One-year Duration Research Articles

Charging Behavior Analysis Based on Operation Data of Private BEV Customers in Beijing

Charging behavior is essential to understanding the real performance and evaluating the sustainability of battery electric vehicle (BEV) development and providing the basis for optimal infrastructure deployment. However, it is very hard to obtain the rules, due to lack of the data support, etc. In this research, analyzing the charging behavior of users with private charging piles (PCPs) is carried out based on the real vehicle data of 168 BEV users in Beijing, covering 8825 charging events for a one-year duration. In this study, the charging behaviors are defined by five indexes: the starting state of charge (SOC) of batteries, charging location selection, charging start time, driving distance, and duration between two charging events. To further find the influencing rules of the PCPs owning state, we setup a method to divide the data into two categories to process further analysis and comparison. Meanwhile, in order to better observe the impact of electric vehicle charging on the power grid, we use a Monte Carlo (MC) simulation to predict the charging load of different users based on the analysis. In addition, an agent-based trip chain model (ABTCM), a multinomial logistic regression (MLR), and a machine learning algorithm (MLA) approach are proposed to analyze the charging behavior. The results show that with 40% or lower charging start SOC, the proportion of users without PCPs (weekday: 55.9%; weekend: 59.9%) is larger than users with PCPs (weekday: 45.5%; weekend: 42.6%). Meanwhile, users without PCPs have a certain decrease in the range of 60–80% charging start SOC. The median charging time duration is 51.44 h for users with PCPs and is 17.25 h for users without PCPs. The charging peak effect is evident, and the two types of users have different power consumption distributions. Due to the existence of PCPs, users have lower mileage anxiety and more diverse charging time choices. The analysis results and method can provide a basis for optimal deployment and allocation of charging infrastructure, and to make suitable incentive policies for changing the charging behavior, targeting the carbon neutral objectives.

Correlation P2Y12 Genetic Polymorphism As Risk Factor of Clopidogrel Resistance in Indonesian Stroke Patients.

Stroke is one of the highest causes of disability and mortality in several countries worldwide. Secondary prevention is important in the management of stroke. Clopidogrel is widely used in Asia as secondary prevention for ischemic stroke, even though several studies in Western show limited data related to clopidogrel resistance in Asia. This study aims to determine the correlation between P2Y12 genetic polymorphism and clopidogrel resistance in Indonesia. This study was conducted on one-year duration, the subjects were chosen through the consecutive sampling method, all subjects were examined for genetics and resistance to clopidogrel. The data were analyzed through statistical analysis, a bivariate analysis was conducted to determine the correlation between several variables and the resistance variable. This study employed resistance diagnostic methods with VerifyNow. Polymorphism of receptor P2Y12 was tested with the Polymerase Chain Reaction method (PCR) and analysis of restriction fragment length polymorphism (RFLP). The genes tested in this study were G52T and C34T. The number of participants in this study was 112. Examination of gene P2Y12 showed that the majority was homozygote, wild-type C34T allele (67%), and G52T (66.1%). There was no significant correlation between clopidogrel resistance and gene G52T and C34T of P2Y12 (p > 0.05). Hb levels significantly correlated with P2Y12 G52T (p = 0.024). Meanwhile, Fatty Liver significantly correlated with P2Y12 C34T (p = 0.037). Indonesia showed a low clopidogrel resistance rate and a very low C34T and G52T allele P2Y12 gene mutation, meaning that Indonesia had low mutations in the P2Y12. This is the cause of clopidogrel resistance in this study only 15%. Therefore, in a region with less clopidogrel resistance, examination of the P2Y12 gene would not give significant results.

One-Year follow-up of 50 Rural Underprivileged Type 1 Diabetes Children on Insulin Pump Therapy: Breaking Socio-Economic Barriers in Diabetes Technologies.

