Hepatitis G Virus associated aplastic anemia: A recent case from Pakistan

<p>Abstract</p> <p>Background</p> <p>Aplastic anemia (AA) is a serious and rare disorder characterized by a hypocellular bone marrow. Hepatitis associated aplastic anemia (HAAA) is a variant of aplastic anemia in which aplastic anemia follows an acute attack of hepatitis. Several reports have noted an association between HGV and hepatitis-associated aplastic anemia besides other hepatitis causing viruses.</p> <p>Case presentation</p> <p>A female girl of age 11 year with a history of loose motion for one month, vomiting for last 15 days and poor oral intake for last few days is reported here. The physical examination presents fever, pallor whereas bleeding, hepatomegaly, Splenomegaly and bruising were absent, abdominal ultrasonography confirmed the absence of hepatomegaly, Splenomegaly and lymphodenopathy. The laboratory investigation parameters were: haemoglobin 6.2 g/L, total leucocytes count 1.51, neutrophils 0.47%, absolute reticulocyte count 0.5%, Monocytes 0.16%, red cell count 3.2 mil/uL, Picked cell volume (PCV) 30.13%, Mean Corpuscular Volume (MCV) 78 fL, Mean Corpuscular Hemoglobin (MCH) 26.3 pg. The liver enzymes were alanine aminotransferease (ALT) 98 IU/L, aspartate aminotransferase (AST) 114 IU/L. Serologic and molecular tests for hepatitis A, B, C, D, E, TTV, B19 were negative, whereas HGV RNA PCR test was found positive for hepatitis G virus. The bone marrow aspirate and trephine biopsy examination revealed hypo- cellularity, erythropoiesis, myelopoiesis and megakaryopoiesis.</p> <p>Conclusion</p> <p>HAAA is an uncommon but severe condition, which may occur following idiopathic cases of acute hepatitis. Our finding suggests the involvement of HGV in the development of aplastic anemia. In patients presenting with pancytopenia after an episode of acute hepatitis, the definitive diagnosis should be considered and confirmed by RT-PCR and if possible by bone marrow biopsy.</p

Moxifloxacin-induced torsades de pointes

Torsade de pointes (TdP) is increasingly recognized as a complication of drug therapy. The most common cause of drug-induced QT prolongation is inhibition of the rapidly activating component of the delayed potassium current (IKr). Moxifloxacin, a widely used fluoroquinolone, is a weak IKr inhibitor and has been associated with QT prolongation. We report a case of marked QT prolongation (618 ms) and TdP associated with moxifloxacin use. Although it is difficult to predict which patients are at risk from TdP, careful assessment of the risk/benefit ratio is important before prescribing drugs known to cause QT prolongation. (Cardiol J 2008; 15: 71-73

Volatility Linkages between Equity Markets of Pakistan, India, Singapore and Hong Kong: A GARCH BEKK Approach

The purpose of current study is to explore the volatility linkages between four Asian equity markets, which arePakistan (Karachi Stock Exchange), India (Bombay Stock Exchange), Hong Kong (Hang Sang Index) and Singapore (Strait Time Index). We estimate Multivariate GARCH BEKK model using weekly returns from January 2000 to August 2011.Direct evidences of linkages are found among all markets with respect to conditional mean returns and volatility.Own volatility spillover is found greater than cross volatility spillover in all emerging and developed economies.The insinuation of this study is that overseas investors may take advantage from the decrease of uncertainty by accumulating the stocks in the emerging markets to their investment portfolio

Human Capital and Economic Growth: Evidence from Selected Asian Countries

Impact of human capital on economic growth of selected Asian countries was examined, in the context of a visual search task. The main aim of this study is to find the empirical relationships among human capital and economic growth by using panel data technique for the period 1990-2012. In this study Government Expenditure on Health and gross school enrolment at secondary level used as a proxy variables for measuring human capital. The results of econometric estimation and panel least squares estimates indicated, a strong positive association of government expenditure on health and gross fixed capital formation with GDP. Another result of this study is that the gross school enrollment has positive but insignificant impact on gross domestic product. The study recommends that Government should escalate the enrollment of students in primary and secondary level, incentives to the people working abroad and should also facilitate the private sector to develop the labor force. Moreover, government should increase their expenditure on different areas of health sector such as for the development of infrastructure of health sector and provision of better health care facilities to the patients. Keywords: Human capital, Economic growth, Capital, Asian countries.

