Advanced energy management system with the incorporation of novel security features

Nowadays, energy management is a subject of great importance and complexity. Pakistan, being in a state of developing country, generates electrical power mainly by using non-renewable sources of energy. Non-renewable entities are fossil fuels such as furnace oil, natural gas, coal, and nuclear power. Pakistan has been facing a severe shortage of production in energy sector for last two decades. This shortfall is affecting the industrial development as well as economic growth. With the growing population, the load demand is rapidly increasing and there must be a need to expand the existing ones or to build new power systems. In this paper, an autonomous management system has been proposed to enhance quality, reliability and confidence of utilization of energy between end consumers and suppliers. Such objectives can only be fulfilled by making the power supply secure for end consumers. Distributed and centralized control systems are involved for maintaining a balance between renewable energy resources and base power, so that end consumers demand can be fulfilled when required. A reliable Two-way communication system between suppliers and end consumers has been proposed by using Message Digest algorithm which ensures that there would be no energy theft. Simulations have been done in MATLAB/ Simulink environment and results have been presented to show the effectiveness of the proposed model

Industry 4.0 or Pharma 4.0?

This chapter examines the convergence of Industry 4.0 and Pharma 4.0 in the context of healthcare supply chains. It investigates the potential applications of these industrial revolutions to enhance the flexibility, benefits, challenges, and opportunities of healthcare supply chains. This chapter highlights the application of state-of-the-art technology to create intelligent, adaptable, and personalized supply chain systems for the healthcare and pharmaceutical sectors. The literature on “Pharma Industry 4.0” is reviewed, with a focus on the opportunities for sustainable value creation and pharmaceutical supply chain research. Healthcare supply chain has some serious issues like counterfeit drugs, non-transparent supply chain, unfear track and trace system of medicines and biomedical instruments. The authors identified the potential solutions for these issues with the help of current innovative technologies and practices

Harmonic Scalpel Hemorrhoidectomy Vs Milligan-Morgan Hemorrhoidectomy

Background: To compare Harmonic Scalpel Hemorrhoidectomy (HSH) with classical Milligan Morgan Hemorrhoidectomy (MMH) in terms of operation time and post-operative pain to establish effectiveness of this novel procedure.Methods: A total of 62 patients planned for excision hemorrhoidecotmy were randomly selected into HSH and MMH groups. Mean operation time was calculated during surgery and pain at time of first defecation was recorded on visual analog scale (VAS).Results: Mean VAS after surgery at time of first defecation was 4.32 (SD 0.909) in HSH group and 6.97 (SD 1.426) in MMH group (p value <0.000). Mean Operation time in HSH group was 18.13 (SD 3.956) minutes and that of MMH group was 22.90 (SD 4.901) minutes (P value <0.000).Conclusion: Harmonic Scalpel Hemorrhoidectomy is better than Milligan Morgan hemorrhoidectom

MTHFR gene C677T and A1298C polymorphisms and homocysteine levels in primary open angle and primary closed angle glaucoma

Contains fulltext : 79920.pdf (publisher's version ) (Open Access)PURPOSE: To investigate the methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C genotypes and plasma concentrations of total homocysteine (tHcy) in Pakistani patients with primary open angle glaucoma (POAG) and primary closed angle glaucoma (PCAG). METHODS: This was a prospective case-control study. A total of 295 patients (173 POAG, 122 PCAG) and 143 age- and sex-matched controls were subdivided into two ethnic groups, Punjabis (Punjab province, central Pakistan) and Pathans (North-West Frontier Province, northern Pakistan). Genotypes of the MTHFR C677T and A1298C polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). An enzyme-linked immunosorbent assay was used to determine the total serum homocysteine (tHcy) levels. Associations were determined by logistic regression analysis. RESULTS: Frequency distributions of genotypes and combined genotypes as well as homocysteine levels were obtained. The overall distribution of the C677T genotype was found to be significantly associated with PCAG (CC 69%, CT 21%, TT 10%; p=0.001, chi(2)=12.6), but not with POAG (CC 71%, CT 28%, TT 1%; p=0.98, chi(2)=0.02) as compared to the controls (CC 71%, CT 29%, TT 1%). The Pathan cohorts revealed no association with the disease; however, the Punjabis demonstrated a significant association with PCAG (CC 75%, CT 11%, TT 13%; p<0.001, chi(2)=17.2). PCAG in the Punjabi subjects was also significantly associated with the A1298C polymorphism (AA 43%, AC 54%, CC 3%; p<0.001, chi(2)=33.9) as compared to the controls. Combined genotype data showed no association with POAG; however, a significant association with all combined genotypes was observed in the overall PCAG subjects (p<0.05, chi(2)=20.1). This difference was particularly apparent in the TTAA and TTAC combinations that were completely absent in the control groups (p<0.05. chi(2)=49.6). Mean serum tHcy levels were found to be significantly increased in the POAG (15.2+/-1.28 micromol/l, p<0.001) and PCAG (20.8+/-4.8 micromol/l) groups as compared to the controls (10.0+/-0.97 micromol/l). The tHcy levels in the TT and AC genotype were significantly elevated in the PCAG group (67+/-12.39 micromol/l, p<0.001; 23+/-5.94 micromol/l, p=0.027) as compared to the controls. CONCLUSION: The TT and AC genotypes of MTHFR C677T and A1298C polymorphisms and the combined genotype TTAC were associated with PCAG in Punjabi subjects of Pakistani origin and correlated with the high serum tHcy levels seen in these patients

