Comparison of Outcome of Bipolar Electrocautery versus Harmonic Scalpel in the Management of Third and Fourth Degree Hemorrhoids

Objective: To compare the outcome of bipolar electrocautery versus harmonic scalpel in the management of third degree hemorrhoids. Methodology: This is a comparative study performed at Different Private Clinics of Karachi from the duration of January 2020 to June 2020. Patients with symptomatic grade III hemorrhoids and grade IV hemorrhoids were randomly divided into two groups. . Either group had 64 patients. One group underwent hemorrhoidectomy using bipolar electrocautery (Group A), other group underwent hemorrhoidectomy using harmonic scalpel hemorrhoidectomy (Group B). Results: The total number of patients was 128 with 64 in either group. The mean operating time in group A was 22 ± 4.7 minutes, while that in group B was 35 ± 2.2 minutes. The mean duration of hospital stay among group A was 1.7 ± 0.5 days while among group B patients was 2.1 ± 1.2 days. Mean VAS score for pain at first post-operative day in group A patients was 7 ± 0.6 days while mean VAS score for pain among group B patients was 8.5 ± .2 days. Conclusion: Our study concludes that harmonic scalpel hemorrhoidectomy offers better post-operative patient satisfaction score as compared to bipolar diathermy. No significant difference in hospital stay was found. The number of patients with post-operative urinary retention were more in harmonic scalpel group while in diathermy group, more patients had post-operative hemorrhage

Farmers’ Characteristics, Crop Diversification and Agricultural Constraints affecting Crop Cultivation in Sindh province of Pakistan: An Empirical Evidence

This paper investigates various factors affecting crop cultivation both in negative and positive ways in the Sindh province of Pakistan. To undertake our analysis, we conducted face-to-face face interviews with farmers using a pre-tested questionnaire and both judgment and simple random sampling methods in the two districts, namely Hyderabad and Matiari, of Sindh province. Our multiple linear regression results capture the influence of various factors; including farmers’ characteristics (e.g. their age, education, and tenancy) and crop diversification (or crop varieties) in addition to main agricultural constraints, such as water scarcity, barren and salinized land, lack of financial resources, discouraging crop cultivation in the province. In the light of our results, we proposed several suggestions for the decision-makers involved in agricultural policymaking, specifically in the Sindh province of Pakistan.&nbsp

A review of scleral buckle procedures performed at a tertiary care center in Karachi

Abstract This retrospective study was done to evaluate the visual and anatomic outcomes of scleral buckling for the repair of rhegmatogenous retinal detachment (RRD). All scleral buckle procedures performed at the Aga Khan University Hospital, Karachi, from May 1999 to April 2012 were included. A total of 75 eyes of 72 patients were studied. The mean age of patients at surgery was 33.0±17.2 years. The mean logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) was 0.9±0.8 pre-operatively and 0.5±0.6 at 1 year (p=0.018). At baseline, 27(36%) eyes had a best corrected visual acuity (BCVA) of 20/50 or better, while at 1 year after surgery 47(63.5%) eyes had BCVA of 20/50 or better. Retina had successfully attached after first attempt in 70(93.3%) cases. Scleral buckling for the repair of RRD resulted in a high anatomical success rate as well as significant improvement in visual acuity

Large sharing networks and unusual injection practices explain the rapid rise in HIV among IDUs in Sargodha, Pakistan