To audit the feasibility and clinical outcomes of fifty rural underprivileged children with Type 1 diabetes on insulin pump therapy for a one-year duration. All patients were audited from the Type 1 database of Madhuram Diabetes and Thyroid Centre (Unit of Idhayangal Charitable Trust www.idhayangal.org, NGO focussed on Type 1 diabetes from poor socio-economic strata). Below Poverty Line (BPL) was defined as any family earning less than Rs 2 lacs per annum. All children acted as their own controls managed on MDI for at least six months before pump start. Data were tabulated in Microsoft Excel and analysed. There were significant reductions in glycosylated haemoglobin at 6 months and one-year of insulin pump therapy compared to baseline pre-pump MDI values. In addition, significant reductions in diabetic ketoacidosis and severe hypoglycaemia admissions were seen. Insulin pump therapy without prejudice on indicated well-selected rural underprivileged children with Type 1 diabetes leads to clinically meaningful outcomes. NGO-Private-Industry partnership is vital to expand access of modern diabetes technologies to reach the most underprivileged.

Granular cell ameloblastoma: A rare and unique variant

Ameloblastoma is a slow-growing and locally invasive epithelial odontogenic tumor of the jaw that runs a benign course in most cases. Granular cell ameloblastoma is a rare subtype of ameloblastoma, showing the granular transformation of its cytoplasm. It is considered as an aggressive variant of ameloblastoma. Herein, we report the case of a 34-year-old male patient who presented with a swelling in the left cheek for a 1-year duration with a recent rapid increase in size. Examination showed a 4 × 3 cm growth involving the left buccal mucosa and retromolar area. Imaging studies showed expansile lytic lesion mandible. Biopsy revealed neoplasm with odontogenic epithelial islands showing peripheral palisading of tall columnar cells with reversal of polarity and the center of the islands showing stellate reticulum-like cells which were markedly replaced by granular cells. Granular cells can appear in various odontogenic and non- odontogenic tumors. When there is extensive granular cell change in ameloblastoma, it should be differentiated from other oral lesions with granular cells including granular cell odontogenic tumor, granular cell tumor, and congenital epulis.Herein we report the case of a 34-year-old male patient presented with swelling left cheek of one-year duration with recent rapid increase in size. Examination showed a 4x3 cm growth involving left buccal mucosa and retromolar area. Imaging studies showed expansile lytic lesion mandible. Biopsy revealed neoplasm with odontogenic epithelial islands showing peripheral palisading of tall columnar cells with reversal of polarity and the center of the islands showing stellate reticulum like cells which were markedly replaced by granular cells. Granular cells can appear in various odontogenic and nonodontogenic tumors. When there is extensive granular cell change in ameloblastoma it should be differentiated from other oral lesions with granular cells including granular cell odontogenic tumour, granular cell tumour and congenital epulis.

Relationship of Body Mass Index (BMI) with the Incidence of Inguinal Hernia

The inguinal wall hernia is the communal hernia of the abdominal wall. It is a communal disorder that affects both males and females from the past long duration. Objective: To assess the incidence of unilateral or bilateral inguinal hernia with low body mass index (BMI) and normal BMI subjects. Methods: This study was performed in the Surgical unit 1 of Khairpur Medical College and civil Hospital Khairpur Mirs for one-year duration from July 2021 to June 2022. Using an appropriate non-probability sampling technique, this cross-sectional study was held at the surgical unit-1 of Khairpur Medical College and civil Hospital Khairpur Mirs. A total of 90 patients, 80 men and 10 women, were selected for the study. Inclusion criteria were defined as patients over 35 years of age with clinical signs such as reducible swelling in the groin area and clinical signs such as overweight and weight lifting. Results: A total of 90 individuals were identified as having an inguinal hernia; their mean age was 26.18± 18.20 years old, and they have 62.78 ± 4.75 inches height. 65.85 ± 5.19 was the patients mean weight and 22.35 ± 3.26 kg/m2 was the mean BMI. BMI was low in 18 (20%) cases and normal in 72 (80%). Conclusion: According to our analysis, a significant number of inguinal hernias on either the right or left side had normal BMIs.