USING HEALTH INSURANCE DATABASES FOR EPIDEMIOLOGICAL RESEARCH: A SCOPING REVIEW

OBJECTIVE: This scoping review aimed to appraise the existing literature on using the claims databases for epidemiological studies and to draw inferences for using data from Pakistan’s health insurance databases. METHODS: We conducted a scoping review of literature focusing on health insurance databases, querying MEDLINE, EMBASE and Google Scholar. We used the frameworks proposed by the Joanna Briggs Institute and Arksy and O’Malley for mapping our results. RESULTS:  There was a considerable chronological increase in studies published using data from health insurance databases. Most of the studies in our search were from economically developed countries. Most of the studies (n=84) focussed on chronic non-communicable diseases, while a limited number (n=09) focussed on communicable (infectious) diseases. Our findings suggest that insurance databases could be utilised to study rare diseases, prospects of prolonged follow-up, and minimal research costs. This is especially important for countries like Pakistan, having limited resources to conduct regular, population-level epidemiological studies. Several methodological approaches (for instance, disease, pharmacy or intervention classification codes) were presented in these studies to extract epidemiological data from the insurance database. CONCLUSION: Health insurance databases are utilised as sources for epidemiological studies, predominantly for chronic illnesses, in economically developed countries. Methodological approaches described in these papers could be used to extract data for epidemiological research from health insurance databases in Pakistan. This could be especially useful for following the patterns of infectious disease in the country

Polycythemia Secondary to Pheochromocytoma

Polycythemia, also known as polyglobulia, is a clinical condition characterized by an increased number of red blood cells (RBC) or haematocrit concentrations in the peripheral blood. It can either be primary (polycythemia vera) or secondary, which can be congenital or acquired; the most common causes include obstructive sleep apnoea, obesity, hypoventilation, Pickwickian syndrome, Chronic obstructive pulmonary disease (COPD), and lastly, pheochromocytoma. Here we present a case of a 54-year-old male with a four-day history of altered state of consciousness (ASOC), right-sided body weakness, and respiratory difficulty. After a thorough history, examination, and investigation, he was diagnosed as a case of polycythemia secondary to pheochromocytoma. Early diagnosis and intervention are critical to save the patient’s life

Yield of Muscle Biopsy in Patients with Findings of Myopathy on Electrodiagnostic Testing

Background: The evaluation of neuromuscular diseases includes detailed clinical assessment, blood testing, electrodiagnostic studies (EDS), biopsy, and genetic tests. EDS alone cannot provide a specific diagnosis. Further testing in the form of genetic tests or muscle biopsy (MB) is required. Objective The objective of the study is to evaluate the yield of MB in patients with findings of myopathy on electrodiagnostic testing and assess the factors affecting an abnormal biopsy outcome. Methods: Electromyography (EMG)/nerve conduction studies (NCS) performed for suspected myopathy over 5 years from 2011 to 2016, at the neurophysiology department of a tertiary care center in Pakistan, were reviewed. Based on inclusion criteria, records of 58 patients were retrospectively reviewed. Results: After an EMG/NCS diagnosis of myopathy, the frequency of MB testing was only 10.1%. The median age of patients was 26.5 years. The clinically suspected diagnosis was categorized into hereditary myopathy (n = 15, 25.9%) and acquired myopathy (n = 18, 31%). The positive predictive value of EMG is 77.2%. Twenty-eight (48.2%) patients had abnormal MB whereas 20 (34.4%) revealed normal findings. Factors significantly influencing an abnormal outcome of biopsy included moderate-to-severe elevation of creatine kinase (\u3e2,000 U/L),presence of denervation changes, and severe myopathy on EMG. Conclusion: Even though the overall yield of MB testing may not be very high in our setting due to the unavailability of special techniques and expertise, certain factors can help to improve the diagnostic yield. Clinicians should encourage MB testing, especially in cases with strong clinical, laboratory and electrodiagnostic suspicion, and absence of genetic testing for suspected myopathy