The n-exponential convexity for majorization inequality for functions of two variables and related results

We apply the refined method of producing n-exponential convex functions of J. Pečarić and J. Perić to extend some known results on majorization type and related inequalities

Mediating Role of Death Anxiety between Supernatural Beliefs and Life Satisfaction among Muslim Adults

The belief in supernatural forces is so pervasive in Pakistani society that it is nearly universal among illiterate and semi-literate people. Few literate individuals also subscribe to the idea of supernatural beings and entities. Such beliefs may invoke anxieties resulting in reduced satisfaction with life. In the current study, a cross-sectional survey of Muslim people was used to examine the potential mediation effect of death anxiety between supernatural beliefs and life satisfaction. A purposive sample (N = 220; with equal representation of both genders) of adults was recruited from different areas of district Sargodha. The supernatural Belief Scale, Arabic Scale of Death Anxiety, and Satisfaction with Life Scale were employed for assessing supernatural belief, death anxiety, and life satisfaction, respectively. Path analysis in Amos revealed the positive direct effect of supernatural belief on death anxiety and the negative direct effect of death anxiety on life satisfaction. Supernatural beliefs also demonstrated a negative indirect effect on life satisfaction through death anxiety. Overall, we found that individuals with supernatural beliefs were more likely to feel death anxiety, which might make them less satisfied with their life. Clinicians and mental health practitioners must envisage such therapeutic strategies as could counter the supernatural beliefs of the clients so that they might enjoy a more fulfilling and satisfying life

Role of Mindfulness and Psychological Wellbeing Between External Locus of Control and Depression: A Moderated Mediation Model

The present research aimed at examining the role of mindfulness and psychological wellbeing in the relationship between external locus of control and depression. Five Facet Mindfulness Questionnaire (Baer, 2003), Ryff Scale of Wellbeing (Ryff, 1989), DAAS Depression Subscale (Lovibond & Lovibond, 1995), and Rotter’s Locus of Control Scale (Rotter, 1966) were administered on a convenient sample of three hundred and four (N=304) adults of Sargodha city (Punjab, Pakistan) to operationalize mindfulness, psychological wellbeing, depression, and external locus of control respectively. Results revealed that external locus of control had positive relationship with mindfulness whereas mindfulness and psychological wellbeing were negatively related with depression. Mindfulness fully mediated between external locus of control and depression. Psychological wellbeing moderated between mindfulness and depression by dampening their negative relationship. Moderated mediation analysis was undertaken through PROCESS macro for SPSS (Hayes, 2013), which revealed that conditional indirect relationship of external locus of control with depression was significant only at lower to moderate levels of psychological wellbeing. Implications of the study and suggestions for further research were discussed

Effect of Aloevera Whole Leaf Extract in Combination with Rosiglitazone on Oxidative Stress and Lipid Profile Levels in Type-2 Diabetic Rats

Objective: To measure the synergistic effects of Aloevera and Rosiglitazone on plasma glucose, oxidative stress and lipid profile in Type-2 Diabetic Sprague-Dawley rats.Subjects and Methods: A Randomized control trail was carried out in Physiology department of Army Medical College, Rawalpindi. Twenty healthy rats were made diabetic according to Srinivasan model. After confirmation of type 2 Diabetes, they were randomly segregated into two equal groups. Groups were named as diabetic control group and Diabetic treatment group. Control group was injected normal saline and treatment group was given 150 mg/kg body weight of Aloevera extract and 2.5mg/kg body weight of rosiglitazone. It was half of the effective doses which were calculated through pilot study.Results: Plasma glucose, Malondialdehyde and lipid profile were significantly reduced (p<0.000) in diabetic treatment group as compared to diabetic control group.Conclusion: A significant reduction in plasma glucose, oxidative stress and lipid profile was obtained in diabetic treatment group although half of the effective doses were used. It would also be help in reducing side effects associated with use of rosiglitazone

Bioavailability and Metabolic Pathway of Phenolic Compounds

As potential agents for preventing different oxidative stress-related diseases, phenolic compounds have attracted increasing attention with the passage of time. Intake of fruits, vegetables and cereals in higher quantities is linked with decreased chances of chronic diseases. In plant-based foods, phenolic compounds are very abundant. However, bio-accessibility and biotransformation of phenolic compound are not reviewed in these studies; therefore, a detailed action mechanism of phenolic compounds is not recognized. In this article, inclusive concept of different factors affecting the bioavailability of phenolic compounds and their metabolic processes is presented through which phenolic compounds go after ingestion