Effect of personality on blood glucose control in patients with type 1 diabetes

ObjectiveThe diagnosis of type 1 diabetes mellitus (DM1) has a major impact on young people and their families. Psychosocial factors, patient motivation, participation and acceptance of the disease are essential to achieve good blood glucose control. Our aims were to analyse personality traits and how they are related to blood glucose control in patients with DM1. MethodsSixty-two patients with DM1 over 18 years of age, with at least one-year disease duration and absence of advanced chronic complications were studied. Clinical, biological and personality parameters were measured. The Millon Index of Personality Styles was administered for personality assessment. ResultsSignificant correlations between different personality variables and glycated haemoglobin (HbA1c) values were found. Individuals with poor blood glucose control had significantly higher scores on the Feeling-guided (53.6±25.7 vs 36.2±26.8, p=0.021), Innovation-seeking (36.7±24.1 vs 21.9±21.4, p=0.025), Dissenting (41.1±24.4 vs 15.6±16.6, p=0.001), Submissive (41.5±25.1 vs 28.3±14.7, p=0.038) and Dissatisfied (37.5±27.5 vs 19.5±20.2, p=0.015) scales. This psychological profile is characterised by greater focus on emotions and personal values (feeling-guided), the tendency to reject conventional ideas (innovation-seeking), an aversion to complying with norms and a preference for autonomy (unconventional/dissenting), labile self-confidence (submissive/yielding) and expressed disagreement with others (dissatisfied/complaining). Factor analysis based on the main components of the variance yielded four factors. Factor characterised as related to rebelliousness or independent judgement and action was correlated with poor blood glucose control (r=0.402, p<0.05). ConclusionThe rebellious or non-conformist personality type is closely associated with poor blood glucose control in patients with DM1.

The Feto-Maternal Outcomes and Incidence of Early-and Late-Onset Preeclampsia

Hypertensive disorders in gestation are categorized as hypertension in pregnancy, chronic hypertension, eclampsia and pre-eclampsia. The World Health Organization states: “There are 529,000 maternal deaths annually worldwide due to pre-eclampsia and eclampsia. This study will help in determining pregnancy outcomes in early vs late-onset pr-eclampsia. Aim: To access the pregnancy outcomes of early and late onset pre-eclampsia. Study Design: A retrospective, descriptive and cross-sectional study Place and Duration: In the Obstetrics and Gynecology department of Allama Iqbal Memorial Teaching Hospital Sialkot and Islamic International Medical College, Rawalpindi for one-year duration form January 2021 to December 2021. Methods: A total 130 were admitted to the gynae ward with pre-diagnosis of pre-eclampsia were included. The cut-off value of the early and late onset PE was thirty-four weeks. Pre-eclampsia analysed &lt; 34 weeks was labeled as early-onset pre-eclampsia and if diagnosed after 34 weeks will be labeled as late-onset pre-eclampsia. Obstetric and perinatal outcomes were assessed with version 21 of the Social Sciences Statistical Package. Results: A total 130 were admitted to the gynae ward with pre-diagnosis of pre-eclampsia were included. The severe pre-eclampsia was observed in 48(36.9%) pregnant women and 82 women (63.1%) had no symptoms of severe pre-eclampsia. In 38 (29.2%) cases; early-onset pre-eclampsia was detected and late-onset PE in 92 (70.7%) cases. The rate of severe PE in early-onset PE has been documented in 22 (57.8%) of 38 cases, and severe PE has been reported in late-onset PE in 29 (31.5%) of 92 cases. Adverse maternal outcomes occurred in 20 cases, including 7 cases of placenta abruptio and 3 cases of eclampsia with seizure disorders. Conclusions: The results indicate that in addition to intensive fetal monitoring in women with early-onset pre-eclampsia, attention should be paid to neurological, cardiopulmonary, and haematological parameters. Keywords: late onset, early onset; pregnancy outcome and preeclampsia.

