Search

Objective: To determine the frequency of different types of juvenile idiopathic arthritis (JIA) in children presenting in a tertiary care hospital. Study Design: Cross-sectional study. Setting: Department of Pediatrics, Children Hospital Complex & Institute of Child Health Multan. Period: January 2021 to July 2021. Material & Methods: Children of both genders with diagnosis of JIA aged 6-12 years and having duration of illness more than six weeks. Age, gender and duration of JIA were noted. Stratification of confounder variables e.g., age, gender and duration of JIA was done. Post-stratification Chi-square test was applied to determine the effect of the variables on frequency of different forms of arthritis. P-value

The combination of Ni-PMA-H2pdc MOF//activated carbon in a hybrid supercapacitor holds great potential for advancements in energy storage technology.

Low back pain (LBP) is pain in the lower part of the trunk, a highly prevalent and disabling condition globally. Clinical management for acute LBP and lumbosacral radiculopathy patients recommends first-line treatment consisting of education, support, and simple analgesics. This study evaluated the short-term alexander technique and core stability exercises versus the McKenzie method in treating lumbosacral radiculopathy. A randomized control trial with four weeks of follow-up was conducted from March 2022 to November 2022, consisting of a sample size of 20. Eligible participants were assigned a treatment protocol based on the McKenzie or Alexander technique for four weeks. The p-value was noted as greater than (0.05 non-significant), so the null hypothesis failed to reject it, meaning there was no significant difference between the Alexander technique and McKenzie method in treating lumbosacral radiculopathy. McKenzie was slightly more effective and responded from the first day to the end of the treatment session, but the reoccurrence of LBP was frequent due to weak muscles, poor working posture, and weight lifting in daily life activity. Alexander technique and core stability exercises response was slow in the first two weeks; after two weeks, both Alexander and McKenzie methods showed similar responses but no reoccurrence in Alexander-technique.

Cholangitis is an inflammation of the biliary tree due to Gallstones. The port region is susceptible to postoperative infections when a patient has excessive wounding and a microorganisms isolated from spontaneously procured tissue or fluid inside the upper cut. Objectives: To analyze the frequency of port site infection (PSI) and to assess variables influencing PSI following laparoscopic cholecystectomies. Methods: This research was carried during 2022 in two hospitals in Peshawar(Pakistan). Only 55 of the 907 patients who had PSI after going through LC surgeries were included and were kept under observations for six months. Data were collected by questionnaire, imported into the SPSS for statistical analysis. Descriptive statistics and Chi-square test were used for association between variables. Results: 34 patients out of 55 had CC, whereas 21 patients underwent surgery following an AC and became infected. Following LC, PSI frequency were lower than after open cholecystectomy. Majority of patients were women. Only five patients, based on the PSI, got an infection at the lateral ports, whereas 11 patients and 39 patients respectively, developed infections at the umbilical and epigastric ports. PSI came from majority of the female patients showing a significant association in frequency of PSI in relation to gender. Conclusion: Females tend to have high PSI rates and frequent epigastric port PSIs.

Organic framework materials, particularly metal-organic frameworks (MOFs), graphene-organic frameworks (GOFs), and covalent organic frameworks (COFs), have led to the revolution across fields including catalysts, sensors, gas capture, and biology mainly owing to their ultra-high surface area-to-volume ratio, on-demand tunable crystal structures, and unique surface properties. While the wet chemistry routes have been the predominant synthesis approach, the crystal phase, morphological parameters, and physicochemical properties of organic framework materials are largely affected by various synthesis parameters and precursors. In this work, we specifically review the influences of synthesis parameters towards crystal structures and chemical compositions of organic framework materials, including selected ligand types and lengths, reaction temperature/solvent/reactant compositions, as well as post-synthesis modification approaches. More importantly, the subsequent impacts on the general electronic, mechanical, surface chemical, and thermal properties as well as the consequent variation in performances towards catalytic, desalination, gas sensing, and gas storage applications are critically discussed. Finally, the current challenges and prospects of organic framework materials are provided.

