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

Line probe assay for detection of rifampicin and isoniazid resistant tuberculosis in Pakistan

Objective: To assess the efficacy of a line-probe assay delta (LiPA) as rapid diagnostic test for early detection of drug-resistant tuberculosis compared to conventional susceptibility methods in Pakistan.Methods: Resistance to rifampicin (RIF) and isoniazid (INH) in 108 smear-positive pulmonary tuberculosis samples was detected using a line-probe assay [GenoType MTBDRplus (Hain Lifescience, GmbH, Nehren, Germany)] at the clinical microbiology laboratory of Aga Khan University Hospital in May, 2009. Results were compared with susceptibilities performed while using agar proportion.Results: In comparison to the agar proportion method, the detection rate and specificity of resistance using MTBDR plus was 92.5% and 98.2% for rifampicin, and 76.3% and 100% for isoniazid. Mutations in codons 531 and 533 of rpoB gene (62%S531L) were responsible for 67.9% of rifampicin resistance. S315T mutation of katG gene was detected in 55.9% and inhA promoter mutation at positions -15 (C15T) in 11.9% of isoniazid resistant isolates. Four phenotypically rifampicin-resistant and 14 isoniazid-resistant strains were not detected by MTBDRplus. Sequencing these strains revealed mutations in 4 strains; 2 in rpoB gene S531W, del518 and 2 in katG genesW300L, S315N. Hence, two phenotypic rifampicin-resistant and 13 phenotypic isoniazid-resistant strains were not detected by the commercial line probe assay.Conclusion: The study showed that MTBDRplus had a high detection rate for rifampicin resistance. However, additional probes need to be included in the assay to improve the detection of isoniazid-resistant mycobacterium tuberculosis strains in Pakistan

CPEC: Pakistan-China Cordial Ties - A Boost to Pakistan's Economy

This paper highlights the need of energy production in Pakistan and to determine the extent to which China Pakistan Economic Corridor (CPEC) and its energy projects will contribute to the economic growth and development of Pakistan. In this regard, a fair amount of literature has been reviewed. The literature review presented confirms that a positive relationship exists between the energy production, security and economic development.  The long term friendship of Pakistan and China is discussed and how this tie has benefitted both the countries. Chinese cooperation and assistance with Pakistan is well evident from the substantial Chinese investment in Pakistan’s infrastructural expansion particularly development of Pakistan’s deep-water port at Gwadar. Under its One Belt One Road plan, China and Pakistan have collaboratively started a multibillion mega project, China Pakistan Economic Corridor. Under CPEC twenty-one energy projects being established, that is supposed to reduce the energy poverty generation in Pakistan. The study finds out that the sufficiency in energy sector will boost economy by energizing the industry and businesses as well as by creating thousands of direct and indirect employment opportunities

HIV prevalence in blood donors and recipients in Pakistan: a meta-analysis and analysis of blood-bank data

Background: The first instances of HIV-antibody detection in donated blood in Pakistan were reported in 1988. Since then, documentation of HIV in blood donors and of rates of transmission via transfusion has been limited. Previously assumed to have a low prevalence, HIV is an increasing health concern in Pakistan. Since there is no national, centralized blood-banking system, there are no reliable data on which to base estimated risks of transfusion-associated HIV infection. This study was therefore conducted to estimate the prevalence of HIV in blood donors and recipients in Pakistan between 1988 and 2012. Methods: Meta-analyses were undertaken of reported prevalences of HIV in blood donors and recipients published during 1988-2012. Papers were identified by searching PubMed, Google, CINAHL and PakMediNet and the websites of the World Health Organization, the national HIV/AIDS Surveillance Project and the National AIDS Control Programme of Pakistan. In addition, the 1998-2012 records of the Aga Khan University blood bank were analysed. Results: The 254 abstracts identified at the preliminary search were reviewed and, after removal of duplications, case-reports, editorials and reviews, 32 papers were selected that met the inclusion criteria. All studies that reported on HIV antibodies in blood donors/recipients were included, irrespective of the methodology used. Since seroconversion had only been confirmed through supplemental testing in a few papers, the results were analysed separately for reports based on screening only and confirmed cases. A total of 142 of 2 023 379 blood donors and 4 of 3632 blood recipients were HIV positive, giving an overall pooled seroprevalence of 0.00111% in blood donors and 0.00325% in blood recipients. The annual prevalences of HIV in donors at the Aga Khan University blood banks were similar, ranging from 0.013% to 0.116%. Conculsion: Very few reports on HIV in blood donors in Pakistan could be retrieved, and the overall pooled prevalence is low. However, the limited data and confounding factors mean that that these results may significantly underestimate the true situation. It is recommended that a complete survey of blood banks should be conducted throughout the country, in order to provide a more reliable estimate of the risk of transfusion-associated HIV infection in Pakistan

