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Down syndrome is a lifelong cognitive impairment characterized by lower mental skills and intelligence quotient (IQ) compared to their typical peers. The profile is not curable. However, research has been conducted to supplement and improve cognitive functioning through computing and software applications. Conventional cognitive applications and IQ scales pose significant challenges as they are not developed based on specific cognitive guidelines. Therefore, such methods often fail to accurately assess cognitive profiling, resulting in uncertainty. To overcome these challenges, Interactive Mental Learning Activity Software utilizes tailored guidelines incorporating fuzzy logic rules, ensuring accurate cognitive profiling for Down syndrome. Fuzziness was applied within the machine learning framework across three groups structured based on IQ levels. A total of N=200 individuals with Down syndrome participated in the IQ assessment. The findings revealed that individuals with mild impairment demonstrated a higher degree of improvement in cognitive abilities compared to moderate and severe levels. However, the severe category appears to have an unrealistic probability, leading to a standstill in progress. The implementation of the specific guided system led to improvements of 6%, 5%, and 5% in individuals with mild, moderate, and severe cases, respectively. [ABSTRACT FROM AUTHOR]

In this paper, there is exploration of the concept of neuromarketing as a newly developed strategy with economic potential deriving from human brain research. The central notion of the essay is that programmatic advertising can be used to better comprehend the idea of neuromarketing and its impact on consumers' decision‐making. So neuromarketing involves the scientific observation of brainwave activity, eye tracking, and skin response to determine how people's brains react to advertisements and other brand‐related communications. By studying the brain, these neuromarketing strategies can forecast how consumers will make decisions. The neuromarketing tactics' benefits and constraints are studied on a number of market input devices in the paper. The influence of various techniques of neuromarketing is studied from the available research studies and literature. In the recent years, the neuromarketing concept has been able to garner a lot of importance in its contribution to the marketing, advertising, and programmatic advertising has been immensely helped by the understanding of consumer decision making. The consumer behaviour has been able to be comprehended through neuromarketing techniques which are one of the key pillars of the purpose and running of programmatic advertising. A neuromarketing study shall be the helping hand for increasing customer base, market leadership, and converting them to loyal customers. It will help in programmatic advertising through the understanding of the advertiser with respect to the likes and wants of the customers and how consumer attention can be drawn. The consumer behaviour can be understood by the marketers in terms of how the consumers react to the advertising. [ABSTRACT FROM AUTHOR]

Background: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare hematologic disorder characterized by a deficiency of GPIanchored proteins in blood cells. It is associated with hemolysis, thromboembolic events, and bone marrow failure. Management includes complement inhibitors, anticoagulation, and stem cell transplantation. Spontaneous remission of PNH is rarely reported. Case Presentation: A 28-year-old male initially diagnosed with aplastic anemia developed portal vein thrombosis and was subsequently diagnosed with PNH. Due to the unavailability of complement inhibitors, anticoagulation therapy and supportive care were employed. Splenectomy with splenorenal shunt was performed for chronic thrombosis and associated complications. The patient achieved spontaneous remission with normalized blood counts and diminished PNH clone. Conclusion: Managing PNH in resource-limited settings presents challenges due to the unavailability of complement inhibitors. Spontaneous remission of PNH is rarely reported and needs further research. A multidisciplinary approach, accessibility to diagnostic tests, and advanced treatments will enhance PNH management in resource-limited settings. [ABSTRACT FROM AUTHOR]

Introduction: Bone segment transport leads to new bone formation (distraction osteogenesis). It is a type of bone healing in which regeneration process fills the bone defects. These long bone defects are produced either by bone loss during high energy trauma, sequestrectomy in chronic osteomyelitis or after excision of bone tumors. There are many external fixators which are designed to achieve the surgical objective of managing bone defects using the principles of distraction osteogenesis. Objective: The objective of Segmental Tibial defects treated by distraction osteogenesis with the help of Naseer Awais (NA) external fixator. Methodology: This quasi experimental study was done on forty four patients with tibial defects at department of Orthopedics surgery and Traumatology Mayo Hospital Lahore from May 2010 to June 2013. NA fixator was applied to in all cases and patients were followed up monthly basis and radiographs were assessed to see the bone healing process. Full weight bearing advised after 8-10 weeks according to the bone healing seen in x-rays. After complete healing and consolidation, fixator dynamization was performed for one month then the fixator was removed. Results: A total of 44 subjects were included in this study with a mean age of 33 ± 4.3 year. Among them forty (90.9%) male and four (9.1%) females had segment transport with NA external fixator, and male and female ratio was 10:1. Out of forty four patients, seven were lost to follow-up. So out of this thirty seven patients, the healing time was 369 ± 56.2 days (median-333).Pin loosening was in nineteen (44.2 %), clamp loosening in ten (23.3%) and pin break in one (2.3%) cases.In four (10.5%) cases knees had to be arthrodesed due to defect in the joint, sixteen (42.1%) cases had flexion in the range of 121-130º, six (15.8%) had flexion <100. Conclusion: NA external fixator is a useful device for segment transport and hence can be used in future for better outcome of segmental tibial defects treated by distraction osteogenesis. [ABSTRACT FROM AUTHOR]

