Publications by authors named "Nadeem Iqbal"

62 Publications

Giardiasis: An Overlooked Cause of Recurrent Abdominal Pain.

Cureus 2021 Sep 3;13(9):e17701. Epub 2021 Sep 3.

Pathology, Shifa International Hospital Islamabad, Islamabad, PAK.

Recurrent abdominal pain is defined as at least three episodes of abdominal pain, lasting for three months or more and affecting the daily activities of an individual. Giardiasis is one of the causes of recurrent abdominal pain but is often overlooked. We report the case of an 11-year-old girl who presented with complaints of severe abdominal pain and two episodes of fresh blood in stool in one day. She had recurrent episodes of abdominal pain, occasional bloating, and diarrhea over the past two years. Workup for differentials like appendicitis and ovarian torsion was done. She was initially treated for an ovarian cyst with oral contraceptives, but her symptoms showed no improvement. Therefore, a laparoscopic ovarian cystectomy and appendectomy were attempted. Despite surgical intervention, the abdominal pain failed to resolve. A duodenal biopsy was performed, which showed vegetative growths of . This report highlights the unusual presentation of giardiasis as an acute abdomen, making it a diagnostic challenge.
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http://dx.doi.org/10.7759/cureus.17701DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489658PMC
September 2021

Massive Gastrointestinal Hemorrhage Secondary to Typhoid Fever.

Cureus 2021 Aug 30;13(8):e17552. Epub 2021 Aug 30.

Gastroenterology, Shifa International Hospital Islamabad, Islamabad, PAK.

Typhoid fever is caused by , a gram-negative organism. The disease usually presents with high-grade fever, abdominal pain, and diarrhea. Gastrointestinal hemorrhage is a frequent complication of the disease. However, adequate treatment with antibiotics has lowered the rate of complications. We present the case of a 21-year-old male who was admitted to the hospital with high-grade fever and per rectal bleeding. A few hours after admission, the patient had episodes of massive per rectal bleeding which resulted in hemodynamic instability. The bleeding was then successfully controlled with endoscopic hemoclipping. Concurrently, his blood culture results showed growth of for which antibiotic therapy was initiated, and the patient's condition improved thereafter. This report highlights the rare occurrence of massive lower gastrointestinal bleeding in patients with typhoid fever. It also signifies the use of endoscopic therapy with endoclips for the management of massive lower gastrointestinal bleeding.
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http://dx.doi.org/10.7759/cureus.17552DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8479853PMC
August 2021

Economic and financial impact of the COVID-19 pandemic in South Asia.

Environ Sci Pollut Res Int 2021 Oct 11. Epub 2021 Oct 11.

AUSOM, Air University, Islamabad, Pakistan.

The world is facing a COVID-19 pandemic outbreak with an unprecedented and enormous impact on the lives of humankind. The economic engine has suffered a big blow in economic and financial performance in all the regions. South Asian countries are also trying to cope with the challenges posed by the pandemic. This paper attempts to understand the severity of the pandemic, the responses by the governments of the region, and the way forward. The pandemic affected the services, manufacturing, trade, supply chain, and particularly the small businesses, which disrupted all the economic indicators, forecasts, and growth patterns. The paper also discusses the strategies devised by the countries to counter the shocks of pandemics and what new opportunities are identified under the circumstances.
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http://dx.doi.org/10.1007/s11356-021-16894-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504559PMC
October 2021

The Neuroprotective Efficacy of Postnatal Magnesium Sulfate in Term or Near-Term Infants With Moderate-to-Severe Birth Asphyxia.

Cureus 2021 Aug 2;13(8):e16826. Epub 2021 Aug 2.

Neonatology, The Children's Hospital & The Institute of Child Health, Lahore, PAK.

Background In Pakistan, the neonatal mortality rate is 41 per 1,000 live births and birth asphyxia is one of the leading causes of neonatal mortality and morbidity. The goal of this study was to determine whether postnatal magnesium sulfate therapy can improve short- and long-term neurological outcomes in term or near-term neonates with moderate-to-severe birth asphyxia. Methodology This prospective double-blind randomized controlled trial was conducted in the Neonatology Department of the Children's Hospital & The Institute of Child Health, Lahore. A total of 62 neonates (31 in each group) were randomized to receive either three doses of magnesium sulfate infusion at 250 mg/kg per dose, 24 hours apart (treatment group), or three doses of injection 10% distilled water infusion at 3 mL/kg, 24 hours apart (placebo group). Both groups received similar supportive care. The neurodevelopmental assessment was done at six months of age using the ShaMaq Developmental Inventory. Results Demographic data such as gestational age, mean weight, age at presentation, gender, hypoxic-ischemic encephalopathy grade, mode of delivery, and the presence of seizures at presentation were comparable between both groups. In the magnesium sulfate group, statistically significant results were seen in terms of early seizure control (p = 0.001), early initiation of feed (p = 0.002), and shorter duration of hospital stay (p = 0.003). Moreover, the magnesium sulfate group had lower mortality compared to the control group, though it was not statistically significant (p = 0.390). There was no significant difference in terms of cranial ultrasound findings between the two groups (p = 0.783) at the time of discharge. Regarding the neurodevelopmental delay, there was no significant difference between the magnesium sulfate and control groups (p = 0.535). Conclusions Postnatal magnesium sulfate treatment improves short-term neurologic outcomes at discharge in term or near-term neonates with moderate-to-severe perinatal asphyxia. However, no difference was noted in the neurodevelopmental outcome at six months.
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http://dx.doi.org/10.7759/cureus.16826DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8407416PMC
August 2021

Use Of Computed Tomography-Based Nomogram In Adult Age Patients To Predict Success Rates After Shock Wave Lithotripsy For Renal Stones: A Single Center Experience.

