A study of monopulse tracking radar systems

Call number: LD2668 .R4 1965 Z6

Spectrum of acute flaccid paralysis in children

Acute flaccid paralysis (AFP) is a clinical syndrome characterized by rapid onset of weakness in a child aged less than 15 years due to any cause when polio is suspected(1). Exact cause of AFP with its incidence is needed for proper management

Spectrum of gullian barre syndrome in children

GBS is a post-infectious poly-neuropathy involving mainly motor but sometimes also sensory and autonomic nerves. This is an epidemiological report on seasonal & monthly distribution of GBS & differences in GBS incidence between male & female in Punjab, Pakistan. Objective: To determine the seasonal variation, age and gender differentiation in children with GBS along with EMG/NCS findings. Study Design: Retrospective, observational,cross sectional study. Place and duration of study: Department of Neurology, Childrens Hospital & The Institute of Child Health, Lahore from January 2014 to December 2014. METHODS: We extracted data from multi centers retrospectively in a 1 year period (January 2014- December 2014). In order to compare the frequency of GBS in different months & seasons we used the chi-square test. RESULTS: There was male predominance with 52.11% (n=37). Highest number of cases (70.4%) were found in age group (11-18 Years) (n=50). Seasonal (P=0.01) and monthly (P=0.02) variation among GBS was observed throughout the year with more prevalence in summer (49.29%) followed by spring (25.35%). Regional date of Punjab revealed highest number of cases 36.6% (n=26) in South Punjab followed by west Punjab 28.16% (n=20) CONCLUSION: Our study shows that there is significant monthly and seasonal variation in the admission rate of patients with GBS in Punjab

Sixth Generation (6G)Wireless Networks: Vision, Research Activities, Challenges and Potential Solutions

The standardization activities of the fifth generation communications are clearly over and deployment has commenced globally. To sustain the competitive edge of wireless networks, industrial and academia synergy have begun to conceptualize the next generation of wireless communication systems (namely, sixth generation, (6G)) aimed at laying the foundation for the stratification of the communication needs of the 2030s. In support of this vision, this study highlights the most promising lines of research from the recent literature in common directions for the 6G project. Its core contribution involves exploring the critical issues and key potential features of 6G communications, including: (i) vision and key features; (ii) challenges and potential solutions; and (iii) research activities. These controversial research topics were profoundly examined in relation to the motivation of their various sub-domains to achieve a precise, concrete, and concise conclusion. Thus, this article will contribute significantly to opening new horizons for future research direction

Thermal performance enhancement of nanofluids based parabolic trough solar collector (NPTSC) for sustainable environment

Due to rapid industrialization and urbanization, upward rise in carbon emissions in the atmosphere, and depletion of fossil fuel and gas reserves have forced to find alternative renewable energy resources, where solar energy is one of the most promising source. Parabolic trough solar collectors (PTCs) can effectively transfer high temperature in the tube of receiver upto 400 °C. In this study, Computational Fluid Dynamics (CFD) analysis is used to analyse the effect of multiple working fluids on efficiency of the PTC. Two different types of nanofluids used for analyising the thermal efficiency of PTC through CFD simulations, are Alumina and Copper-oxide nanofluids. The concentration of Copper Oxide and Alumina was kept to 0.01% in the nanofluids. The efficiency for PTC is calculated at two different mass flow rates i.e., 0.0112 Kg/s and 0.0224 Kg/s. The highest efficiency is 13.01 and 13.1% using Al2O3 as nanofluids at 0.0112 Kg/s and 0.0224 Kg/s flow rates, while CuO has an efficiency of 13.92% and 14.79% for these flow rates. The behaviour of absorber tube material on temperature distribution for steel, copper and aluminum as absorber tube material was also investigated. Changing the material from steel to copper and aluminum increased the outlet temperature of the fluid. The maximum output temperature was achieved for copper is 311 K while steel and aluminum showed lower temperature of 307 K and 308 K of the fluid at the outlet. Furthermore, the impact of the receiver tube's length on the working fluid's temperature is also studied. Copper Oxide nanofluid has higher temperature at the outlet for both mass flow rates as compared to alumina nanofluid. Accordingly, a comparison was made for the CFD results with the experimental findings from literature. The nanofluids based PTCs system is promising method for the sustainable environment applications

Disposition Kinetics and Optimal Dosage of Ciprofloxacin in Healthy Domestic Ruminant Species

The purpose of this experimental study was to determine the disposition kinetics and optimal dosages of ciprofloxacin in healthy domestic ruminant species including adult female buffalo, cow, sheep and goat. The drug was given as a single intramuscular dose of 5 mg/kg. The plasma concentrations of the drug were determined with HPLC and pharmacokinetic variables were determined. The biological half-life (t1/2 β was longer in cows (3.25 ± 0.46 h) followed by intermediate values in buffaloes (3.05 ± 0.20 h) and sheep (2.93 ± 0.45 h) and shorter in goats (2.62 ± 0.39 h). The volume of distribution (Vd) in buffaloes was 1.09 ± 0.06 l/kg, cows 1.24 ± 0.16 l/kg, sheep 2.89 ± 0.30 l/kg and goats 3.76 ± 0.92 l/kg. Total body clearance (ClB) expressed in l/h/kg was minimum in buffaloes 0.25 ± 0.02 followed by values in cows 0.31 ± 0.02 and sheep 0.75 ± 0.04 and maximum in goats 1.09 ± 0.11. An optimal dosage regimen for 12-h interval consisted of 5.17, 5.62, 6.54 and 6.10 mg/kg body weight as priming and 4.84, 5.37, 6.26 and 5.91 mg/kg body weight as maintenance intramuscular dose in buffalo, cow, sheep and goat, respectively. The manufacturers of ciprofloxacin have claimed 5 mg/kg dose to be repeated after 24 h. However, the investigated dosage regimen may be repeated after 12 h to maintain MIC at the end of the dosage interval. Therefore, it is imperative that an optimal dosage regimen be based on the disposition kinetics data determined in the species and environment in which a drug is to be employed clinically

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030