Frequency of silent myocardial ischaemia in diabetics: a single centre study

OBJECTIVE: To find the frequency of silent myocardial ischaemia in diabetics as compared to non-diabetics. METHODS: This was a cross sectional study conducted between November 2008 and March 2010. Two hundred subjects were recruited by convenience sampling after informed consent. All were subjected to an exercise stress test. Electrocardiographic changes were noted for silent Ischaemia Descriptive Statistics were applied for significance. RESULT: Of the 200 subjects included in the study, 31 had diabetes and 1 69 were non-diabetics. The mean age was 46 +/- 10 years. Twenty eight subjects tested positive for silent ischaemia, of whom six were diabetics (19%) and 22 were non-diabetics (13%). Hypertension and obesity were found more frequently in diabetics (48% Vs 27%) p = 0.019 and (35% Vs 18%) p = 0.027 respectively. Despite the greater proportion of diabetics having asymptomatic myocardial ischaemia as compared to nondiabetics statistical significance (p = 0.397) was not observed. CONCLUSION: There was no significant difference in the frequency of silent ischaemia amongst the two groups

Determination of Most Frequent Emergencies in Patients with Fixed and Removable Orthodontic Appliances at Tertiary Care Dental Hospital

OBJECTIVES: To determine the frequency of emergencies in patients with fixed and removable orthodontic appliances at tertiary care dental hospital. METHODOLOGY: A questionnaire was designed for this descriptive cross-sectional study to be filled by the clinician (L3/L4 FCPS resident) at the end of addressing every orthodontic emergency. Sampling was done under consecutive non-probability protocols. Descriptive statistics were applied to determine the frequency of different orthodontic emergencies, and Pearson’s chi-square test was applied to determine association of emergencies with gender and etiology of emergency (patient related vs operator related). Data was analyzed on SPSS version 20. RESULTS: A total of 175 patients reported with orthodontic emergencies. The sample comprised 38.3% males and 61.7% females. Most frequent orthodontic emergency reported was deboned brackets in fixed appliances, while the most common emergency in removable appliances was traumatic PNAM. A statistically significant association (Pearson’s Chi Square=4.74, Cramer’s V=0.165, p=0.029) was seen for removable and fixed appliance emergencies with males and females. CONCLUSION: Most frequent fixed appliance orthodontic emergencies were deboned brackets while for removable appliance emergencies were trauma due to PNAM. Emergencies with removable appliances were mostly due to the operator related factors, while in fixed appliances patient related factors were dominating

Areca nut chewing and the risk of re-hospitalization and mortality among patients with acute coronary syndrome in Pakistan

Objectives: Areca nut is widely consumed in many parts of the world, especially in South and Southeast Asia, where cardiovascular disease (CVD) is also a huge burden. Among the forms of CVD, acute coronary syndrome (ACS) is a major cause of mortality and morbidity. Research has shown areca nut chewing to be associated with diabetes, hypertension, oropharyngeal and esophageal cancers, and CVD, but little is known about mortality and re-hospitalization secondary to ACS among areca nut users and non-users. Methods: A prospective cohort was studied to quantify the effect of areca nut chewing on patients with newly diagnosed ACS by categorizing the study population into exposed and non-exposed groups according to baseline chewing status. Cox proportional hazards models were used to examine the associations of areca nut chewing with the risk of re-hospitalization and 30-day mortality secondary to ACS. Results: Of the 384 ACS patients, 49.5% (n=190) were areca users. During 1-month of follow-up, 20.3% (n=78) deaths and 25.1% (n=96) re-hospitalizations occurred. A higher risk of re-hospitalization was found (adjusted hazard ratio [aHR], 2.05; 95% confidence interval [CI], 1.29 to 3.27; p=0.002) in areca users than in non-users. Moreover, patients with severe disease were at a significantly higher risk of 30-day mortality (aHR, 2.77; 95% CI, 1.67 to 4.59; p<0.001) and re-hospitalization (aHR, 2.72; 95% CI, 1.73 to 4.26; p<0.001). Conclusions: The 30-day re-hospitalization rate among ACS patients was found to be significantly higher in areca users and individuals with severe disease. These findings suggest that screening for a history of areca nut chewing may help to identify patients at a high risk for re-hospitalization due to secondary events

