The Economic Impact of Lower Extremity Amputations in Diabetics. a Retrospective Study From a Tertiary Care Hospital of Faisalabad, Pakistan

Background: Among the various complications of diabetes, lower-extremity amputation due to diabetic foot is a common problem. In Pakistan, 6-7% of patients with diabetes suffer from diabetic foot ulceration. Objectives: Our primary objective was to explore the frequency of diabetic foot amputations, and the secondary objective was to calculate the economic burden of these preventable surgeries on the health budget of the provincial government. Materials & Methods: It was a retrospective cross-sectional observational study conducted after obtaining approval from the Ethical Review Committee of Allied hospital, Faisalabad Medical University. The data of diabetic foot patients who underwent amputations between July 2017 and December 2017 were retrieved from three Surgical Units (I, II & III), using a purposive sampling technique. All amputations carried out for reasons other than diabetic foot were excluded. The direct medical cost of one diabetic foot amputation was calculated via a local survey of the various private hospitals of Faisalabad. The indirect costs in terms of loss of productivity and disability costs, transport costs, rehabilitation costs were not included in this study. The data were evaluated by using SPSS Version 23. Results: A total of 85 patients were included in our study. The male to female ratio was 2.7 to 1. The mean direct treatment cost for minor amputation was PKR 46926.00 ± 11730.90 ($382.35 ± 95.58), and the mean direct treatment cost for major amputation was PKR 53720.00 ± 12401.24 ($437.71 ± 101.40). Out of 85 amputations, 63 (74%) were major amputations, and the remaining 22 (26%) were minor amputations. The total cost for 63 major amputations was PKR 3,384,360 ($27568.91) and for 22 minor amputation was PKR 1,032,372 ($8409.67). The net cost came out to be PKR 4,416,732 ($35978.59) for all the 85 cases being reported in a tertiary care hospital of Faisalabad for six months. Conclusion: Diabetic foot, a preventable complication of long-term diabetes mellitus, has an economic burden on the hospital budget, which, if adequately addressed via primary prevention programme, can yield not just economical but medical benefits as well

PSO modelling and PID controlled of automatic fish feeder system

Automatic fish feeding system is an electronic device that is designed to distribute fish pellets at particular time with maximum speed regulation. There are three (3) main parts in the system which are storage, dispenser and distribution parts. A problem has been reported that the distribution part was not performed at the required speed. The main objective of this study is to improve the performance of fish feeding system by using PID controller through ARX modelling. In this study, raw data at distribution part with speed of 130 rpm, 160 rpm, 190 rpm, 220 rpm and 250 rpm were extracted and used to determine ARX equation parameters as transfer function by using PSO algorithm to optimize ARX model parameter. Validation tests used was residual analysis. The best transfer function was then used as a modelling plant in the simulation process with PID controller to determine the optimum PID parameters. Finally, implementation of a PID controller into real time system was done to verify whether this system improved or not. The PSO analysis showed that the best ARX model was at 190 rpm speed because of well superimposed predicted model with the actual system. The lowest normalized output MSE value is 0.0042015 , the lowest convergence output error value is 0.0040886, the stable pole zero map and correlation test verify the accuracy of the model reaching a 95% confidence level. ARX model parameters obtained using the PSO algorithm are two inputs ( , ) and two outputs ( , ). The input parameter obtained is (− 0.3391, − 0.4329) while the output parameter is (− 0.06498, − 0.08334). The optimum PID parameter value obtained by the auto tune method is = − 3.4854, = − 50.2207 and = 0.05815. In conclusion, the PID controller successfully improved the performance of the fish feeding system with the highest percentage of speed change of 92.59%

The Impacts of Ethanol on the US Catfish Farm Sector

In this study, we estimated catfish feed and farm price reduced form equations. Of particular importance was the impact of the recent increase in grain prices induced by ethanol production on feed cost and farm prices. This relationship was examined using an autoregressive distributed lag (ARDL) model. Results show that a 1% increase in corn prices caused a 0.134% and 0.263% increase in feed prices in the short- and long-run, respectively. Catfish farm prices increased by 0.106% (short-run) and 0.211% (long-run) given a 1% increase in feed prices. Between 2004 and 2008, corn prices increased from $2 to$6 per bushels. Taheripour and Tyner (2008) state that of the total increase, 25% was due to US ethanol subsidies and 75% was due to the increase in the price of crude oil. Given the $1 increase in corn prices (50%), this should result in a feed price increase of 13% and a farm price increase of 2.7% in the long-run. Park and Fortenbery (2007) found that for every percentage increase in ethanol production, corn prices increased by 0.16 % in the short run. From this we conclude that a 100% increase in ethanol production will cause catfish feed prices to increase by 4.21% in the long run, and catfish farm prices to increase by 0.89%.catfish, price, catfish feed, ethanol, autoregressive distributed lag model, ARDL, Demand and Price Analysis, Research Methods/ Statistical Methods,

