Effectiveness of thrombolytic therapy in patients with acute myocardial infarction within 12 hours of symptoms

Background: Atherosclerotic coronary artery disease particularly myocardial infarction is the leading cause of morbidity and mortality all over the world and its incidence is also on the rise in Pakistan. This study was done to assess the effectiveness of thrombolytic therapy in patients with acute myocardial infarction and comparison between diabetics and non- diabetics.Methods: This cross sectional study was conducted at Department of Cardiology, Bahawal Victoria Hospital, Bahawalpur from January to June 2019. Total 380 patients of aged 30-70 years either male or female with diagnosis of acute ST-elevation myocardial infarction presenting within 12 hours of the onset of chest pain were selected. Patients were given thrombolytic therapy with Streptokinase 1.5 MIU over 1 hour and post therapy, efficacy was assessed.Results: Mean age of the patients was 51.37±10.08 years. Mean duration of diabetes mellitus was 5.99±3.47 years. Duration of chest pain ranged from 1 hour to 12 hours with mean duration of 4.66±2.98 hours. Out of 380 patients of MI, treatment was found effective in 202 (53.2%) patients. Female gender, type of MI, and duration of chest pain were significantly associated with reduced efficacy (p value 0.05) while patients having diabetes had significantly reduced efficacy (p value < 0.001).Conclusions: There is reduced effectiveness of thrombolytic therapy in diabetic patients with ST elevation myocardial infarction

Synthesis of Ag-Fe3O4 nanoparticles for degradation of methylene blue in aqueous medium

Fe3O4 known as magnetite is one of the oxides of iron which plays a major role in various fields of sciences. Fe3O4 was synthesized by precipitation method using NH3.H2O, FeCl2.4H2O and FeCl3.6H2O as precursor materials. For synthesis of 5% Ag-Fe3O4, the green synthetic method was used for immobilization of Ag nanoparticles on Fe3O4 using leaves extract of Calotropis gigantea plant. The synthesized Fe3O4 and 5% Ag-Fe3O4 were employed as catalyst in degradation of methylene blue. The photo catalytic activity of Fe3O4 was remarkably enhanced by doping of Fe3O4 with Ag nanoparticles. Advanced instrumental techniques including XRD, EDX, TGA and SEM were used for characterization of synthesized particles. The immobilization of Ag on Fe3O4 enhanced the photo degradation of methylene blue from 40 to 72% at 40 °C which confirms that 5% Ag-Fe3O4 is an active catalyst for treatment of dye contaminated water. Ag-Fe3O4 exhibited almost same catalytic activity in two successive cycles. &nbsp; Bull. Chem. Soc. Ethiop. 2020, 34(1), 123-134.&nbsp; DOI: https://dx.doi.org/10.4314/bcse.v34i1.1

Establishing reference interval for thyroid-stimulating hormone in children below two-year ages in Pakistani population

Introduction: Reference intervals (RIs) of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) are age, assay and population specific. Currently, the age and assay-specific RIs for TSH are not available for children under two years of age. This study aimed to establish reference intervals for serum concentrations of TSH and FT4 in healthy children aged 1-24 months as per CLSI C28-A3 guidelines.Methods: This prospective cross-sectional study was conducted in children from 1 to 24 months visiting the clinical laboratory for serum vitamin D testing but without any recent illness, hospitalization, medication and history of maternal thyroid diseases from August 2018 to March 2019 were invited to participate in the study.Serum TSH and FT4 were measured on ADVIA Centaur (Siemens Diagnostics, US), using chemiluminescence immunoassay. Kolmogorov-Smirnov test assessed normality of the data and RIs based on central 95% of the population were established using the non-parametric approach.Results: After excluding one subject with confirmed congenital hypothyroidism, a total of 131 children were included in the study. The median (IQR) age of the study subjects was 12 months (11), and majority 78 (59.5%) were boys. The RIs were established using non-parametric approach as the data was not normally distributed. Reference interval for TSH was 0.73-4.94 μIU/mL and for FT4 was 0.81-1.51 ng/dl.Conclusion: We established assay-specific RIs for serum TSH and FT4 in children aged 1-24 months in our population. The RIs were slightly lower from RIs developed on other platforms in different population