Different efforts have been made especially in the fields of nanotechnology that employed various combinations of nanoparticles to overcome the stresses occurred in the agricultural lands. Nanoparticles that potentially designed through nanotechnology applied to the soil in the form nanofertilizers that increased the yield also good impact on soil composition. Application of nano-SiO2 improves also seed germination throiugh rooting applications, chlorophyll content with proline accumulation. Soil composition also improved the overall fruits and vegetables varieties in such a way that nanoparticles makes intact combinations with inner layers of soil. Biological applications of iron sulfate (FeSO4) in the form of foliar spray also showed excellent resistance to the salinity stress tolerance in the case of sunflower cultivars. Nano zeolite; another type of newly modified materials efficient for long term delivery of nutrients and minerals in soil composition and mineral balance ensures for plant growth. Nanopesticides can be used for efficient crop protection also promote plant stress tolerance and soil enhancement. Nano-Si that improves the various other stresses in plants species such as nickle and chromium. Nanotechnology has several advantages over other technologies due to cost efficient and simple to use and imply on more effective treatment and remediation methods.

This study is conducted to check the asymmetric impact of the pandemic uncertainty (PUI), oil prices and uncertainty index (UI) on the large, mid and small capitalization of US Islamic stock market. The analysis is conducted for the time period of 18 years starting from 2002 to 2020 using auto-regressive distributive lags (ARDL) for exploring the nonlinear or asymmetric influence of variables on. The results suggested that oil prices (OP) did not significantly impact the Large, Mid and Small capitalization of US stock market. Whereas, the pandemic uncertainty have a significantly negative long term relationship with the Large, Mid and Small capitalization of US Islamic stock market. However, uncertainty index have a significantly positive long term relationship with the Large, Mid and Small capitalization of US stock market.

Biomass energy is an important source of energy consumption. It is a renewable, abundant, and easily produced energy source. Its usage supports economies in reducing their dependence on fossil fuels and safeguards national energy security. The literature has extensively explored the association between biomass energy and environmental quality. However, the influence of biomass energy on sustainable development is overlooked. Against this background, the objective of this research study is to empirically scrutinize the utility of biomass consumption as a source of renewable energy for sustainable development in the Asian region. The panel data used in the study is taken from World Development Indicators and Global Material Flows Database for twenty-one Asian countries covering the time 1990-2017. Numerous econometric techniques are used in the study to ensure the robustness of the results. To know the nature of cointegration, the tests designed by Kao (1999) and Pedroni (1999) and second-generation tests, inter alia, have been employed. Furthermore, the cointegration test of Westerlund (2007), among others, is used in this research. Moreover, fully modified ordinary least square, dynamic ordinary least square, and Driscoll and Kraay methods are used to estimate the model. Finally, the conclusion of the study proves the argument that the consumption of biomass as a source of renewable energy has a significantly positive impact on sustainable development in the selected Asian economies. It is recommended that the region should efficiently utilize biomass to the maximum extent to travel on the path of sustainable development.

Background: In developed countries, colorectal cancer continues to rank as the third-most prevalent cancer to be reported and the third-most popular reason for cancer mortality in both genders. Objective: The purpose of the retrospective research was to compare the operational parameters and short-term oncological effects of laparoscopic surgery (LS) with traditional open surgery (OS) in colorectal cancer patients in our hospital. Methods: In this study, 148 patients who underwent CRC surgery between January 2020 and January 2022 at the Medical Teaching Institute (MTI) Peshawar, Pakistan's Khyber Teaching Hospital and Hayatabad Medical Complex Hospital were included. 64 people who had all had LS were included in the study. On the other hand, 84 people who had had OS were randomly selected from groups of people who were of the same gender and age. Result: In the group undergoing OS, the median of dissected lymph nodes was 22.8 (9–35) and 3 (0–14), whereas, in the group undergoing laparoscopy, the median number was 21.56 (8–32) and 6.2 (0–9). For 13 (15.47%) patients undergone through and 9 patients (14.06%) undergone through laparoscopy, blood transfusions were necessary. Although the LS group's procedure took longer than the OS group, their time in the ICU, time to start feeding and duration of stay at the hospital were all shorter. Practical implication Importance Laparoscopic surgery has not been proven to be more effective than open surgery for patients with low rectal cancer. Conclusion: LS provides the benefits of a shorter hospital stay and fewer problems and delivers relatively adequate lymph node dissection. Keywords: laparoscopic surgery, open surgery, colorectal cancer, oncological outcomes, developing countries