Complementarity of Semileptonic BB to K2∗(1430)K_2^*(1430) and K∗(892)K^*(892) Decays in the Standard Model with Fourth Generation

The $B\rightarrow K_{2}^{\ast}(1430)l^{+}l^{-}$ $(l=\mu,\tau)$ decays are analyzed in the Standard Model extended to fourth generation of quarks (SM4). The decay rate, forward-backward asymmetry, lepton polarization asymmetries and the helicity fractions of the final state $K^{*}_{2}(1430)$ meson are obtained using the form factors calculated in the light cone sum rules (LCSR) approach. We have utilized the constraints on different fourth generation parameters obtained from the experimental information on $K$, $B$ and $D$ decays and from the electroweak precision data to explore their impact on the $B\rightarrow K_{2}^{\ast}(1430)l^{+}l^{-}$ decay. We find that the values of above mentioned physical observables deviate deviate significantly from their minimal SM predications. We also identify a number of correlations between various observables in $B\rightarrow K_{2}^{\ast}(1430)l^{+}l^{-}$ and $B\rightarrow K^{\ast}(892)l^{+}l^{-}$ decays. Therefore a combined analysis of these two decays will compliment each other in the searches of SM4 effects in flavor physics.Comment: 28 pages, 12 figure

The Livestock Economy of Pakistan: An Agricultural Sector Model Approach

The Pakistan Agricultural Sector Model (PASM) developed by Davies et al. (1991) was modified to enhance the livestock sub-sector. Nutrient-based rations replaced feedstuff-based rations and dry matter minimum and maximum constraints (stomach capacity) were added. Several initial simulations were undertaken to examine the structure of the modified model and its impact across the crop and livestock sub-sectors. These simulations included relaxing exogenous livestock numbers and selected crop hectarage constraints, and requiring that green forage be fed in the season grown. Most importantly, the results demonstrated that fodder hectarage will grow with livestock numbers to insure that sufficient green forage is available seasonally. Two other analyses were performed to demonstrate the need to specify linkages between the crop and livestock sub-sectors. An analysis of transforming the livestock sub-sector from traditional to feedlot-based technology demonstrated that the reduced numbers of non-milking cattle needed for a given output of meat would provide the potential for increased production of various crops and other livestock products. Also, expanded cotton and Irri rice exports, hypothesised to occur through trade liberalisation from the Uruguay Round of the GATT, highlighted other inter-relationships between the crop and livestock sub-sectors. Greater production of both livestock and other crops might accompany the expansion of cotton production but less livestock feed would be available with expanded exports of Irri rice.

HUBUNGAN TINGKAT PENGETAHUAN ORANG TUA DENGAN DERAJAT ASMA BRONKIAL DI RUMAH SAKIT UMUM DAERAH (RSUD) DR. ZAINOELABIDIN BANDA ACEH

ABSTRAKAsma bronkial merupakan suatu penyakit inflamasi kronis pada saluran pernafasan yang memerlukan tingkat kontrol yang baik. Tingkat kontrol pada penyakit asma bronkial sangat mempengaruhi derajat atau serangan asma pada penderita asma bronkial baik itu pada anak maupun pada orang dewasa. Salah satu indikator dalam pencapaian asma terkontrol adalah pengetahuan yang baik tentang penyakit asma, baik itu pada orang tua pasien maupun pasien itu sendiri sehingga mampu mengurangi bahkan sampai mencegah terjadinya serangan asma. Penelitian ini bertujuan untuk mengetahui hubungan antara tingkat pengetahuan orang tua dengan derajat asma bronkial pada anak usia 4-12 tahun di Rumah Sakit Umum Daerah (RSUD) dr. Zainoel Abidin Banda Aceh. Jenis penelitian ini adalah Cross sectional. Subjek penelitian terdiri atas 34 pasien di poliklinik anak dr. Zainoel Abidin Banda Aceh yang diperoleh dengan metode accidental sampling terhitung dari tanggal 7 September sampai dengan 7 Oktober 2016 Hasil uji statistik Spearman menunjukan nilai p < 0,001 (