A review on gastric diverticulum

The gastric fundal diverticulae are rare. They can present with variable symptoms. We are enclosing a literature review on gastric fundal diverticulum. Lessons have emerged which may help in the management of this rare condition in future

Frequency and predictors of recurrence of bladder tumour on first check cystoscopy - a tertiary care hospital experience

Abstract OBJECTIVE: To determine the frequency and predictors of non-muscle invasive bladder tumour recurrence on first-check cystoscopy after transurethral resection of bladder tumour. METHODS: This cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from April to November 2014, and comprised patients with a suspected newly-diagnosed urothelial cancer. Patients with non-muscle invasive disease with complete resection of all visible lesions along with deep biopsy from the tumour base were included. Patients received standard adjuvant intravesical therapy according to their risk stratification and underwent a white-light check cystoscopy at 3 months to look for tumour recurrence. Association between clinico-pathological variables and recurrence at first cystoscopy was determined. SPSS 20 was used for data analysis. RESULTS: The mean age of 84 patients at presentation was 63.3±12.5 years (range: 36-89 years). There were 75(89%) men and 9(11%) women. On initial transurethral resection, the size of tumour was less than 3cm in 32(38%) participants and equal to or above 3cm in 52(62%). Single tumour was found in 51(61%) subjects and multiple tumours in 33(39%). None of the resected tumours was primary carcinoma in situ and 35(42%) tumours were of high grade. The overall recurrence rate at first cystoscopy was 28(33.3%). Larger tumour, higher grade and tumour multifocality were factors associated with recurrence at check cystoscopy (p\u3c0.05 each). Patients\\u27 age, gender, smoking status and tumour stage did not correlate with early recurrence (p\u3e0.05 each). CONCLUSIONS: The number, size and grade of the tumour strongly correlated with recurrence at check cystoscopy

Dengue fever in Northern Pakistan: The Hepatic Implications

Background: To gauge the clinical spectrum of dengue fever in northern Pakistan and to assess its hepatic implications Methods: This prospective study was conducted at Rawalpindi General Hospital (now BBH), Rawalpindi from 1st Oct 2006 to 31st Dec 2008. It included all 264 patients suffering from dengue fever who presented during this period. Dengue infection was suspected if two or more of the following features in addition to fever were present: headache, retro-orbital pain, myalgias/arthralgias, scarlet/maculopapular rash, vomiting/epigastric pain and haemorrhagic manifestations. Blood samples were sent for dengue virus IgM. A blood complete picture, liver function tests, serum urea and creatinine, and urine R/E were also obtained. Specific evidence of liver involvement was also sought on examination. Results: The 264 patients comprised of 146 males and 118 females. Age of patients ranged from 14 to 80 years. 220 patients were seen in the last three months of 2006, the time of the dengue epidemic. Fever and myalgias were present in all patients. Vomiting was seen in 223 (85%) and abdominal pain in 163 (62%) patients. A skin rash was present in 148 (56%) while 56 (21%) complained of joint pains and 53 (20%) of retro-orbital pain. 26 (10%) patients had a bleeding disposition and jaundice was noted in 6 (2%). Leukopenia and thrombocytopenia were present in all patients, while 254 (96%) had proteinuria. ALT was elevated in 163 (62%) and AST was raised in 135 (51%) patients. Conclusion: The liver is affected in a large number of cases of dengue fever. Liver function tests are useful to evaluate the degree of liver damage and markers such as AST and ALT may be used as parameters to assess severit

Mapping Turbidity Levels in the Lake’s Water using Satellite Remote Sensing Technique

Haleji lake, Thatta, Sindh, has been affected by water pollution in the past decades. This study focuses on mapping water pollution at Haleji lake using turbidity as the pollution indicator. In this study, an algorithm was developed by correlating satellite reflectance data and in-situ turbidity measurements using regression analysis. The determination coefficient R2 of the developed algorithm showed a value of 0.83 that is evidence of a good correlation between field-based and mapped turbidity. Moreover, a temporal analysis was carried out using the same algorithm for the years 1999 and 2011. Results of temporal analysis confirmed that the turbidity levels in Haleji lake have increased from below 5 NTU to around 15 – 30 NTU. This is a clear sign of lake pollution in the interim of the past twelve years

Characterization of sorghum germplasm for various morphological and fodder yield parameters

This study was performed to evaluate and characterize 24 sorghum accessions for various morphological and fodder yield parameters. The germplasm displayed considerable variability for leaf color, midrib color, panicle shape, days to 50% flowering, leaf area, flag leaf area, plant height and green fodder yield, while differences of smaller magnitude were observed for number of leaves and tillers plant-1. Genotype Fsd -sorghum was mature early with minimum days to maturity (63) while maximum plant height (232 cm) was observed for Acc.1692. Moreover, Acc.1827 exhibited maximum leaf area (447 cm2) and the highest green fodder yield at 50% maturity (58 t ha-1) was recorded for Acc. 1763. The results of this study indicate that significant genetic diversity exists among the sorghum accessions. The genetic potential of Fsd-sorghum, accessions 1692, 1827 and 1763 can be exploited in future sorghum breeding programs. Further, these genotypes are recommended for commercial cultivation to meet the fodder needs of the country.Keywords: Fodder, Sorghum bicolor, accession

