Situation analysis of child labour in Karachi, Pakistan: A qualitative study

In Karachi, large employment opportunities, burgeoning population and the availability of cheap labour might be the contributing factors for the increasing prevalence of child labour. A literature review was conducted in 2007 that included published and unpublished literature since 2000. Various organizations working in the field were also covered, while the perception of the child labourers was covered through three focus group discussions. Common health issues among the child labourers in Karachi included respiratory illnesses, fever and generalised pains, as well as drug and sexual abuse. Organisations working for child labour could be broadly categorised into those working for legal advice and advocacy; those generating statistics; and those that are providing interventions. Discussion with children showed that irrespective of the immediate cause, the underlying determinant for child labour was poverty. The best practices identified included evening schools and drop-in centers for working children with provision for skill-based education and basic health facilities. There is need to have more such centres

Outcome and factors associated with hospital mortality in patients with impaired left ventricular function undergoing coronary artery bypass grafting: where do we stand?

Objective: Impaired ventricular function is a known risk factor for mortality after coronary artery bypass grafting however increasingly more patients with impaired ventricular function are referred for surgery. Currently no large data is available from Pakistan regarding this aspect of coronary surgery. Our objectives were to find out the hospital mortality and mid term functional improvement in patients with impaired ventricular function undergoing coronary artery by pass grafting and identify the risk factors for mortality. Methodology: Retrospective analysis of preoperative, operative and postoperative variables of patients with impaired ventricular function who were operated for isolated first time coronary artery bypass between October 2006 to April 2009. Results: Total 190 patients with impaired ventricular function underwent isolated first time coronary artery bypass grafting during this period with a male predominance (82.6%). Mean ejection fraction of the group was 25.4±5.3%. Mean predicted mortality on logistic Euro score was 10.9±2.7%. Actual in hospital mortality of the group was 4.7% which is comparable to contemporary published results. Multivariate analysis identified use of intra aortic balloon pump, non use of internal mammary artery and preoperative NYHA functional class as factors associated with mortality. Conclusion: Coronary artery bypass grafting can be performed in patients with impaired ventricular function with acceptable hospital mortality and mid term functional improvement

Differentiation of Small Hepatic Hemangioma from Small Hepatocellular Carcinoma with Tri-Phasic Helical Computed Tomography Method

Background: Hepatocellular carcinoma (HCC) ranks second amongst all causes of cancer deaths globally. It is on a rise in Pakistan and might represent the most common cancer in adult males. Among women, HCC is the 7th most common cancer and 6th most common cancer related death. In Pakistan prevalence of HCC varies from 3.7%-16% of malignant tumors and most common cause of HCC is viral hepatitis B, C and D related cirrhosis. Pakistan contributes significantly to global burden of hepatitis C, which is a known risk factor for HCC, and has one of the highest prevalence rates (>3%) in the world. Objective: To find out the difference of small hemangioma from small hepatic cellular carcinoma by using tri- phasic helical Computed Tomography method. Methodology: In this descriptive study, among 81 patients of suspected hepatocellular carcinoma and hepatocellular hemangioma were selected with age and gender discrimination by convenient sampling, at Department of Radiology, UOL Teaching hospital Lahore Pakistan. 128 slice Computed Tomography Toshiba Aquilion machine was used. Results: Out of 81 patients collected with the suspicion of hepatic hemangioma and hepatocellular carcinoma , 41 were females and 40 were males who visited radiology department. It shows 50.6% were females and males were 49.4%. Out of 81 patients, 25 patients came with HHS and 31 were with HCC. 25.9% develop carcinoma on left side, 32.1% on right side, 6.2% on R/L side and remaining 35.8% were Nill. Out of 81 patients 8 develop carcinoma on anterior, 5 on both, 3 on caudate, 5 on lateral,13 on both 4 on middle, 7 on posterior, 6 on segment eight, 1 on segment 4, 1 on segment 7, 1 on segment 2 and remaining 36 sites were nill. 27.5% males develop HCC and 48.8% females develop HCC. Out of 81 patients 36.6% female patients develop HHS and 25.0% male patients develop HHS. Conclusion: In this study we conclude that females develop a large number of HCC and HHS than males. Hepatocellular carcinoma shows enhancement in early arterial and early washout phase while post-contrast images showing capsule-appearance which is relatively specific for HCC. On the other hand, HHS shows uniform enhancement in arterial phase and iso- or hyper-attenuating to liver parenchyma on delayed phase. Keywords: Hepatocellular carcinoma, Hepatocellular hemangioma, Computed tomography DOI: 10.7176/JHMN/73-07 Publication date: April 30th 202

Exploring Hydride Formation in Stainless Steel Revisits Theory of Hydrogen Embrittlement