Bone graft donor site infection with a rare organism, aeromonas hydrophila: A typical location, presentation and organism with 2 years follow-up: Case report

Introduction: Aeromonas are Gram-negative bacilli often causing necrotizing fasciitis or sepsis in immunocompromised patients. Aeromonas Hydrophila is most often found in immunocompromised patients or those with burns or aquatic trauma. When patients present with a discharge and infection on bone graft donor site and progressive sepsis, an Aeromonas hydrophila infection should be considered in the differential diagnosis. Presentation of Case: We report here a rare case of Aeromonas hydrophila with surgical site sep- sis/infection in an immunocompromised 69 years old female, with several comorbids. Here we are reporting infection on donor surgical graft site, sparing major surgical site with the implant. After getting culture report of exudates from the wound that grew A. hydrophila, immediate wound debridement and antibiotic beads insertion was performed with appropriate antimicrobial therapy and regular wound dressing. She was followed for around 2 years. Discussion: This is the first report to our knowledge of A. Hydrophila infection in bone graft donor site. Aeromonas most often cause gastrointestinal and soft tissue infections, and bacteremia in immuno- compromised patients. Early surgical intervention is essential to reducing mortality in deep soft tissue infections caused by this organism. Aeromonas have shown resistance to penicillin but are sensitive to other broad-spectrum antibiotics. Conclusion: Early suspicion, diagnosis, and treatment with potent antibiotics are needed to prevent any further complications resulting from infection by this emerging aggressive pathogen

Inheritance patterns, challenges, and outcomes of fracture management in osteopetrosis patients. CASE series and review of pertinent literature

Background: Osteopetrosis (OP) is a group of rare inheritable genetic disorders which show increased bone radiodensity on radiography. As no cure exists, careful symptomatic treatment is the mainstay in management due to brittle bone and frequent complications. We would like to present a case series of OP patients, their management, a review of literature about this rare disease and its genetic and inheritance patterns.Materials and methods: Retrospective case series of 6 patients with OP seen at our institution from 2010 to January 2018. We searched PubMed and Google Scholar for articles using the following keywords: Osteopetrosis, Radiology, Fracture and Management to review literature.Cases presentation: We present 6 cases of OP each showing diverse history of frequent fractures and describe the challenges faced during management and the long-term follow-up results.Results: Abnormal osteoclast activity in OP results in defective bone resorption with patients having varied clinical presentations. Bones are brittle, increasing risk of fractures. Osteosynthesis is the recommended first-choice treatment for osteopetrotic fractures despite the risk of failure. Good preoperative planning is critical. Genetic studies showed multiple genes to be involved and varied patterns of inheritance in different types of OP. Conservative management could including varied therapies has also been proposed.Conclusion: With all-inclusive preoperative planning and careful postoperative care surgical treatment of fractures in OP is effective. The cases presented showed that plate osteosynthesis and intramedullary nailing are suitable options. Genetic factors and inheritance pattern should be discussed with patients

The Electrokinetic Stabilization (EKS) Green Approach Towards Improving the Geotechnical Properties of the Gulf Sabkha Soil at Rabigh, Saudi Arabia

