Post Covid Anti-Nmdar Encephalitis in an Adolescent Girl

Anti-N-Methyl D-aspartate receptor (NMDAR) encephalitis is a neuro-inflammatory disorder caused by antibodies targeting neurons in the central nervous system. Certain viruses break immune tolerance of neuronal proteins and increase the permeability of blood brain barrier (BBB) to antibodies resulting in post infectious autoimmunity. We report a case about a 13 years old girl diagnosed as a case of anti-NMDAR encephalitis, who presented with psychiatric symptoms followed by abnormal movements and encephalopathy, with later development of autonomic instability with tachycardia and blood pressure at 98th centile. Her thyroid profile initially showed hyperthyroidism with negative anti-thyroid antibodies with subsequent normalization without anti-thyroid drug. Her SARS-CoV-2 antibody was positive despite being asymptomatic that had induced autoimmunity in central nervous system and caused transient thyroiditis. She poorly responded to first tier immune therapy (methylprednisolone pulse & plasmapheresis) but there was remarkable response to second tier immune therapy with Rituximab, with prompt attainment of ambulation and self care

Diagnostic accuracy of CT scan in staging resectable esophageal cancer

Abstract INTRODUCTION: CT scan is an important tool in staging of esophageal cancer. Survival can be improved by providing neoadjuvant treatment which depends on stage of esophageal cancer. So it is very important to stage the disease accurately. METHODS: The objective of this study is to determine diagnostic accuracy of CT scan to stage esophageal cancer. Ct scans of 62 patients included in the study were reviewed by a Consultant radiologist who was blinded to the final stage of tumour. Diagnosticaccuracy measured by comparing with histopathological staging. RESULTS: Accuracy, sensitivity and specificity of CT for T2 and T3 are 66%, 61%, 68% and 63%, 67%, 56% respectively. Accuracy, sensitivity and specificity of CT for presence of nodal disease are 65%, 59% and 75%. CONCLUSIONS: Ct scan alone has low diagnostic accuracy for staging Esophageal Cancer

Evaluation of toxic impact of the synthetic cannabinoids JWH-018 and its N-(3-hydroxypentyl) metabolite on human cell lines

Poster presented at Young Researchers in Life Sciences, 26-28 May 2014, Institut Pasteur, Paris, France

Clinical Decision Support System for Unani Medicine Practitioners

Like other fields of Traditional Medicines, Unani Medicines have been found as an effective medical practice for ages. It is still widely used in the subcontinent, particularly in Pakistan and India. However, Unani Medicines Practitioners are lacking modern IT applications in their everyday clinical practices. An Online Clinical Decision Support System may address this challenge to assist apprentice Unani Medicines practitioners in their diagnostic processes. The proposed system provides a web-based interface to enter the patient's symptoms, which are then automatically analyzed by our system to generate a list of probable diseases. The system allows practitioners to choose the most likely disease and inform patients about the associated treatment options remotely. The system consists of three modules: an Online Clinical Decision Support System, an Artificial Intelligence Inference Engine, and a comprehensive Unani Medicines Database. The system employs advanced AI techniques such as Decision Trees, Deep Learning, and Natural Language Processing. For system development, the project team used a technology stack that includes React, FastAPI, and MySQL. Data and functionality of the application is exposed using APIs for integration and extension with similar domain applications. The novelty of the project is that it addresses the challenge of diagnosing diseases accurately and efficiently in the context of Unani Medicines principles. By leveraging the power of technology, the proposed Clinical Decision Support System has the potential to ease access to healthcare services and information, reduce cost, boost practitioner and patient satisfaction, improve speed and accuracy of the diagnostic process, and provide effective treatments remotely. The application will be useful for Unani Medicines Practitioners, Patients, Government Drug Regulators, Software Developers, and Medical Researchers.Comment: 59 pages, 11 figures, Computer Science Bachelor's Thesis on use of Artificial Intelligence in Clinical Decision Support System for Unani Medicine

Flexural Behavior of Reinforced Rubberized Reactive Powder Concrete Beams under Repeated Loads

Non-biodegradability of rubber tires contributes to pollution and fire hazards in the natural environment. In this study, the flexural behavior of the Rubberized Reactive Powder Concrete (RRPC) beams that contained various proportions and sizes of scrap tire rubber was investigated and compared to the flexural behavior of the regular RPC. Fresh properties, hardened properties, load-deflection relation, first crack load, ultimate load, and crack width are studied and analyzed. Mixes were made using micro steel fiber of the straight type, and they had an aspect ratio of 65. Thirteen beams were tested under two loading points (Repeated loading) with small-scale beams (1100 mm, 150 mm, 100 mm) size. The fine aggregate is replaced by 5, 10, and 15%, respectively, with crumb rubber. While replacement of silica fume was 10, 20, 30, and 50%, respectively, with very fine rubber. Also, chip rubber was added to the mixture as coarse aggregate with 5, 10, and 15%. Five tested beams were chosen as case studies to analyze and compare the results of the ABAQUS software with the experimental results. The results showed that the flexural behavior of RRPC beams that contains rubber was acceptable when compared with the flexural behavior of the RPC beam (depending on load-carrying capacity). The crack width was decreased by including waste rubber and steel fibers. There is a satisfactory agreement between the results of the numerical analysis and the results of the experimental testing. Slight ultimate load differences are targeted between the effects of the monotonic loading and the repeated loading.

