ASSOCIATION OF KIDNEY STONES SEVERITY WITH DIABETES MELLITUS, FATNESS & HYPERTENSION

Objective: The purpose of this research work is to interrogate the association between the availability of kidney stones with BMI, DM & HT (hypertension). Methodology: Five hundred and seventy-four patients were the part of this research work. Past history of the kidney stones was not present in any patient. Total one hundred and twenty-one patients diagnosed with the presence of kidney stones with the evaluation of ultrasound & four hundred and fifty-three patients without stones compared with respect to body mass index, hypertension & diabetes mellitus. The burden of one hundred and twenty-one patients with stones also compared with similar variables. Results: Out of 121 kidney stone’s patient, 24.70% (n: 30) were available with hypertension, while 14.50% (n: 66) out of 453 without stone patients were present with hypertension. The values of body mass index in the patient with and without kidney stones were 27.20±4.930 kg/m2 & 25.290±4.120 kg/m2 correspondingly. Total 20.60% (n: 25) patients with kidney stones were available with diabetes mellitus whereas 10.8% (n: 49) patients without stones were available with diabetes mellitus. Analysis of logistic regression showed in the comparison of the patients of both groups that diabetes mellitus & body mass index has an association with the presence of the kidney stones. There was no important association among the similar variables and CSD (Cumulative Stone Diameter) and the surface area of stones assessed for the stone burden. Conclusions: DM, HT and high BMI may add the risk factors for the possibility of the formation of the kidney stones but they were not affecting the burden of the stones. KEY WORDS: Kidney, Ultrasound, Hypertension, Association, Cumulative, Diabetes, Mellitus, Cumulative Stone Diameter

Superior septal approach versus left atrial approach for mitral valve replacement: a retrospective cohort study

Abstract OBJECTIVE: To compare the outcomes of superior septal approach and left atrial approach for mitral valve replacement. METHODS: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients who had undergone isolated mitral valve replacement from May 2003 to April 2012. Cases were reviewed for the outcomes [primary: loss of normal sinus rhythm; secondary: complications, residual defect and mortality]. Patients with prior history of dysrhythmia, low ejection fraction (\u3c30%), emergency/redo mitral valve replacement and concomitant coronary artery bypass grafting were excluded. SPSS 19 was used for data analysis. RESULTS: Of the 78 patients, 52(66.67%) were of superior septal approach and 26(33.33%) of left atrial approach. Both groups were comparable for baseline variables except cardiopulmonary bypass and cross-clamp times, which were significantly shorter in the superior septal approach group than the left septal approach group (p\u3c0.05). No residual atrial septal defect was found in any approach. Although loss of normal sinus rhythm was observed more frequent in superior septal approach 25(48%) compared to left septal approach 10(38.4%), but the difference was statistically insignificant (p=0.28). Age was the only significant variable affecting loss of normal sinus rhythm after adjusting for approaches. The difference of post-operative complications was also statistically insignificant between superior 9(17.3%) and left septal approach 4(15.38%) (p=1.0)]. CONCLUSIONS: The operative durations were significantly higher in left atrial approach compared to superior septal approach

Development of the VEGANScreener, : a Tool for a Quick Diet Quality Assessment among Vegans in Europe

Peer reviewe

A heuristic optimization method of fractional convection reaction: An application to diffusion process

The convection differential models play an essential role in studying different chemical process and effects of the diffusion process. This paper intends to provide optimized numerical results of such equations based on the conformable fractional derivative. Subsequently, a well-known heuristic optimization technique, differential evolution algorithm, is worked out together with the Taylor’s series expansion, to attain the optimized results. In the scheme of the Taylor optimization method (TOM), after expanding the functions with the Taylor’s series, the unknown terms of the series are then globally optimized using differential evolution. Moreover, to illustrate the applicability of TOM, some examples of linear and non-linear fractional convection diffusion equations are exemplified graphically. The obtained assessments and comparative demonstrations divulged the rapid convergence of the estimated solutions towards the exact solutions. Comprising with an effective expander and efficient optimizer, TOM reveals to be an appropriate approach to solve different fractional differential equations modeling various problems of engineering

Generalized integral inequalities on time scales

Abstract The theory of dynamic equations on time scales which was formulated by Hilger is an area of mathematics which is currently receiving profuse attention. Despite the fact that the basic objective of times scales is to bring together the study of difference and differential equations, it also extends these classical cases to ‘in-between’. In the present article we present a version of Feng Qi integral inequalities on time scales which are in fact generalizations of results given in different articles

Comparison of effects of manual physical therapy and exercise therapy for patients with Temporomandibular disorders

