Acute disseminated encephalomyelitis in a middle age female

Acute disseminated encephalomyelitis (ADEM) is an autoimmune condition that predominately involve demyelination of the white matter of the brain and spinal cord. It resembles other acute demyelinating syndromes like multiple sclerosis and most often presents in childhood.This is a case of a 52-year woman, presented with lower limb weakness, confusion and spasticity throughout the body with no preceding illness. CSF showed increased proteins with no oligoclonal bands. MRI Brain showed abnormal high intensity areas in bilateral parietal, periventricular region, with no contrast enhancement. She was given 1gram iv methylprednisolone based on the diagnosis of ADEM and responded well

Adapting photovoice to explore identity expression amongst people with intellectual disabilities who have limited or no verbal communication

© 2021 The Authors. This is an open access article under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.People with intellectual disabilities who have limited, or no verbal communication can be involved in research. Ethnographic observations and interview techniques can work together with photovoice. More research needs to be completed directly involving people with intellectual disabilities. Abstract: Background Inclusive research requires adapting methodologies to meet the needs of people with all degrees of intellectual disabilities. However, it must also balance this with the requirements of academic research. Building from previous research a study was completed to illustrate how photovoice could not only be adapted to meet the needs of people with intellectual disabilities who have limited or no verbal communication but to also explore how they express their identity. Methods A qualitative multiple case study method was used to explore identity expression amongst three participants with intellectual disabilities and limited or no verbal communication. The methodology integrated ethnographic observations, photovoice and interview techniques. Findings Integrating the ethnographic observations, photovoice and interview techniques offered families and carers the opportunity to become curious about participants' identities, and this methodology was considered valuable in getting to know more about the person. Conclusions It is hoped that through conducting research that directly involves people with intellectual disabilities, more creative and inclusive methods can be explored, verified and applied across various research contexts.Peer reviewedFinal Published versio

Associating Perinatal Mortality With Diet By Adapting Robust Clustering Using Links For Categorical Variables

Perinatal Mortality (perinatal death), is death of a neonate within 6 days (early neonatal mortality) or from 7 – 27 days of birth (late neonatal mortality). Food consumed by an expectant mother is said to have an impact on the pregnancy outcome apart from other factors. For the past few years, perinatal mortality rate has been increasing in developing and under-developed parts of the world. Two-thirds of the world’s perinatal deaths occur in only 10 countries, and Pakistan is ranked third amongst these countries. These deaths have not been studied widely, in fact they have been under-reported and these reports have not even been considered in any attempts made to improve birth outcomes in developing nations [1]. Nutritional, socioeconomic, demographic and health advice seeking behavior factors are responsible for higher mortality rates in countries such as Pakistan. Data mining and machine learning can be used to identify factors that are responsible for such high infant mortality rates as it is an important factor indicating progress on Millennium Development Goals. In this paper, we discuss how using ROCK we can cluster expectant mothers as per the food intake and identify major food items causing perinatal mortality

N-acetylcysteine (NAC) ameliorates Epstein-Barr virus latent membrane protein 1 induced chronic inflammation

Chronic inflammation results when the immune system responds to trauma, injury or infection and the response is not resolved. It can lead to tissue damage and dysfunction and in some cases predispose to cancer. Some viruses (including Epstein-Barr virus (EBV)) can induce inflammation, which may persist even after the infection has been controlled or cleared. The damage caused by inflammation, can itself act to perpetuate the inflammatory response. The latent membrane protein 1 (LMP1) of EBV is a pro-inflammatory factor and in the skin of transgenic mice causes a phenotype of hyperplasia with chronic inflammation of increasing severity, which can progress to pre-malignant and malignant lesions. LMP1 signalling leads to persistent deregulated expression of multiple proteins throughout the mouse life span, including TGFα S100A9 and chitinase-like proteins. Additionally, as the inflammation increases, numerous chemokines and cytokines are produced which promulgate the inflammation. Deposition of IgM, IgG, IgA and IgE and complement activation form part of this process and through genetic deletion of CD40, we show that this contributes to the more tissue-destructive aspects of the phenotype. Treatment of the mice with N-acetylcysteine (NAC), an antioxidant which feeds into the body’s natural redox regulatory system through glutathione synthesis, resulted in a significantly reduced leukocyte infiltrate in the inflamed tissue, amelioration of the pathological features and delay in the inflammatory signature measured by in vivo imaging. Reducing the degree of inflammation achieved through NAC treatment, had the knock on effect of reducing leukocyte recruitment to the inflamed site, thereby slowing the progression of the pathology. These data support the idea that NAC could be considered as a treatment to alleviate chronic inflammatory pathologies, including post-viral disease. Additionally, the model described can be used to effectively monitor and accurately measure therapies for chronic inflammation

