Management of Post Traumatic Epilepsy in Pediatric Population in Pakistan

Objective:  To investigate the efficacy of seizure prophylaxis in the prevention of early and late-onset seizures after the traumatic brain injury known as post-traumatic epilepsy (PTE). Material and Methods:  A retrospective study was performed on children aged 0 to < 12 years who were presented to a level 1 trauma center during the six months with the diagnosis of mild to severe TBI. Data included is of 66 patients from Children’s Hospital, Lahore. It was analyzed according to a patient’s demographic data, mechanism of injury, clinical and radiological presentation, management, and follow-up. History of seizures was tracked through guardian referral or staff witnesses. Results:  Among 66 pediatric cases of acute brain injury from June 2019 to December 2019, 45 were males (68%) and 21 were females (32%) with a male to female ratio of 2:1. The mean age in our study was 3.8 years. 60% of children were managed under observation, 30% of children required medical pharmacological treatment, 9% of children needed surgical intervention, and 13% of children required artificial ventilation. Overall mortality is 4.5%. In our study, we found a considerable relationship between residual neurological deficits and severity of injury (p = 0.3), there is no noteworthy relationship between mechanism of injury and outcome (p = 0.5). The mean length of stay was 3.9 days but 60% of patients had stayed less than 3 days. Conclusion:  Analyzing the underlying mechanisms of post-traumatic epilepsy can lead us to propose effective treatments to prevent seizures following traumatic brain injury

Pattern of unnatural deaths during COVID-19 lockdown in comparison with deaths reported during 2019 in Sahiwal city

Background:  Lockdown, a social isolation restriction measure has a direct impact on covid-19 transmission but its effect on unnatural deaths remains unknown. Objective:  This study has been designed to observe the effects of covid-19 lockdown on unnatural deaths in Sahiwal by comparing with the same period in 2019. Study design: Descriptive retrospective study. Setting: The study was conducted in mortuary of DHQ Teaching Hospital Sahiwal attached with the Department of Forensic Medicine & Toxicology Sahiwal medical college, Sahiwal. Study Duration: Covid-19 lockdown period from 24th March 2020 to 9th May 2020 and the same period in 2019. Materials and Methods: This study includes 62 cases of unnatural deaths, out of which 23 Cases in 2019 and 39 cases in 2020. We have included age, sex, marital status, area of belonging, manner of death, and cause of death as variables in our study. Results: In total 62 cases, in 2019 there were 15 males and 8 females with a mean age of 37.30±19.55 years and in 2020, there were 27 males and 12 females with a mean age of 32.85±15.16 years. The age group in which most number of deaths occurred was 30-59 years (46.8%). In 2019 majority of victims died due to homicide 15(65.2%) while during the lockdown period 14 (35.9%) victims lost their lives in accidents. Firearm injuries were the cause of death in 11(47.8%) cases in 2019 while in the COVID 19 lockdown period the majority of cases 13 (33.3%) were those who died due to roadside accidents. Conclusions: We could not detect significant difference in the two periods examined with respect to sociodemographic factors, but manner of death was significantly affected

A cross sectional assessment of health related quality of life among patients with Hepatitis-B in Pakistan

OBJECTIVE: The study aims to assess Health Related Quality of Life (HRQoL) among Hepatitis B (HB) patients and to identify significant predictors of the HRQoL in HB patients of Quetta, Pakistan. METHODS: A cross sectional study by adopting European Quality of Life scale (EQ-5D) for the assessment of HRQoL was conducted. All registered HB patients attending two public hospitals in Quetta, Pakistan were approached for study. Descriptive statistics were used to describe demographic and disease related characteristics of the patients. HRQoL was scored using values adapted from the United Kingdom general population survey. EQ-5D scale scores were compared with Mann–Whitney and Kruskal-Wallis test. Standard multiple regression analysis was performed to identify predictors of HRQoL. All analyses were performed using SPSS v 16.0. RESULTS: Three hundred and ninety HB patients were enrolled in the study. Majority of the participants (n = 126, 32.3%) were categorized in the age group of 18-27 years (36.07 ± 9.23). HRQoL was measured as poor in the current study patients (0.3498 ± 0.31785). The multivariate analysis revealed a significant model (F(10, 380) = 40.04, P < 0.001, adjusted r(2) = 0.401). Educational level (β = 0.399, p = 0.025) emerged as a positive predictor of HRQoL. Age, gender, occupation, income and locality were not predictive of better quality of life in HB patients. CONCLUSIONS: Hepatitis B has an adverse affect on patients’ well-being and over all HRQoL. The study findings implicate the need of health promotion among HB patients. Improving the educational status and imparting disease related information for the local population can results in better control and management of HB

