Politics of Representation in Raza Rabbani’s Invisible People

This study focuses on the problematics of representation of the downtrodden in the Invisible People by Raza Rabbani. This research presents a case study of how when the rich and the powerful decide to represent the poor and the powerless, the endeavour may result not only in an artistic failure but may also amount to an ethical failure. Such a study is warranted as Rabbani belongs to the politicalelite of Pakistan but chooses to represent the oppressed in his collection of stories. This cross-class representative endeavor cannot be taken normatively and has to be investigated and evaluated in the context of relevant discourses. The theories of Re-Orientalism (Lau, Introducing ReOrientalism, 2014) and Huggan’s The Postcolonial Exotic have been utilized to build a theoretical framework to undertake this study. Nivedita Majumdar’s work “The Question of Exoticism in Indian Anglophone Literature” has also been utilized for deeper scrutiny of the text. The importance of the politics of representation cannot be overestimated, as the so-called representative institutions continue to operate on a non-representative basis

Effects of co-infection on the clinical outcomes of Clostridium difficile infection

Background: Clostridium difficile (C. difficile) is a spore-forming, Gram-positive rod that is known to be associated with antibiotic use. It is one of the leading causes of nosocomial diarrhea in the industrialized world and therefore warrants further study of its nature. It isn\u27t clear if co-infection by other organisms can affect the outcome of C. difficile infection (CDI). Methods: A single center retrospective study was done and it used inclusion criteria of 18 years of age and being tested positive for CDI on FilmArray® multiplex gastro-intestinal (GI) panel. Exclusion criteria were a GI panel performed on an outpatient basis, recurrent CDI, and the presence of end-stage renal disease, cirrhosis, or a non-GI infection. The stool sample for all patients were collected within 48 h of presentation to the hospital. There were 235 of 2576 GI panels selected for a retrospective chart review based on the above criteria. Among these 235 patients, 38 had a co-infection (CDI+ another GI infection = group A or cases) and the rest had only CDI (group B or controls). Group A was compared with group B for CDI severity, its response to treatment, recurrence, and length of the hospital stay, using 0.05 as the alpha criterion. Results: Most patients with CDI were female and above the age of 60 years. Co infection did not increase the severity of CDI based both on the American College of Gastroenterology criteria (p 0.16) as well as Infectious Disease Society of America criteria (p 0.77). Co infection group also didn\u27t have significantly different CDI related treatment failure rate (p 0.23), or CDI recurrence rate (p 0.49). Co-infection was also not associated with lengthier hospital stay (p 0.41). Conclusion: Our study suggests that co-infection doesn\u27t affect the severity of CDI or can cause treatment failures. Additionally, there was no significant increase in hospital stay, or increase in CDI recurrence associated with co-infection. Therefore, if CDI is the leading clinical diagnosis and a patient is tested positive for co-infection in addition to CDI on FilmArray® multiplex GI panel, this co-infection shouldn\u27t change the management for CDI. Limitations of this study (including retrospective nature of the study, small sample size, single site study, not including all microbiome and non-inclusion of race) should also be taken into account, while considering the applicability of the results of this study

Acute cerebellitis successfully managed with temporary cerebrospinal fluid diversion using a long tunnel external ventricular drain: A long-term radiological follow-up of two cases

Acute cerebellitis (AC) is a rare inflammatory childhood disorder. Although there is no consensus on standard treatment for cerebellitis, its outcome is usually favourable. We report two cases of AC in the paediatric age group, successfully managed with long tunnel external ventricular drain (EVD). The first patient was an 8-year-old boy with a history of fever and headache. Sequential MRI showed diffuse cerebellar swelling with tonsillar herniation and resulting hydrocephalus. The second patient was a 6-month-old boy who presented with high-grade fever associated with chills. CT scan of the head showed triventricular hydrocephalus with obliteration of cerebrospinal fluid spaces and cisterns. Both patients underwent immediate emergency right-sided long tunnel EVD insertion. The EVD was removed on the 9th day in the first patient and the 10th day in the second patient; the patients showed no neurological deficits at a follow-up of 2 years and 1 year, respectively

Dopamine-Agonist Induced Cerebrospinal Fluid Rhinorrhea; a Case Report

Introduction: Prolactinomas are the most common pituitary adenomas. Medical therapy with dopamine agonists (DA) is the mainstay of treatment and rarely requires surgical manipulation. Patients may rarely present with cerebrospinal fluid (CSF) rhinorrhea after starting therapy with DA in case of massive or invasive prolactinomas. Case Description: We present a case of a 29-year-old lady with invasive prolactinoma who presented with CSF rhinorrhea after a month of starting bromocriptine therapy with the development of meningitis and warranting early surgical repair. Practical Implications: Patients with macroprolactinoma should be closely monitored initially after starting on dopamine agonists to avoid life-threatening complications

Robust Method for Semantic Segmentation of Whole-Slide Blood Cell Microscopic Image

Previous works on segmentation of SEM (scanning electron microscope) blood cell image ignore the semantic segmentation approach of whole-slide blood cell segmentation. In the proposed work, we address the problem of whole-slide blood cell segmentation using the semantic segmentation approach. We design a novel convolutional encoder-decoder framework along with VGG-16 as the pixel-level feature extraction model. -e proposed framework comprises 3 main steps: First, all the original images along with manually generated ground truth masks of each blood cell type are passed through the preprocessing stage. In the preprocessing stage, pixel-level labeling, RGB to grayscale conversion of masked image and pixel fusing, and unity mask generation are performed. After that, VGG16 is loaded into the system, which acts as a pretrained pixel-level feature extraction model. In the third step, the training process is initiated on the proposed model. We have evaluated our network performance on three evaluation metrics. We obtained outstanding results with respect to classwise, as well as global and mean accuracies. Our system achieved classwise accuracies of 97.45%, 93.34%, and 85.11% for RBCs, WBCs, and platelets, respectively, while global and mean accuracies remain 97.18% and 91.96%, respectively.Comment: 13 pages, 13 figure

Bacterobilia in acute cholecystitis: bile cultures\u27 isolates, antibiotic sensitivities and antibiotic usage. a study on a Pakistani population.