ASSESSMENT OF LIVER FUNCTION IMPAIRMENT AND ITS IMPACT ON SYMPTOMATIC COVID-19 INFECTED PATIENTS

It is noted in literature that a significant number of COVID-19 infected patients had abnormal liver enzyme values as the disease progressed. Studies have shown a higher prevalence of hepatic impairment in patients with severe COVID-19. This study was designed to assess the variation of liver function test in COVID-19 patients and their relation to the severity of the illness. The secondary outcome of the study was the length of hospital stay and mortality assessment. This study was conducted at Bahira town international hospital Lahore from September 1, 2020, to September1, 2021. A total of 169 participants were included in the cross-sectional study those who meet the inclusion criteria. In this study we assessed the records of 169diagnosed cases of COVID-19 Infection on RT-PCR, and data were analyzed. They were further divided into two groups. First with abnormal liver function tests (LFT) and second Group consisted of normal LFTs. Liver function tests including total bilirubin, Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, were recorded and liver dysfunction was labeled if any of the parameters were found to be elevated from the normal physiological range. A total of 236 COVID-19 individuals were examined during the one-year duration. Of those, 169 were found to be eligible, but 67 were disqualified because they had a history of hepatitis B and C or previous history of liver disease. The Abnormal liver function tests group included 81 participants whereas second group with normal LFTs had 88 participants. Patients with severe illnesses were more affected by liver malfunction than those with moderate illnesses. Patients with liver dysfunction required a longer stay in the hospital on average than patients with healthy livers did. Patients who had normal LFT at admission had a cure rate of 95.06%, while 4.94% of them passed away, whereas 18.18% of patients passed away in abnormal liver function test. Liver function derangement is frequent in individuals with severe COVID-19, and it can be brought on directly by a virus that damages the bile duct cells or indirectly by a cytokine storm and lead to increased mortality and length of hospital stay.

POST-COVID PULMONARY COMPLICATIONS IN THE OUTPATIENT SETTING: ARE WE PREPARED FOR THE AVALANCHE?

POST-COVID PULMONARY COMPLICATIONS IN THE OUTPATIENT SETTING: ARE WE PREPARED FOR THE AVALANCHE?

Derotational Plate Augmentation with Retention of Intramedullary Interlocking Nail in Resistant Nonunion at Distal Femur Shaft

Background: Non-union in femur shaft after satisfactory treatment with closed intramedullary interlocking nail is not very common. This nonunion is always a challenging condition for surgeon. These nonunion are usually treated by dynamization, close exchange nail with larger diameter, retention of nail and onlay bone graft, removal of nail and fixed with plates and bone graft, removal of nail and application of cast brace and sometimes removal of nail and applications of external fixators. But no treatment is’ gold standard’ the rotational instability is blamed to be one of the most common reason of nonunion. Aim: To control rotational instability, we did plate augmentation with or without bone grafts without removing the nail to treat this nonunion. Methods: Total patients were 16. Proximal and distal interlocking screws were removed, nonunion site was opened, compression at nonunion site was done, and broad DCP was applied as de rotation plate with or without bone grating. We excluded fracture less than one-year duration and fracture with infective nonunion. Results: In 12 patients bone grafting was done where there was less callus or there was suspicion of atrophic non-union. We got union in all patients. 6.25 months were average time of union. 13 months was average time between the primary and secondary surgery. 71 minutes was means surgical time. Complications or implant failure were not noted. 0.9 cm was average residual limb shortening and 115 degrees was average range of motion at knee joint. Conclusion: Nonunion in distal femur shaft fracture with interlocking nail in situ is reliable and effective procedure Keywords: Distal femur, plate, External fixator. Bone grafting