The term temporomandibular disorder is used for pain and dysfunction at the temporomandibular joint. Manual therapy or exercise therapy has proven to be an effective measure for pain relief. The purpose of this study was to compare the effectiveness of manual therapy and exercise therapy in temporomandibular disorders. A quasi-experimental study was conducted from June 30, 2020 to December 30, 2020 in Al-Sheikh teaching hospital, Sialkot, Pakistan. A convenient sample of 24 patients was involved in the study. Lottery method was used to randomise the patients in either the Manual Therapy Group or Exercise Therapy Group. The participantswere assessed before and after the intervention through Numeric Pain Rating Scale (NPRS) for pain, Patient-Specific Functional Scale (PSFS) for function, Fonesca Amnestic Index (FAI) for the severity of condition, and MillimetreMouth Opening (MMO) for ranges. ---Continu

Wavelets optimization method for evaluation of fractional partial differential equations: an application to financial modelling

Abstract In the present paper, we employ a wavelets optimization method is employed for the elucidations of fractional partial differential equations of pricing European option accompanied by a Lévy model. We apply the Legendre wavelets optimization method (LWOM) to optimize the governing problem. The novelty of the proposed method is the inclusion of differential evolution algorithm (DE) in the Legendre wavelets method for the optimized approximations of the unknown terms of the Legendre wavelets. Sequentially, the functions and components of the pricing models are discretized by utilizing the operational matrix of fractional integration of Legendre wavelets. Illustratively, the implementation of the LWOM is exemplified on a pricing European option Lévy model and successfully depicted the stock paths. Moreover, comparison analysis of the Black-Scholes model with a class of Lévy model and LWOM with q-homotopy analysis transform method (q-HATM) is also deliberated out. Accordingly, the technique is found to be appropriate for financial models that can be expressed as partial differential equations of integer and fractional orders, subjected to initial or boundary conditions

HYPER EOSINOPHILIC SYNDROME; A CASE SERIES

ABSTRACT Hyper eosinophilic syndrome (HES) is a subset of idiopathic eosinophilia that fulfils the criteria of a persistent (>6 months) increase in absolute eosinophil count (AEC) (>1.5×10 9 \l) associated with target organ damage. Recently it was classified into myeloproliferative and lymphoid variants. Present study is aimed to study the clinico morphological features and variants of HES and their response to various therapeutic modalities. In Pakistani population. It is a case series conducted at Haematology department, Shaikh Zayed hospital, Lahore during 4 years from Jan 2005 to Dec 2008. This study included 8 adult patients of HES diagnosed on history, clinical features and elevated absolute eosinophil count (AEC). Seven of 8 patients were of lymphoid-HES and 1 was of myeloproliferative-HES. M: F ratio is 7:1, mean age of presentation was 37 years in lymphoid-HES and 69 years in myeloproliferative -HES. Presenting features were fatigue, weight loss, fever, SOB, paraesthesia and skin rash. Mean AEC in l-HES was 16×10 9 /l and in myeloproliferative-HES was 22.7x10 9 /l. Organ damage was seen in cardiovascular, gastrointestinal (GIT), respiratory and nervous systems. All of the lymphoid-HES responded to steroids. In conclusion, early diagnosis and targeted therapy improve outcome in HES

Physical Status and Parent-Child Feeding Behaviours in Children and Adolescents with Down Syndrome in The United Arab Emirates

The prevalence of Down syndrome (DS) in the United Arab Emirates (UAE) is high in comparison to the global statistics. The aim of this study is to assess the physical status, feeding problems, parent-child feeding relationship and weight outcome in children and adolescents with DS in the UAE. In this cross-sectional study, 83 individuals aged between 2–19 years with DS were recruited from three humanitarian centres for differently abled in the Emirates of Sharjah and Dubai, UAE. Socio-demographic characteristics; height, weight, BMI and body composition; feeding problems (STEP-CHILD screening tool); and parent-child feeding relationship (child feeding questionnaire—CFQ) were assessed. Correlations and regression analyses were used to determine the relationships and the best predictor of weight outcome (BMI) in DS participants. The median age of the participants was 9 (8) years. Fifty-five (66.3%) males and twenty-eight (33.7%) females constituted a sex ratio of 1.96:1. Five (6.2%) participants were short for their age, and 20.6% were overweight/obese compared to the growth charts for DS population. Body composition of females showed significantly higher percent body fat than males (25.5 (14.3)% vs. 18.2 (4.0)%, p = 0.03; 29.9 (2.8)% vs. 16.3 (12.2)%, p = 0.006) in 5–8.99 years and 12–19.99 years, respectively. The most common feeding difficulties on STEP-CHILD tool were food selectivity (62.2%), continued eating in the presence of food (57.7%) and swallowing without sufficient chewing (50%). Median score of total-CFQ for the parent-child feeding behaviour was 3.2 (1.9); parental restriction 3.3 (1.0); pressure to eat 3.0 (0.8); concern about child weight 3.7 (2.3). Parent-child feeding relationship was significantly positively correlated with feeding problems, and body weight of the participants. The best predictor for BMI was the parental concern about child weight (OR: 1.4, p = 0.02). The findings can be valuable for the health care professionals, parents and caretakers of children and adolescents with DS in emphasizing the need for regular monitoring of their physical status, and feeding behaviours. In addition, it reinforces the role of parents in mindfully managing their child feeding relationship in promoting healthy eating behaviours and weight of their youth with DS