Cyber Harassment and Women of Pakistan: Analysis of Female Victimization

Cyber harassment refers to an unwanted aggressive behavior by misusing Information Communication Technology (ICT). Cyber harassment is a grave problem all over the world, and is growing fast with the increased use of ICTs. Women are considered the core victims of cyber harassment, although men are also not exception to it. The study analyses the situation of Pakistan regarding cyber harassment of women. To probe the situation related to cyber harassment, we analyzed 68 available cases from different sources during 2012-2018. We then matched those cases with the data of Federal Investigation Agency (FIA). The results showed that comparatively a small number of cases of cyber harassment got registered and prosecuted. Out of registered cases, most of the cases were registered in the Punjab Province. Most of the victims were between the ages of 21-30 years and were well educated. Pictures sent through Facebook and cell phones were the primary source of blackmailing and harassment. The purpose of harassment is heterogeneous which is comprised of monetary benefits, revenge, and exploitation. The study suggests awareness campaigns regarding cyber harassment among women belonging to different trades and social groups. The research also suggests campaigns in society at a massive scale to create sensitization about these issues. The study further suggests training of law enforcement agencies to make them more effective in this scenario

Urban ecosystem services on the local level: urban green spaces as providers

Ecosystem services are provided at different spatial and service/functional scales. The local level is the basic unit for ecosystem services, especially when it comes to the human dimension of urban landscapes. These services are provided by green elements (patches) or basic complex ecosystems (green areas) which differ from their neighbourhoods through their structures and functions. This study reviews the generally available knowledge on urban green functions and services at the site level and explains them by using own studies in five different cities in three different continents related to distinct ecosystem services. This allows the development of a methodology to evaluate and compare ecosystem services at the site level. The methodology is based at two levels, patch and green space, and includes the relationship with the surrounding green and built-up space. Different urban green space types are characterized by their internal structures of vegetation, size, shape and location in relation to at least a semi-quantitative scaling of their urban ecosystem services. The evaluated urban green spaces are public urban green spaces. The urban ecosystem services assessed include climate regulation, biodiversity, nature experience, recreation and health. The actual urban challenges, such as land use change, adaptation to climate change, demographic change and urban cultural diversity, demand a systematic and very concrete monitoring of urban ecosystem services at the site level.Fil: Breuste, Jürgen. University of Salzburg. Department of Geography and Geology; AustriaFil: Schnellinger, Johanna. University of Salzburg. Department of Geography and Geology; AustriaFil: Qureshi, Salman. Birmingham City University. School of Architecture; Reino UnidoFil: Faggi, Ana Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales; Argentin

Prevalence and risk factors associated with multi-drug resistant organisms (MDRO) carriage among pediatric patients at the time of admission in a tertiary care hospital of a developing country. A cross-sectional study

