Etiology of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care center in Karachi, Pakistan

Objective: Our study aimed at identifying the characteristics and etiology of various causes of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care hospital.Methods: This was a retrospective study conducted at the department of emergency medicine, Aga Khan University Hospital from January to June 2016. Adult patients presenting to Emergency department with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever, whereas frequency and percentage were computed for categorical variables like gender and causes of fever.Results: A total of one hundred and fifty five patients were included. Out of these 97 (62.6%) were males and 58 (37.4%) were females. Most patients (25.2%, n= 39) were diagnosed as malaria followed closely by dengue fever (n=33, 21.3%) and then enteric fever (n= 10, 6.5%). while 41.9% (n=65) were diagnosed as suspected viral fever based on clinical judgment and inconclusive laboratory results.Conclusion: Malaria was found to be the most common confirmed cause of acute undifferentiated fever followed by dengue and enteric fever. The provision of accurate epidemiological data will enable resources to be directed towards key areas and will be of practical importance to clinicians

Spectral Reflectance Qualities of Soils with Various Salts and Moisture Levels in the Ultraviolet, Visible and Near Infrared Regions of the Electromagnetic Spectrum

Civil Engineerin

Fibers-based Porous Structures for Oil Absorption Applications

In the age of environmental awareness the persistent problem of oil spills and their frequent occurrences have urged researchers to advance and innovate the methods for oil spill remediation. Besides being a significant economic loss oil spills have devastating impact on the environment that lasts for decades. Current oil spill clean up methods like: skimming, onsite burning and dispersants are often deemed as ineffective and are not eco- and environment friendly. Alternatively porous materials with their excellent innate proprieties are being considered as an enticing avenue for developing clean, inexpensive and an environment friendly solution to the problem of oil spills. This work examines the use of short polymer fibers derived from recycled waste streams which can be enclosed in a suitable containment and used for oil absorption applications. Preventing fiber waste occupying valuable land fill sites and instead using them to solve another environmental problem makes this an environment friendly and a sustainable solution. The recycled short polymer fibers were used to build a porous medium with varying porosity. Methods for characterizing the fiber material were studied and experiments were performed to evaluate the feasibility of these fibers and prove that they indeed are an excellent choice for oil absorption. The hydrophobic and oleophilic character of the recycled fiber material was confirmed by contact angle measurements which also supplemented the study of spontaneous imbibition. The method for water-air capillary pressure curve was also obtained which showed that positive pressure is required to force water into the porous structure which further verified the non-wetting behavior of water on the fiber material. Spontaneous imbibition experiment was performed to characterize the porous media sample to determine the wetting behavior of a range of low bulk densities porous samples with different hydrocarbon oils. The sorption behavior was studied as an immiscible displacement phenomena and the competing mechanisms for oil sorption were discussed while interpreting results. The sorption kinetics of hydrocarbon oils inside the porous media were monitored using a load cell arrangement, thus resulting in the calculation of gravimetric and volumetric absorbency. It was found that certain hydrocarbons reached their peak absorbency at a particular bulk density. The effect of changing bulk density, oil properties and their subsequent effects were evaluated which afforded a fundamental analysis of the sorption mechanism. Wetting phase saturation was used as a criterion for comparing performance of varying bulk densities. Traditional models like the Lucas-Washburn and the Darcy-based model were used to validate the experimental data. Due to considerable differences in the viscosities of the displacing (invader) and the displaced fluid (defender) the invasion front was assumed as compact and a stable sharp front. Under this assumption the fluid flow was modeled as single phase flow and the pore level physics was ignored. These models provide simple phenomenological macroscopic description of flow and with their mathematical simplicity can be conveniently applied on the experimental data. The driving force arising due to the interfacial pressure difference between the wetted and non-wetted regions was found to be an important parameter to derive some useful understanding of the porous structure. Since these models assume porous media to be a bundle of vertically aligned capillary tubes, the capillary pressure as described by the Young-Laplace equation was imposed as the pressure boundary condition at the moving liquid front. The governing equations thus derived gives a relationship between the front height, time and some macroscopic parameters like permeability, effective capillary radius and capillary pressure. It was determined that porosity and wettability changes alone does not correlate with the observed data, hence to evaluate the performance of the sorbents correctly requires further studies on pore connectivity and pore size distributions. This was proposed as future work to analyze the porous structure by obtaining tomographic images and forming a 3-D structure of the real porous media sample. Moving forward the imbibition data could be simulated as two-phase flow directly in these 3-D pore network models. Moreover, accurate relative permeabilities could be used to know the exact front saturation. Using this approach fluid behavior could be predicted much more accurately which would enable to design optimal porous structures for specific applications like sorbent booms for recovery of hydrocarbons from water

Risk Management of Aflatoxin Through Mutagenic Potential Modification and Toxin Formation by Intrinsic Components in Food.