Metal-organic frameworks (MOFs) with exceptional features such as high structural diversity and surface area as well as controlled pore size has been considered a promising candidate for developing room temperature highly-sensitive gas sensors. In comparison, the hetero-metallic MOFs with redox-active open-metal sites and mixed metal nodes may create peculiar surface properties and synergetic effects for enhanced gas sensing performances. In this work, the Fe atoms in the Fe3 (Porous coordination network) PCN-250 MOFs are partially replaced by transition metal Co, Mn, and Zn through a facile hydrothermal approach, leading to the formation of hetero-metallic MOFs (Fe2IIIMII, M=Co, Mn, and Zn). While the PCN-250 framework is maintained, the morphological and electronic band structural properties are manipulated upon the partial metal replacement of Fe. More importantly, the room temperature NO2 sensing performances are significantly varied, in which Fe2Mn PCN-250 demonstrates the largest response magnitude for ppb-level NO2 gas compared to those of pure Fe3 PCN-250 and other hetero-metallic MOF structures mainly attributed to the highest binding energy of NO2 gas. This work demonstrates the strong potential of hetero-metallic MOFs with carefully engineered substituted metal clusters for power-saving and high-performance gas sensing applications.

Urinary incontinence is defined by international continence society as “a condition in which involuntary loss of urine is objectively demonstrable and is a social hygiene problem “It refers to the involuntary leakage of urine can be associated with a systemic complication. Its prevalence is higher in women than in men thought it can affect men and women equally. It has the high prevalence due to its impact on the quality of life. The presence of urinary incontinence can be associated with anger; embarrassment related to any clinical condition, with loss of self-esteem and decrease motivation and decrease social, physical quality of life. Moment plausibility is that the bladder is presently overactive because of the surgery or changes in the pelvic floor musculature related with hysterectomy. Urge incontinence causes spillage of urine all of a sudden, related with critical ness and the powerlessness to smother such inclinations. Objective: Aim of this study is to determine urinary incontinence in women with hysterectomy. To assess the impact of urinary incontinence on quality of life of women undergone hysterectomy. Background: Furthermore, this study highlighted the presence of pain, discomfort, alteration of Quality of life and functional limitation due to incontinence of urine associated after Hysterectomy. An observational survey from different hospitals of Rawalpindi and Islamabad was conducted to collect relevant information. Methods: Standard questionnaire tools (UDI-6) and (KHQ) was used to collect data from 100 women using convenient random sampling technique in different hospitals of Rawalpindi and Islamabad. Results: The result revealed that urinary incontinence in women with hysterectomies strongly associated with altered quality of life causing loss of self-esteem leading to an impairment. Conclusion: This study concluded urinary incontinence associated with hysterectomy had pronounced effects on quality of life of women causing physical, social and psychological role limitations and participation restriction.

2D Ag2SO4 nanosheets have been delaminated from bulk Ag2S using a two-step combined exfoliation method. Upon blue light irradiation, the 2D Ag2SO4-based sensor exhibits high-performance responses toward low-concentrated NO2 gas at room temperature.

Objective: The goal of this study is to determine the degree of CD4 expression in histopathologically confirmed cases of psoriasis using immunohistochemistry. Study Design: Cross-sectional/ Descriptive study Place and Duration: Pathology Department of North West School of Medicine (NWSM), Peshawar and Avicenna Medical and Dental College, Lahore for duration of six months April 2021 to September 2021. Methods: There were 80 patients of both genders with age 18-70 years were presented in this study. Informed written consent was taken from all the patients for detailed demographics including age, sex and body mass index. Psoriasis was diagnosed by taking skin biopsy of all the patients. Histopathology slides were made from paraffin-embedded sections of the whole skin biopsy. When examined in the 40x magnification field, the cases were classified as having light staining (4-10 capillaries), moderate staining (11-20 capillaries), or strong staining (21-28 capillaries). On the basis of histopathology, psoriasis was determined to be present when the following features were observed: hyperkeratosis, acanthosis, a munro's abscess, the extension of rete ridges, and abnormalities of the dermal vasculature. SPSS 24.0 version was used to analyze. Results: Majority of the patients in or study were males 55 (68.8%) and the rest were females 25 (31.2%) with mean age 35.51+19.61 years. Mean BMI of the patients was 24.23+11.34 kg/m2. Frequency of moderate staining of CD34 expression was high found in 50 (62.5%) cases, mild staining in 17 (21.3%) patients and 21-28 capillaries (strong staining) in 13 (16.3%) patients. According to histopathological findings hyperkeratosis, acanthosis, a munro's abscess, the extension of rete ridges, and abnormalities of the dermal vasculature majority had moderate (11-20 capillaries) staining of CD34 expression. Conclusion: We concluded in this study that the mild staining expression of CD34 was majority seen among patients of psoriasis. Psoriasis's enhanced cutaneous vasculature has been demonstrated by this crucial angiogenesis marker. As a result, it can be used to better understand the disease's histiogenesis. Keywords: CD34 expression, Histopathology, Immunohistochemistry, Psoriasis

