Postoperative outcome of early appendectomy in patients having appendicular mass by laparoscopic surgery

Objective: To determine the frequency of postoperative outcome of early appendectomy in patients having appendicular mass by laparoscopic surgery.Methodology: It was a descriptive & case series study. Study was conducted in the department of surgery Liaquat University Hospital Jamshoro/Hyderabad, during the time period of Jan 2015 to Dec 2017. Patients were both gender and patients aged between 10-40 years having tender and palpable right iliac fossa mass on clinical examination confirmed on ultrasound abdomen as appendicular mass. Patients with mass in right iliac fossa but with associated features like fixed and immobile mass for more than 1 month, bleeding per rectum, history of weight loss, cardio respiratory diseases like recent myocardial infarction, congestive cardiac failure, chronic obstructive pulmonary disease and renal diseases like glomerulonephritis, nephrotic syndrome and renal failure etc, gynecological and obstetrical diseases in female patients were excluded from the study. The postoperative hospital stay was counted and wound infection was noted.Results: During the study period of one year, total of 73 patients with appendicular mass were included in this study.  The age range 10 to 40 years with mean age ± SD (range) was 25.75±9.2 years. Out of them 46 (63.0%) were male whereas 27(37.0 %) were females During operation we found appendicular abscess in 12(16.43%) cases followed by perforated appendix in   10(13.69%) cases, while during operations we found in adhesions in 15(20.5%) cases and difficulty in localisation of appendix 06 (8.21%) cases. The mean hospital stay + SD (range) was 4.91 +1.65 (3-9 days).  Wound infection was seen in 15(20.5 %) cases.Conclusion: Early appendectomy can be safely performed in appendix mass without any increased risk of mortality and morbidity. The outcome of early surgical management of appendicular lump showed benefits for single hospitalization, shorter hospital stay and lower treatment costs

Pre Processing of Twitter's Data for Opinion Mining in Political Context

AbstractIn the wake of political activism among youth in particular and the whole population in general, everyone is not only eager to share their political orientation but equally curious regarding the voice of the masses. As a known notion, the perfect orifice to this emerging need of political activism can be found on social media platforms, from where the numerous aspects of public opinion can be captured easily. These sites have begun to have a large impact on how people think and act. It is a known phenomenon that public opinion is the largest indicator of success and failure of political parties and is a direct reflection of the party's reign. Where increased sharing of public feedback has increased awareness and promoted accountability, it has also created chaos and confusion for many. Using Twitter, the most popular micro blogging platform, this paper aims to give a method to ease and smooth the task of opinion mining with the help of linguistic analysis and opinion classifiers, which will together determine positive, negative and neutral sentiments for the political parties of Pakistan. A method is provided which pre-processes the raw data of twitter and comparison of two classification techniques to classify this data. That will aspire to capture a snapshot of current political scenario to promote the spirit of accountability, self-analysis and improvement in among Pakistani politicians. Moreover, with this we aim to give general public an important consolidated voice in the realm of politics

Misconceptions Regarding COVID-19 Vaccine Hesitancy, an Obstacle in the Light of Pandemic in Rural Community Lahore, Pakistan