J Ayub Med Coll Abbottabad 2021 Jul-Sep;33(3):386-392

4Diagnostic Radiology, Aga Khan university Hospital, Karachi, Pakistan.

Background: The Triple D score is a novel and easy to use nomogram to predict shock-wave lithotripsy (SWL) outcomes. It is based on Computed Tomography (CT scan) parameters including stone density, skin-to-stone distance, and stone volume. However, its use has not been validated much as studies are sparse regarding its use. Our aim was to validate and evaluate accuracy of the Triple D scoring system in predicting SWL success rates.

Methods: It was a prospective study of 277 patients who had undergone SWL procedure for renal stones. They were evaluated by using non-contrast tomography, before undergoing SWL. CT scan-based parameters including distance of stone to skin (SSD), stone volume (SV), stone density was assessed. Computation of Cut off values was done with receiver operating characteristics analysis. Score was assigned on the basis of these cut-off values and success rate of SWL was determined. This score ranged from 0 (least favourable score) to 3 (most favourable score).

Results: Stone-free status was attained in 160 patients (57.7%), and 117 (42.3%) patients were labelled to have failed the procedure. Differences between these two groups in terms of Stone volume, stone density and skin to stone distance were significant. Triple D scores of zero,1, 2, and 3 had stone-free rates of 3.6%, 52.56%, 53.3%, and 93.1% respectively (p-vaue<0.001).

Conclusions: Shock-wave lithotripsy outcomes can be predicted with use of Triple D score and hence, it's externally corroborated. It may help urologist in appropriate patient selection and hence decision making and patient counselling.
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September 2021

The Remarkable Journey of a Weed: Biology and Management of Annual Ryegrass () in Conservation Cropping Systems of Australia.

Plants (Basel) 2021 Jul 22;10(8). Epub 2021 Jul 22.

Weed Research Unit, The University of Sydney, Camden, NSW 2570, Australia.

Annual ryegrass ( Gaud.), traditionally utilised as a pasture species, has become the most problematic and difficult-to-control weed across grain production regions in Australia. Annual ryegrass has been favoured by the adoption of conservation tillage systems due to its genetic diversity, prolific seed production, widespread dispersal, flexible germination requirements and competitive growth habit. The widespread evolution of herbicide resistance in annual ryegrass has made its management within these systems extremely difficult. The negative impacts of this weed on grain production systems result in annual revenue losses exceeding $93 million (AUD) for Australian grain growers. No single method of management provides effective and enduring control hence the need of integrated weed management programs is widely accepted and practiced in Australian cropping. Although annual ryegrass is an extensively researched weed, a comprehensive review of the biology and management of this weed in conservation cropping systems has not been conducted. This review presents an up-to-date account of knowledge on the biology, ecology and management of annual ryegrass in an Australian context. This comprehensive account provides pragmatic information for further research and suitable management of annual ryegrass.
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http://dx.doi.org/10.3390/plants10081505DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8400064PMC
July 2021

Delayed Presentation of a Retained Fecalith.

Cureus 2021 Jun 25;13(6):e15919. Epub 2021 Jun 25.

Gastroenterology, Shifa International Hospital, Islamabad, PAK.

A fecalith is a common cause of acute appendicitis, and laparoscopic surgery is the mainstay of its management. Literature review shows that a fecalith may be retained in the gut following a laparoscopic appendectomy in some rare cases. In most cases, the fecalith becomes symptomatic with time due to the formation of an abscess, fistulous tract, or inflammation of the appendicular stump (stump appendicitis). We report a case of retained appendicular fecalith presenting with symptoms similar to acute appendicitis, 15 years after laparoscopic appendectomy.
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http://dx.doi.org/10.7759/cureus.15919DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312775PMC
June 2021

Role of ethylene and light in chitosan-induced local and systemic defence responses of tomato plants.

J Plant Physiol 2021 Aug 26;263:153461. Epub 2021 Jun 26.

Department of Plant Biology, University of Szeged, H-6726 Szeged, Közép Fasor 52, Hungary. Electronic address:

Plant defence responses can be triggered by the application of elicitors for example chitosan (β-1,4-linked glucosamine; CHT). It is well-known that CHT induces rapid, local production of reactive oxygen species (ROS) and nitric oxide (NO) resulting in fast stomatal closure. Systemic defence responses are based primarily on phytohormones such as ethylene (ET) and salicylic acid (SA), moreover on the expression of hormone-mediated defence genes and proteins. At the same time, these responses can be dependent also on external factors, such as light but its role was less-investigated. Based on our result in intact tomato plants (Solanum lycopersicum L.), CHT treatment not only induced significant ET emission and stomatal closure locally but also promoted significant production of superoxide which was also detectable in the distal, systemic leaves. However, these changes in ET and superoxide accumulation were detected only in wild type (WT) plants kept in light and were inhibited under darkness as well as in ET receptor Never ripe (Nr) mutants suggesting pivotal importance of ET and light in inducing resistance both locally and systemically upon CHT. Interestingly, CHT-induced NO production was mostly independent of ET or light. At the same time, expression of Pathogenesis-related 3 (PR3) was increased locally in both genotypes in the light and in WT leaves under darkness. This was also observed in distal leaves of WT plants. The CHT-induced endoplasmic reticulum (ER) stress, as well as unfolded protein response (UPR) were examined for the first time, via analysis of the lumenal binding protein (BiP). Whereas local expression of BiP was not dependent on the availability of light or ET, systemically it was mediated by ET.
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http://dx.doi.org/10.1016/j.jplph.2021.153461DOI Listing
August 2021

Outcomes Of Percutaneous Nephrolithotomy In Elder Age Patients-Single Center Experience.