Abstract Acute cholecystitis is one of the most common acute surgical conditions. Laparoscopic cholecystectomy remains the mainstay of treatment. In patients managed non-operatively, antibiotics play an important role in the treatment of cholecystitis. The current retrospective observational study was conducted at a tertiary care hospital in Karachi, and comprised medical records of patients admitted between 2008 and 2014with acute cholecystitis and in whom bile cultures were obtained. Of the 509 patients with a mean age of 51.15 ± 13.4years, early laparoscopic cholecystectomy (within 72hours) was performed on 473(92.9%) cases, while the rest underwent percutaneous cholecystostomy. Bile cultureswere positive in 171(33.6%) patients. Predominantly gram-negative organisms were isolated among a total of 137(27%), with E.coli 63(46%) being the most commonly isolated organism. Of the gram-positive organism, enterococcus 11(8%) was the most common. Antibiotic sensitivities were determined.Based on our findings gram-negative coverage alone should be sufficient in our segment of the population

Bacterobilia in acute cholecystitis: bile cultures\u27 isolates

Abstract Acute cholecystitis is one of the most common acute surgical conditions. Laparoscopic cholecystectomy remains the mainstay of treatment. In patients managed non-operatively, antibiotics play an important role in the treatment of cholecystitis. The current retrospective observational study was conducted at a tertiary care hospital in Karachi, and comprised medical records of patients admitted between 2008 and 2014with acute cholecystitis and in whom bile cultures were obtained. Of the 509 patients with a mean age of 51.15 ± 13.4years, early laparoscopic cholecystectomy (within 72hours) was performed on 473(92.9%) cases, while the rest underwent percutaneous cholecystostomy. Bile cultureswere positive in 171(33.6%) patients. Predominantly gram-negative organisms were isolated among a total of 137(27%), with E.coli 63(46%) being the most commonly isolated organism. Of the gram-positive organism, enterococcus 11(8%) was the most common. Antibiotic sensitivities were determined.Based on our findings gram-negative coverage alone should be sufficient in our segment of the populatio

Genetic Association of Beta-Myosin Heavy-Chain Gene (MYH7) with Cardiac Dysfunction

Cardiac dysfunction accelerates the risk of heart failure, and its pathogenesis involves a complex interaction between genetic and environmental factors. Variations in myosin affect contractile abilities of cardiomyocytes and cause structural and functional abnormalities in myocardium. The study aims to find the association of MYH7 rs121913642 (c.1594 T>C) and rs121913645 (c.667G>A) variants with cardiac dysfunction in the Punjabi Pakistani population. Patients with heart failure (n = 232) and healthy controls (n = 205) were enrolled in this study. MYH7 variant genotyping was performed using tetra ARMS-PCR. MYH7 rs121913642 TC genotype was significantly more prevalent in the patient group (p < 0.001). However, MYH7 rs121913645 genotype frequencies were not significantly different between the patient and control groups (p < 0.666). Regression analysis also revealed that the rs121913642 C allele increases the risk of cardiac failure by ~2 [OR:1.98, CI: 1.31–2.98, p < 0.001] in comparison to the T allele. High levels of the cardiac enzymes cardiac troponin I (cTnI) and CK-MB were observed in patients. There was also an increase in total cholesterol, LDL cholesterol, and uric acid in patients compared to the healthy control group (p < 0.001). In conclusion, the MYH7 gene variant rs121913642 is genetically associated with cardiac dysfunction and involved in the pathogenesis of HF

WOMEN'S STRUGGLE AND AGENCY IN THE NOVEL BEST OF FRIENDS BY KAMILA SHAMSIE

This research project explores the portrayal of hardship and women's agency in Kamila Shamsie's novel Best of Friends. The study aims to uncover the intricate interplay between personal aspirations and societal expectations while assessing Shamsie's contributions to feminist discourse. Shamsie's narratives, rooted in British-Pakistani heritage, offer valuable insights into the complexities of gender roles, agency, and cultural norms. The study employs feminist literary theory to analyze how the female protagonists in Best of Friends navigate challenges, exercise agency, and redefine their roles within patriarchal contexts. Through a multi-perspective narrative style, Shamsie highlights the collective agency of her characters, emphasizing the strength and support found in female friendships. Ultimately, the research showcases the resilience and autonomy of women in the face of cultural constraints, contributing to a broader understanding of gender dynamics, identity, and social restrictions within diverse cultural contexts. The methodology selected serves as a powerful lens for understanding human emotions and societal influences beyond the immediate novel analysis. It bridges the gap between the fictional world and real-world emotions, enriching the discussion surrounding human nature and interpersonal interactions. This research contributes to the exploration of language and gender bias, drawing from the perspectives of various feminist theorists. Ultimately, it underscores feminism's core principle of achieving social, economic, and political equality for women while offering a profound insight into the complexities of female relationships and human experiences