Recurrent Cervical Neurofibrosarcoma: A Rare Case of Malignant Peripheral Nerve Sheath Tumor of Head and Neck Region

Neurofibrosarcoma is a malignant peripheral nerve sheath tumor (MPNST). The cervical location of the neurofibrosarcoma is very rare and is less than 1% in the literature. MPNSTs are often associated with neurofibromatosis type 1 (NF1).&nbsp; We are presenting a case report of 31 years old female, with huge recurrent cervical neurofibrosarcoma on the right side of the neck.&nbsp; To date, surgical excision followed by chemotherapy and radiotherapy is the treatment of choice which requires a multidisciplinary approach. We excised the above-mentioned cervical neurofibrosarcoma in a piecemeal fashion and discharged the patient on follow-up with the oncology department

Pharmacists’ Perception of the Sale of Non-Clinically Proven Health Supplements in Penang, Malaysia

Purpose: To explore community pharmacists’ perception of the sale of non-clinically proven health supplements and over-the-counter (OTC) products available in Penang, Malaysia.Methods: A cross-sectional survey using a self-completed postal questionnaire was conducted in July 2010 among 200 community pharmacists practicing in Penang Island.Results: Fifty six pharmacists participated in the study (response rate, 28.0 %). A total of 10.7 % respondents indicated that the sale of non-clinically proven products result in high profit. Only 25.0 % of the pharmacists believed that non-clinically proven OTC products are effective, while 35.7 % thought that it is not ethical to sell these products. A majority of the respondents (94.7 %) agreed that manufacturers’ advertisement have a huge effect on positive consumers’ behaviour towards such products. Most respondents agreed that manufacturers of these products claim that their products are effective (57.1 %) and have fewor no side effects (60.7 %).Conclusions: Pharmacists who participated in the study have mixed  opinions on the efficacy and effectiveness of non-clinically proven products. There is a need for pharmacists to be well educated on the  evidence-based use of these products in order to be able to offerappropriate advice to those who come to them to purchase the items.Keywords: Perception, Health promotion, Urban poor, Health supplements

Psychological Drivers of Alternative Fuel Vehicles' Adoption and Ecologically Responsible Use

Environmental problems caused by global warming are becoming alarming with every passing day. To curb greenhouse gas (GhG) emissions, promoting alternative fuel vehicles (AFVs) and sustainable transport mode choices is critical. This study explores the predictors of eco-social purchase, use, and conservation intentions in a developing country by employing an extended model of the theory of planned behaviour (TPB). Using a self-administered survey technique, data were collected from a nationally representative sample of 1372 customers of three leading automobile manufacturers from eight big cities of Pakistan. Partial Least Squares Structural Equation Modelling (PLS-SEM) was applied to test the measurement and structural models. Results showed that the extended model of TPB received support in the context of Pakistani culture and for the targeted behaviours related to eco-social purchase, use, and conservation intentions concerning AFVs. Implications for marketers and theoretical contribution are discussed at the end

OBA2: An Onion approach to Binary Code Authorship Attribution

A critical aspect of malware forensics is authorship analysis. The successful outcome of such analysis is usually determined by the reverse engineer’s skills and by the volume and complexity of the code under analysis. To assist reverse engineers in such a tedious and error-prone task, it is desirable to develop reliable and automated tools for supporting the practice of malware authorship attribution. In a recent work, machine learning was used to rank and select syntax-based features such as n-grams and flow graphs. The experimental results showed that the top ranked features were unique for each author, which was regarded as an evidence that those features capture the author’s programming styles. In this paper, however, we show that the uniqueness of features does not necessarily correspond to authorship. Specifically, our analysis demonstrates that many “unique” features selected using this method are clearly unrelated to the authors’ programming styles, for example, unique IDs or random but unique function names generated by the compiler; furthermore, the overall accuracy is generally unsatisfactory. Motivated by this discovery, we propose a layered Onion Approach for Binary Authorship Attribution called OBA2. The novelty of our approach lies in the three complementary layers: preprocessing, syntax-based attribution, and semantic-based attribution. Experiments show that our method produces results that not only are more accurate but have a meaningful connection to the authors’ styles