APACHE-II Score Correlation With Mortality And Length Of Stay In An Intensive Care Unit

Objective: To correlate the APACHE-II score system with mortality and length of stay in ICU. Study Design: Cohort study. Place and Duration of Study: The Intensive Care Unit (ICU) of the Aga Khan University Hospital, Karachi, from May 2005 to May 2006. Methodology: All adult patients who were admitted in the ICU were included. APACHE-II score was calculated at the second and seventh days of admission in the ICU. Patients who were discharged alive from the ICU or died after first APACHE-II Score (at 2nd day) were noted as the primary outcome measurement. Second APACHE-II score (at 7th day) was used to predict the length of stay in the ICU. Pearson\u27s correlation coefficient (r) was determined with significance at p \u3c 0.05. Results: In the lowest score category 3-10, 27 out of 30 patients (90%) were discharged and only 3 (10%) died. Out of those 39 patients whose APACHE-II score was found in high category 31 - 40, 33 (84.6%) deaths were observed. This revealed that there might be more chances of death in case of high APACHE-II score (p=0.001). Insignificant but an inverse correlation (r = -0.084, p \u3c 0.183) was observed between APACHE-II score and length of ICU stay. Conclusion: The APACHE-II scoring system was found useful for classifying patients according to their disease severity. There was an inverse relationship between the high score and the length of stay as well higher chances of mortality

Effect of alloying elements on the compressive mechanical properties of biomedical titanium alloys: A systematic review

Due to problems such as the stress-shielding effect, strength-ductility trade-off dilemma, and use of rare-earth, expensive elements with high melting points in Ti alloys, the need for the design of new Ti alloys for biomedical applications has emerged. This article reports the effect of various alloying elements on the compressive mechanical performance of Ti alloys for biomedical applications for the first time as a systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines on this subject. The search strategy in this systematic review used Scopus, Web of Science, and PubMed databases and searched the articles using (Beta-type OR β) AND Titanium AND (Mechanical property OR Microstructure) AND Alloying element keywords. Original articles from 2016 to 2022 published in English have been selected for this study as per the inclusion criteria. The results have shown that Nb can be used as the primary alloying element with Ti as it is a strong β-stabilizer element which also reduces the elastic modulus of Ti alloys. The β-eutectic elements (Fe, Cr, and Mn) have also emerged as cost-effective alloying elements that could improve the mechanical performance of Ti alloys. Ti-Nb-Zr-Ta alloyed with Si has shown potential to withstand the strength-ductility trade-off dilemma. The combination of a Ti-Nb binary alloy has emerged as an attractive material for designing low elastic modulus Ti alloys. The mechanical performance of the Ti-Nb alloy can be further improved using the β-eutectic (Fe, Cr, and Mn) and neutral (Zr, Sn) elements to be alloyed with a Ti-Nb binary alloy. The strength-ductility trade-off issue can be overcome using Si as an alloying element in Ti-Nb-Zr-Ta alloys

Satellite Derived Sea surface temperature fronts in relation with Tuna catch In EEZ of Pakistan

Sea surface temperature (SST) is an important parameter in marine ecosystem studies as its relations of Fishery and other marine resources. In this study SST fronts have also been studied with relate to tuna fish catch data of April and August 2014 was acquired. Satellite derived MODIS daily products have been used to derive thermal fronts in the exclusive economic zone (EEZ) of Pakistan. Research results indicated that the Sea surface temperature gradually changed from 22C to 24C where Tuna catch is high and By Catch is low in frontal region. The further Relationship between these two data are discussed in this study and also made recommendations for in what way these two datasets should be handled. Remote sensing data and GIS tools are efficient and less time consuming for mapping and classifying sea surface temperature in a broader way. Survey of fishing resources is really time consumed and costly, Satellite Remote sensing data shows a promising tool to monitor fishery resources in a cost effective manner. Satellite data play an important role to identify fish aggregation zones and these techniques could also be used to forecast potential fishing zones by measuring oceanic parameters which influence on fish distribution on a broader scale and these techniques can help to local fisherman and fishery organizations to observe fishery resources

KCNQ1 rs2237895 polymorphism is associated with Gestational Diabetes in Pakistani Women