Background: Severe and rigid scoliosis and kyphosis are difficult to treat but with the advent of new spinal operative techniques and implants, it has become manageable in expert hands. However these implants are too expensive for developing countries like us. The Halo-pelvic traction is a relatively cheaper device system used to treat such deformities. Moreover, rapid curve correction and one stage surgery may lead to permanent neurological deficit. Objective: To evaluate treatment outcome of Halopelvic Traction in the treatment of severe scoliosis and kyphosis. Methodology: This descriptive study was conducted in the department of Orthopedics surgery and traumatology unit -- I, King Edward Medical University, Mayo Hospital Lahore from September 2010 to August 2012. The patients with severe spinal deformity which could not be corrected at a single stage were included. A Performa was made for each patient and results were statistically analyzed by using SPSS version 20. Results: Total no. of 07 patients were treated, out of them 04 scoliosis patients having mean Cobb's angle of 77.25 ± 5.31° before treatment, improved significantly to 45 ± 5.35° after surgery (p<0.0001), 03 kyphosis patients with mean Kyphus angle of 96.67 ± 24.66° improved to 58.33 ± 17.56° (p<0.0001). Two major complications i.e. one paraplegia which recovered incompletely and one had CSF discharge from cranial pin that was also revived thoroughly after changing the position of the pin. Conclusion: Halopelvic traction device can help in treating the patients of severe scoliosis and kyphosis. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C virus (HCV) infection is a major health problem worldwide. Around 185 million people are suffering from HCV infection all over the world, out of which 10 million people are residing in Pakistan. 4.7% (2-14% by different studies) of Pakistanis are suffering from this deadly disease. Interferon+Ribavarin IFN/RIB is the mainstay of treatment for this infection. Various cardiovascular adverse reactions have been reported of this therapy. We conducted this study at Punjab Institute of cardiology to look for the cardiac safety of interferon therapy in our population., Methods: We studied HCV infected patients planned for interferon therapy between 21st of November 2012 to 20th of August 2014. Echocardiography was performed before, during and after the completion of therapy. Pegylated interferon once a week plus ribavirin therapy was given to the patients. Patients received 16-40 injections of pegylated interferon depending upon the decision of hepatologist. Patients with prior structural heart disease, patients who did not start the treatment or patients who did not turn up on follow up were excluded from the study., Results: A total of 102 patients planned to have interferon therapy were screened echocardiographically. One patient died after 5 injections due to infection (a non-cardiac cause). 46 patients completed the treatment and the follow up. None of the patients had any acute cardiac event. All patients had normal biventricular systolic function at the end of study. None of the patients had significant valvular heart disease or pulmonary hypertension. Reversal of E/A ratio or E/A ratio>2, parameters of diastolic dysfunction and mild pericardial effusion were noted in a statistically significant number of patients., Conclusions: Interferon therapy for HCV infection is cardiac safe in patients who have structurally normal heart. Female patients have propensity of adverse events like severe diastolic dysfunction and mild pericardial effusion. The safety of drug in patients already having cardiac ailment needs to be studied. Moreover HCV infection itself is not injurious to the heart.

Hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) are a group of cholesterol lowering agents that have become the largest selling drugs in the world. They are of proven clinical benefit in coronary heart disease, at least in those patients who do not have overt chronic heart failure (CHF). Co-administration of statins with angiotensin II receptor blockers (ARBs) is most common, since there is strong synergy between hypertension and hypercholesterolemia in terms of risk factors for the development of cardiovascular diseases. In present paper, we describe the in vitro availability of atorvastatin, a potent HMG-CoA reductase inhibitor, in presence of losartan potassium, which is a non-peptide angiotensin II receptor antagonist. These studies were carried out at 37, 48 and 60 degrees C in different pH environments simulating human body compartments. It was observed that in pH 1, 7.4 and 9 the availability of atorvastatin was very high while losartan was not at all available. However in pH 4 these effects were reversed and atorvastatin was not available at all. At 48 degrees C the availability of atorvastatin was high and that of losartan was depressed at pH 9, whereas the later was not available at pH 1, 4 and 7.4 at all. Likewise at 60 degrees C, the availability of atorvastatin at pH 7.4 and 9 was high, whereas the charge-transfer complex formed between the two drugs was broken at pH 1 at this temperature and the entire drug was available. On the other hand the availability of losartan at pH 4 and 9 was high while it was not available at pH 1 and 7.4. The availability of atorvastatin was maximum in simulated gastric juice as compared to buffer of pH 7.4 and 9. This high availability of one drug in presence of other is attributed to the formation of a charge-transfer complex, which was stable at elevated temperatures, except at 60 degrees C in pH 1.

A case of malignant melanoma metastatic to small bowel mesentery in an old female is reported. Her primary malignant melanoma of nasal mucosa was already treated. She presented with intestinal obstruction, underwent surgical excision of the tumour and was tumour-free postoperatively.