Albuminocytological dissociation in different electrophysiological gbs variants

The objective of our study was to determine the distribution of different electrophysiological variants of GBS and its relationship with albuminocytological dissociation (ACD). The rationale of the study was to determine whether presence or absence of albuminocytological dissociation has any association with NCS findings and whether can be relied upon as an indirect predictor of axonal variant which warrants poor patient out comes versus demyelinating. Materials and Methods: A consecutive series of 76 patients who presented at PIMS over a 12 month period with GBS were included. Nerve Conduction studies (NCS) and Electromyographic (EMG) findings with CSF characterization for albuminocytological dissociation were recorded. P value \u3c 0.05 was taken significant. Results: NCS revealed AIDP as the most common variant (44; 57.8%) followed by AMAN (19; 25%) and AMSAN (7; 9.2%).For 5(6.5%) patients with normal NCS, EMG revealed early neuropathic changes in 4 (80% of normal NCS; 5.2% of total) (suggesting axonal degeneration). Total axonal degenerative type accounted for (AMAN + AMSAN + axonal neuropathy on EMG=30) 39.4% while demyelinating (AIDP + prolonged/absent F-wave=45) 59.2%. ACD was found in 60 (78.9%) patients.There was no signification association between ACD and NCS variants (p\u3e0.05). Conclusion: AIDP is the most prevalent (58%) GBS variant in our population, at least in the vicinity of Islamabad. There is high prevalence of axonal variants (≈40% of total) as compared to Western countries. There is no correlation between ACD and NCS variants. ACD cannot be used as an independent predictor of NCS variant. Presence or absence of ACD has no definite predilection for axonal variant which itself warrants poor patient outcomes versus demyelinating type

Etiology of stroke in young pakistani adults; results of a single center study

The aim of this study was to determine the demographic profile and incidence of young stroke at a tertiary care setup in Islamabad, Pakistan. Materials and Methods: This single centre, cross sectional study was conducted by recruiting 119 patients of either gender, ≥ 12and ≤ 45 years of age with stroke and receiving care at Pakistan Institute of Medical Sciences, Islamabad. Results: Total number of young strokes was 119 out of a total of 322 strokes i-e-, 36.9 %; 1/3rd strokes were in ≤ 45 years of age. Ischemic arterial strokes were 47% (56 out of 119) while venous ischemic strokes were 11.7 % (14 out of 119) and almost all in females (13 out of 14; 92.8 %).Infective causes of central nervous system were identified in24.3 % (29 out of 119). 49 patients (41.1 %) had hemorrhagic strokes. Major individual risk factors for stroke included hypertension identified in 35 (29.4 %)followed by diabetes mellitus in 8 (6.7 %) patients. Amongst infectious causes, CNS tuberculosis was the major infection associated with young stroke i-e-, 89.6 % (26 out of 29). Conclusion: Nearly 1/3rd of strokes in our population are in young.While risk factors in general for stroke stand true for young stroke as well namely hypertension and diabetes, CNS infections are a major cause of young stroke in Pakistan; particularly CNS TB. While majority of strokes in elderly are ischemic, strokes in young comparatively are almost equally divided between ischemia and hemorrhage i-e-, 1.4:1. 1/5th of these ischemic strokes are due to cerebral venous thrombosis. National level guidelines should therefore adopt different strategies for primary and secondary prevention, laboratory work up and imaging, and treatment of stroke in young

Understanding Early Hemophilic Arthropathy in Children and Adolescents Through Magnetic Resonance Imaging Based on T2 Mapping

Hemophilia is an X-linked recessive disease, which mainly affects males. This disease results in bleeding events targeting mainly the joints, which leads to arthropathy and cartilage degeneration. Human cartilage is primarily composed of water; as a result, past studies have noted that magnetic resonance imaging through T2 mapping can hold great promise for assessment of early changes in the cartilage. Hence this cross-sectional study seeks to validate T2 mapping as a tool for studying children and adolescents with hemophilic arthropathy. T2 relaxation times of hemophilia and healthy ankle/knee joints were compared, and found to have significant differences in mean T2 relaxation times. Furthermore, significant negative associations between age and T2 relaxation times were noted in both groups. Therefore, this investigation suggests that future studies may be able to use T2 mapping as a tool to better understand early hemophilic arthropathy in children and adolescents.M.Sc

Smart Antenna - MIMO, OFDM and Single Carrier FDMA for LTE.

With the evolution in the telecommunication generations, more and more research is going on in the field of wireless communications. The purpose of these researches has always been to provide good network coverage across the region with higher data rates, accuracy and better performance. Control on coverage and performance has always been in focus and is achieved using better and better antennas. Research has brought us with a sophisticated approach on the control of the properties of the antennas – introduction to Smart Antennas. Smart antennas can be used to support any radio based telecommunication system in any band, with the same level of performance. Several techniques are used to get good performance out of the antennas’ system. One impressive way is the usage of multiple antennas techniques. The approach is to transmit and receive 2 or more unique data on a single radio channel. To increase the diversity gain with the use of multiple input multiple output (MIMO), OFDM is a good technology used at the physical layer. It provides robustness to frequency selective fading, high spectral efficiency and low computational complexity. So MIMO-OFDM generates a good basis for 3GPP (3rd Generation Partnership Project) and 4G telecommunication technologies as well as other wireless communications systems. With MIMO-OFDM as basis, different standards like WiMAX (Wireless Interoperability for Microwave Access) and LTE (Long Term Evolution) have been implemented now. The use of OFDM has some limitations when it is considered for uplink like high peak to average power ratio (PAPR), for which a new technique of using Single Carrier is considered for uplink. Single Carrier FDMA has same advantages as of OFDM with low PAPR. In this thesis, we investigate the smart antennas with its application as LTE with the study of MIMO-OFDM and Single Carrier FDMA Systems. Performance of MIMO OFDM and SC-FDMA is evaluated by using simulations on MATLAB

Environmental epidemiology of Kawasaki disease: Linking disease etiology, pathogenesis and global distribution.

The pathogenesis of Kawasaki disease (KD) is commonly ascribed to an exaggerated immunologic response to an unidentified environmental or infectious trigger in susceptible children. A comprehensive framework linking epidemiological data and global distribution of KD has not yet been proposed.Patients with KD (n = 81) were enrolled within 6 weeks of diagnosis along with control subjects (n = 87). All completed an extensive epidemiological questionnaire. Geographic localization software characterized the subjects' neighborhood. KD incidence was compared to atmospheric biological particles counts and winds patterns. These data were used to create a comprehensive risk framework for KD, which we tested against published data on the global distribution. Compared to controls, patients with KD were more likely to be of Asian ancestry and were more likely to live in an environment with low exposure to environmental allergens. Higher atmospheric counts of biological particles other than fungus/spores were associated with a temporal reduction in incidence of KD. Finally, westerly winds were associated with increased fungal particles in the atmosphere and increased incidence of KD over the Greater Toronto Area. Our proposed framework was able to explain approximately 80% of the variation in the global distribution of KD. The main limitations of the study are that the majority of data used in this study are limited to the Canadian context and our proposed disease framework is theoretical and circumstantial rather than the result of a single simulation.Our proposed etiologic framework incorporates the 1) proportion of population that are genetically susceptible; 2) modulation of risk, determined by habitual exposure to environmental allergens, seasonal variations of atmospheric biological particles and contact with infectious diseases; and 3) exposure to the putative trigger. Future modelling of individual risk and global distribution will be strengthened by taking into consideration all of these non-traditional elements