FREQUENCY OF HCV INFECTION AND ITS GENOTYPES AMONG PATIENTS ATTENDING A LIVER CLINIC AND VOLUNTARY BLOOD DONORS IN A RURAL AREA OF PAKISTAN

ABSTRACT Objectives: To determine the frequency of Hepatitis C virus (HCV) infection and its genotypic distribution in a rural area of Sindh, Pakistan. Methodology: Retrospective study of patients attending the Free Liver Clinic (FLC), and investigated for detectable HCV antibodies (n=1638), and those screened for HCV infection prior to voluntary blood donation (n=804) at a teaching hospital, located in rural Sindh. All patients had HCV antibodies tested by ELISA. A total of 1022 patients, who tested 'reactive' to HCV antibodies, and who could financially afford to have HCV RNA tested by PCR, had their results analysed. A total of 200 patients also had their HCV genotyped and analysed. Results: Patients at FLC had a higher chance of being reactive for HCV antibodies, compared to voluntary blood donors (20% VS 14% -p = 0.004). HCV RNA was detectable in 904/1022 (88%) patients. Among typeable genotypes, 125/166 (75%) had a single genotype, and 7 patients (4%) were infected with genotype 1, either alone (n=4) or in combination with 3a. Conclusions: One out of every five people tested in our FLC, and 14% of "healthy" voluntary blood donors were seropositive for HCV antibodies. Genotype 1 is very rare in our region

Minor Oral Surgery with Out Stopping the Daily Low Dose of Aspirin Therapy

OBJECTIVES Patients with the low-dose long-term aspirin regime have a severe risk of excessive bleeding during surgery, placing them at risk of "adverse thrombotic events". This study aims to evaluate the bleeding in patients undergoing minor oral surgery procedures without stopping daily low-dose aspirin therapy. METHODOLOGY A descriptive cross-sectional hospital-based investigation involved the patient with minor oral surgery at "Altamash Institute of Dental Medicine, Karachi, Pakistan" from mid-April 2021 to mid-June 2021, who were between the age group 30 to 75 with a low-dose aspirin regime. The data was collected via a questionnaire to record the variables, i.e. duration of aspirin, postoperative medications, platelets count, clotting time, normal bleeding time, and intraoperative bleeding time.  RESULTS 51 patients, of which 32 were males while 19, were females. The normal bleeding time was comparatively analyzed with the intraoperative bleeding time using SPSS statistical software version 22. The results revealed that the mean bleeding time for the patients with a low-dose aspirin regime during minor oral surgery was 5.49 ± 1.07, while for the patients with a stopped aspirin dose was 4.57 ± 1.07. The comparative analysis using a t-test doesn't reveal significant statistical differences of p<0.05 between both groups. CONCLUSION We concluded that minor oral surgical procedures could safely be done without altering or stopping the low-dose, long-term aspirin regime.

Prevalence of Oral Manifestations of Systemic Diseases in Patients Visiting the Dental Outpatient Department of Sindh, Pakistan

OBJECTIVES The purpose of the study was to evaluate the awareness of oral health workers in identifying the prevalence of oral manifestations of systemic diseases in patients visiting the Dental Out-Patient Department of Sindh, Pakistan. METHODOLOGY A descriptive, cross-sectional survey-based study was conducted in Karachi, Pakistan, from October to December 2021. The study was conducted in various institutes from all over Sindh, Pakistan. An online, well-structured questionnaire was designed using Google Forms and distributed to the participants through social media platforms in the dental community. Using the Open-Epi software regarding a parent article, the sample size of this study was calculated. Keeping the confidence interval at 95% and the desired percentile at 50, the total sample size was calculated to be 100. Around 175 questionnaires were given out to the candidates. RESULTSThe results showed that  81% male and 19% female participated, including 45% postgraduate trainees, 30% house officers, and 25% general dentists. 80% detected 2-3 systemic diseases in a patient, with 75% observing oral manifestations preceding systemic illness diagnosis. The majority favoured treating underlying ailments (75%), and prevalent conditions included hypertension (90%), diabetes (80%), anaemia (75%), and lichen planus (40.7%). CONCLUSION Oral health workers play a vital role in the initial and early identification and multidisciplinary medical management of various systemic diseases. A coordinated approach between physicians and dentists in diagnosing and managing these conditions is necessary to achieve optimal clinical outcomes