Human Capital and Economic Growth: Evidence from Selected Asian Countries

Impact of human capital on economic growth of selected Asian countries was examined, in the context of a visual search task. The main aim of this study is to find the empirical relationships among human capital and economic growth by using panel data technique for the period 1990-2012. In this study Government Expenditure on Health and gross school enrolment at secondary level used as a proxy variables for measuring human capital. The results of econometric estimation and panel least squares estimates indicated, a strong positive association of government expenditure on health and gross fixed capital formation with GDP. Another result of this study is that the gross school enrollment has positive but insignificant impact on gross domestic product. The study recommends that Government should escalate the enrollment of students in primary and secondary level, incentives to the people working abroad and should also facilitate the private sector to develop the labor force. Moreover, government should increase their expenditure on different areas of health sector such as for the development of infrastructure of health sector and provision of better health care facilities to the patients. Keywords: Human capital, Economic growth, Capital, Asian countries

Monolithic ontological methodology (MOM): An effective software project management approach

Due to rapid changes in software applications, especially incorporating the demands of self-regulating technologies becomes a major challenge in software projects. This research focuses on technological, managerial, and procedural challenges, which are believed to be the most significant factors contributing to projects failure. To address these issues, this study proposes Monolithic Ontological Methodology (MOM) which addresses the weakness in the existing benchmark methodologies including PRINCE2, Extreme Programming, and Scrum in terms of project management, quality control, and stakeholder involvement. The MOM consists of seven phases and each phase has the required number of iterations until it is approved by management. The updated information is recorded and shared with the respective teams. The standard documentation with control language is structured by descriptive logic (DL) that reduces ambiguity and technical debate. Furthermore, the illustration of the MOM includes figures, logical expressions, and descriptions. To demonstrate the effectiveness of the proposed methodology, an Analytic Hierarchy Process (AHP) was performed. The findings indicate the validity of MOM concerning considered performance metrics. Although the applicability of the proposed methodology involves relatively more documentation and formalities. The adaptive nature of MOM makes it suitable for the standard organization and brings sustainability to the organization by implementing distributed project management

Optimal Clustering in Wireless Sensor Networks for the Internet of Things Based on Memetic Algorithm: MemeWSN

In wireless sensor networks for the Internet of Things (WSN-IoT), the topology deviates very frequently because of the node mobility. The topology maintenance overhead is high in flat-based WSN-IoTs. WSN clustering is suggested to not only reduce the message overhead in WSN-IoT but also control the congestion and easy topology repairs. The partition of wireless mobile nodes (WMNs) into clusters is a multiobjective optimization problem in large-size WSN. Different evolutionary algorithms (EAs) are applied to divide the WSN-IoT into clusters but suffer from early convergence. In this paper, we propose WSN clustering based on the memetic algorithm (MemA) to decrease the probability of early convergence by utilizing local exploration techniques. Optimum clusters in WSN-IoT can be obtained using MemA to dynamically balance the load among clusters. The objective of this research is to find a cluster head set (CH-set) as early as possible once needed. The WMNs with high weight value are selected in lieu of new inhabitants in the subsequent generation. A crossover mechanism is applied to produce new-fangled chromosomes as soon as the two maternities have been nominated. The local search procedure is initiated to enhance the worth of individuals. The suggested method is matched with state-of-the-art methods like MobAC (Singh and Lohani, 2019), EPSO-C (Pathak, 2020), and PBC-CP (Vimalarani, et al. 2016). The proposed technique outperforms the state of the art clustering methods regarding control messages overhead, cluster count, reaffiliation rate, and cluster lifetime

Corrected QT interval as a predictor of mortality in elderly patients with syncope

Background: Prolonged corrected QT interval (QTc) holds independent prognostic importance in predicting mortality in patients with coronary artery disease, diabetes mellitus and congestive heart failure. However, its association with all cause or cardiac mortality in the general population remains unclear. We evaluated the relationship between prolonged QTc and total mortality among patients with syncope. Methods: This was a retrospective study of 348 patients presenting to the emergency department with syncope of any etiology over a period of one year. All patients with atrial fibrillation, left bundle branch block and cardiac devices (pacemaker/defibrillator) were excluded. Prolonged QTc interval was defined as QTc interval &#8805; 440 ms. The primary end point for this study was total mortality in patients presenting with syncope. Results: There were 58 (16%) deaths in this population during a mean follow-up of 30 months. Patients with prolonged QTc interval had significantly higher mortality when compared to those with normal QTc interval (22% vs 11%; p = 0.004). This significance was not retained after adjustment for covariates in the Cox regression model, where we found that age &#8805; 65 years (hazard ratio [HR] 7.9; 95% confidence interval [CI] 1.9&#8211;32.9; p = 0.004) and QTc interval &#8805; 500 ms (HR 3.5; 95% CI 1.56&#8211;8.12; p = 0.002) were predictors of increased mortality among patients with syncope. Conclusions: In elderly patients presenting to the emergency department with syncope, QTc interval &#8805; 500 ms helps identify patients at higher risk of adverse outcomes. (Cardiol J 2011; 18, 4: 395&#8211;400