J Ayub Med Coll Abbottabad 2021 Apr-Jun;33(2):217-221

Department of Urology and Kidney Transplant, Shifa International Hospital Islamabad, Pakistan.

Background: Urolithiasis is a prevailing ailment affecting all age groups across global population. In modern innovative industry endoscopic instruments alterations and miniaturization has simplified the interventional strategy for undertaking these procedures for renal stones. However, there has been paucity of studies regarding outcomes of Percutaneous Nephrolithotomy (PCNL) in elder age group. We aimed to report success rates and complications in elder age group.

Methods: This was a retrospective review of the charts for subjects that underwent unilateral PCNL from 2012 till 2018 November at a tertiary care hospital at capital of Pakistan. Patients of age ≥60 years were chosen for this study. PCNL procedures were done in prone position. We implemented the Guy stone scoring (stone complexity) to forecast the net results of PCNL. Information regarding variables were recorded in specified proforma and then processed in SPSS version 16 for the statistical computations.

Results: On the whole 79 patients were incorporated for this study. Most common presenting complaint in clinic was flank pain followed by haematuria and fever respectively. Mean age in this analysis was calculated as 63.36±5.19 years. Mean size for calculi was 449±163mm2. One patient underwent transfusion after surgery while only 2.5% of these patients had sepsis (post PCNL procedure). Stone free rate was significantly affected by Guys stone score (GSS).

Conclusions: PCNL can be undertaken safely and effectually for achieving treatment goals even in elder subjects. Stone free rates are higher in lower Guys stone score as compared to the higher scores.
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July 2021

Role of Stone Heterogeneity Index in Determining Success of Shock Wave Lithotripsy in Urinary Calculi.

J Clin Transl Res 2021 Apr 24;7(2):241-247. Epub 2021 Mar 24.

Department of Urology, Faculty of Medicine, University of Freiburg, Germany.

Introduction: Various stone factors can affect the outcome of shock wave lithotripsy (SWL). A novel factor called the stone heterogeneity index (SHI) may have an impact on stone free rates. The objective of this study was to assess the role of SHI in SWL outcomes.

Methods: Patients' medical records were reviewed for the collection of data variables. They were subjected to SWL, using an electromagnetic lithotripter machine (Storz Modulith SLX-MX). Computation of mean stone density (mean value of the Hounsfield units) and SHI was accomplished by generating elliptical regions of interest on the computed tomography (CT) scan images. Grouping was performed on the basis of stone free and failure outcomes. Relevant statistical tests were applied for continuous and categorical variables. P ≤ 0.05 was considered statistically significant.

Results: Overall, 385 subjects were included having a mean age of 38.4 ± 14.7 years. The cohort comprised 276 (71.7%) males and 109 (28.3%) female patients. A total of 234 (60.8%) patients were rendered successful (stone free after one session) while 151 (39.2%) of the patients were declared to have failed the SWL procedure. Stone length, stone density, and SHI values were 13.7 ± 7.6 mm, 935 ± 404, and 201 ± 107, respectively. The stone density, SHI, and stone length were significantly different between the two groups (p-values of 0.001, 0.02, and 0.04, respectively).

Conclusions: SHI can be a helpful CT scan-based parameter to assess stone fragility. It can help clinicians in the judicious selection of patients before implementing SWL procedure.

Relevance For Patients: Non-contrast CT-based stone parameters have been found to be effective for predictions of outcomes. SHI can be a helping tool to better predict SWL success rates when treating the renal stones.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8177853PMC
April 2021

Intraoperative flexible nephroscopy during percutaneous nephrolithotomy: An 8 years' experience.

Pak J Med Sci 2021 May-Jun;37(3):716-720

Faheemullah Khan Resident Diagnostic Radiology, Aga Khan University Hospital, Karachi, Pakistan.

Objectives: To see the effect of intra operative antegrade flexible nephroscopy during Percutaneous nephrolithotomy on stone free rate.

Methods: We retrospectively reviewed electronic medical records of patients who underwent percutaneous nephrolithotomy from 2010 to 2017 for renal stones >2cm. Patients found eligible were divided in, Group-I who did not have intraoperative Flexible nephroscopy and Group-II who had flexible nephroscopy during percutaneous nephrolithotomy. All procedures were done by senior consultants. Variables like Mean age, side, stone size, skin to stone distance and Hounsfield unit were compared. Outcomes like Stone free rate, hospital stay and operative time were compared between the groups.

Results: The study included 248 patients, consisting 85 (34.3%) females and 163 (65.7%) males. Mean age ± SD was 45.8±13.8 years. Both group were similar in characteristics like mean age, stone size, skin to stone distance and Hounsfield units. The overall stone free rate was 71%. It was not significantly different between the groups, 76% in Group-II vs. 67% in Group-I. However stone free rate markedly improved with flexible nephroscopy in patients with staghorn calculi. Mean operative time and hospital stay were similar between the groups.