Aflatoxins are the secondary metabolites of Aspergillus flavus and their presence in food and feed crops is unavoidable. This study evaluates the antimutagenic properties of phytic and linoleic acids in aflatoxin-affected food. A reduction in the number of revertants was a function of an increased concentration of phytic/linoleic acids and phosphotidylinositol in the Salmonella/microsomal mutagenicity assay (tester strains TA-100 and TA-98) with and without metabolic activation (S-9). Linoleic acid (10 and 100 mug/plate) and phosphotidylinositol (25mug/plate) were antimutagenic against most of the mutagens tested. Although a reduction in the number of revertants was observed in the phytic acid treatments, the results, however, do not suggest phytic acid as antimutagenic in this assay. The inhibition of AFB1 biosynthesis in the A. flavus inoculated Czapek-Dox liquid medium was observed as the concentration of phytic acid was increased in a 25 day study. A complete inhibition of AFB 1 production was recorded at phytic acid levels of 0.5 and 1 mg/100ml. The role of metal ions was also tested under similar conditions. In the absence of Fe++ and Zn++ ions, a complete inhibition of AFB1 production was observed; however, Cu++ and Mg++ ions did not exhibit the same response. In a 35 day storage study of corn the aflatoxin levels in the A. flavus inoculated ground and whole kernels were higher than the treatments. The reduction in the AFB1 levels was observed after 14 days of inoculation in both the treatment and controls. Phytic acid extended the most reduction among the treatments regardless of substrate type; however, not a complete inhibition in the biosynthesis of AFB1 was exhibited. The production of AFB1 and AFB2 was significantly lower (\u3e50%) than the Aspergillus-dependent and -independent controls. The production of AFB1 in linoleic acid-treated corn was also found significantly lower (\u3e50%) than the controls. No such observations were recorded in the combination treatment of phytic and linoleic acid. However, the production of AFB1 was like the linoleic acid treatment. Phytic acid and linoleic acid have been reported as antimutagenic in vitro. More research is warranted to evaluate their potential antimutagenic role in vivo

Cost-effectiveness of traffic enforcement: case study from Uganda

BACKGROUND: In October 2004, the Ugandan Police department deployed enhanced traffic safety patrols on the four major roads to the capital Kampala. OBJECTIVE: To assess the costs and potential effectiveness of increasing traffic enforcement in Uganda. METHODS: Record review and key informant interviews were conducted at 10 police stations along the highways that were patrolled. Monthly data on traffic citations and casualties were reviewed for January 2001 to December 2005; time series (ARIMA) regression was used to assess for a statistically significant change in traffic deaths. Costs were computed from the perspective of the police department in $US 2005. Cost offsets from savings to the health sector were not included. RESULTS: The annual cost of deploying the four squads of traffic patrols (20 officers, four vehicles, equipment, administration) is estimated at$72,000. Since deployment, the number of citations has increased substantially with a value of $327 311 annually. Monthly crash data pre- and post-intervention show a statistically significant 17$603 per death averted or $27 per life year saved discounted at 3$300 GDP per capita). CONCLUSION: The costs of traffic safety enforcement are low in comparison to the potential number of lives saved and revenue generated. Increasing enforcement of existing traffic safety norms can prove to be an extremely cost-effective public health intervention in low-income countries, even from a government perspective

Weather effects on stock returns and volatility in South Asian markets

We study the effect of mood-proxy variables on index returns and volatility in six South Asian markets. Our mood-proxy variables include six weather (temperature, humidity, cloud cover, air pressure, visibility, and wind speed), three weather indicator variables (fog, thunder storm and rain or drizzle) and two biorhythmic variables (SAD and lunar phases). We adopt a robust approach and attempt to select the best parsimonious econometric model for each market. Our findings suggest that mood-proxy variables have some convincing influences in South Asian capital markets. In some instances, these variables are influencing returns while in other instances they are influencing volatility

