Effect of Nanosilica and Carbon Nanotubes Addition on Mortar Mechanical and Durability Properties

Nowadays, nanomaterials are being extensively used in civil engineering works for improving their quality. Improved compressive strength, flexural strength, modulus of elasticity, and good durability performance of nanocomposites attracted the researcher's interest in understanding these nanomaterials’ behavior in cementitious composites. In the present paper, mechanical and durability properties of 1.0 wt% nanosilica (NS) and four different types of 0.3 wt% carbon nanotubes (CNTs) admixed cement mortar was assessed at 28, 56, 90 and 120 days under sulphate water curing. The outside diameters of CNTs are 10-20 nm and 30-50 nm, each type are un-treated and treated with COOH group, respectively. Results showed that flexural and compressive strength was improved for mortar sample admixed with nanomaterials than normal one. Also, nanomaterials came up as a good solution against abrasion and sulphate attacks. The durability is also enhanced for such mortar samples as the density increases, reducing the porosity and water absorption capacity. Resistivity results indicated negligible to low risk of corrosion, thus increasing the durability of these mortar samples. Overall, the sample formed with treated CNTs and 30nm – 50nm outside diameter gave better results than control specimen and other admixed mortar. Scanning Electron Microscopic  images were in strong correlation with the experimental results

No Action Today, No Cure Tomorrow - A Review of Agricultural Factors Predisposing Humans at The Risk of Antimicrobial Resistance and Its Preventive Strategies

One of the most significant public health issues today is AMR (AMR), which poses significant difficulties in controlling and treating infectious diseases. It is believed that the abuse and overuse of numerous antibacterial agents in the healthcare and agriculture industries led to the emergence of antimicrobial resistance. Even though irrational prescriptions have been blamed for the rise in resistance among microbes to various antimicrobial drugs, a variety of environmental factors have also been linked to the development of multidrug-resistant (MDR) organisms. Several studies have stressed the significance of using a one-health approach, or a holistic strategy, to combat antibiotic resistance that takes into account people, animals, and the environment. Models describing how resistance starts and spreads could be created with a better understanding of the environmental factors that encourage its development. Yet, preventing the establishment and spread of mobile resistance elements is challenging since it is unclear how and when the environment favors resistance growth. Hence the current review focuses on the agricultural factors predisposing humans to the risk of AMR and preventive strategies

Cross Sectional Survey On Maxillo Facial Injuries In Road Traffic Accidents In Karachi

Background: Injuries due to motorcycle accidents are frequent happenings in developing countries as people utilize it commonly as a mode of transport. In Pakistan 56% of Maxillofacial injuries can be associated to Road traffic accidents (RTA) majority of which are due to involvement of motorbikes. Methods: This cross sectional survey was carried out in public tertiary care setting in the year 2016. Three Hundred and Seventy participants were inducted in the study using Purposive sampling technique. Only those with maxillofacial injuries were included and diagnosed through conventional and panoramic radiographs and computed tomographic scans. Those who consented were included whereas, participants with language barrier or unable to answer were excluded. Data was collected by questionnaire with analysis being performed on SPSS version 21. Descriptive analysis was performed for quantitative variables with association between categorical variables tested through chi square. Bond of error was taken at 5% with 95% confidence interval. Permission was sought from ethical review board. Results: Majority, [267(84.5%)] were young patients with [ 282(89.2%)] patients involved in Motorcycle accidents. Of total participants male gender was [275(87%)] the driver inflicted in most situations [184(58.2%)]. Most patients [285(90.2%)] were without any safety device. Majority [220(69.6%)] had Mandibular fractures whereas, 111(35.1%) had Maxillary fractures. Soft tissue injuries were seen in 212(67.1%) patients. Conclusion: Motorcycle related accidents are common cause for maxillofacial injuries in road traffic accidents. Most patients suffered soft tissue injuries. Most commonly fractured bones were mandible and maxilla. Key Words: Maxillofacial injuries, Motorcycle, Accident