The Risk Factors and Incidence of Perineal Tears among Pregnant Women

Aim: To determine the risk factors and prevalence of perineal tear in low-risk pregnant females. Study Design: A retrospective cross-sectional study. Place and Duration: In the Obstetrics and Gynecology department of Khawaja Muhammad Safdar Medical College, Allama Iqbal Memorial Teaching Hospital Sialkot for one-year duration from January 2020 to December 2020. Methods: The females with perineal tear after birth included in this study. A total of 400 females were selected for this study. Results are articulated as adjusted odds ratio (OR) and &lt;0.05 of P value is considered significant. Results: 400 total females had singleton vaginal delivery and perineal tears were noticed in 140 females. The episiotomy frequency for the total of 1st and 2nd degree, and 3rd and 4th degree (OASI) were 16.3%, 25%, and 1.5%, correspondingly. The perineal tear risk-factors are young mothers (teenagers OR = 5.6, 21-25 years OR = 4.3), primiparous women (OR = 12.6), gestational age less than 32 weeks OR = 0.175), received antenatal care (OR = 0.42), correspondingly. Primiparous females were 12.4 times more probable to have an episiotomy (OR = 12.4, 95% CI, 1.48-104.8, p = 0.02). A birth weight between 2.5-3.0 kgs and less than 2.5 kg (OR = 0.012 and 0.084, respectively) protects against Obstetric Anal Sphincter Injury. Conclusions: The perineal injuries risk factors are comparable to those formerly described in other researches. There is an urgent need to train the gynae staff and doctors in proper selection for episiotomy and better perineal care in order to improve obstetric services in the Gynecology department. Identifying those at danger can decrease obstetric perineal injuries. Keywords: Low risk pregnancy, episiotomy, low-risk pregnancy and Obstetric Anal Sphincter Injury.

Descriptive Study of Liver Hydatid Cyst in the Post Graduated Hospital Khost

Liver hydatid cyst is a parasitic disease whose life cycle involves carnivores. And humans can also get infected by swallowing of parasite eggs. This disease can affect both men and women. This disease does not have a severe course; therefore, it is often diagnosed in the mixed stages or when the patient performs abdominal ultrasound examinations due to some other health problems. This is the reason why most of the serious hydatid disease conditions occur. Since Afghanistan is an agricultural country and livestock farming is common there, the possibility and incidence of this disease is very high in human.&#x0D; This study is a descriptive study in the form of a case series, from the 1400/07/01 to 1401/06/31 (one-year duration), on 40 patients which have been treated in Khost post graduate Hospital.&#x0D; In 40 patients who have a hydatid cyst of the liver, 29 patients representing 72.5% of the cases are from the districts and 11 from the center of Khost representing 27.5%. according to age, the most cases occurred in people under 30 years of age (28 people), which make up 59.5 %, 7 people were between 30 and 50 years old, 17.5 % and 5 people were over 50 years old. Which is 12.5 %. From the point of view of gender, the most cases are women (27), which make up 67.5 %. And 13 men, which constitute 32.5 % of the cases. From the point of view of cyst size, 25 patients whose cyst size was less than 7 cm and 70 % of patients and 15 patients whose cyst size was more than 9 cm showed 30 % cases. Open surgery was performed on all the above patients (100 %). According to complications, 2 patients had cyst rupture, which was 5 %, and one patient had a obstructive jaundice, which was 2.5 %.&#x0D; Most of the cases of this disease occurred in women and people under the age of thirty. From the point of view of the place of residence, the incidents occur more in the suburban areas. All patients with hydatid cyst of the liver, when diagnosed and operated on time, recover quickly, but follow-up treatment was necessary.

Prevalence of Non-Carious Tooth Wear in Patients

Non-carious lesions caused by tooth wear include hypersensitivity, bad oral cleanness (plaque formation), cosmetic complications and tooth fractures. It is associated with a number of dental problems if present. Objective: To determine the frequency of non-carious lesions in tooth wear among patients attending the dental OPD. Methods: A descriptive and cross-sectional study which was carried out in the Dental department of Army Medical and Dental College Rawalpindi for one-year duration from January 2021 to December 2021. After formal approval by the Ethics Review Committee; regardless of the gender, 180 subjects of age 20-60 years were studied by means of the Tooth Wear Index of Knight and Smith. Five surfaces of each tooth were examined in the maxillary and mandibular arches: buccal (B), cervical (C), lingual (L) and occlusal /incisal (O and I). Results: It was instituted that non-carious tooth wear prevalence was probable in premolars trailed by molars and less pronounced in incisors. The surfaces of O&amp;I were most susceptible to injury, trailed by the surfaces of cervical. The carious tooth wear was less likely in lingual surfaces. Descriptive statistical analysis was used to obtain results on the incidence of non-carious tooth wear by giving the median, standard deviation and mean. Conclusions: Premolars and molars are the teeth mostly affected by non-carious tooth wear, and the incisors are the minimum teeth which are affected. The surfaces most affected were O&amp;I, trailed by the cervical surface with a lower incidence of lingual surface lesions.