Objectives: Sabkha soil is widely formed in the Arabian Gulf in the Kingdom of Saudia Arabia, particularly along the coastline. Over the past 25 years, numerous studies have been conducted to understand and characterize sabkha soil and increase its strength and durability. To enhance the geotechnical properties of Sabkha soil using an environmentally friendly electrokinetic stabilization method. From a geotechnical perspective, the construction process heavily depends on improving weak soil strength, durability, and treatment cost. The presence of water, high salinity, low shear strength, and low specific gravity are the soft geotechnical features that need to be enhanced before any construction on sabkha soil. Methods/Analysis: The electrokinetic stabilization method was applied to extract salty particles and enhance the geotechnical properties of sabkha soil. The voltage gradient of 40 V was applied for 1, 3, and 7 days using stainless steel electrodes. Findings: The result showed an outstanding improvement of sabkha soil geotechnical properties where the shear strength was increased from 116 to 165, 230, and 360 kPa for Rabigh I (RI), 122 to 155, 254, and 371 kPa for Rabigh II (RII), and for Rabigh III (RIII), the shear strength was improved up to 405 kPa. The moisture content decreased from 34.5 to 16.8% for RI, 35.2 to 15.9% for RII, and 37.5 to 14.7% for RIII. Novelty and applications: Experimental results demonstrated that all parameters were improved massively by increasing the voltage gradient and operational time. This technique is highly recommended to strengthen weak soil and improve geotechnical properties

Single Stage Management of Anorectal Malformation in Male Neonates: Experience of a Tertiary Care Centre

Introduction: Anorectal malformation [ARM] can be treated either by staged procedures or by a single stage procedure. In the present study we have performed single stage surgery of ARM in male neonates. Materials and Methods: Retrospective review of cases of ARM operated over 4 years at Indira Gandhi Institute of Medical Sciences, Patna, and Bihar from January 2015 to December 2018 were undertaken. In this study we have compared the results of single stage repair of Anorectal malformation with that of staged procedures performed earlier. Fifty four patients of Anorectal malformation were operated by single stage procedure (category 1) this was compared with staged procedures (category 2). Forty three patients underwent primary PSARP (posterior sagittal anorectoplasty) and the remaining 11 primary APP (abdomino-perineal pull through) procedure. The result of these single stage procedures were compared with that of staged procedures (category 2) in which a total of 39 cases were operated from 2012 to 2014. Result: Mean post-operative hospital stay in category 1 was 11 days and 32 days in category 2. In category 1, 20 patients were analysed. In which PSARP procedure was done in 15 and in 5 patients APP procedure was performed. The Rest of the patients are in follow up. Kelly score was good to fair in 17 patients (85%) and poor in 3 (15%) patients. In category 2 it was good to fair in 28 (71.7%) cases and poor in 11 cases (28%). Conclusion: Single stage surgical repair of anorectal malformation in male neonates is reliable and can be safely performed. Early results are encouraging; however, a long term follow-up is required to get any definite conclusion

Macrolide and fluoroquinolone resistance in helicobacter pylori isolates: An experience at a tertiary care centre in Pakistan

Objective: To assess fluoroquinolone and clarithromycin susceptibility pattern along with the types of genomic mutations involved in the resistance of Helicobacter pylori isolates.Methods: The cross-sectional study was conducted at the Department of Pathology and Microbiology, Aga Khan University Hospital, Karachi, from June 2009 to July 2010, and comprised 162 gastric biopsy samples which were tested with GenoTypeHelicoDR (Hain Lifescience GmbH, Germany), a reverse hybridisation multiplex polymerase chain reaction (PCR) line probe assay (LiPA). Also, 23S rRNA (ribosomal ribonucleic acid) gene was analysed with three-point mutations at A2146G, A2146C and A2147G for clarithromycin, and gyrA gene was analyzed at two codon positions 87 and 91 for fluoroquinolone susceptibility testing. SPSS 19 was used for statistical analyses.Results: Clarithromycin resistance was seen in 60 (37.0%) of the isolates mainly involving mutation at A2147G (85%) followed by A2146G (n=35; 21.6%) and A2146C (n=19; 11.6%). Fluoroquinolone resistance was noted in 101(62.3%) isolates, while gyrA mutations at codon 87 was seen in 64 (39.6%) and at codon 91 in 66 (40.6%). Isolates showing combined resistance to both antibiotics were 44 (26.9%).Conclusion: High rate of resistance to fluoroquinolones was seen despite the fact that the drug was not part of the first-line anti-helicobacter therapy. There was moderate increase of clarithromycin resistance beyond the cutoff rates where empirical use of this antibiotic is abandoned. The findings warrant the need for pre-treatment susceptibility testing in Helicobacter pylori infections, especially in Pakistan where burden of disease is high and very limited data is available, to improve patient care by providing targeted therapy