Introduction: Instantly after declaring COVID-19 as a pandemic, many conspiracy theories sprouted through word of mouth and social media. Pakistan is vulnerable to such conspiracy narratives and has experienced failures of polio vaccination programs due to such claims. Recently, two well-known political figures raised voice against COVID-19 vaccines in Pakistan, stating that COVID-19 is a grand illusion by non-Muslims and a great agenda against Muslim countries. This theory is much discussed in the local community, supporting COVID-19 vaccine hesitancy. The current crises created by the COVID-19 pandemic is impacting all dimensions of life. Vaccines have been developed to fight the pandemic and prevent the corona virus. Misperceptions about vaccines persist despite the evidence of vaccine safety. The study aims to identify the misconceptions of the general public of Malikpur community towards COVID-19 vaccine hesitancy and also different conspiracy theories, acceptance, and preference for the COVID-19 vaccine. This study is conducted in Malikpur a rural Community Lahore, Pakistan. Methods: A cross sectional study was carried out through an adaptive questionnaire on a representative random sample of 98 resident of above 18 years old from Malikpur community, Lahore Pakistan. The SPSS software was utilized for statistical data analysis. COVID-19 vaccine hesitancy. Conclusion: This study revealed the existence of conspiracy beliefs regarding the COVID-19 vaccine spread by the social media and word of mouth in Malikpur Community Lahore, Pakistan. These beliefs are posing a major threat to the upcoming immunization program for the control of COVID-19 in Pakistan. We urge healthcare authorities in Pakistan to take measures against such claims before they penetrate to the general community. Anti-vaccine actions could undermine efforts to end the COVID-19 pandemic. We believe that ethical and responsible conduct of mass media, a careful advisory from the Pakistan Electronic Media Regulatory Authority, measures from healthcare authorities, practical maneuvers to increase public awareness and publication of beliefs and opinions from health professionals will help in neutralizing such misleading claims. Because Pakistan is experiencing an overload of disease, with a rise in confirmed cases, immediate action is important to eradicate any possible barriers to a future COVID-19 vaccination program. Results: Many people of Malikpur Community has misconception regarding COVID-19 vaccine that is need to be eradicated as soon as possible otherwise pandemic will not end. Keywords: Pandemic, Corona Virus, Polio vaccination, Conspiracy theories, Vaccine, Health authorities, Regulatory authorities, Anti-vaccine, Covid-19, pandemic. DOI: 10.7176/JHMN/102-05 Publication date:October 31st 202

A brief review on molecular, genetic and imaging techniques for HCV fibrosis evaluation

<p>Abstract</p> <p>Background</p> <p>Chronic HCV is one of the major causes of morbidity and mortality in the present day world. The assessment of disease progression not only provides useful information for diagnosis and therapeutic supervision judgment but also for monitoring disease. Different invasive and non invasive methods are applied to diagnose the disease from initial to end stage (mild fibrosis to cirrhosis). Although, liver biopsy is still considered as gold standard to identify liver histological stages, an assessment of the disease development based on non-invasive clinical findings is also emerging and this may replace the need of biopsy in near future. This review gives brief insight on non-invasive methods currently available for predicting liver fibrosis in HCV with their current pros and cons to make easier for a clinician to choose better marker to assess liver fibrosis in HCV infected patients.</p> <p>Methods</p> <p>More than 200 studies regarding invasive and noninvasive markers available for HCV liver disease diagnosis were thoroughly reviewed. We examined year wise results of these markers based on their sensitivity, specificity, PPV, NPV and AUROCs.</p> <p>Results</p> <p>We found that in all non-invasive serum markers for HCV, FibroTest, Forn's Index, Fibrometer and HepaScore have high five-year predictive value but with low AUROCs (0.60~0.85) and are not comparable to liver biopsy (AUROC = 0.97). Even though from its beginning, Fibroscan is proved to be best with high AUROCs (> 0.90) in all studies, no single noninvasive marker is able to differentiate all fibrosis stages from end stage cirrhosis. Meanwhile, specific genetic markers may not only discriminate fibrotic and cirrhotic liver but also differentiate individual fibrosis stages.</p> <p>Conclusions</p> <p>There is a need of marker which accurately determines the stage based on simplest routine laboratory test. Genetic marker in combination of imaging technique may be the better non invasive diagnostic method in future.</p

A comparison of four fibrosis indexes in chronic HCV: Development of new fibrosis-cirrhosis index (FCI)