Difference of Clotting Time and Bleeding Time in the ABO Blood Groups

Introduction: Blood group, clotting time (CT) and bleeding time (BT) are vital haematological parameters that are tested prior to any surgery. Blood groups are associated with various diseases and blood group "O" linked with nose bleeds. The aim of this study is to evaluate the association between CT and BT between various blood groups and to find differences in gender among these parameters. Study Design: A cross-sectional observational study. Place and Duration: In the department of Physiology and Medicine, MTI LRH, Peshawar Pakistan for one-year duration from March 2021 to February 2022. Methods: This study was held amongst the 200 healthy individuals. The agglutination method is used for blood grouping, capillary tube method for CT and Dukes method for BT. Mean clotting and bleeding times (in seconds) were compared. Results: The study was conducted among 200 individuals (120 men, 80 women) aged 20-25 years. Although the changes were not statistically significant, the values of CT and BT were higher in blood group O, less BT in type B and AB blood grouping had lowest CT (p&gt; 0.17). Women had greater CT and BT values than men (p values &lt;0.001). There was also a significant association between the clotting time and bleeding time (Pearson's correlation coefficient, p = 0.512, p &lt;0.001). Conclusion: The conducted analysis showed a propensity to a greater jeopardy of haemorrhagic conditions and a lesser risk of thrombotic events in ‘’O’’ blood group in comparison to groups AB, A or B. A multicentre, bigger population study with an importance on determining plasma vWF levels may be useful for confirming results, identifying risk groups and taking preventive measures early. Keywords: Bleeding time (BT), ABO blood group, von Willebrand factor (vWF) and Clotting time (CT).

Deucravacitinib versus placebo and apremilast in moderate to severe plaque psoriasis: Efficacy and safety results from the 52-week, randomized, double-blinded, placebo-controlled phase 3 POETYK PSO-1 trial

Effective, well-tolerated oral psoriasis treatments are needed. To compare the efficacy and safety of deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, versus placebo and apremilast in adults with moderate to severe plaque psoriasis. Participants were randomized 2:1:1 to deucravacitinib 6mg every day (n=332), placebo (n=166), or apremilast 30mg twice a day (n=168) in the 52-week, double-blinded, phase 3 POETYK PSO-1 trial (NCT03624127). Coprimary end points included response rates for ≥75% reduction from baseline in Psoriasis Area and Severity Index (PASI 75) and static Physician's Global Assessment score of 0 or 1 (sPGA 0/1) with deucravacitinib versus placebo at week 16. At week 16, response rates were significantly higher with deucravacitinib versus placebo or apremilast for PASI 75 (194 [58.4%] vs 21 [12.7%] vs 59 [35.1%]; P<.0001) and sPGA 0/1 (178 [53.6%] vs 12 [7.2%] vs 54 [32.1%]; P<.0001). Efficacy improved beyond week 16 and was maintained through week 52. Adverse event rates with deucravacitinib were similar to those with placebo and apremilast. One-year duration, limited racial diversity. Deucravacitinib was superior to placebo and apremilast across multiple efficacy endpointsand was well tolerated in moderate to severe plaque psoriasis.