Background Clostridium perfringens is a well-known cause of gas gangrene with a very high mortality rate. Multiple cases of internal organs have been reported in the literature; however, non-traumatic spontaneous gas gangrene due to C. perfringens with solely cardiac involvement in a patient without any risk factors has not been reported before. Case Summary A 52-year-old male presented to the emergency department with chest pain and exertional dyspnoea for three days. The patient was haemodynamically stable initially, and the physical examination was unremarkable. Initial laboratory workup revealed elevated D-dimer and troponin levels. Computerized tomography (CT) of the chest was negative for pulmonary embolism but showed a hypodense focus in the cardiac silhouette. Acute coronary syndrome protocol was initiated; however, invasive cardiac workup was negative. The patient had rapid clinical deterioration with development of respiratory failure, shock, and multiorgan failure within 24 h. A transesophageal echocardiogram demonstrated an abnormal echogenic focus, corresponding to CT chest area. Despite aggressive treatment, the patient passed away within 36 h. Later, the patient’s blood culture grew C. perfringens. A limited autopsy showed an abscess cavity in the interventricular septum, pathology of which revealed acute myocarditis and fibrinous pericarditis. Discussion Unlike other reported cases of C. perfringens with cardiac abscess, our patient had no known risk factors, and no other organs were involved. We conclude from this case that an air focus on the CT scan in the myocardium can be suggestive of a spontaneous gas gangrene of the myocardium, and the patients should be treated accordingly.

Hypothesis: The active anti-carcinogenic compound of Curcuma longa a member of ginger family is curcumin which inhabit the growth of tumor in breast cancer. Aims and objectives: The aims and objectives of present study were to determine the clinical and preclinical effects of curcumin against breast cancer. Materials and Methods: 100 women patients with grade- I and grade-II breast cancer were treated with 10g/day curcumin powder orally for six months. The tumor markers such as CA 15-3, CA 27.29, Carcinoembryonic antigen (CEA) and CA 125 were measured from blood serum of each patient. Conclusion: In the present study it was concluded that a significant changes (p

Introduction: Breast cancer is the most common cancer in women throughout the globe, and the modern therapeutic available options have been widely researched currently. For a developing nation with limited resources, such as Pakistan, a quick, affordable, and least invasive technique like FNAC may give useful information. Aim: The aim of this study was; 1 Perform and evaluate cytomorphological classification of all breast cancer patients using the Robinson's three-tier grading system. 2 Histopathological evaluation and classification of all samples of MRM by using a modified BR classification system. 3 Correlation of histo-morphological and cytomorphological classification systems. Place and Duration: In the Pathology department of Khyber Teaching Hospital Peshawar for six months duration from February 2018 to July 2018. Material and methods: A prospective study was conducted in which two independent observers classified all breast cancer patients on the basis of cytology and histology of the tissue and cyto-histological correlation. Results: This study provided good individual correlation and inter-observer agreement in the cytopathological classification of breast cancer aspirates. Conclusion: Cytopathological classification may be useful for these patients and should therefore be included in routine reports. Keywords: Breast carcinoma; Cytopathology; Robinson classification system