PERCEIVED WEIGHT STATUS AND WEIGHT MANAGEMENT INTENTIONS OF ADULTS: A CROSS-SECTIONAL STUDY IN PAKISTAN

Objective: To study the phenomena of weight misperception and to assess the intentions of weight management in the adult population of Karachi, Pakistan. Factors which lead to weight loss efforts will also be identified. Methods: A cross-sectional study was conducted with a total of 450 male and female adults aged 20 to 60 years. Data was collected through purposive sampling technique. All participants had their weight and height measured and filled a questionnaire asking about perceived weight status. Data was analyzed using SPSS version 20. Chi square was used to form associations, with P value of less than 0.05 being taken as significant. Results: Based on body mass index (BMI), 13.3% of the participants were underweight, 54.9% were of normal weight, 25.3% were overweight and 6.4% were obese. Misperception was prevalent in 37.8% (40.3% in females versus 33.1% in males) of the subjects. 28% overestimated their weight and 9.3% underestimated their weight. About 46.7% of underweight, 17.6% of overweight and 31.7% of obese participants were not making any efforts about the discrepancy in their weight. 28% were trying to lose and 28.7% were trying to control their weight. The highest rated reason for this weight consciousness was ‘feeling better about myself’. Conclusion: There was more weight misperception in females than males with a tendency of overestimation in females and underestimation in males. More females were trying to lose weight and more males were trying to gain it. A significant number of participants were making efforts that were not in correspondence with their weight status. Satisfaction about self was rated to be more important than health concerns

Interpretation of Electrocardiogram and Emergency Management of Myocardial Infarction: A Survey among Doctors

Background: A virtuous understanding of Electrocardiogram is an indispensable ability and essential skill required in doctors. This study assessed the understanding of the electrocardiogram and acute management of myocardial infarction among emergency doctors, general practitioners, medical officers, house officers and postgraduate students. Methods: A cross sectional survey was conducted for 7 months on n=312 doctors working in tertiary care public and private hospitals and as General practitioners in Karachi, Pakistan. Convenience sampling technique was used. Participants were asked to interpret a 12 lead electrocardiogram attached to questionnaire and write down their findings and diagnoses. They were then asked about its acute management. ANOVA and Chi square was applied for making inferences from the acquired data. p value of less than 0.05 was taken as significant. Approval was taken from the Ethical Review board. Results: Knowledge was assessed on basis of designation, 84.6% of the emergency doctors correctly interpreted the ECG while 75.4% of general physicians read it correctly. House officers and medical officers had the lowest scores in ECG interpretation. Years of experience demonstrated inverse results with >5 years experience at the lowest scores for interpretation of ECG and MI management. Interpretation scores of ECG were significantly high (p value 0.03) in participants who attended workshops compared to those who did not. Conclusion: Emergency doctors had better scores when it comes to ECG interpretation and management of MI. Frequent workshops and cardiology rotations should be mandatory for health care professionals to improve essential skill and knowledge of acute management of myocardial infarction

DEPRESSION AMONGST PARENTS OF CHILDREN WITH INTELLECTUAL DISABILITY

Background: Parental stress is the major factor that increases a risk of unwillingly placing children with disabilities. The aim of our study is to assess the frequency of depression amongst parents of children with intellectual disability. Methods: This was a cross sectional study conducted for 10 months in various hospitals and rehabilitation centers in Karachi, Pakistan. Participants were inducted using purposive sampling technique. Parents of intellectually challenged children up to 18 years of age were included and a self-administered questionnaire was utilized for data collection both in English and Urdu. PHQ 8 was used to assess the severity of depression amongst parents. For all purposes, p-value of <0.05 was considered statistically significant. Permission was sought from the ethical review board. Results: High proportion of parents interviewed suffered significantly from moderate to severe depression [223 (66.2%)]. Gender comparison revealed [186 (75.9%)] females had moderate to severe depression compared to [136 (40.3%)] males (p-value=0.000). Some factors associated with the child such as severity of disability also had an impact [197 (69.3%)], parents having children with Cerebral Palsy suffered moderate to severe depression as opposed to [26 (49%)] parents of children with Down’s Syndrome (p-value=0.03). The most common way to relieve stress was praying practiced by [176 (52.2%)] the parents. Conclusion: Amongst the parents of children with intellectual disability (ID), a significantly high proportion was suffering from depression. From the child’s aspect, age and severity of disability had an impact. Most common strategy identified to overcome depression was praying

Frequency Of Depressive And Anxiety Symptoms Among Patients On Interferon And Pegylated Interferon