Variables that Predict Significant Intracranial Damage in Mild Head Injury

Objective: To identify patients, at risk of intracranial complications, after mild head injury.Study Design: It was an observational study.Place and Duration: Patients received at the emergency department or OPD or referred to Pakistan institute of Medical Sciences, Islamabad were included in the study. Pakistan institute of Medical Sciences is a tertiary care hospital that recruits patients from Punjab and northern areas. The data was collected over a period of six mon-ths from 1st August 2008 till 31st January 2009. A total of 206 patients were included in our study.Methodology: Data were analyzed relating to a consecutive series of 206 patients who presented to the emer-gency department of Pakistan Institute of Medical Sciences, Islamabad. Data was collected through non-pro-bability convenience sampling. Characteristics studied, were age, gender, mode of trauma, level of consciousness and CT scan brain findings.Result: Our study included 206 patients with mild head injury. Their age ranged from 1 to 90 years with a mean age of 32.06 19.86 years. Maximum patients (59 patients 28.6%) were in the age range of 21 – 30 years. Only 34 (16.5%) patients were above 50 years of age and 26 (12.6%) were below the age of 10 years.163 (79%) were males and remaining 43 (21%) were females. 124 (60.2%) were due to road traffic accidents, 62 (30.1%) were due to falls, 18 (8.7%) were assault injuries and 2 (0.9%) were sports injuries. All patients had a GCS score of 13 – 15; with a mean score of 14.35 0.902. Majority of the patients (132 patient, 64%) had a GCS of 15, 14 (6.8%) had a GCS of 14 and 60 (29%) had a GCS of 13. 127 (61.7%) patients presented with vomiting after head injury and 79 (38.3%) patients did not vomit. 49 (23.8%) vomited once and 78 (37.9%) vomited on multiple occasions. CT scan was done without contrast in all patients. It was reported as normal in 68 (33%) patients, 39 (18%) had extradural hematoma, 15 (7.3%) had subdural hematoma, 4 (1.9%) showed intracerebral hemor-rhage, 30 (14.6%) had cerebral contusion, 6 (2.9%) had subarachnoid hemorrhage, 20 (9.7%) had diffuse axonal injury and 9 (11.7%) patients had skull fracture.Conclusion: Our study was conducted to derive and validate a set of criteria that could be used to identify patients with minor head injury in whom CT could be forgone. It concluded that men, in their twenties, suffered from mild head injury, most commonly from a road traffic accident and were more likely to have an intracranial surgical lesion, such as an extra dural haematom

Prevalence of Lumbosacral Transitional Vertebra in Individuals with Low Back Pain: Evaluation Using Plain Radiography and Magnetic Resonance Imaging

Study DesignDescriptive cross-sectional study.PurposeTo determine the frequency of lumbosacral transitional vertebrae (LSTV) in patients with low back pain (LBP) and the role of iliolumbar ligament (ILL) origin from L5 in LSTV cases.Overview of LiteratureTransitional vertebrae are developmental variants of the spine. LSTV is a common congenital abnormality, and failure to recognize this anomaly may result in serious consequences during surgery.MethodsAll patients aged 11–90 years of either gender with LBP for any duration, who presented for X-ray and magnetic resonance imaging (MRI) of the lumbosacral spine, were included. X-rays of the lumbosacral spine in anteroposterior and lateral views were acquired. In addition, T1- and T2-weighted sagittal and axial MRI was performed. Images were evaluated on a workstation.ResultsOf 504 patients, transitional vertebrae were observed in 75 patients (15%). Among them, 39 (52%) patients had Castellvi type III and 36 (48%) patients had Castellvi type II. However, on MRI, 42 (56%) patients had O'Driscoll type II, 18 (24%) patients had O'Driscoll type IV, and 15 patients (20%) had O'Driscoll type III. ILL origin from L5 was significantly higher (n=429, 100%) among patients with a normal lumbosacral junction than among patients with a transitional lumbosacral junction (n=22, 29.3%) (p<0.001).ConclusionsLSTV occurs at a high frequency in patients with LBP. Furthermore, in the presence of LSTV, the ILL is not a reliable marker for the identification of L5

Papillary Renal Cell Carcinoma: Demographics, Survival Analysis, Racial Disparities, and Genomic Landscape

Papillary renal cell carcinoma (PRCC) is the second most common histological subtype of renal cell cancer. This research aims to present a large database study highlighting the demographic, clinical, and pathological factors, racial disparities, prognosis, and survival of PRCC. The clinical and demographic data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database, and molecular data was cured from the Catalogue Of Somatic Mutations in Cancer (COSMIC) database. PRCC had a median age of diagnosis at 64 years, with a higher incidence in men (77%), and Whites (68%). 70.3% of cases were Grades I–IV (13, 53, 31, and 3%, respectively). In patients with known data, 85% were localized to the kidney, and 84% of cases were 7 cm in size. No metastasis occurred in 97% of the known data. The most common treatment offered was surgical resection (9%). The 5-year overall survival was 79%, with patients undergoing surgery having a 90.6% 5-year survival. Multivariable analysis revealed age &gt; 60 years, Black race, poor histologic differentiation, distant metastases, and tumor size &gt; 10 cm as independent risk factors for mortality. The most common mutations identified from the COSMIC database were MET, KMT2D, KMT2C, ARID1A, and SPEN. PRCC affects male individuals in the sixth decade of life. Increased age, Black race, distant metastases, and tumors &gt; 10 cm are associated with a worse prognosis. Surgical resection offers a favorable survival outcome. Next-generation sequencing (NGS) could identify potentially targetable alterations and future personalized therapeutic approaches

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348