Background: The rise of Multidrug-resistant organisms (MDROs) poses a considerable burden on the healthcare systems, particularly in low-middle income countries like Pakistan. There is a scarcity of data on the carriage of MDRO particularly in the pediatrics population therefore, we aimed to determine MDRO carriage in pediatric patients at the time of admission to a tertiary care hospital in Karachi, Pakistan, and to identify the risk factors associated with it.Methods: A cross-sectional study conducted at the pediatric department of Aga Khan University Hospital (AKUH) from May to September 2019 on 347 children aged 1-18 years. For identification of MDRO (i.e., Extended Spectrum Beta-Lactamase (ESBL) producers, Carbapenem Resistant Enterobacteriaceae (CRE), Vancomycin Resistant Enterococci (VRE), Methicillin Resistant Staphylococcus aureus (MRSA), Multidrug-resistant (MDR) Acinetobacter species and MDR Pseudomonas aeruginosa), nasal swabs and rectal swabs or stool samples were cultured on specific media within 72 h of hospitalization. Data was collected on a predesigned structured questionnaire on demographics, prior use of antibiotics for \u3e 48 h in the last 6 months, history of vaccination in last 6 months, exposure to health care facility regardless of the time of exposure, ICU stay for \u3e 72 h, and about the prior use of medical devices (urinary catheter, central venous lines etc.) in last 1 year. Statistical analysis was performed by Standard statistical software.Results: Out of 347 participants, 237 (68.3%) were found to be MDRO carriers. Forty nine nasal swabs from 346 children (14.2%) showed growth of MRSA. The majority of the stool/rectal swabs (n = 222 of 322; 69%) collected were positive for MDRO. The most isolated species were ESBL Escherichia coli 174/222 (78.3%) followed by ESBL Enterobacter species 37/222 (16.7%) and ESBL Klebsiella pneumoniae 35/222 (15.8%). On univariate analysis, none of the risk factors showed statistically significant association with MDRO carriage.Conclusion: Overall, a high prevalence of MDRO carriage was identified among admitted pediatric patients. Implementation of systematic screening may help to identify true burden of MDROs carriage in the health care settings

CAPITAL & EARNINGS MANAGEMENT: EVIDENCE FROM THE BANKING SECTOR OF PAKISTAN

This paper examines the relationship of loan loss provisions with the capital and earnings management in the banking sector of Pakistan. The study applies the Clustered Robust Linear Regression while examining the panel models when the data had heteroscedasticity and autocorrelation in it. This regression is used to remove the effects of these disturbances from the dataset. The study targets 25 banks (Islamic and commercial banks) from the banking sector of Pakistan. Descriptive analysis showed that the banks are engaged in the use of loan loss provisions for their capital and earnings management practices. The results of Clustered Robust Linear Regression showed a significant relationship of Tier1 and EBTLLP on the dependent variable LLP. This significant relationship depicts the strong influence of loan loss provisions (LLPs) on the capital and earnings management of the banks in Pakistan. In further research perspective, the time duration of the study can be extended, and more variables can be added. It can also include a comparative study amongst different banks in Pakistan

Prevalence And Morphometric Analysis Of Fossa Navicularis Magna In Dry Human Skulls

Introduction: Basiocciput is the part of occipital bone present on the inferior aspect of skull. Fossa Navicularis Magna-an osseous defect is a variation in normal anatomy of basiocciput. Lately few case reports presented this fossa as a cause of spread of infection from nasopharynx to brain resulting in meningitis and osteomyelitis. Objectives: This study aims to find the incidence and morphometry of this fossa in Pakistani populace to avoid any misdiagnosis or misinterpretations. Materials & Methods: This study was conducted on dry human skulls at King Edward Medical University Lahore. Fossa was measured in its transverse and vertical diameters and to locate the fossa its distance from various anatomical land marks such as foramen ovale, foramen Lacerum, carotid canal, occipital condyles, pharyngeal tubercle and posterior border of vomer was noted. Results:  The incidence of this fossa was found to be 5.3% in Pakistani population. Predominantly oval shaped, fossa measured 5.5 and 3.06 mm in vertical and transverse diameters respectively. It was 12.2 mm posterior to vomer and 5.9 mm anterior to pharyngeal tubercle. Conclusion: This study is useful for radiologists and clinicians in avoiding any misinterpretations on radiographs and unnecessary investigation