Background and Objective: Genetic studies on gestational diabetes (GDM) are relatively scarce; moreover, limited data is available for KCNQ1 polymorphism in Pakistani pregnant women. We aimed to determine the frequency of KCNQ1 rs2237895 in GDM and normal pregnant controls and its association with GDM-related phenotypes.Methods: A total of 637 pregnant females (429 controls and 208 cases) in their second trimester were classified according to the International Association of the Diabetes and Pregnancy Study criteria in this study. Their blood samples were genotyped for KCNQ1 SNP rs2237895 using PCR-RFLP method and sequencing. Fasting and two hour-post glucose load blood levels, serum HbA1c, insulin, and anthropometric assessment was performed.: Pearson\u27s Chi Square test, Mann- Whitney U test, and regression analyses were performed. A p-value of \u3c 0.05 was considered significant.Results: The variant genotyped was in Hardy-Weinberg equilibrium (p \u3e 0.05). The rs2237895 showed an association with GDM (OR 2.281; 1.388-3.746: p \u3c 0.001) and remained significant after multiple adjustments for age and body mass index (OR 2.068; 1.430-2.997: p=0.005). The C allele showed positive association with insulin level, and HOMA-IR in study subjects.Conclusions: This study identifies that KCNQ1 rs2237895 polymorphisms might be associated with risk of GDM in Pakistani population and that it is related to higher glucose levels and insulin resistance. Further large scale studies are required to consolidate on the functional aspect of this polymorphism

Catalytic Decomposition of 2% Methanol in Methane over Metallic Catalyst by Fixed-Bed Catalytic Reactor

The structure and performance of promoted Ni/Al2O3 with Cu via thermocatalytic decomposition (TCD) of CH4 mixture (2% CH3OH) were studied. Mesoporous Cat-1 and Cat-2 were synthesized by the impregnation method. The corresponding peaks of nickel oxide and copper oxide in the XRD showed the presence of nickel and copper oxides as a mixed alloy in the calcined catalyst. Temperature program reduction (TPR) showed that Cu enhanced the reducibility of the catalyst as the peak of nickel oxide shifted toward a lower temperature due to the interaction strength of the metal particles and support. The impregnation of 10% Cu on Cat-1 drastically improved the catalytic performance and exhibited 68% CH4 conversion, and endured its activity for 6 h compared with Cat-1, which deactivated after 4 h. The investigation of the spent carbon showed that various forms of carbon were obtained as a by-product of TCD, including graphene fiber (GF), carbon nanofiber (CNF), and multi-wall carbon nanofibers (MWCNFs) on the active sites of Cat-2 and Cat-1, following various kinds of growth mechanisms. The presence of the D and G bands in the Raman spectroscopy confirmed the mixture of amorphous and crystalline morphology of the deposited carbon

Statistical analysis of waiting time of patients by queuing techniques: case study of large hospital in Pakistan

[EN] The purpose of this empirical research was to analyze the comfortable waiting time (CWT) of patients at the outpatient department (OPD) of Gastrology of ABC hospital of Karachi. It is based on the analysis of CWT of patients who were being served at the OPD of Gastrology of ABC hospital of Karachi. The data was collected by the help of questionnaire. Altogether 250 questionnaires were distributed among the patients, 210 of them were collected back and 10 of them were incompletely filled. Data was analysed in the statistical package for social sciences (SPSS) version 22. Data analysis included frequency distribution of various demographics;stratification tables were made for the comparison of CWT across various demographics. Results indicated that more females (old aged) had greater CWT in the comparison of males. It is found that the mean CWT of patients decreased with decreasing age, increasing OPD visiting time and increasing income. It is also found that he mean CWT for the patients from Afghanistan was greater than the patients from other regions i.e. Baluchistan, interior Sindh and Karachi. The authors highlighted that when patients arrive at the hospital and wait for their service, in this scenario, waiting cost is associated with their waiting time; since it is the matter of cost, thus it should be known to the hospital that if patients are made to wait longer, it can lead to the customer dissatisfaction. In this regard, analysis of comfortable waiting time of patients was extremely needed. Since, Karachi is the biggest city of Pakistan and targeted hospital is one the biggest private hospitals of Karachi and in the analysis of this paper. Only 200 patients were approached for data collection which is the main limitation of the paper. In future, the researchers should also focus on the same OPD for more responses and at the same time, other departments can also be targeted for conclude better and precise results. The authors have tried to focus on the CWT of patients so that the waiting capacity of patients could be highlighted. At the same time, detailed analysis was conducted across demographics so that their influence on CWT could be analysed. Authors of this research paper thank the management committee of ABC private hospital of Karachi for allowing us to collect the data and we are also thankful to the patients who cooperated in filling the questionnaires.Kalwar, MA.; Memon, MS.; Khan, MA.; Tanwari, A. (2021). Statistical analysis of waiting time of patients by queuing techniques: case study of large hospital in Pakistan. 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Ependymal tumors with oligodendroglioma like clear cells: Experience from a tertiary care hospital in Pakistan