Awareness of stroke risk factors, signs and treatment in a Pakistani population

OBJECTIVE: To assess the level of awareness in the general public on risk factors, symptomatology and immediate treatment of stroke.METHOD: A cross sectional study was conducted in a sample of subjects visiting a tertiary care university hospital by means of a self-designed questionnaire. The study period extended between May and June, 2007.RESULTS: A total of 398 individuals were surveyed. Hypertension (69.1%) and stress (55.8%) were identified as two major risk factors for stroke. Among them 50.8% identified Brain as the principal organ involved in stroke out of which 78.2% of the response came from people whose level of education was intermediate-and-above. Around 13% of the study respondents did not know of any risk factor for stroke, while 11.6% of the study respondents didn\u27t know about the alarming signs of stroke. The most frequent response (26.16%) to immediate management of stroke was to take the individual to Emergency Department/hospital. In all 56% reported that basic information about stroke was given to them by friend/relative.CONCLUSIONS: The overall awareness of the study population regarding stroke was shown to be inadequate by this study. Knowledge was significantly greater in participants of younger age and a higher level of education

Skeletal Traction Followed by Plaster of Paris vs Open Reduction and Internal Fixation – Comparison of the Functional and Radiological Outcome of the Two Treatment Modalities in Schatzker Type V and VI Tibial Fractures

Objective: To compare the functional and radiological outcomes of Schatzker type V and VI tibialfractures for the two currently employed treatment modalities.Methodology: It was a quasi-experimental study conducted at Orthopedics department. Patientswere admitted through ER and OPD of Mayo hospital Lahore over a period of 1 year. Total 84 patientswere included in the study. Patients were divided into two groups. Patients in Group A weremanaged with skeletal traction for 2 weeks followed by plaster of Paris back splint applied for next 2weeks followed by plaster of Paris casting for stabilization of the fracture for another next 4 weeks.Patients in Group B were managed with ORIF by wires, screws or plates. Functional andRadiographic evaluations were performed to assess pain, range of motion weight bearing andfracture union in each follow-up visitResults: In this study functional outcome of patients was significantly better and higher in patientswho were treated with ORIF techniqueConclusion: ORIF is more effective for treating Schatzker type V and VI tibial fracture in terms offunctional and radiological outcome as that skeletal traction followed by plaster of Paris casting.Keywords: Skeletal Traction; ORIF; Schatzker type V; Schatzker type VI; Tibial Fractur

Techno-Economic and Environmental Impact Analysis of Large-Scale Wind Farms Integration in Weak Transmission Grid from Mid-Career Repowering Perspective

Repowering a wind farm enhances its ability to generate electricity, allowing it to better utilize areas with high mean wind speeds. Pakistan’s present energy dilemma is a serious impediment to its economic development. The usage of a diesel generator as a dependable backup power source raises the cost of energy per kWh and increases environmental emissions. To minimize environmental emissions, grid-connected wind farms enhance the percentage of wind energy in the electricity system. These wind generators’ effects, on the other hand, are augmented by the absorption of greater quantities of reactive electricity from the grid. According to respective grid codes, integration of commercial onshore Large-Scale Wind Farms (LSWF) into a national grid is fraught with technical problems and inter-farm wake effects, which primarily ensure power quality while degrading overall system operation and limiting the optimal use of attainable wind resources. The goal of this study is to examine and estimate the techno-economic influence of large-scale wind farms linked to poor transmission systems in Pakistan, contemplating the inter-farm wake effect and reactive power diminution and compensating using a range of voltage-ampere reactive (VAR) devices. This study presents a partial repowering technique to address active power deficits produced by the wake effect by raising hub height by 20 m, which contributed to recovering the active power deficit to 48% and so reduced the effects of upstream wind farms. Simulations were conducted for several scenarios on an actual test system modeled in MATLAB for comparative study using capacitor banks and different flexible alternating current transmission system (FACTS) devices. Using the SAM (System Advisor Model) and RETscreen, a complete technical, economic, and environmental study was done based on energy fed into the grid, payback time, net present value (NPV), and greenhouse gases (GHG) emission reduction. The studies suggest that the unified power flow controller (UPFC) is the optimum compensating device via comparison analysis as it improved the power handling capabilities of the power system. Our best-case scenario includes UPFC with hub height augmentation, demonstrating that it is technically, fiscally, and environmentally viable. Over the course of its lifespan, the planned system has the potential to save 1,011,957 tCO2, resulting in a greener environment. When the energy generated annually by a current wake-affected system is compared to our best-recommended scenario, a recovered shortfall of 4.851% is seen, with improved system stability. This modest investment in repowering boosts energy production due to wake effects, resulting in increased NPV, revenue, and fewer CO2 footprints