Advance thermodynamic analysis of a CO2 compression system using heat-pump for CCS

CO2 pressurization represents a significant portion of energy penalty resulting from CO2 capture in carbon capture and storage process (CCS). Effective measures to improve the pressurization scheme directly translates into an improvement of plant economics. In this paper we aim to reduce the energy expenditure of CO2 pressurization step in the CCS process by assisting the CO2 multi-stage compressors with a heat-pump system. The CO2 compressors raised CO2 pressure to an intermediate liquefaction pressure. Afterwards, the CO2 is liquefied in the heat-pump and subsequently pumped to the high pressure instead of being compressed. In addition to the conventional energetic analysis, the advance exergy analysis of the heat-pump assisted pressurization scheme is also presented. The advance exergy analysis of the proposed strategy reveals the optimum operating parameters and design of the heat pump system. Through the implementation of results obtained by the advance exergetic analysis, it was found out the proposed system can achieve 6.21% saving in electric power

INTEGRATED DETERRENCE: RELEVANCE & IMPLICATIONS FOR SOUTH ASIA

The US National Security Strategy of 2022 introduced a relatively new concept of Integrated Deterrence (ID) that will likely impact security discourse amongst global rivals such as the US, China, and Russia while affecting the strategic thinking of relatively smaller powers like India, Pakistan, and others. With an expanded scope and objectives, ID aims to build and integrate the entire spectrum of capabilities of the US, its allies, and partners against the perceived threat from China and possibly Russia. Resultantly, the paper focuses on implications of ID for security and strategic stability in South Asia. India, being a major strategic partner with the will to play a significant role in the US-led China containment strategy, is likely to be a major beneficiary of the new US posture of ID. With enhanced and integrated military capabilities, India is likely to adopt a more hostile posture towards its neighbours, especially Pakistan, thus forcing the latter to develop options in the form of 'Integrated Response', to help maintain strategic stability in the region without indulging in an arms race, and by maintaining neutrality in the evolving US-China great power competition.   Bibliography Entry Sultan, Adil, Faraz Haider and Shayan Hassan Jamy. 2023. "Integrated Deterrence: Relevance & Implications for South Asia." Margalla Papers 27 (2): 71-84

Balancing science and public policy in Pakistan\u27s COVID-19 response

Background: Coronavirus disease 2019 (COVID-19) has affected the world in an unprecedented manner and South Asian countries were among the first to experience imported cases. Pakistan\u27s response to COVID-19 has been under scrutiny for its granularity, reach and impact.Aims: to evaluate objectively the chronology and depth of the response to COVID-19 in Pakistan.Methods: We evaluated available national and subnational epidemiological and burden information on COVID-19 cases and deaths in Pakistan, including projection models available to the Government at an early stage of the pandemic.Results: Pakistan, with a population of 215 million and considerable geographic diversity, experienced case introduction from pilgrims returning from the Islamic Republic of Iran, followed by widespread community transmission. The National Command and Operations Centre, established through civilian and military partnership, was critical in fast tracking logistics, information gathering, real-time reporting and smart lockdowns, coupled with a massive cash support programme targeting the poorest sections of society. Cases peaked in June 2020 but the health system was able to cope with the excess workload. Since then, although testing rates remain low (\u3e 300 000 cases confirmed to date), case fatality rates have stabilized, and with 6300 deaths, Pakistan seems to have flattened the COVID-19 curve.Conclusion: Despite notable successes in controlling the pandemic, several weaknesses remain and there are risks of rebound as the economy and educational systems reopen. There is continued need for strong technical and programmatic oversight, linked to civic society engagement and working with religious scholars to ensure nonpharmacological intervention compliance

Balancing science and public policy in Pakistan\u27s COVID-19 response

Background: Coronavirus disease 2019 (COVID-19) has affected the world in an unprecedented manner and South Asian countries were among the first to experience imported cases. Pakistan\u27s response to COVID-19 has been under scrutiny for its granularity, reach and impact.Aims: to evaluate objectively the chronology and depth of the response to COVID-19 in Pakistan.Methods: We evaluated available national and subnational epidemiological and burden information on COVID-19 cases and deaths in Pakistan, including projection models available to the Government at an early stage of the pandemic.Results: Pakistan, with a population of 215 million and considerable geographic diversity, experienced case introduction from pilgrims returning from the Islamic Republic of Iran, followed by widespread community transmission. The National Command and Operations Centre, established through civilian and military partnership, was critical in fast tracking logistics, information gathering, real-time reporting and smart lockdowns, coupled with a massive cash support programme targeting the poorest sections of society. Cases peaked in June 2020 but the health system was able to cope with the excess workload. Since then, although testing rates remain low (\u3e 300 000 cases confirmed to date), case fatality rates have stabilized, and with 6300 deaths, Pakistan seems to have flattened the COVID-19 curve.Conclusion: Despite notable successes in controlling the pandemic, several weaknesses remain and there are risks of rebound as the economy and educational systems reopen. There is continued need for strong technical and programmatic oversight, linked to civic society engagement and working with religious scholars to ensure nonpharmacological intervention compliance

The Relationship between Exports and Economic Growth in Saudi Arabia

One of the most important objectives of an economy is to achieve high rate of economic growth so as to improve the well-being of their citizen. For the purpose, export-oriented policy measures are more preferably prescribed in the recent past. The present study aims at to find the linkages between exports and economic growth in case of Saudi Arabia. The study uses the most efficient unit root, cointegration and causality tests to find the true relationships between exports and economic growth. The study tries to examine the dynamic association for exports and economic growth in Saudi Arabia. Applying more popular time series technique of long run relationship and causality, the paper finds the long-run cointegration relationships in our export-growth model. Further, we have found feed-back effect in export-growth relationships and suggest the further export-promotion to foster economic growth in Saudi Arabia