patients having EF \u3c 45% compared with EF \u3e 45%. In patients with systolic dysfunction (EF \u3c 45%), the level of selenium was decreased while the level of chromium and nickel was increased compared to patients with EF \u3e 45%. Selenium level was also decreased significantly (p \u3c 0.05) in grade 1A and 2 patients that are considered as higher grades of diastole dysfunction in comparison to grade 0-1. Overall, selenium deficiency was identified in both systolic and diastolic dysfunctions of IHD patients corresponding to the progression of disease that could be related to many metabolic and translational pathways specifically which involve selenoproteins

Risk factors associated with clinical malaria episodes in Bangladesh: A longitudinal study

Malaria is endemic to Bangladesh. In this longitudinal study, we used hydrologic, topographic, and socioeconomic risk factors to explain single and multiple malaria infections at individual and household levels. Malaria incidence was determined for 1,634 households in 54 villages in 2009 and 2010. During the entire study period 21.8% of households accounted for all (n = 497) malaria cases detected; 15.4% of households had 1 case and 6.4% had ≥2 cases. The greatest risk factors for malaria infection were low bed net ratio per household, house construction materials (wall), and high density of houses. Hydrologic and topographic factors were not significantly associated with malaria risk. This study identifies stable malaria hotspots and risk factors that should be considered for cost-effective targeting of malaria interventions that may contribute to potential elimination of malaria in Bangladesh. Copyright © 2013 by The American Society of Tropical Medicine and Hygiene

Study protocol of DIVERGE, the first genetic epidemiological study of major depressive disorder in Pakistan

INTRODUCTION: Globally, 80% of the burdenof major depressive disorder (MDD) pertains to low- and middle-income countries. Research into genetic and environmental risk factors has the potential to uncover disease mechanisms that may contribute to better diagnosis and treatment of mental illness, yet has so far been largely limited to participants with European ancestry from high-income countries. The DIVERGE study was established to help overcome this gap and investigate genetic and environmental risk factors for MDD in Pakistan. METHODS: DIVERGE aims to enrol 9000 cases and 4000 controls in hospitals across the country. Here, we provide the rationale for DIVERGE, describe the study protocol and characterise the sample using data from the first 500cases. Exploratory data analysis is performed to describe demographics, socioeconomic status, environmental risk factors, family history of mental illness and psychopathology. RESULTS AND DISCUSSION: Many participants had severe depression with 74% of patients who experienced multiple depressive episodes. It was a common practice to seek help for mental health struggles from faith healers and religious leaders. Socioeconomic variables reflected the local context with a large proportion of women not having access to any education and the majority of participants reporting no savings. CONCLUSION: DIVERGE is a carefully designed case-control study of MDD in Pakistan that captures diverse risk factors. As the largest genetic study in Pakistan, DIVERGE helps address the severe underrepresentation of people from South Asian countries in genetic as well as psychiatric research