Aim: Given the relevance of irresistible infections to the wellbeing of women, we intended to evaluate the current attentiveness, interest and relevance of the unresisted obstetrical and gynecological infection among the residents and residents of contemporary obstetrics and gynecology. Methods: Two independent assessments which deal with attention, appreciation. Sub-specialty premiums were also sent out to (1) an irregular 22 percent sample of residents in obstetrics and gynecology and (2) all Gynecology obstetrics mailed out. Results: More than two-thirds of the chief students in the scientific section were aware of the specialty and 68,2% respected compelling disease experts. About a third of the employees were attentive to the specialization. The formal training of clinical specialists in the field of intractable diseases was reported by thirty-six percent of chief residents. Conclusion: Pakistani obstetrics and residents of gynecology and leaders have little knowledge of the sub-specialty. There is an open specialty to formal instruction by practitioners skilled in the field for residents in irresistibly infected object ology and gynecology. These findings may lead to continuous enrollment efforts in obstetrical and gynecology sub-specialties of irresistible diseases. Keywords: Women's Infectious Disease, Obstetrical and Gynecological Specialty, Pakistani Population.

Mycobacterium chimaera is a nontuberculous mycobacterium that belongs to the Mycobacterium avium complex. Invasive infections are very rare and have been associated with contaminated heater-cooler water systems used during cardiopulmonary bypass. There is usually a long latency period and patients have nonspecific symptoms that can result in a delayed diagnosis or misdiagnosis. We report a case of M. chimaera infection in a man who presented with worsening shortness of breath and was found to have pleural effusion. The patient did not have any history of cardiopulmonary bypass surgery, which raises concerns about community spread of this rare infection and needs further investigation in the general population. Furthermore, he had a history of sarcoidosis and was on immunosuppressive medications, which might suggest that immunosuppressed patients can acquire this infection without the described risk factors.

Background Idiopathic chronic constrictive pericarditis (CP) is an uncommon yet very important clinical entity as prompt diagnosis and early treatment are affiliated with improved outcomes. We describe an uncommon case of CP with a series of textbook findings and received successful treatment with surgical pericardiectomy (SP). Case summary A 58-year-old male presented to the emergency department with exertional dyspnoea and anasarca. The past medical history was negative for infections like tuberculosis, viral, etc., connective tissue disease, prior cardiac surgery, human immunodeficiency virus, or any radiation therapy. The vital signs were within normal limits except mild hypoxia while the physical examination was consistent with congestive heart failure. Further investigations with laboratory testing, imaging with chest X-ray, computed tomography, echocardiogram, and invasive study with right heart catheterization were all consistent with idiopathic chronic CP. The patient underwent successful SP with significant improvement in clinical condition. Discussion This case highlights the classical signs and symptoms along with important diagnostic features of CP. It is uncommon to see all the classical features of CP in one patient as described in the above case. Familiarity with these findings is crucial to make the diagnosis as early treatment is affiliated with improved outcomes.

OBJECTIVE: To determine the histological pattern of non-diabetic renal disease in type 2 diabetes mellitus. MATERIAL AND METHODS: This study was conducted in Nephrology department MTI Lady Reading Hospital Peshawar from January 2018 to January 2021. All type 2 diabetic patients with normal fundi were included in the study irrespective of time duration. Total of 30 patients were registered. Their bio data was entered in a prescribed proforma. Their fundoscopy was done. Those having normal fundi were included in the study and exposed to renal biopsy. Those patients having diabetic retinal changes were excluded from the study. RESULTS: Out of 30 patients, male were 20 and female were 10 with ratio of 2:1 with mean age of 55.5±13.3SD years. Pure diabetic nephropathy (DN) was noted in 9 (30%) cases, Non-Diabetic Renal Disease (NDRD) in 13 (43.3%) cases and NDRD on DN in 8 (26.7%) cases. Among the Non-Diabetic Renal Disease (NDRD), Membranous Glomerulonephritis (MGN) was present in 9 (30%) cases, Acute Tubular Necrosis (ATN) in 5 (16.6%) cases, Focal Segmental Glomerulosclerosis (FSGN) in 4 (13.33%.) cases, Mesangiocapillary Glomerulonephritis (MCGN) in 2 (6.7%) cases and Hemolytic Uremic Syndrome (HUS) in 1 (3.3%) cases. CONCLUSION: Early diagnosis of non-diabetic renal disease in type 2 diabetic patients benefits from early immunosuppressive therapy and prevent from CKD. Renal biopsy should be done in all patients with type 2 DM irrespective of time duration especially with normal fundi and atypical renal involvement. KEY WORDS: Renal biopsy, fundoscopy, non-diabetic renal disease, glomerulonephritis