Vehicular sensor networks: Applications, advances and challenges

Vehicular sensor networks (VSN) provide a new paradigm for transportation technology and demonstrate massive potential to improve the transportation environment due to the unlimited power supply of the vehicles and resulting minimum energy constraints. This special issue is focused on the recent developments within the vehicular networks and vehicular sensor networks domain. The papers included in this Special Issue (SI) provide useful insights to the implementation, modelling, and integration of novel technologies, including blockchain, named data networking, and 5G, to name a few, within vehicular networks and VSN.N/

Assessing the Role of Digital Finance on Shadow Economy and Financial Instability: An Empirical Analysis of Selected South Asian Countries

The advancement in fintech technological development in emerging countries has accelerated the role of digital finance in economic development. Digital finance assists in financial inclusion; however, it may also increase the chances of financial instability due to systematic risks. Emerging countries are also in the clutches of shadow economic growth, which reduces taxable income revenue and creates pressure on financial inclusion prospects. The current study attempts to measure the impact of digital finance on the shadow economic growth and financial stability among the selected South Asian emerging countries. We have used the CUP-FM and CUP-BC estimation methods to measure the above relationship on two model frameworks from 2004 to 2018, with the former measuring the influence of digital finance on the shadow economy and the latter examining the relationship between digital finance and financial stability. In addition, the second-generation unit root test, and the Westerlund cointegration analysis are also employed to confirm the stationarity and cointegration among the variables. The result of the Westerlund’s cointegration confirms a long cointegration between the explanatory and outcome variables. Furthermore, the long-run estimation results conclude that an increase in digital finance helps in reducing the growth of the shadow economy among the selected sample countries. However, it also increases the likelihood of systematic risks and increases financial instability. The study also reveals that the control variables like unemployment and industrial productivity also have a significant influence on financial stability and the shadow economy. The findings will assist readers in comprehending how digital finance influences the shadow economy and promotes financial inclusion and stability in emerging nations

Management of Fournier’s Gangrene; A Randomized Controlled Trial at High Volume Center Comparing the Efficacy of Honey and Eusol Dressing in Wound Healing

OBJECTIVE: To assess the effectiveness of honey dressing in Fournier’s Gangrene against conventional Edinburgh University solution of lime (EUSOL) dressing. METHODOLOGY: This was a prospective experimental study conducted in Liaquat National Medical College and Hospital Karachi for duration of 5 and half years. Total 44 patients having gangrene and no co morbid conditions were included in this study. Patients who had co-morbid conditions like deranged coagulation profile and CVA, who were not willing to participate or loss to follow up were excluded from the study. After getting baseline blood workup (i.e. CBC, S. Creatinine, S. Electrolytes, Urine D/R, C/S and Diabetic workup) done and taking consent, the patients were immediately shifted to operation theatre, the incision and drainage was performed, and the necrotic tissues were debrided. Pus cultures were sent, and patients were started on routine intravenous antibiotics (3rd generation Cephalosporin and metronidazole). A Dressing of wound was done randomly by honey in Group A and by Eusol in Group B. Patients were discharged after wound was completely healed. The data were obtained and analyzed by using SPSS version 20. Mann-Whitney U-test and chi-square test was applied to find out the significance. RESUTS: The patients in Group A got slough cleared in4.82±0.96 days, on average requiring 3.22±0.75 number of debridement’s, complete wound healing and duration of hospital stay being 9.54±0.74 days. The patients in Group B got slough cleared in 8±0.87 days, requiring 5.32±0.72 number of debridement’s, complete wound healing and duration of hospital stay 13.68±1.09 days.There was a significant difference in slough clearance, number of debridement’s required, time taken for complete wound healing and hospital stay between Group A and Group B (P-value <0.001). CONCLUSION: This study predicted that honey is very valuable in the management of Fournier’s gangrene as it ensured early clearance of slough, required lesser number of debridement’s, had early wound healing and had relatively shorter duration of stay in hospital than those treated with conventional EUSOL as dressing material

Is There an Asymmetric Relationship between Economic Policy Uncertainty, Cryptocurrencies, and Global Green Bonds? Evidence from the United States of America

The environmental degradation and the concern for sustainable development have garnered extensive attention from researchers to evaluate the prospects of green bonds over other traditional assets. Against this backdrop, the current study measures the asymmetric relationship between green bonds, U.S. economic policy uncertainty (EPU), and bitcoins by employing the Nonlinear Autoregressive Distribution Lag (NARDL) estimation technique recently developed by Shin et al. The outcome of the empirical analysis confirms an asymmetric cointegration between EPU, bitcoins, the clean energy index, oil prices, and green bonds. The NARDL estimation substantiates that positive shock in EPU exerts a negative impact on green bonds, whereas a negative shock in EPU increases the performance of green bonds. It implies, in the long run, a 1 percent increase (decrease) in EPU decreases (increases) the performance of green bonds by 0.22 percent and 0.11 percent, respectively. Likewise, the study also confirms a bidirectional relationship between bitcoins and green bonds. A positive shock in bitcoin increases the performance of green bonds and vice versa. In addition, our study also reveals a direct co-movement between clean energy, oil prices, and green bonds. This outcome implies that green bonds are not a different asset class, and they mirror the performance of other asset classes, such as clean energy, oil prices, and bitcoins. The findings offer several implications to understand the hedging and diversification properties of bitcoins, and assist in understanding the role of U.S. economic policy uncertainty on green bonds