Automated facial characterization and image retrieval by convolutional neural networks

IntroductionDeveloping efficient methods to infer relations among different faces consisting of numerous expressions or on the same face at different times (e.g., disease progression) is an open issue in imaging related research. In this study, we present a novel method for facial feature extraction, characterization, and identification based on classical computer vision coupled with deep learning and, more specifically, convolutional neural networks.MethodsWe describe the hybrid face characterization system named FRetrAIval (FRAI), which is a hybrid of the GoogleNet and the AlexNet Neural Network (NN) models. Images analyzed by the FRAI network are preprocessed by computer vision techniques such as the oriented gradient-based algorithm that can extract only the face region from any kind of picture. The Aligned Face dataset (AFD) was used to train and test the FRAI solution for extracting image features. The Labeled Faces in the Wild (LFW) holdout dataset has been used for external validation.Results and discussionOverall, in comparison to previous techniques, our methodology has shown much better results on k-Nearest Neighbors (KNN) by yielding the maximum precision, recall, F1, and F2 score values (92.00, 92.66, 92.33, and 92.52%, respectively) for AFD and (95.00% for each variable) for LFW dataset, which were used as training and testing datasets. The FRAI model may be potentially used in healthcare and criminology as well as many other applications where it is important to quickly identify face features such as fingerprint for a specific identification target

Effects of CdCl2 Treatment on Physical Properties of CdTe/CdS Thin Film Solar Cell

We report CdTe, CdS, and ITO thin films on glass substrates for solar cell fabrication by closed space sublimation and chemical bath deposition. CdTe and CdS thin films were sublimated to chemical treatment at 25°C in a saturated CdCl2 solution (1.04 g/100 ml methanol) and heat treated at 400°C for 30 minutes. Indium tin oxide and tellurium films were analyzed by spectrophotometer and scanning electron microscopy. It has been observed that solar cell performance can be improved by depositing a CdCl2 layer on the CdTe/CdS layers. The optical, structural, and morphological changes of CdTe and CdS surfaces on CdTe/CdS/ITO/glass solar cells due to CdCl2 solution treatment followed by annealing for 400°C were studied. Optical analysis showed about 15% decrease in transmittance after CdCl2 heat treatment in case of CdTe thin film, whereas CdS thin film demonstrated an increase of about 10–15% transmittance after CdCl2 heat treatment. Similarly, a decrease in band gap values was found for both CdTe and CdS thin films after CdCl2 heat treatment. XRD and SEM results of CdCl2 heat‐treated CdTe and CdS samples showed recrystallization, reorientation, and progressive increase in grain size. The grain sizes of CdTe and CdS samples demonstrated an increase of about 0.2 µm

Near complete aortic transection and its successful repair using a novel cardiopulmonary bypass technique

Abstract The case of a 38-year old female, victim of a road traffic accident who presented with a near complete aortic transection is presented. An emergent repair employing cardiopulmonary bypass was attempted in the operating room. Anticipating a high-risk of compromise to cerebral perfusion from air micro-emboli, the bypass was attempted with an innovative approach involving the successful cannulation of the pulmonary artery and descending aorta. The patient survived and was found to be doing well on subsequent post-operative visits

Wilson\u27s disease: experience at a tertiary care hospital.

Wilson\u27s disease (WD) is a rare autosomal recessive disorder of copper metabolism. Data regarding WD is not available from Pakistan. A cross-sectional study was conducted at The Aga Khan University Hospital, Karachi, and all patients admitted with primary and secondary diagnosis of Wilson\u27s disease were added. A total of 47 patients were seen; 68% (n = 32) were male. The mean age was 26.6 ± 9.97 years. Most of the patients presented with hepatic, (n = 22, 46.8%), neurological, (n = 17, 36.2%) and psychiatric (n = 8, 17%) symptoms. Mean ceruloplasmin level was 0.17 ± 0.13 g/dl; it was \u3c 0.25 g/dl in 39 (86.6%) patients. Serum copper (Cu) was reduced in 32 (68.1%) patients and 24-hr-urinary Cu was raised in 22 (47.6%) patients. Slit lamp examination for Kayser-Fleischer (KF) rings was done on 15 (31.9%) patients and 9 (60%) of them had KF rings. Mean serum aspartate transaminase (AST) / alanine transaminases (ALT) ratio was 1.92 and median alkaline phosphatase / total bilirubin ratio was 79.30 (IQR 35.05; 166.50)