Conclusions: Intraoperative flexible nephroscopy during percutaneous nephrolithotomy significantly increases stone free rate in patients with staghorn stones.
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http://dx.doi.org/10.12669/pjms.37.3.3565DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8155419PMC
June 2021

Effect of Different Climate Change Variables on the Ecology and Management of through Glyphosate.

Plants (Basel) 2021 May 1;10(5). Epub 2021 May 1.

School of Agriculture and Food Sciences, The University of Queensland, Gatton, QLD 4343, Australia.

An elevated atmospheric carbon dioxide (CO) concentration and frequent droughts are two anticipated climate change scenarios in which certain invasive weeds may develop competitive advantages over crops and adversely impact productivity and herbicide efficacy. Hence, a study was conducted to explore the effect of different climatic scenarios on the growth and management of (Retz.) Pers with glyphosate. The variables investigated were two CO concentrations (400 and 700 ppm), two soil moisture levels (100% and 50% of field capacity (FC)), and three glyphosate rates (0 (control), 517 (50% of recommended rate), and 1034 g ae ha (recommended rate)). CO concentrations and soil moisture levels had different effects on the growth and management of . Overall, 100% FC and elevated [CO] of 700 ppm recorded the maximum plant height (38 cm), leaves per plant (20), growth index (60), chlorophyll content (SPAD value 37), and dry biomass (3 g) in comparison with ambient [CO] of 400 ppm and 50% FC treatment. The recommended glyphosate application gave 100% weed biomass reduction; however, efficacy was reduced (63%) when applied at 50% of the recommended rate under elevated [CO] of 700 ppm and 50% FC conditions.
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http://dx.doi.org/10.3390/plants10050910DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8147314PMC
May 2021

Plant defence mechanisms against mycotoxin Fumonisin B1.

Chem Biol Interact 2021 Jul 27;343:109494. Epub 2021 Apr 27.

Department of Plant Biology, University of Szeged, H-6726, Szeged, Közép fasor 52., Hungary.

Fumonisin B1 (FB1) is the most harmful mycotoxin which prevails in several crops and affects the growth and yield as well. Hence, keeping the alarming consequences of FB1 under consideration, there is still a need to seek other more reliable approaches and scientific knowledge for FB1-induced cell death and a comprehensive understanding of the mechanisms of plant defence strategies. FB1-induced disturbance in sphingolipid metabolism initiates programmed cell death (PCD) through various modes such as the elevated generation of reactive oxygen species, lipid peroxidation, cytochrome c release from the mitochondria, and activation of specific proteases and nucleases causing DNA fragmentation. There is a close interaction between sphingolipids and defence phytohormones in response to FB1 exposure regulating PCD and defence. In this review, the model plant Arabidopsis and various crops have been presented with different levels of susceptibility and resistivity exposed to various concentration of FB1. In addition to this, regulation of PCD and defence mechanisms have been also demonstrated at the physiological, biochemical and molecular levels to help the understanding of the role and function of FB1-inducible molecules and genes and their expressions in plants against pathogen attacks which could provide molecular and biochemical markers for the detection of toxin exposure.
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http://dx.doi.org/10.1016/j.cbi.2021.109494DOI Listing
July 2021

Managing Patient With Coexisting Emphysematous Pyelonephritis And Cystitis.

J Ayub Med Coll Abbottabad 2021 Jan-Mar;33(1):162-164

Department of Urology and Kidney Transplant, Pakistan Kidney and Liver Institute, Lahore Pakistan.

Emphysematous pyelonephritis (EPN) is a type of critical renal infection having dire consequences at times. It is said to be result of gases produced inside renal parenchymal tissue or pelvicalyceal system. Rarely coexistence of emphysematous pyelonephritis and emphysematous cystitis (EC) may lead to an intimidating condition in case it is not dealt with swiftly. The resent case report narrates the management of a 45-year-old female patient who suffered from EPN with concomitant EC. Right-sided emergency percutaneous nephrostomy was passed. Afterwards, Double J stent was passed under general anaesthesia. Although she had an initial improvement clinically but later on due to recurrent urinary tract infections and non-resolving right kidney abscess and fever right sided nephrectomy was done. This is a very rare presentation and has not previously reported much in literature.
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June 2021

Socioeconomic impacts of domestic biogas plants on rural households to strengthen energy security.

Environ Sci Pollut Res Int 2021 Jun 28;28(21):27446-27456. Epub 2021 Jan 28.

Faculty of Basic Sciences, BUITEMS Quetta, Quetta, Pakistan.