<p>Abstract</p> <p>Background</p> <p>Of the nearly 100,000 street-based IDUs in Pakistan, 20% have HIV. We investigated the recent rise in HIV prevalence from 12 to 52% among IDUs in Sargodha despite > 70% coverage with syringe exchanges.</p> <p>Methods</p> <p>We interviewed approximately 150 IDUs and 30 outreach workers in focus group discussions.</p> <p>Results</p> <p>We found six rural and 28 urban injecting locations. Urban locations have about 20–30 people at any time and about 100 daily; rural locations have twice as many (national average: 4–15). About half of the IDUs started injecting within the past 2 years and are not proficient at injecting themselves. They use street injectors, who have 15–16 clients daily. Heroin is almost exclusively the drug used. Most inject 5–7 times daily.</p> <p>Nearly all injectors claim to use fresh syringes. However, they load, inject and share using a locally developed method called scale. Most Pakistani IDUs prefer to double pump drug the syringe, which allows mixing of blood with drug in the syringe. The injector injects 3 ml and keeps 2 ml (the scale) as injection fee. The injector usually pools all the leftover scale (now with some blood mixed with drug) either for his own use or to sell it. Most IDUs backload the scale they buy into their own fresh syringes.</p> <p>Discussion</p> <p>Use of an unprecedented method of injecting drugs that largely bypasses fresh syringes, larger size of sharing networks, higher injection frequency and near universal use of street injectors likely explain for the rapid rise in HIV prevalence among IDUs in Sargodha despite high level provision of fresh syringes. This had been missed by us and the national surveillance, which is quantitative. We have addressed this by hiring injectors as peer outreach workers and increasing syringe supply. Our findings highlight both the importance of qualitative research and operations research to enrich the quality of HIV prevention programs.</p

A Comparative Analysis of Supportive Navigation on Movie Recommenders

This literature review covers the research and thought process that went into making a solution for the infinite scrolling problem faced in streaming services such as Netflix. Using the data collected, we have come to the conclusion that an alternate layout can somewhat alleviate the problems it takes in navigating a list of movies. We also found out by a comparative analysis that some layouts, the circular one in particular, is advantageous in certain settings making it an ideal candidate for a movie recommender system.Comment: This was an extensive survey and prototyping we did to purpose and alternative user interface for movie recommender systems like Netfli

Evaluation of Electrolyte Imbalance in Acute Stroke

Objective:&nbsp;&nbsp;Electrolyte imbalance is common in acute stroke; it may cause severe morbidity and mortality, so timely management of electrolyte imbalance may improve morbidity and mortality in cerebro-vascular accident. The purpose of this study was to evaluate electrolyte imbalance in acute stroke and its effect on the outcome of patients. Material and Methods:&nbsp;&nbsp;This study was prospective descriptive in nature and it is comprised of 106 patients of acute stroke after clinically diagnosis confirmed by CT scan brain plain admitted in Khairpur Medical College Hospital. Serum electrolyte along with the other baseline investigation was performed. Results:&nbsp;&nbsp;Hyponatremia was comparatively more common in brain infraction than spontaneous ICH. Hypokalemia is also more common in brain infarction as compared to the hemorrhagic stroke patients of this study. Conclusion:&nbsp;&nbsp;Incidence of Hyponatremia was more common than hypokalemia in patients with acute stroke. Keywords:&nbsp;&nbsp;Hemorrhage, Infraction, Hyponatremia, Hypokalemia

The Role of Radiology (X-Ray versus Computed Tomography) in Medicolegal Cases Presented at a Tertiary Care Hospital in Pakistan

Objectives:&nbsp;&nbsp;A prospective observational study was aimed to assess the role of plain radiographs and computed tomography in detecting head injuries presented at the medicolegal office at the Forensics and Radiology Departments, Gambat Medical Hospital, Sindh. Material and Methods:&nbsp;&nbsp;All cases referred from the Medicolegal Office (MLO) with head injury were included. All victims underwent X-ray head and computed tomography skull was done with 1 or 1.5 cm thick axial sections without administration of intravenous contrast. The radiological reports of X-ray head and CT scans were documented and comparatively evaluated. Results:&nbsp;&nbsp;Mean age was 38.63 ± 3.91 years. In 51 (45.13%) cases, X-ray was able to detect skull fracture, while CT scan detected 64(56.64%) skull fractures. There were 54 (84.3%) true positives, 3 (2.6%) false positives, 10(8.8%) false negatives, and 40 (40.7%) true negatives. The accuracy of X-ray to detect skull fracture was 88.50%. Conclusion:&nbsp;&nbsp;X-ray had a sensitivity and specificity of 84.38% and 93.88%, respectively. It is a reliable tool to detect skull fractures in victims of assault in comparison with CT scans. X-ray is also associated with low dose radiation exposure as compared with CT scan which delivers 70 times more exposure than the former

Assessing the Removal of Turbidity and Coliform Transport through Canal-Bed Sediment at Lab-Scale: Column Experiments

