Non-Traumatic Laryngeal Fractures: A Systematic Review

Non-traumatic laryngeal fractures are an extremely uncommon presentation, and the diagnosis can be missed. Recognizing these fractures is important to appropriately direct management because most have a good prognosis and result in complete recovery. This article aimed to review the characteristics of all documented cases of non-traumatic fractures of the larynx. We sought to address questions related to the etiology, clinical presentation, and diagnostic assessment of this condition and provide recommendations about the management of these fractures. Electronic databases, mainly PubMed and Google Scholar, were searched for relevant literature with no language or time restrictions. Since 1950, 15 cases of non-traumatic laryngeal fractures have been documented in the medical literature. Out of these, thyroid cartilage fractures have been described in 14 patients, while only one instance demonstrated a fracture in the cricoid cartilage. Patients were managed conservatively using voice rest and observation with complete recovery in all cases. All patients who present with odynophagia, hoarseness, and tenderness over the thyroid cartilage after an episode of severe coughing or sneezing, should be evaluated for a thyroid cartilage fracture using laryngoscopy and computed tomography scan. Management of the airway should be the primary priority in any laryngeal injury, and further management performed after the airway is stable

Assessment of selected heavy metals uptake from soil by vegetation of two areas of district Attock, Pakistan

The present study was conducted to examine the heavy metals in the soil and vegetation of two areas of district Attock (Pakistan). Investigations were made to compare the heavy metals concentrations (Cu, Pb, Cd, Ni, Zn) in a relatively less polluted site (Khour City) and a polluted site (Khour Company). An assessment of the selected heavy metals uptake by the soil and vegetation was made through calculation of bioaccumulation and enrichment factors. Samples of soil and plants were collected from both sites. From each site, four points were selected randomly for vegetation and soil sampling. Plant species included Eucalyptus camaldulensis, Calotropis procera, Ziziphus nummularia, Cynodon dactylon, Acacia senegal, Parthenium hysterophorus, Dalbergia sissoo and Desmostachya bipinnata. Heavy metals were detected in soil and vegetation of both areas using atomic absorption spectrophotometer. Lead concentration was highest amongst other heavy metals in both soil and vegetation (Cynodon dactylon). In studied plant species heavy metals concentrations varied among different species. The level of heavy metal concentration in Khour Company was greater compared to Khour City. The increasing level of heavy metal contamination in the Khour Company area may be because of higher traffic density and industrialization compared to Khour City

Green Paradox in Emerging Tourism Supply Chains: Achieving Green Consumption Behavior through Strategic Green Marketing Orientation, Brand Social Responsibility, and Green Image

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Replica Bit-Line Technique for Embedded Multilevel Gain-Cell DRAM

Multilevel gain-cell DRAMs are interesting to improve the area-efficiency of modern fault-tolerant systems-on-chip implemented in deep-submicron CMOS technologies. This paper addresses the problem of long access times in such multilevel gain-cell DRAMs, which are further aggravated by process parameter variations. A replica bit-line (BL) technique, previously proposed for SRAM, is adapted to speed up the multilevel read operation at a negligible area-increase. Moreover, the same replica column is used to improve the write access time. An 8-kb DRAM macro implemented in 90-nm CMOS technology shows that the replica column is able to successfully track die-to-die process, voltage, and temperature variations to generate control signals with optimum delay. Finally, Monte-Carlo simulations show that a small timing margin of 100 ps is sufficient to also cope with within-die process variations

Seasonal influence, heat unit accumulation and heat use efficiency in relation to maize grain yield in Pakistan

Variations in ambient temperature affect crop yield by modifying the duration of phenological phases and physiologicalprocesses. An experimental study was carried out at the Maize and Millets Research Institute (MMRI),Yusafwala, Sahiwal, Pakistan, to determine the seasonal effects of temperature on indigenous and exotic maize(Zea mays L.) hybrids based on morphological, phenological, physiological and grain quality traits in four differentgrowing seasons: kharif 2016 and 2017, and spring 2017 and 2018. Seven indigenous and three exotic hybridswere sown in a randomized complete block design with a split plot arrangement, in three replications. Significantdifferences between hybrids and growing seasons were found for grain yield, related traits and temperature indices(cumulative heat units, photothermal index and heat use efficiency). Correlation analysis disclosed a significantpositive relationship between grain yield and net photosynthetic rate (0.854, P≤0.01), number of grains per ear(0.624, P≤0.01) and heat use efficiency (0.980, P≤0.01) in spring seasons. During kharif, net photosynthetic rate(0.675, P≤0.01) and heat use efficiency (0.996, P≤0.01) contributed significantly to grain yield, whereas number ofgrains per ear (−0.146, not significant) had no significant impact on grain yield. Cumulative heat units and heat useefficiency resulted the temperature indices with the greatest influence on grain yield, and should be consideredduring the selection of parents to develop high-yielding, climate-smart maize hybrids. Indigenous maize hybridsshowed higher yields and were more heat tolerant than exotic hybrids, and the spring sowing season appearedto be the most suitable for the cultivation of maize crops

Parametric optimisation of friction stir welding on aluminium alloy (EN AW-1100) plates