The central theme of the study is to assess the socioeconomic impact of household biogas plants on rural households. To this end, the study selected respondents from biogas plant holders and non-holders of biogas plants in rural areas of Muzaffar-Garh. During the field survey, a questionnaire survey was conducted on 40 biogas users in two villages in each Tehsil and 40 non-biogas users in the same village. A survey based on pre-designed questionnaire was conducted, and main data of 320 households in four Tehsil districts (interviewees) in the Muzaffar-Garh region were collected. In this study, biogas is the input variable, while elderly education and total household income are the input socioeconomic variables. Farm productivity, time saving, indoor air pollution, household hygiene, and expenditure are intermediate variables. The output variables include income, health, and education level of minor children aged 2-5 years. Structural equation modeling (SEM) techniques that describe the relationship between input variables and output variables can be used to obtain steadfast results. Based on the estimates, we have observed that BG investments have substantial impacts on farm productivity, time savings, indoor air pollution, household hygiene, and expenditure, which in turn has played a role in improving the status of people. It is concluded that many direct and indirect socioeconomic impacts of holding biogas plants on rural households can be measured. In order to widely promote biogas technology as an alternative energy source nationwide, there must be greater public participation.
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http://dx.doi.org/10.1007/s11356-021-12633-2DOI Listing
June 2021

Petri Net modelling approach for analysing the behaviour of [inline-formula removed] and signalling pathways in arrhythmogenic right ventricular cardiomyopathy.

IET Syst Biol 2020 12;14(6):350-367

Department of Biotechnology, Abdul Wali Khan University Mardan, Mardan, Pakistan.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart muscle disease that may result in arrhythmia, heart failure and sudden death. The hallmark pathological findings are progressive myocyte loss and fibro fatty replacement, with a predilection for the right ventricle. This study focuses on the adipose tissue formation in cardiomyocyte by considering the signal transduction pathways including [inline-formula removed] and regulation system. These pathways are modelled and analysed using stochastic petri nets (SPN) in order to increase our comprehension of ARVC and in turn its treatment regimen. The [inline-formula removed] model predicts that the dysregulation or absence of signalling, inhibition of dishevelled and elevation of glycogen synthase kinase 3 along with casein kinase I are key cytotoxic events resulting in apoptosis. Moreover, the SPN model demonstrates that the gene inhibited by protein in the event of endoplasmic reticulum stress due to action potential and increased amount of intracellular Ca which recovers the Ca homeostasis by phospholipase C, this event positively regulates the to suppress the mitochondrial apoptosis which causes ARVC.
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http://dx.doi.org/10.1049/iet-syb.2020.0038DOI Listing
December 2020

A Comparison of Complications and Success Rates after PCNL in Younger and Elderly Patients.

J Coll Physicians Surg Pak 2020 Dec;30(12):1316-1320

Department of Urology and Kidney Transplant, Pakistan Kidney Institute, Shifa International Hospital, Islamabad, Pakistan.

Objective: To compare the outcomes of percutaneous nephrolithotomy (PCNL) across younger and elderly, especially PCNL complications in terms of modified Clavian grading system.

Study Design:  Cros-sectional comparative study.

Place And Duration Of Study: Department of Urology, Shifa International Hospital, Islamabad, from 2010 till 2018 December at a tertiary care hospital.

Methodology: Patients who underwent unilateral PCNL were reviewed group 1 (younger, age < 60 years) had 594 patients; while group 2 (elderly, age >60 years) had 137 patents. Information regarding complication and success rate were recorded by residents in proforma and then processed for statistical computations.

Results: There were total of 731 subjects. The mean age in group 1 was 39.7±11.2 years and that of group B was 65.66±4.55 years. The mean size for calculi in group 1 was 2.83±1.32 cm while in group 2 stone size reached 2.81±1.04 cm. A total of 174 (23.8%) complications and stone free rate of 81.8% (598/731) was recorded in this study. Overall when compared, no notable difference in complications, hospital duration and success rates was observed between the young and elderly age group.

Conclusion: Despite old age, the success rates and complications were not remarkably different from that of the younger subjects for prone PCNL. Key Words: Percutaneous nephrolithotomy, Geriatrics, Renal stone, Complications.
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http://dx.doi.org/10.29271/jcpsp.2020.12.1316DOI Listing
December 2020

Laparoscopic Orchiopexy For Management Of Bilateral Non-Palpable Testes

J Ayub Med Coll Abbottabad 2020 Oct-Dec;32(4):445-449

Shifa International hospital Islamabad, Pakistan.

Background: Despite numerous clinical studies regarding the management of unilateral impalpable testes by laparoscopy, there is a paucity of such studies regarding the management of bilateral 'non-palpable' testes. We shared the outcome of the laparoscopic management of bilateral 'non-palpable' testes in terms of successful orchiopexy and complications in children.

Methods: A total of 22 children underwent bilateral diagnostic laparoscopy for undescended testes who presented to our department from January 2010 till March 2018. We did chart review for variables such as the age of children, operative time, hospital stay, single-stage or 2 stage procedure, and operative complications. Preoperatively history and physical examination were done along with baseline investigations and Ultrasound abdomen and scrotum before surgery for general anaesthesia fitness. They were managed by single or two steps laparoscopic orchiopexy according to suitability for each case.

Results: We performed bilateral laparoscopic orchidopexies in 22 children having a mean age of 4.1±1.98 years (49.2 months) Mean operative time for single setting bilateral single-stage orchiopexy was 136±32 minutes. Out of twenty-two children with bilateral impalpable testes, 12 boys (54.5%) were managed with a single-stage Bilateral Laparoscopic technique while the other 10 (45.45%) were managed in 2 staged laparoscopic intervention using Fowler-Stephens technique. Testicular atrophy was seen in 2/44 testes (4.54%). While 1 /44 (2.27%) testis had ascended to the inguinal region requiring redo surgery.

Conclusions: Laparoscopic management of bilateral 'non-palpable' testes in a single or double setting is a safe and effective method of bringing testes down to the scrotum. It has no major morbidities.
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January 2021

It is time to control the worst: testing COVID-19 outbreak, energy consumption and CO emission.