Various mechanisms have been proposed for hydrogen embrittlement, but the causation of hydrogen-induced material degradation has remained unclear. This work shows hydrogen embrittlement due to phase instability (decomposition). In-situ diffraction measurements revealed metastable hydrides formed in stainless steel, typically declared as a non-hydride forming material. Hydride formation is possible by increasing the hydrogen chemical potential during electrochemical charging and low defect formation energy of hydrogen interstitials. Our findings demonstrate that hydrogen-induced material degradation can only be understood if measured in situ and in real-time during the embrittlement process.Comment: 31 Pages, 18 Figures, Preprin

Snippet based trajectory statistics histograms for assistive technologies

Due to increasing hospital costs and traveling time, more and more patients decide to use medical devices at home without traveling to the hospital. However, these devices are not always very straight-forward for usage, and the recent reports show that there are many injuries and even deaths caused by the wrong use of these devices. Since human supervision during every usage is impractical, there is a need for computer vision systems that would recognize actions and detect if the patient has done something wrong. In this paper, we propose to use Snippet Based Trajectory Statistics Histograms descriptor to recognize actions in two medical device usage problems; inhaler device usage and infusion pump usage. Snippet Based Trajectory Statistics Histograms encodes the motion and position statistics of densely extracted trajectories from a video. Our experiments show that by using Snippet Based Trajectory Statistics Histograms technique, we improve the overall performance for both tasks. Additionally, this method does not require heavy computation, and is suitable for real-time systems. © Springer International Publishing Switzerland 2015

Assessing emergency medical care in low income countries: A pilot study from Pakistan

Background: Emergency Medical Care is an important component of health care system. Unfortunately it is however, ignored in many low income countries. We assessed the availability and quality of facility-based emergency medical care in the government health care system at district level in a low income country - Pakistan. Methods: We did a quantitative pilot study of a convenience sample of 22 rural and 20 urban health facilities in 2 districts - Faisalabad and Peshawar - in Pakistan. The study consisted of three separate cross-sectional assessments of selected community leaders, health care providers, and health care facilities. Three data collection instruments were created with input from existing models for facility assessment such as those used by the Joint Commission of Accreditation of Hospitals and the National Center for Health Statistics in USA and the Medical Research Council in Pakistan. Results: The majority of respondents 43/44(98%), in community survey were not satisfied with the emergency care provided. Most participants 36/44(82%) mentioned that they will not call an ambulance in health related emergency because it does not function properly in the government system. The expenses on emergency care for the last experience were reported to be less than 5,000 Pakistani Rupees (equivalent to US$ 83) for 19/29(66%) respondents. Most health care providers 43/44(98%) were of the opinion that their facilities were inadequately equipped to treat emergencies. The majority of facilities 31/42(74%) had no budget allocated for emergency care. A review of medications and equipment available showed that many critical supplies needed in an emergency were not found in these facilities. Conclusion: Assessment of emergency care should be part of health systems analysis in Pakistan. Multiple deficiencies in emergency care at the district level in Pakistan were noted in our study. Priority should be given to make emergency care responsive to needs in Pakistan. Specific efforts should be directed to equip emergency care at district facilities and to organize an ambulance network

AnyNovel: detection of novel concepts in evolving data streams: An application for activity recognition

A data stream is a flow of unbounded data that arrives continuously at high speed. In a dynamic streaming environment, the data changes over the time while stream evolves. The evolving nature of data causes essentially the appearance of new concepts. This novel concept could be abnormal such as fraud, network intrusion, or a sudden fall. It could also be a new normal concept that the system has not seen/trained on before. In this paper we propose, develop, and evaluate a technique for concept evolution in evolving data streams. The novel approach continuously monitors the movement of the streaming data to detect any emerging changes. The technique is capable of detecting the emergence of any novel concepts whether they are normal or abnormal. It also applies a continuous and active learning for assimilating the detected concepts in real time. We evaluate our approach on activity recognition domain as an application of evolving data streams. The study of the novel technique on benchmarked datasets showed its efficiency in detecting new concepts and continuous adaptation with low computational cost

Fall Detection with Unobtrusive Infrared Array Sensors

As the world’s aging population grows, fall is becoming a major problem in public health. It is one of the most vital risks to the elderly. Many technology based fall detection systems have been developed in recent years with hardware ranging from wearable devices to ambience sensors and video cameras. Several machine learning based fall detection classifiers have been developed to process sensor data with various degrees of success. In this paper, we present a fall detection system using infrared array sensors with several deep learning methods, including long-short-term-memory and gated recurrent unit models. Evaluated with fall data collected in two different sets of configurations, we show that our approach gives significant improvement over existing works using the same infrared array sensor