Serum malondialdehyde and adiponectin in albuminuric kidney disease patients

Background: Diabetes, hypertension, oxidative stress, obesity, adipocytokine dysfunction, and dyslipidemia are causative factors in development of Chronic Kidney Disease (CKD). Adiponectin secreted from adipose tissue, has Reno protective effect against development of albuminuria in animal studies. The previous studies investigated the relationship between serum adiponectin level and urinary albuminuria in kidney disease patients, but the results are conflicting.Methods: The pre diagnosed kidney disease patients were divided into microalbuminuria and macroalbuminuria groups, while control subjects were called as normoal buminuria group. The pre diagnosed adult kidney disease patients of both genders with age matching control subjects with no known comorbidity were included in the study. Whereas pregnant female patients and the patients with comorbidity were excluded from the study. The demographic data and the anthropometric data of control and kidney patients were recorded. The blood was analyzed for Glycosylated Hemoglobin (HbA1c), electrolytes, glucose, calcium, total protein, albumin, urea, creatinine adiponectin and malondialdehyde. The Urine was analyzed for Creatinine and albuminuria. The glomerular filtration rate was estimated.Results: The blood pressure, blood urea, creatinine, glycated hemoglobin, malondialdehyde, adiponectin levels were higher in albuminuric kidney patients as compared to normal control subjects. The mean glomerular filtration rate was lowest in macroalbuminuric patients as compared to micro and normoalbuminuric patients. The serum adiponectin and serum malondialdehyde both showed positive correlation with serum creatinine, and with albuminuria/urinary creatinine ratio.Conclusions: The study concludes that, positive correlation of serum malondialdehyde with adiponectin and albuminuria

Empirical Relationship between Operational Efficiency and Profitability (Evidence from Pakistan Exploration Sector)

This study is a part of our course work. In this study the operational efficiency of firms is checked against profitability. For the purpose of research oil and gas sector of Pakistan stock exchange is selected. Six years data from 2010-2015 is collected through financial reports of companies. Since efficiency can be measured through several financial ratios. In this article total asset turnover, fixed assets turnover, debtors turnover are used as explanatory variables and current ratio and quick ratio as control variables. The profitability of firms is measured through return on equity. Ordinary least square, correlation matrix and descriptive statistics are used to describe the findings of the study and features of the data. The results of the study show that the total assets turnover, debtors turnover and quick ratio have strong negative impacts on the profitability measured by ROE, of firms. The current ratio and fixed asset turnover have positive impacts on the return on equity. The results of the study support the hypothesis that efficiency as measured by (total assets turnover, debtors’ turnover, quick ratio current ratio and fixed asset turnover) has impacts on the profitability of firms

Total knee arthroplasty: Does day of surgery matter?

Introduction: There has been an influx of research studies aimed at identifying all factors that contribute to minimizing cost and maximizing postoperative care after total knee arthroplasty (TKA). Length of stay (LOS) has been defined as a significant factor that contributes to increased burden. We aimed at looking whether day of surgery has any significant effect on the LOS and postoperative complications following total knee arthroplasty (TKA). Material and Methods: Retrospective cohort study done at the Aga Khan University Hospital, Pakistan, from January 2007 to December 2015. A total of 611 patients who underwent a unilateral or bilateral total knee arthroplasty (TKA) were included in study: 269 (44.0%) patients underwent unilateral TKA and 342 (56.0%) underwent a bilateral TKA. Results: Kruskal-Wallis test and post hoc pairwise comparisons showed that unilateral TKAs performed on Tuesday, Saturday, and Sunday resulted in a lower median LOS (P \u3c .05). No significant association was seen in bilateral TKA group. Day of surgery was not associated with postoperative complications. Conclusions: Unilateral TKAs performed earlier during the week and later on the weekend are associated with a significantly lower LOS. It is highly probable that patch ancillary services during the latter part of the week and a higher workload for the staff are important reasons for this phenomenon

Synthesis, spectral analysis and pharmacological study of N'- substituted-2-(5-((2,4-dimethylphenoxy)methyl)-1,3,4-oxadiazol-2-ylthio)acetohydrazides

A series of molecules bearing multiple functional groups were synthesized to study their antibiotic effect against Gram-positive and Gram-negative bacteria and lipoxygenase activity as well. 2,4-Dimethylcarbolic acid (1) was refluxed with ethyl 2-bromoacetate to synthesize ethyl 2-(2,4-dimethylphenoxy)acetate (2). Compound 2 was converted to the corresponding hydrazide 3, again on refluxing with hydrazine. The compound 5-((2,4-dimethylphenoxy)methyl)-1,3,4-oxadiazol-2-thiol (4) was synthesized by the reaction of 3 and CS2 in the presence of KOH. Compound 4 was further converted to the corresponding ester 5 and then 2-(5-((2,4-dimethylphenoxy)methyl)-1,3,4-oxadiazol-2-ylthio)acetohydrazide (6). The final molecules N'-substituted-2-(5-((2,4-dimethylphenoxy)methyl)-1,3,4-oxadiazol-2-ylthio)acetohydrazide, 8a-m, bearing ether, 1,3,4-oxadiazole, thioether, hydrazone and azomethine functional groups were synthesized by stirring the aryl carboxaldehydes 7a-m with 6 in methanol at room temperature. The depicted structures of all synthesized molecules were corroborated by IR, 1H-NMR and EIMS spectral data analysis. 8m and 8i showed substantial antibacterial activity and lipoxygenase inhibitory activity, respectively