<p>Abstract</p> <p>Background</p> <p>Hepatitis C can lead to liver fibrosis and cirrhosis. We compared readily available non-invasive fibrosis indexes for the fibrosis progression discrimination to find a better combination of existing non-invasive markers.</p> <p>Methods</p> <p>We studied 157 HCV infected patients who underwent liver biopsy. In order to differentiate HCV fibrosis progression, readily available AAR, APRI, FI and FIB-4 serum indexes were tested in the patients. We derived a new fibrosis-cirrhosis index (FCI) comprised of ALP, bilirubin, serum albumin and platelet count. FCI = [(ALP × Bilirubin) / (Albumin × Platelet count)].</p> <p>Results</p> <p>Already established serum indexes AAR, APRI, FI and FIB-4 were able to stage liver fibrosis with correlation coefficient indexes 0.130, 0.444, 0.578 and 0.494, respectively. Our new fibrosis cirrhosis index FCI significantly correlated with the histological fibrosis stages F0-F1, F2-F3 and F4 (r = 0.818, p < 0.05) with AUROCs 0.932 and 0.996, respectively. The sensitivity and PPV of FCI at a cutoff value < 0.130 for predicting fibrosis stage F0-F1 was 81% and 82%, respectively with AUROC 0.932. Corresponding value of FCI at a cutoff value ≥1.25 for the prediction of cirrhosis was 86% and 100%.</p> <p>Conclusions</p> <p>The fibrosis-cirrhosis index (FCI) accurately predicted fibrosis stages in HCV infected patients and seems more efficient than frequently used serum indexes.</p

Current Stance on Requirement Prioritization Techniques: Challenges, Opportunities, and Future Directions

Requirement Engineering is an important aspect of Software Engineering, while Requirement prioritization is a crucial phase of Requirement Engineering, specifically in agile development. In today's world, software systems are nothing but the backbone for business organizations. However, for business operations, requirements are changing rapidly, and it seems to be impossible to accomplish the requirements at once. It may be possible with the help of requirement Prioritization as it decreases the risk for failure. It helps implement the most required and prioritized feature given by stakeholders. The entire purpose of this research is to investigate and rate the complete process of Requirement Engineering, specifically the current requirement prioritization techniques, by conducting an extensive literature review. Furthermore, to identify the opportunities, gaps, and challenges for futur

γ-irradiated chitosan based electrospun nanofibrous scaffolds materials for biomedical applications

Electrospun fibrous scaffolds are prepared from indigenously extracted and &gamma;-irradiated blended chitosan (CS) with poly (vinyl alcohol) (PVA). The structure and morphology of the electrospun scaffolds are studied by FTIR spectroscopy and scanning electron microscopy (SEM). FTIR analyses verified the deacetylation of chitin and the developed interactions between chitosan and PVA. SEM images showed that bead on string fibers were obtained with high gamma rays dose due to the decrease in the molecular weight but no effect was observed on the size of the nanofibers. The cell cytotoxicity of the nanofibrous scaffolds was examined by indirect method using human fibroblast cells and human cancerous bone cells were employed for direct method. The evaluated results explained that CS/PVA electrospun scaffolds were compatible to the cells and can be employed for different biomedical applications

Association of laboratory parameters with viral factors in patients with hepatitis C

<p>Abstract</p> <p>Background and Aims</p> <p>HCV infection may lead to hepatic fibrosis. In this study, we tried to determine whether there is any correlation of HCV genotypes and viral load to the clinical parameters such as ALT, AST, ALP, bilirubin, Hb level, patient's age and gender; and then correlated this association with disease progression in liver biopsy samples.</p> <p>Methods</p> <p>In cross-sectional and observational study, 6048 serum HCV RNA positive patients were chosen. The study consists of 53 months from March 2006 to September 2010. Patients were divided into three cohorts to validate our data. Statistical analysis and correlation of lab parameters with viral factors was determined by using SPSS version 16.</p> <p>Results</p> <p>The most prevalent genotype was 3 (70.9%) followed by 1 (13.3%) and 4 (7.4%), collectively. During Univariate analysis, in all cohorts; serum bilirubin, ALP, ALT and AAR showed significant correlation with genotypes, however multivariate analysis showed that all genotypes except 4a have no association with host biochemical markers. Disease progression was also independent of all genotypes. Serum ALP, ALT, bilirubin and viremea levels were significantly elevated in patients with genotype 4a. Viral load showed negative association with serum bilirubin (<it>r </it>= -0.112, <it>P </it>= 0.000) and ALP levels (<it>r </it>= -0.098, <it>P </it>= 0.000). We observed positive correlation of ALP and bilirubin levels, while negative associations of viral load with HCV liver disease progression.</p> <p>Conclusion</p> <p>Disease progression seems independent of the genotypes. Relationship between ALP and bilirubin with viral load may be an attractive marker to guess disease progression in patients with hepatitis C.</p