Environ Sci Pollut Res Int 2021 Apr 12;28(15):19008-19020. Epub 2020 Nov 12.

Department of Business Administration, Ghazi University, Dera Ghazi Khan, Pakistan.

During the COVID-19 outbreak, managing energy consumption and CO emission remained a serious problem. The previous literature rarely solved this real-time issue, and there is a lack of public research proposing an effective way forward on it. However, the study examines the impact of the COVID-19 outbreak on energy consumption and CO emission. The design of the study is quantitative, and the data is acquired from different online databases. The model of the study is inferred by using panel unit root test and ARDL test. The robustness of study findings was checked through panel quantile regression. The findings highlighted that the COVID-19 outbreak is negatively significant with energy consumption and CO emission. The study suggested revising the energy consumption patterns by developing and implementing the national action plan for energy consumption and environmental protection. The study also contributed in knowledge by suggesting the novel insight into CO emission and energy consumption patterns during COVID-19 pandemic and recommended to consider renewable energy transition methods as an opportunity for the society. For a more effective management of energy consumption and environmental pollution, country-specific measures are suggested to be taken, and the national government should support the concerned public departments, ministries and private organizations on it. To the best of our study, this is one of the pioneer studies studying this novel link and suggesting the way forward on recent topicality.
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http://dx.doi.org/10.1007/s11356-020-11462-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7659900PMC
April 2021

Managerial policy and economic analysis of wind-generated renewable hydrogen for light-duty vehicles: Green solution of energy crises.

Environ Sci Pollut Res Int 2021 Mar 24;28(9):10642-10653. Epub 2020 Oct 24.

Department of Business Administration, Ghazi University, D.G. Khan, Pakistan.

The unconventional energy sources like hydrogen energy have tremendous potential of filling the gap between economic growth and clean energy consumption. A little intention has been made in this regard in the developing economies like Pakistan. This study develops a fusibility analysis to highlight the potential of hydrogen energy source in Pakistan. For this purpose, this study used a hybrid mathematical model that combines the range of wind speed with the log law to push wind power's potential to generate wind hydrogen in Pakistan. The study results indicate that Pakistan has an excellent source to generate hydrogen energy through wind power stations. According to the outcomes, Nooriabad can produce 303.66 million RE/kWh per year through wind energy sources. According to the results, the rest of the seven wind generation sites also can generate enough hydrogen energy. This study also concluded that hydrogen energy has enough sources to meet the demand for light-duty vehicles in Pakistan.
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http://dx.doi.org/10.1007/s11356-020-11018-1DOI Listing
March 2021

Prediction of Recombination Spots Using Novel Hybrid Feature Extraction Method via Deep Learning Approach.

Front Genet 2020 17;11:539227. Epub 2020 Sep 17.

Department of Bioinformatics and Biological Statistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China.

Meiotic recombination is the driving force of evolutionary development and an important source of genetic variation. The meiotic recombination does not take place randomly in a chromosome but occurs in some regions of the chromosome. A region in chromosomes with higher rate of meiotic recombination events are considered as hotspots and a region where frequencies of the recombination events are lower are called coldspots. Prediction of meiotic recombination spots provides useful information about the basic functionality of inheritance and genome diversity. This study proposes an intelligent computational predictor called iRSpots-DNN for the identification of recombination spots. The proposed predictor is based on a novel feature extraction method and an optimized deep neural network (DNN). The DNN was employed as a classification engine whereas, the novel features extraction method was developed to extract meaningful features for the identification of hotspots and coldspots across the yeast genome. Unlike previous algorithms, the proposed feature extraction avoids bias among different selected features and preserved the sequence discriminant properties along with the sequence-structure information simultaneously. This study also considered other effective classifiers named support vector machine (SVM), K-nearest neighbor (KNN), and random forest (RF) to predict recombination spots. Experimental results on a benchmark dataset with 10-fold cross-validation showed that iRSpots-DNN achieved the highest accuracy, i.e., 95.81%. Additionally, the performance of the proposed iRSpots-DNN is significantly better than the existing predictors on a benchmark dataset. The relevant benchmark dataset and source code are freely available at: https://github.com/Fatima-Khan12/iRspot_DNN/tree/master/iRspot_DNN.
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http://dx.doi.org/10.3389/fgene.2020.539227DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527634PMC
September 2020

Assessing the perceived impact of exploration and production of hydrocarbons on households perspective of environmental regulation in Ghana.

Environ Sci Pollut Res Int 2021 Feb 22;28(5):5359-5371. Epub 2020 Sep 22.

School of Management Sciences, Quid E Azam University, Islamabad, Pakistan.

This paper seeks to critically study the perceived impacts of the exploration of hydrocarbons in selected coastal communities in the Western region, the oil and gas industry benefits to local communities, and to determine whether hydrocarbon development is a means for sustainable development. The study uses both quantitative and qualitative approaches using a questionnaire survey, key informant interview, and focus group discussion tools to understand the impact of oil and gas exploration and production in selected affected communities along the coast of Ghana. The activities of oil production and exploration impact negatively on communities; it also leads to a sharp increase in food prices thereby increasing their costs of living. The activity has also caused a decline in fish catch levels which happens to be the main economic activity as a result of exclusion zones created by oil companies which limited the extent fishermen can go fishing. In terms of infrastructure, the three communities are lacking, 77% of respondents from Princess Town hold the view that there is no motorable road linking their community in the next town and 60% from Aketakyi also hold the same view. Infrastructure such as roads, schools, water provision, and clinics are woefully provided in these communities.
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http://dx.doi.org/10.1007/s11356-020-10880-3DOI Listing
February 2021

Assessing energy security in Africa based on multi-dimensional approach of principal composite analysis.