Seasonal differences in breastfeeding in the United States: a secondary analysis of longitudinal survey data

BackgroundBoth the consumption of breastmilk in infancy and a person’s season of birth influences his or her health, educational, professional, and behavioral outcomes. Further, season of birth effects differ by sex. However, current research, for the most part, neglects to examine if season of birth and breastfeeding are related. This paper examines the impact of sex-based variations in season of birth on breastfeeding likelihood and duration in the U.S.MethodsUsing data from children born to female respondents of the National Longitudinal Survey of Youth 1979 (born between 1970 and 2012), this study examines with Probit, Negative Binomial, and Ordinary Least Squares (OLS) regressions if a child’s season of birth and sex are correlated with breastfeeding incidence and duration. The breastfeeding incidence and duration data are self-reported by the mother.ResultsSeason of birth has a small but statistically significant impact on the incidence and duration of breastfeeding, which varies depending on the sex of the infant. Mothers giving birth to sons in the spring are 13.5% less likely to breastfeed than those giving birth to sons in the winter (with a p - value of 0.0269). Mothers with daughters born in the summer or fall (autumn) breastfeed slightly longer than mothers with daughters born in the spring. On average, mothers of summer-born daughters breastfeed 4.1% longer (with a 95% confidence interval of 0.3 - 7.8) and those with fall-born daughters 3.8% longer (with a 95% confidence interval of 0 - 7.5). Mothers giving birth to daughters in the spring are also significantly less likely to reach the breastfeeding six-week duration target (compared to fall and winter births) and the one-year duration target (compared to fall births).ConclusionsThese findings suggest that the costs and benefits of breastfeeding an infant vary with the season of birth and the sex of the child. This finding could explain some of the season of birth effects previously identified in the literature. Further, policymakers seeking to increase breastfeeding rates should consider the reduced breastfeeding rates and durations for children born in the spring.

Exercise Echocardiography and Dobutamine Stress Echocardiography in The Assessment of Suspected or Known Coronary Artery Disease

Exercise echocardiography has become a significant tool of non-invasive valuation of coronary artery disease (CAD). The Exercise echocardiography and dobutamine stress echocardiography are widely applied methods with different clinical procedures and indications. Objective: To determine the exercise echocardiography and dobutamine stress echocardiography in the assessment of suspected or known coronary artery disease. Methods: 260 consecutive patients endured Stress Echocardiography in the Cardiology department of NICVD Karachi for one-year duration from January 2021 to December 2021. The treadmill was used for Exercise echocardiography applying the Bruce protocol. The standard method was applied for dobutamine stress echocardiography. The Stress Echocardiography was taken as positive on the basis of the appearance of worsening or new wall motion abnormalities. Results: Exercise echocardiography performed by 160 patients and DSE in 100 subjects with mean age of 47.21 and 53.10 years, correspondingly. Males were dominated in both groups. The both groups have similar risk factors. In the diagnosis of CAD, Exercise echocardiography was used more often than dobutamine stress echocardiography (61.5% vs 38.5%). The Viability tests have been carried out exclusively by DSE. The frequency of adverse events was 29% in dobutamine stress echocardiography and no one has side-effects in exercise echocardiography. Stress-related dysfunction of left ventricle was much communal in dobutamine stress echocardiography. Conclusion: Exercise Echocardiography is a better and safer non-invasive imaging method among subjects who can execute exercise, but DSE is further beneficial for pre-operative evaluation, viability and patients who are disabled physically for ergometer and treadmill exercise test.

Incidence of Several Forms of Tuberculosis (TB) and Their Bacillus Calamette Guerin (BCG) Vaccination Status among Children