Friction stir welding is a solid-state welding process used extensively for aluminium alloys. EN AW-1100 alloy is mostly used for its exceptional corrosion resistance, high ductility, high thermal and electrical conductivities, and cost-effectiveness. This study is focused on the optimisation of friction stir welding parameters to achieve enhanced mechanical properties of 5mm thick EN AW-1100 alloy plates welded with a single pass, using Taguchi L9 orthogonal array and ANOVA analysis. Experimental results revealed that maximum tensile strength of 79 MPa and percentage elongation of 38.87 % were achieved. The maximum Vickers hardness achieved in the stir zone was 34.15. These results were used for optimisation using Minitab and it was determined that 2000 RPM, 30 mm·min−1 traverse speed and square probe profile came out to be the best parameters for maximum tensile strength. 4000 RPM, 30 mm·min−1 traverse speed and square probe geometry were the best parameters for maximum hardness in the stir zone. ANOVA analysis showed that the most significant parameter for tensile strength was traverse speed. None of the considered parameters were influencing the hardness value in the stir zone at a 95 % confidence level

Zoonotic and Reverse Zoonotic Events of SARS-CoV-2 and their Impact on Global Health

Coronaviruses (CoVs) are enveloped, positive sense, single-stranded RNA viruses. The viruses have adapted to infect a large number of animal species, ranging from bats to camels. At present, seven CoVs infect humans, of which Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is responsible for causing the Coronavirus Disease 2019 (COVID-19) in humans. Since its emergence in late 2019, SARS-CoV-2 has spread rapidly across the globe. Healthcare systems around the globe have been stretched beyond their limits posing new challenges to emergency healthcare services and critical care. The outbreak continues to jeopardize human health, social life and economy. All known human CoVs have zoonotic origins. Recent detection of SARS-CoV-2 in pet, zoo and certain farm animals has highlighted its potential for reverse zoonosis. This scenario is particularly alarming, since these animals could be potential reservoirs for secondary zoonotic infections. In this article, we highlight interspecies SARS-CoV-2 infections and focus on the reverse zoonotic potential of this virus. We also emphasize the importance of potential secondary zoonotic events and the One-Health and One-World approach to tackle such future pandemics

Islamic capitalism: an approaching truth or an expectant panorama for Islamic finance – a case of Pakistan and Malaysia

The investigation of future capitalism in the wake of Islam is rather complicated. The difference of interests and difference of opinions between secular scholars and fiqh scholars can stymie the progress of innovation. Nevertheless, a harmony between their intellectual views can prove to be a boon for encouraging Islamic financial elements. This paper scrutinizes an alternative capitalist structure as one of the basic and fundamental key elements for Islamic finance. In this study, interview-based multi case-study method is used, which is based on qualitative approach. This study concludes that Islam promotes the concept of risk sharing in trading and other financial activities, which may lead to lessen the burden on an individual. However, external factors are playing major roles in both of the countries as conventional system is very strong around the globe

Effect of Gabapentin-Fluoxetine Derivative GBP1F in a murine model of depression, anxiety and cognition

Background and Objective: Gabapentin is a commonly prescribed antiepileptic agent for seizures, which is also used for pain and addiction management. Due to growing evidence of its abuse liability, there has been an incentive to synthesise potentially useful gabapentin derivatives devoid of adverse effects. A gabapentin adduct with a fluoxetine moiety, GBP1F, was assessed for any sedative, cognitive, anxiolytic, or antidepressant-like actions in murine behavioral models. Materials and Methods: Selected groups of mice were used for each behavioral paradigm, and the effect of GBP1F (5, 10, and 15 mg/kg) was assessed using spontaneous locomotor activity, the tail suspension test, elevated plus maze test, and the Y maze test models. Immediately following behavioral experiments, postmortem striatal and hippocampal tissues were evaluated for the effect of GBP1F on concentrations of dopamine, DOPAC, HVA, serotonin, 5-HIAA, vitamin C, and noradrenaline using high performance liquid chromatography with electrochemical detection. Results: GBP1F induced a mild suppression of locomotor activity, ameliorated anxiety and depression-like behavior, did not alter cognitive behavior, and raised serotonin and 5-HIAA concentrations in the hippocampus and striatum. GBP1F also positively enhanced dopamine and vitamin C tissue levels in the striatum. Thus, GBP1F represents a compound with anxiolytic- and antidepressant-like effects though further studies are warranted at the molecular level to focus on the precise mechanism(s) of action

Prevalence and demographics of anxiety disorders: a snapshot from a community health centre in Pakistan

<p>Abstract</p> <p>Background</p> <p>The developing world is faced with a high burden of anxiety disorders. The exact prevalence of anxiety disorders in Pakistan is not known. There is a need to develop an evidence base to aid policy development on tackling anxiety and depressive disorders in the country. This is the first pilot study to address the prevalence of anxiety disorders and their association with sociodemographic factors in Pakistan.</p> <p>Methods</p> <p>A cross-sectional study was conducted among people visiting Aga Khan University Hospital (AKUH), a tertiary care facility in Karachi, Pakistan. The point prevalence of anxiety amongst the sample population, which comprised of patients and their attendants, excluding all health care personnel, was assessed using the validated Urdu version of the Hospital Anxiety and Depression Scale (HADS). The questionnaire was administered to 423 people. Descriptive statistics were performed for mean scores and proportions.</p> <p>Results</p> <p>The mean anxiety score of the population was 5.7 ± 3.86. About 28.3% had borderline or pathological anxiety. The factors found to be independently predicted with anxiety were, female sex (odds ratio (OR) = 2.14, 95% CI 1.36–3.36, p = 0.01); physical illness (OR = 1.67, 95% CI 1.06–2.64, p = 0.026); and psychiatric illness (OR = 1.176, 95% CI 1.0–3.1, p = 0.048). In the final multivariate model, female sex (adjusted odds ratio (AOR) = 2, 95% CI 1.28–3.22) and physical illness (AOR = 1.56, 95% CI 0.97–2.48) were found to be significant.</p> <p>Conclusion</p> <p>Further studies via nationally representative surveys need to be undertaken to fully grasp the scope of this emerging public health issue in Pakistan.</p