Environ Sci Pollut Res Int 2021 Jan 1;28(2):2158-2171. Epub 2020 Sep 1.

Institute of Business Research and CFVG University of Economics, Ho Chi Minh City, Vietnam.

The concept of energy security has become an increasingly challenging issue in Africa, forcing energy-deficient countries to forge mutual partnerships with energy sufficient countries to access it for their domestic consumption. This study formulates a composite index of energy security in Africa as well as evaluates its impacts and trends using a sample of 28 countries on the continent, during the 2000-2018 period by using a principal composite factor analysis (PCA), with the series of 13 variables. Further interpretation was carried out using these tests: Kaiser-Meyer-Olkin measure of sampling adequacy and Bartlett's test of sphericity, Pearson correlation test, and Cronbach's alpha test. The key results show a trend of energy insecurity among the countries studied, as energy imports loads high in most countries as well as per capita emission, together with fossil fuel source consumption correlating high. These results validate the stark reality on the African continent. The inference from the results of the anaylsis conclude that the principal component analysis (PCA) results of the energy index were considered fit and reliable for the analysis, with the most important Cronbach's alpha test coefficient of 0.8797, far above the standard 0.6 model reliability level. Based on this study, the paper proffers there should be increased intra-regional trading of energy among the various power pools on the continent and increased regional renewable energy investments as well as investment in energy infrastructure, measures to reduce electricity system losses, environmental sustainability, and the adoption of energy in efficiency on the continent.
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http://dx.doi.org/10.1007/s11356-020-10554-0DOI Listing
January 2021

Incidental Findings Of Polypoid Cystitis In A 6-Year Old Child Without Any History Of Lower Urinary Tract Symptoms And Previous Urinary Catheterization.

J Ayub Med Coll Abbottabad 2020 Jul- Sep;32(3):410-412

Avecenna Medical College, Lahore, Pakistan.

A 6-year-old boy presented to ER with acute pain in right iliac fossa without any history of lower urinary tract symptoms, haematuria and urinary catheterization. Ultrasound showed loculated cystic area in pelvis with non-visualized appendix. A CT scan abdomen and pelvis revealed loculated, multi-septated cystic lesion in right hemipelvis thought to be a collection from possible appendicular inflammation / perforation. The laboratory findings revealed raised CRP and normal urine routine examination and culture. Exploratory laparotomy revealed cystic urinary bladder growth involving dome with normal appendix, partial cystectomy was done. Histopathology confirmed polypoid cystitis with no evidence of malignancy. This is a very rare presentation of polypoidal cystitis, not previously reported in literature.
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December 2020

Scaling up renewable energy in Africa: measuring wind energy through econometric approach.

Environ Sci Pollut Res Int 2020 Oct 18;27(29):36282-36294. Epub 2020 Jun 18.

Faculty of Management Sciences, Ghazi University Dera Ghazi Khan, Dera Ghazi Khan, Pakistan.

Wind energy continues to make inroads in Africa due to falling costs and technological advancements. Most African countries are planning, exsiccating and connecting their renewable energy projects with national grid system with giving high propriety to energy security, sustainable energy consumption and low carbon emission. Many policies have been enacted by countries to promote the scaling up of wind energy and renewable energy in particular, across the globe. However, these policies have mixed effects on the deployment of wind energy. For this purpose, current study used panel data and fixed effects model for 17 African countries with wind installed generation capacity to determine the driver of wind energy development on the African continent between 2008 and 2017. The variables were grouped into three thematic areas: policy, socioeconomic, and country-specific factors. After conducting the analysis, socioeconomic variables (GDP, CO, energy use) and energy security variables (energy import, electricity consumption) have significant effects in determining the scaling up of wind energy in Africa. However, the policy variables of FITs, licensing during, and Tax did not have significant effects on wind energy capacity addition for the case of Africa. This study adds to the drivers of nascent wind energy deployment literature in Africa. This study suggests that set of effecitive policies are deem necessary to scale up wind energy in Africa.
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http://dx.doi.org/10.1007/s11356-020-09596-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302724PMC
October 2020

Nexus between sustainable entrepreneurship and environmental pollution: evidence from developing economy.

Environ Sci Pollut Res Int 2020 Oct 18;27(29):36242-36253. Epub 2020 Jun 18.

Department of Economics, Ghazi University, D.G. Khan, Pakistan.