Background: Ependymal tumors with oligodendroglioma like clear cells have never been reported from Pakistan. We aimed to see the features and outcomes of this rare entity.Methods: It was retrospective cohort conducted at the Department of Neurosurgery, Aga Khan University from 2003 to 2013. The medical records and radiology of patients with proven histopathology were reviewed. Analysis was done on SPSS 20.Results: Eleven cases of ependymal tumors with clear cells were found, which equated to 1.5% of the total tumor burden in 11 years. The median age was 49 years. Most common presenting symptom was headache 54.5%. Out of 11 patients, 9 patients had a supratentorial tumor. Magnetic resonance imaging showed hypointense signals on T1 and hyperintense signals on T2-weighted images in all cases. Contrast enhancement was found in 9 patients (77.8%), necrosis and hemorrhage was found in 4 (36%) and 3 (27%) patients, respectively. Immunohistochemistry showed glial fibrillary acidic protein and epithelial membrane antigen positivity in all cases. Ki-67 showed high proliferative index in 6 patients. According to the World Health Organization grading of ependymal tumors, 2 patients had Grade II tumors, and 9 patients had Grade III tumors with clear cells. Gross total resection was achieved in 6 (54.5%) and subtotal resection in 5 patients (45.4%). Recurrence was observed in 9 patients. Six patients died of the disease. Median progression-free survival and overall survival was 8 months and 10 months, respectively.Conclusion: Ependymal tumors with clear cells presented more commonly in Grade III lesions and were more aggressive in behavior with poorer outcome compared to similar studies

Characterization of Diesel-Hydrogen Peroxide Fuel Blend

In the present work, the outcome of Hydrogen peroxide–diesel fuel blends on the physicochemical properties and kinetic study has been studied. A various blends of diesel-hydrogen peroxide ranging from 5% hydrogen peroxide (H2O2), up to 15% by volume in several fuel blends were experimentally investigated and compared with standard diesel fuel. A new emulsifier has been developed for obtaining better emulsion between diesel and hydrogen peroxide. According to ASTM Standard for fuel tests, the results showed that hydrogen peroxide is capable of enhancing the diesel fuel properties. This is due to the presence of additional oxygen atom within the H2O2 molecule which can enhance the combustion process and ultimately affecting the exhaust emission. Keywords:ASTM test, diesel, hydrogen peroxide, physicochemical properties

Chemical Analysis and Biological Activities of Salvia lavandulifolia Vahl. Essential Oil

Genus Salvia is one of important genera belonging to family lamiaceae. Most of reported biological activities of Salvia usually attributed to its volatile oil. The chemical composition of essential oil from Salvia lavandulifolia was analyzed by GC/MS. A total of sixty seven components were identified in the oil of S. lavandulifolia representing 95.78% of the total oil. β-caryophyllene (11.87%), spathulenol (8.13%), neomenthol (7.75%), pulegone (6.97%), hexadecanoic acid (6.85%), germacrene-D (5.70%), bicyclogermacrene (4.53%), caryophyllene oxide (3.97%) and humulene (3.29%) were found to be the major constituents. The oil showed no antimicrobial and antileishmanial activities in a concentration up to 200 and20 µg/mL, respectively. It displayed a weak antimalarial activity (47 % inhibition) against P. flaciparium.The oil exhibited anti-inflammatory activity adopting iNOS inhibition assay with IC50of 30 µg/mL, but there is no cytotoxicity demonstrated by the oil at tested concentration of 100 µg/mL. Keywords: S. lavandulifolia, essential oil, antimalaria, antimicrobial, antiinflammtory, anticancer

Pre-Operative Workup of Cochlear Implant

Hearing loss, an increasing problem across the globe, results in an important solution in the form of cochlear implants, highlighting the critical need for effective interventions. This review involves analyzing 46 relevant publications via databases such as PubMed and Google Scholar, providing current insights into pre-operative issues. Studies through databases such as PubMed and Google Scholar, ensuring contemporary insights into the pre-operative considerations. The pre-operative evaluation encompasses medical history, covering prenatal events and immediate post-natal health, along with physical examinations and complete audiometric assessments. High-Resolution Computed Tomography (HRCT) and Magnetic Resonance Imaging (MRI) emerge as crucial imaging techniques, guiding surgical planning and electrode placement. Brainstem Evoked Response Audiometry (BERA) supplements inconclusive MRI data, while vestibular screening aids in candidate selection. Cochlear duct length determination, often assessed through imaging techniques, contributes to optimal electrode array selection. Models in cochlear implant research, spanning computational, animal, tissue engineering, and physical models, further enhance our understanding and refinement of cochlear implant designs. In conclusion, this comprehensive pre-operative workup plays a significant role in assessing patient health, identifying causes of deafness, and contributing to the overall success of cochlear implantation, a transformative solution for profound hearing impairment