Relationship between exercise induced dyspnea and functional capacity with doppler-derived diastolic function

Background Dyspnea is the frequent cause of exercise intolerance and physical inactivity among patients referred for exercise tolerance test. Diastolic dysfunction has shown significant correlation with exercise capacity and exercise induced dyspnea. To find out the frequency of diastolic dysfunction (DD) and the relationships between impaired exercise capacity and exercise induced dyspnea with DD by Doppler-derived indices among patients referred for stress test in a tertiary care hospital of Karachi. Methods For this study 135 consecutive patients who were referred for stress test at our non-invasive lab were screened for eligibility. Patients with valvular pathology, atrial fibrillation (AF) and coronary artery disease (CAD) were excluded. Stress test was performed on treadmill using Bruce protocol. Assessment of diastolic function as determined by trans-mitral flow velocity pattern was carried at baseline and at peak exercise. We evaluated impaired exercise capacity and exercise induced dyspnea using validated Borg Scale among study subjects. Results Study subjects 88% were males, mean age was 46 ± 16 years, BMI 27 ± 5 kg/m2, prevalence of diabetes mellitus (DM) 15%, hypertension 28% and smoking 21%. Exercise induced DD occurred among 44.6%. Patients with exercise induced DD had lower exercise capacity (9.2 vs. 10.2 METS; p = 0.04) and higher Borg Scale (5.2 vs. 4.0; p \u3c 0.001). DD at baseline was present in 25(26%) of patients so they were excluded from the study. Five patients develop ischemia during stress test so were also excluded. So final analysis was done on 105 patients. Among patients without DD at baseline, there was significant vicariate linear inverse correlation between post exercise E/A ratio and Borg scale (r = −0.23; p = 0.02) and exercise capacity was assessed by exercise duration and MET (r-0.825; p = 0.04). Multivariate regression analysis revealed post exercise E/A ratio as an independent determinant of severity of exercise induced dyspnea and impaired exercise tolerance. Conclusion DD is significantly associated with impaired functional capacity and dyspnea among patients referred for exercise tolerance test

Simulated CSM-CROPGRO-cotton yield under projected future climate by SimCLIM for southern Punjab, Pakistan

Climate change is widely affecting the agriculture sector in Pakistan with an estimated annual loss of up to 16 billion dollars by the end of 21st century (GOP, 2015). Southern Punjab is famous for producing more cotton than the entire province of Sindh in Pakistan but here the climatic variations largely affect the cotton production. The present research was carried out in Vehari, an arid area of Southern Punjab, Pakistan, to determine the intensity of the climatic impacts on the projected agricultural production of cotton in southern Punjab for 2025 and 2050 using SimCLIM(climate model) with CSM (crop simulation model)-CROPGRO-Cotton by comparing with observed data (2013 and 2014).The integrated assessment model (IAM) SimCLIM uses a statistical approach for regional downscaling. Scenarios for two general circulation models (GCMs) (BCC-CSM1-1 and MIR005) and three greenhouse gas concentration pathways (RCP-8.5, 6.0, 4.5) were developed. The three levels of phosphorous (0, 57, and 114 kg ha(-1)) were applied to find the yield output of cotton cultivars (MNH-886 and FH-142) for the prediction of development and yield with different GCMs. The model predicted that FH-142 would give a higher percentage yield than MNH-886 for 2025 and 2050; the lowest percentage yield would be for MNH-886 at maturity for three RCPs. The lowest percentage change in the yield was projected for MNH-886 by RCP-8.5 ( - 0.77) and ( - 0.85) for 2025 and 2050, respectively. Farmers might have to apply a moderate level of phosphorous (57 kg P ha(-1))to avoid the potential threat of climate change. Both the cultivars MNH-886 and FH-142 are suitable for 57 kg P ha(-1), but cultivar FH-142 performed better when compared to MNH-886 for GCM and three RCPs