Least square-support vector machine based brain tumor classification system with multi model texture features

Radiologists confront formidable challenges when confronted with the intricate task of classifying brain tumors through the analysis of MRI images. Our forthcoming manuscript introduces an innovative and highly effective methodology that capitalizes on the capabilities of Least Squares Support Vector Machines (LS-SVM) in tandem with the rich insights drawn from Multi-Scale Morphological Texture Features (MMTF) extracted from T1-weighted MR images. Our methodology underwent meticulous evaluation on a substantial dataset encompassing 139 cases, consisting of 119 cases of aberrant tumors and 20 cases of normal brain images. The outcomes we achieved are nothing short of extraordinary. Our LS-SVM-based approach vastly outperforms competing classifiers, demonstrating its dominance with an exceptional accuracy rate of 98.97%. This represents a substantial 3.97% improvement over alternative methods, accompanied by a notable 2.48% enhancement in Sensitivity and a substantial 10% increase in Specificity. These results conclusively surpass the performance of traditional classifiers such as Support Vector Machines (SVM), Radial Basis Function (RBF), and Artificial Neural Networks (ANN) in terms of classification accuracy. The outstanding performance of our model in the realm of brain tumor diagnosis signifies a substantial leap forward in the field, holding the promise of delivering more precise and dependable tools for radiologists and healthcare professionals in their pivotal role of identifying and classifying brain tumors using MRI imaging techniques

Diagnosis and management of premalignant penile lesions

Diagnosing premalignant penile lesions from benign penile dermatoses presents a unique challenge. The rarity of these conditions and the low incidence of penile cancer mean that the majority of our knowledge is based on small, non-randomized, retrospective studies. The introduction of specialist penile cancer centres in the UK has resulted in the centralization of expertise and resources, and has furthered our understanding of the biological behaviour and management of this rare malignancy. We review the current trends in the approach to diagnosing and treating various premalignant penile conditions

Mobility Aware Blockchain Enabled Offloading and Scheduling in Vehicular Fog Cloud Computing

The development of vehicular Internet of Things (IoT) applications, such as E-Transport, Augmented Reality, and Virtual Reality are growing progressively. The mobility aware services and network-based security are fundamental requirements of these applications. However, multi-side offloading enabling blockchain and cost-efficient scheduling in heterogeneous vehicular fog cloud nodes network become a challenging task. The study formulates this problem as a convex optimization problem, where all constraints are the convex set. The goal of the study is to minimize communication cost and computation cost of applications under mobility, security, deadline, and resource constraints. Initially, we propose a novel vehicular fog cloud network (VFCN) which consists of different components and heterogeneous computing nodes. The ensure mobility privacy, the study devises Mobility Aware Blockchain-Enabled offloading scheme (MABOS). It extends blockchain enable multi-side offloading (e.g., offline offloading and online offloading) with proof of work (PoW), proof of creditability (PoC) and fault-tolerant techniques. The purpose is to offload all tasks under the secure network without any violation. Furthermore, to ensure Quality of Service (QoS) of applications, this work suggests linear search based task scheduling (LSBTS) method, which maps all tasks onto appropriate computing nodes. The experimental results show that devise schemes outperform all existing baseline approaches to the considered problem

Practices of vitamin D supplementation leading to vitamin D toxicity: Experience from a low-middle income country