Background: Chronic Hepatitis C (CHC) is highly prevalent in Pakistan. Current standard treatment is Interferon alpha/ Peginterferon with oral ribavirin. Interferon therapy is associated with development & worsening of depressive symptoms in CHC patients and to determine the frequency of depressive and anxiety symptoms among patients on treatment with interferon/ Pegasus. Methods: This cross sectional study was conducted at OPD of Liaquat University Hospital Hyderabad during a period of 4 months (from July2013 to October2013). A sample of 120 patients aged 18-60 years, either currently receiving interferon/ Pegasus treatment or had received that treatment during last 12 months was taken. Known cases of anxiety, depression and those suffering from other debilitating co morbid conditions like carcinoma & non-consenting were excluded. Ethical approval was taken from LUH ethical review committee. A Proforma was used to gather the data. The data collected were analyzed using SPSS version 20.0. Mean (±SD) were computed for quantitative variables. Categorical variables (such as gender and outcome variables i.e. anxiety and depressive symptoms) were measured in frequencies and percentages. Stratification was done with regard to age group & gender to see the impact of these on the outcome followed by application of chi-square test with P-value <0.05 taken significant. Results: Total 120 patients were included in the study & 119 completed the questionnaire. Male patients were 55.5%. Mean age of patients was 32.59 ± 8.56 years (Range: 16-56 years). Primary outcome i-e; frequency of depression & anxiety in patients on interferon were 77.3% & 70.6% respectively. (n=92) had depression. Frequency of depression of almost similar in both genders (77.3% in males & 77.4% in females; p value= 0.584), while anxiety was more in females than males (75% vs 68.2%; p value= 0.273). Both psychiatric symptoms increased with increasing age from 16-26 years to 47-56 years of age (p values = 0.432 & 0.736 respectively). Vast majority (86.6%) were treated with interferon while only 13.4% received the PEGylated interferon therapy. Patients treated with PEGylated interferon had less frequency of depression than those treated with interferon (62.5% vs 79.6%; p value= 0.131). Conclusion: Depression and anxiety were found to be common in CHC patients who had been or are being treated with antiviral treatment leading to increased risk of morbidity and mortality. Screening for risk of depression, proper education and timely treatment through anti-depressant followed by close monitoring is mandatory to achieve success in antiviral treatment. Key Words: Hepatitis C, Depressive symptoms, Anxiety, Interferon alpha

An Unbiased Lipid Phenotyping Approach To Study the Genetic Determinants of Lipids and Their Association with Coronary Heart Disease Risk Factors.

Direct infusion high-resolution mass spectrometry (DIHRMS) is a novel, high-throughput approach to rapidly and accurately profile hundreds of lipids in human serum without prior chromatography, facilitating in-depth lipid phenotyping for large epidemiological studies to reveal the detailed associations of individual lipids with coronary heart disease (CHD) risk factors. Intact lipid profiling by DIHRMS was performed on 5662 serum samples from healthy participants in the Pakistan Risk of Myocardial Infarction Study (PROMIS). We developed a novel semi-targeted peak-picking algorithm to detect mass-to-charge ratios in positive and negative ionization modes. We analyzed lipid partial correlations, assessed the association of lipid principal components with established CHD risk factors and genetic variants, and examined differences between lipids for a common genetic polymorphism. The DIHRMS method provided information on 360 lipids (including fatty acyls, glycerolipids, glycerophospholipids, sphingolipids, and sterol lipids), with a median coefficient of variation of 11.6% (range: 5.4-51.9). The lipids were highly correlated and exhibited a range of associations with clinical chemistry biomarkers and lifestyle factors. This platform can provide many novel insights into the effects of physiology and lifestyle on lipid metabolism, genetic determinants of lipids, and the relationship between individual lipids and CHD risk factors

Genome-wide analysis of blood lipid metabolites in over 5000 South Asians reveals biological insights at cardiometabolic disease loci.

The authors would like to thank Michael Inouye for his helpful comments on an earlier version of the manuscript.Peer reviewe

Genome-wide analysis of blood lipid metabolites in over 5000 South Asians reveals biological insights at cardiometabolic disease loci.

Funder: PfizerFunder: NovartisFunder: National Institute for Health ResearchFunder: MerckBackgroundGenetic, lifestyle, and environmental factors can lead to perturbations in circulating lipid levels and increase the risk of cardiovascular and metabolic diseases. However, how changes in individual lipid species contribute to disease risk is often unclear. Moreover, little is known about the role of lipids on cardiovascular disease in Pakistan, a population historically underrepresented in cardiovascular studies.MethodsWe characterised the genetic architecture of the human blood lipidome in 5662 hospital controls from the Pakistan Risk of Myocardial Infarction Study (PROMIS) and 13,814 healthy British blood donors from the INTERVAL study. We applied a candidate causal gene prioritisation tool to link the genetic variants associated with each lipid to the most likely causal genes, and Gaussian Graphical Modelling network analysis to identify and illustrate relationships between lipids and genetic loci.ResultsWe identified 253 genetic associations with 181 lipids measured using direct infusion high-resolution mass spectrometry in PROMIS, and 502 genetic associations with 244 lipids in INTERVAL. Our analyses revealed new biological insights at genetic loci associated with cardiometabolic diseases, including novel lipid associations at the LPL, MBOAT7, LIPC, APOE-C1-C2-C4, SGPP1, and SPTLC3 loci.ConclusionsOur findings, generated using a distinctive lipidomics platform in an understudied South Asian population, strengthen and expand the knowledge base of the genetic determinants of lipids and their association with cardiometabolic disease-related loci