Etiology and chemical composition of gall stone disease: a prospective observational study from the developing world

Background: Aim of the study was to assess the etiology and determine the chemical composition of gallstones in our population.Methods: This was a prospective observational study conducted at GMC Srinagar from 2018 to 2020. One hundred patients having gall stone disease were enrolled into the study and after cholecystectomy was performed the stones chemical composition was analyzed by fourier-transform infrared (FTIR) spectroscopy. The data was collated and analysed.Results: 54 patients had mixed stones with chemical composition of cholesterol, calcium carbonate and calcium bilirubinate; 39 had cholesterol stones and 7 patients had pigmented stone with chemical composition of cholesterol, calcium carbonate and calcium bilirubinate.Conclusions: Our results suggest that cholesterol, either singularly or in combination with calcium carbonate or bilirubin is a common component of gall stones in our population

Factors Predicting the Recurrence of Spontaneous Bacterial Peritonitis in Patients with Cirrhosis

Objective: To evaluate the frequency of recurrence of spontaneous bacterial peritonitis (SBP) in patients with end stage liver disease and the factors responsible for it. Study Design: Descriptive study. Place and Duration of Study: The Aga Khan University Hospital, Karachi, from November 2008 till November 2009. Methodology: Patients with cirrhosis who were admitted at AKUH with diagnosis of SBP during the study period were included. Any episode of SBP after resolution of the first index case of SBP within one year was considered as recurrence. Results: Out of 238 cirrhotic patients, 157 (66%) had single, while 81 (34%) had recurrent episodes of SBP. History of using proton pump inhibitors (PPI) and diuretics was found in 113 (47.5%) and 139 (58.4%) patients respectively. Only 58 (24.4%) patients were on prophylactic antibiotic therapy. Univariate analysis revealed that the female gender (52%), and presence of porto-systemic encephalopathy (PSE, 31%) were statistically significant (p=0.03) among those who had recurrent SBP. On multivariate analysis bilirubin level of \u3e 1.0 mg (OR=7.03; 95%CI=1.55-32), protective factor of hepatitis B (OR 0.31; 95%CI=0.13-0.70) and presence of urinary tract infection (UTI) (OR=2.24; 95%CI=0.99-5.09) were significant in patients with recurrent SBP. Conclusion: Recurrent SBP was noticed in 34% patients. Serum bilirubin level of \u3e 1.0 mg, protective factor of HBV and presence of UTI were significant factors present in patients with recurrent SBP

Healthy lifestyle as a preventive measure against victimization among school-going adolescents

Background: Bullying and violence are problems of aggression in adolescents. Healthy lifestyle practices are common health promotion approaches in school settings; however, their association with aggressive behaviours in school-going adolescents is less explored. Aims: This study examined the associations of healthy lifestyle behaviours including good hygiene, physical activity, recommended diet and refrainment from tobacco use with bully victimization and violence among adolescents. Methods: Data were obtained from the Global School Health Survey conducted in Pakistan (2009). The study population consisted of school-going adolescents aged 13 to 15 years. We constructed our final dataset using information from 4102 participants. Association of healthy lifestyle behaviours with bully victimization and violence experience were assessed using multivariate logistic regression. Results: Results indicate lower odds of being bullied (good hygiene: OR = 0.62, 95% CI 0.50–0.76, P Conclusions: Our study supports the significance of healthy lifestyle as a preventive measure against victimization. Anti-bullying programmes focusing on social–emotional skill development may also consider promotion of healthy lifestyle behaviours among adolescents, aiming at reducing victimization and its related consequences