Multi-dimensional potential assessment of grid-connected mega-scale floating PV power plants across heterogeneous climatic zones

Floating Photovoltaic (FPV) systems are gradually becoming more desirable due to a multitude of reasons, encompassing proximity to urban water reservoirs (facilitating city access) and their technical advantages. Climate change potentially presents risks of drought and FPV can potentially benefit by providing clean energy as well as saving water from evaporation. However, detailed studies are required to comprehensively evaluate the potential of FPV considering not only the technical parameters but evaluating the climatic effects as well. This paper presents an integrated multi-dimensional framework for the analysis of 2.5 MW grid-connected FPV systems over different climatic zones. In the first layer, a techno-economic and performance evaluation is carried out by fine-tuning different inputs of systems to make it ideal for proposed analyses under actual FPV conditions. Similarly, in the second layer environmental along with forest absorbing carbon analyses are performed. While socio analysis observed in the third fold is based on various SDGs and their indicators. Results reveal that the Dam with cold in winter and hot in summer climate conditions observed a most feasible site with a Levelized cost of energy (LCOE) of $0.047/kWh and a Net present value (NPV) of million$1.7705, respectively. In contrast, a Dam with mild cold climate conditions proves the least feasible site with LCOE of $0.057/kWh and NPV of million$1.0256, respectively. Similarly, the former Dam saved 20.50% higher CO2 emissions as compared to the latter, as well as required hectares of forest absorbing carbon. A comparative analysis observes a capacity factor of 22% and a performance ratio (PR) of 5%–10% higher as compared to solar photovoltaic (SPV) for dams with extreme weather

EFFECT OF SUPPLEMENTAL IRRIGATION ON WHEAT WATER PRODUCTIVITY UNDER RAINFED ECOLOGY OF POTHOHAR, PAKISTAN

For rainfed ecology, water is the most limiting natural resource and its effective utilization is indispensable in order to optimize crop water productivity. A field study on wheat crop was carried out to asses the impact of different irrigation depths through sprinkler irrigation system at three phonological stages viz. tilleing, anthesis and grain filling. Randomized Complete Block Design (RCBD) was used in the trail and had three repeats.  The area under study received 195 mm seasonal rainfall. Supplemental irrigation depths at three phonological stages, using small quantities of water through sprinkler irrigation system, significantly promoted the crop growth. The irrigation depth 25 mm gave the maximum output for biological yield (6504 ), grain yield (2030 ), thousand grain weight (28), plant height (87 ) and spike length (10 ). The highest water productivity of 0.97 kg/m3 was achieved with 25 mm supplemental irrigation depth when applied at tillering and anthesis stages

Systematic Development of Short-Term Load Forecasting Models for the Electric Power Utilities:The Case of Pakistan

Load forecasts are fundamental inputs for the reliable and resilient operation of a power system. Globally, researchers endeavor to improve the accuracy of their forecast models. However, lack of studies detailing standardized model development procedures remains a major issue. In this regard, this study advances the knowledge of the systematic development of short-Term load forecast (STLF) models for electric power utilities. The proposed model has been developed by using hourly load (time series) of five years of an electric power utility in Pakistan. Following the investigation of previously developed load forecast models, this study addresses the challenges of STLF by utilizing multiple linear regression, bootstrap aggregated decision trees, and artificial neural networks (ANNs) as mutually competitive forecasting techniques. The study also highlights both rudimentary and advanced elements of data extraction, synthetic weather station development, and the use of elastic nets for feature space development to upscale its reproducibility at global level. Simulations showed the superior forecasting prowess of ANNs over other techniques in terms of mean absolute percentage error (MAPE), root mean squared error (RMSE) and R2 score. Furthermore, an empirical approach has been taken to underline the effects of data recency, climatic events, power cuts, human activities, and public holidays on the model's overall performance. Further analysis of the results showed how climatic variations, causing floods and heavy rainfalls, could prove detrimental for a utility's ability to forecast its load demand in future