Introduction: The trend of prescribing VD preparations for nonspecific body aches and self-medication has increased significantly. The importance of vitamin D toxicity (VDT) has been underestimated and under recognized. This study was done to determine the frequency toxicity (\u3e150 ng/ml) in subjects for 25-hydroxyvitamin D (25OHD) and evaluate the vitamin D (VD) supplements used by these subjects. Methodology: This descriptive cross-sectional study was conducted at the Section of Chemical Pathology, Aga Khan University Hospital Karachi from April 2020 to March 2021. Subjects with 25OHD toxicity were contacted and information related to history of calcium and VD supplementation were collected. The statistical analysis was performed using the Microsoft Excel 2016. Results: Over a year period 105398 subjects were tested for serum 25OHD, of which 0.34% (n = 364) subjects had 25OHD level of \u3e150 ng/ml. After satisfying exclusion criteria 186 subjects (78 were adults) were included in final analysis. All of these were using VD supplements and the main indications were delayed growth/short height (43.7%, n = 34) and aches or pains in (54.6%, n = 59) in pediatric and adult subjects respectively.Most of the subjects were taking supplements orally (74.1%, n = 138). Commonly prescribed preparation in adults and pediatric was 200,000 IU (70.4%, n = 76) and 400 IU (35.9%, n = 28) respectively. Most subjects took supplements for 1-3 months (68.3%, n = 127). Stated total supplementation ranged from 20,000 IU to 3600,000 IU in pediatric subjects and 200,000 IU to 96,00,000 IU in adults. Conclusions: Supplementation is a leading cause of potential toxic levels of 25OHD. The condition can be prevented by careful use of VD supplements and consistent monitoring

Inappropriate supplementation of Vitamin D can result in toxicity: A crosssectional study of paediatrics population

Objective: To evaluate children with suspected or definite hypervitaminosis D with respect to prevalence, clinical manifestations and pharmacological aspects.Methods: The retrospective cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, and comprised medical records from January 1 to December 31, 2018, of children aged \u3c18 years with 25-hydroxyvitamin D levels \u3e50ng/ml. Clinical and pharmacological data was retrieved. Data was analysed using SPSS 23.Results: Of the 118,149 subjects visiting the clinical laboratory during the study period, children tested for serum 25-hydroxyvitamin D levels were 16,316(13.8%) who had a median age of 9.78 years (interquartile range: 10.2 years). Children who registered for consultation were 2720(16.6%), and, out of them, 602(22%) had serum 25-hydroxyvitamin D \u3e50ng/ml. The median 25-hydroxyvitamin D levels and age were 70.1ng/ml (interquartile range: 100ng/ml) and 3.1 years (interquartile range: 17.93 years), respectively, and 345(57.3%) of them were boys. Children supplemented with vitamin D were 197(33.1%) and 193(97.9%) of them were prescribed by physicians. Mega-doses were taken by 68(34.17%), while the remaining had used various combinations in syrup or tablet forms. Commonly prescribed mega-doses were 600,000IU 30((44.1%) and 200,000IU 31(45.5%) injections of vitamin D. The primary indications were pains/aches in 51(25.8%) cases, developmental delay 50(25.3%), and vitamin D deficiency 49(24.8%). The main symptoms of hypervitaminosis D or toxicity were abdominal pain 27(13.7%) and constipation 31(15.7%).Conclusions: Children should be given vitamin D supplements with caution as prolonged supplementation and repeated mega-doses can result in toxicity which may cause serious consequences

A comparative sorption study of Cr3+ and Cr6+ using mango peels: kinetic, equilibrium and thermodynamic

The present study investigates a comparative study of the sorption of Cr3+ and Cr6+ from water using an agricultural by-product; mango peels in batch system under the effect of initial metal ion concentrations, solution pH, temperature, sorbent dose and contact time. Characterization of the mango peels was done before and after sorption of Cr3+ and Cr6+ using scanning electron microscopy, surface area pore size analyzer and FTIR spectroscopy. The pH study revealed that that maximum removal of Cr3+ and Cr6+ was obtained at pH 5.0 and 7.0 respectively. Among various kinetic models, pseudo-2nd order well explained the data owing to the higher values of R2 and the nearness between the values of experimental and calculated sorption capacities. The isotherms study revealed that Freundlich is the suitable isotherm for explanation of the equilibrium data due to higher R2 values. The monolayer sorption capacity of mango peels was found to be 98.039 mg g-1 for Cr3+ and 66.666 mg g-1 for Cr6+. The spontaneity and exothermic nature of the sorption process of Cr3+ and Cr6+ using mango peels was reflected from thermodynamic study