Aim: The purpose of the study was to govern the incidence of various forms of tuberculosis and the status of BCG vaccination in children. Study design: A Cross-sectional study. Place and Duration of the Study: In the Pediatrics department of Jinnah hospital, Lahore for one-year duration from January 2021 to December 2021. Methods: A total of 200 patients with various forms of tuberculosis were recruited who met the inclusion and exclusion criteria. A demographic profile including age, gender and hospital registration numbers is recorded. Informed oral consent was obtained from the parents of each child. BCG scar present or absent. Form of tuberculosis, pulmonary tuberculosis (fever&gt; 14 days, ESR&gt; 50, sputum positive for AFB, x-ray results), tuberculous meningitis (fever with focal neurological symptoms lasting longer than 14 days, CT results according to inclusion criteria, CSF pleocytosis), tuberculous lymphadenitis (detection of tuberculosis by histopathology on excisional lymph node biopsy), abdominal tuberculosis (fever longer than 14 days, previous weight loss and anorexia, mesenteric lymphadenitis, biopsy of the lesion suggestive of tuberculosis), description and labelling of the vaccinated and unvaccinated patient with the presence or absence of BCG scar. Results: During this period, 200 patients who met the exclusion and inclusion criteria were selected in the study. Of the 200 patients included, 110 (55%) were males and 90 (45%) were females (Table 1), their age varies from 1 to 14 years, with 7.22 ± 3.78 years of an average age. Out of 200 enrolled patients, the four most common types of tuberculosis were examined. Out of 200 cases, 95 (47.5%) were pulmonary tuberculosis, 50 (25%) tuberculous meningitis, 35 (17.5%) tuberculous lymphadenitis, and 25 (12.5%) abdominal tuberculosis. Of the 200 patients enrolled, 85 (42.5%) were vaccinated (with BCG scarring) and 115 (57.5%) were unvaccinated. Keywords: Tuberculosis, BCG, Pulmonary tuberculosis

Assessment of Temporomandibular Joint Disorders and Related Factors in Patients at Tertiary Care Hospital

Background and goals: Temporomandibular disorders (TMD) are the utmost communal disorders of the temporomandibular joint and its linked structures. The objective of the study was the epidemiological assessment of Temporomandibular joint disorders and associated factors. Study Design: A descriptive cross-sectional study. Place and Duration: In the Oral and Maxillofacial surgery department of Punjab Dental Hospital, Lahore for one-year duration from January 2021 to December 2021. Methods: This study comprises a sample of 400 young adults aged 15-40 years of age selected by cluster sampling technique. The surveyors finalized questionnaires and conducted clinical trials. The analysis of data was done with the Fisher exact tests and Chi-square. Results: The pervasiveness of Temporomandibular disorders in the considered sample was 43.8%. The most communal symptoms of TMD were muscle tenderness, clicking and tenderness of temporomandibular joint. The utmost common influencing aspects for TMD were clenching, early contact in the bruxism and protrusive movement. There was a clear preponderance of girls (68.6%) over boys (31.4%) (p = 0.001). Conclusion: Symptoms of TMD in adults were common with the apparent preponderance of women. Keywords: Adolescents, Epidemiology, Diseases of the Temporomandibular joints.

A Randomized Controlled Trial on the Effectiveness of Tramadol as an Adjunct to Bupivacaine for Caudal Analgesia in Children

Introduction: The purpose of analgesia in postoperative period is to minimize pain with the fewest probable side effects and to obtain the highest possible cost-effectiveness in our environment. In children, caudal anesthesia is often given in combination with general anesthesia for postoperative and intraoperative anesthesia. To extend the length of anesthesia; adjuvants can be further added to local anaesthetics. This research was performed to determine the caudal bupivacaine anesthesia duration given in combination with tramadol. Study Design: A prospective, comparative, randomized, double-blinded study Place and duration: In the department of Anesthesia, Khyber Teaching Hospital, Peshawar for one-year duration from 21st January 2021 to 20th January 2022. METHODS: 80 patients, 3-8 years of age, enduring elective urological, lower limb and lower abdominal surgery. Patients were randomised in to group A (n = 40) given 0.25% bupivacaine 1 ml / kg and group B (n = 40) receiving bupivacaine 0.25% in dose of 1 ml / kg plus 1 mg / kg tramadol. The hemodynamic responses, side effects and analgesia total duration were observed and analyzed. Results: The patients were comparable in groups A and B in terms of hemodynamic response and demographics and were not significant statistically (p greater than 0.05). It was detected that the analgesia mean time was longer significantly in B group (464.2 ± 167.1 minutes vs 238.1 ± 71.5 minutes, P &lt;0.001). The postoperative vomiting was perceived in two cases, one in each group. Conclusions: One mg / kg Tramadol adjuvant to 0.25% bupivacaine for caudal anesthesia in children effectively lengthens the analgesia duration deprived of increasing side effects. Keywords: bupivacaine; tramadol and caudal analgesia.