This study was conducted at lab scale to determine the performance of the canal-bed for the removal of turbidity and microorganisms TC (Total Coliforms) from surface water. The canal-bed sediments were collected and analyzed for the characteristics of sediments for grain size distribution, hydraulic conductivity and the POM (Particulate Organic Matter) percent. Canal-bed sediments were containing fine particles less than 0.075mm in the range of 40-58%, with hydraulic conductivity averaged 7ft/day, and the POM 2.75%. The water samples collected from the canal-water have shown average POM 3.6%. Theremoval-reduction in turbidity and TC were determined through the column experiments on the canal-bed sediments. Three columns were prepared at lab-scale by using prepared canal-bed sediment as a filter-bed in the columns for the filtration of raw water samples. Fine particles of the canal-bed grain size D10 0.2 and D10 0.1mm were selected for the filter-bed formation. The prepared concentrated and diluted influent water samples containing turbidity and TC were passed through the washed filter-bed into the columns for 8-weeks filter run. The frequency of sampling and analysis were followedafter the interval of one-week run, the influent (raw water) and effluent (filtered) water samples were collected and analyzed for the turbidity and TC concentrations. The performance of the grain size D10 0.1mm have shown 95-99.95% reduction in turbidity and TC compared to the larger grain size having D10 0.2mm particles

Neuroendoscopic Management of Hydrocephalus in Children

Objective: To determine the Neuroendoscopic management of hydrocephalus in children.Materials and Methods: The study was conducted at the Department of Neurosurgery, Peoples University of Medical and Health Science for women Nawabshah from January 2014 to May 2015. All of the patients with hydrocephalus diagnosed on history, clinical examination and CT scan included in the study. Subjects with co–morbidities such as uncontrolled diabetes, cardiac diseases or uremia were excluded. Patients with age of 6 months to 13 years either gender were included in the study. Aesculap rigid rod lens neuroendoscope with 0 degree was utilized. Warm ringers were utilized for irrigation, a Fogarty embolectomy catheter was utilized for ETV. Hemostasis was accomplished with irrigation, tamponade or coagulation. Endoscopic third ventriculostomy (ETV) was labeled successfully when characteristics of intracranial hypertension (ICP) clinically improved and the size of ventricular decreased on post-operative CT scan. All the data was recorded in the Proforma.Results: Thirty patients with male to female ration 2.5:1 were administered. Age ranged between 6 months and 12 years with a mean of 22.03 months. There were 15(%) cases of Tri Ventricular Hydrocephalus, 10 cases of Tetra Ventricular Hydrocephalus. Two cases of Dandy Walker Hydrocephalus, one case of Asymmetrical Ventricles Hydrocephalus and postoperative fever occurred in two subjects. CSF leak appeared in one patient who was managed conservatively. No operative mortality was found.ETV worked effectively for Hydrocephalus treatment in 99.9% patients included in the study

NH4+-stimulated and -inhibited components of K+ transport in rice (Oryza sativa L.)

The disruption of K+ transport and accumulation is symptomatic of NH4+ toxicity in plants. In this study, the influence of K+ supply (0.02–40 mM) and nitrogen source (10 mM NH4+ or NO3–) on root plasma membrane K+ fluxes and cytosolic K+ pools, plant growth, and whole-plant K+ distribution in the NH4+-tolerant plant species rice (Oryza sativa L.) was examined. Using the radiotracer 42K+, tissue mineral analysis, and growth data, it is shown that rice is affected by NH4+ toxicity under high-affinity K+ transport conditions. Substantial recovery of growth was seen as [K+]ext was increased from 0.02 mM to 0.1 mM, and, at 1.5 mM, growth was superior on NH4+. Growth recovery at these concentrations was accompanied by greater influx of K+ into root cells, translocation of K+ to the shoot, and tissue K+. Elevating the K+ supply also resulted in a significant reduction of NH4+ influx, as measured by 13N radiotracing. In the low-affinity K+ transport range, NH4+ stimulated K+ influx relative to NO3– controls. It is concluded that rice, despite its well-known tolerance to NH4+, nevertheless displays considerable growth suppression and disruption of K+ homeostasis under this N regime at low [K+]ext, but displays efficient recovery from NH4+ inhibition, and indeed a stimulation of K+ acquisition, when [K+]ext is increased in the presence of NH4+