Today, society is seeking solutions to achieve sustainable development, through association between entrepreneurship, innovation and sustainable development has become a topic of great apprehension. In this perspective, this article aims to link environmental responsive entrepreneurship with sustainable development through empirical evidences from developing country. Therefore, the purpose of this study is to validate the environmental Kuznets curve hypothesis to confirm the achievement of sustainable development goals in Pakistan. We use the combined mean estimator of the autoregressive distribution lag model and GMM model to determine the long-term relationship between the variables and analyze the environmental Kuznets curve hypothesis. We found U-shaped environmental Kuznets curves in Pakistan. Further results show long-term relationship using the PMG-ARDL estimator. Our findings indicate the presence of EKC, U-shaped EKC. This means that at a certain level of economic growth, a 1% increase in per capita income can lead to reductions in environmental pollution by 2.88%, 4.54%, and 2.48%. Therefore, governments and policy makers should strengthen policies to reduce environmental pollution and, more importantly, formulate green financing policies to encourage aspiring environmental entrepreneurs to establish environmentally driven enterprises, promote the use of environmental products to reduce environmental problems, and achieve sustainable development in Pakistan.
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http://dx.doi.org/10.1007/s11356-020-09642-yDOI Listing
October 2020

Trilemma assessment of energy intensity, efficiency, and environmental index: evidence from BRICS countries.

Environ Sci Pollut Res Int 2020 Sep 16;27(27):34337-34347. Epub 2020 Jun 16.

School of Economics, BZU, Multan, Pakistan.

This paper provides an assessment of energy density and energy efficiency and creates an important indicator of environmental performance. This article applied two mathematical models and econometric techniques to obtain detailed and specific results. The DEA and the non-normative account aggregation mean a collective aggregation to form a mathematical aggregation tool to create an environmental index for the BRICS countries (Brazil, Russia, India, China, and South Africa) based on available data from 2011 to 2016. The advantage of the proposed approach is to manage the irregularities of the data and follow the desired properties of the index number. The current paper is relevant for the broad scope of construction, the environmental index, and the evolution of the rankings of countries based on multiple indicators. Our results indicate that Brazil and Russia have the highest values of the Environmental Performance Index, which range between 67.44 and 60.70, respectively. India has a minimum value of 30.57 of the environmental index. The analysis shows that Brazil, Russia, and South Africa have the best scores and that these countries have the best results, while China and India also have the best results. This study can help form a valuable political tool for the development and development of the country's politics.
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http://dx.doi.org/10.1007/s11356-020-09578-3DOI Listing
September 2020

Biology, ecology and management of Raphanus raphanistrum L.: a noxious agricultural and environmental weed.

Environ Sci Pollut Res Int 2020 May 3;27(15):17692-17705. Epub 2020 Apr 3.

The Centre for Crop Science, Queensland Alliance for Agriculture and Food Innovation (QAAFI), The University of Queensland, Gatton, Queensland, 4343, Australia.

Weeds are a major constraint to crop production and a barrier to human efforts to meet the ever-rising global demand for food, fibre and fuel. Managing weeds solely with herbicides is unsustainable due to the rapid evolution of herbicide-resistant weeds. Precise knowledge of the ecology and biology of weeds is of utmost importance to determine the most appropriate nonchemical management techniques. Raphanus raphanistrum L. is an extremely invasive and noxious weed due to its prolific seed production, allelopathic potential, multiple herbicide resistance and biological potential. R. raphanistrum causes high crop yield losses and thus has become one of the most troublesome agricultural and environmental weeds. R. raphanistrum could exchange pollen with herbicide-tolerant canola and could become an environmental threat. This weed has evolved resistance to many herbicides, and relying exclusively on herbicide-based management could lead to severe crop loss and uneconomical cropping. Although reviews are available on the ecology and biology of R. raphanistrum, significant changes in tillage, weed management and agronomic practices have been occurring worldwide. Therefore, it is timely to review the status of noxious weeds in different agro-ecological zones and management scenarios. This review focuses on the response of R. raphanistrum to different cultural, mechanical, biological, chemical and integrated management strategies practiced in various agro-ecosystems, and its biological potential to thrive under different weed management tactics. In addition, this review facilitates a better understanding of R. raphanistrum and describes how weed management outcomes could be improved through exploiting the biology and ecology of the weed.
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http://dx.doi.org/10.1007/s11356-020-08334-xDOI Listing
May 2020

Small-cell neuroendocrine carcinoma of the urinary bladder: A case report.

Int J Health Sci (Qassim) 2020 Mar-Apr;14(2):53-55

Department of Pathology, Shifa International Hospital, Islamabad, Pakistan.

Primary neuroendocrine carcinomas of the urinary bladder are rare. A 60-year-old male presented with gross hematuria for the past 3 months. Diagnostic flexible cystoscopy revealed a papillary lesion above the right ureteric orifice. Transurethral resection of bladder tumor was performed and resected tissue was sent for histopathology that revealed high-grade urothelial carcinoma with small-cell neuroendocrine differentiation. Lamina propria, muscularis propria, and perineural invasion was seen which was later also confirmed by immunohistochemistry. The patient received neoadjuvant four cycles of chemotherapy and then underwent radical cystoprostatectomy with ileal conduit. The patient's recovery was uneventful and he is on regular follow-up from the past 12 months without any disease recurrence. Early detection and aggressive management can improve the survival and prognosis of these patients.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069666PMC
March 2020

Outcome Of Percutaneous Nephrolithotomy In Preschool And School-Age Children-Single Center Experience.

J Ayub Med Coll Abbottabad 2019 Jul-Sep;31(3):391-396

Department of Urology, Shifa International hospital Islamabad, Pakistan.

Background: Efficacy of percutaneous nephrolithotomy in adults has been studied well in past. However, such studies are sparse within paediatric age group. As this procedure is being adopted in smaller and older children alike, we wanted to determine its safety and efficacy in two different age groups of children (preschool age and school age).

Methods: The records of 59 children undergoing PCNL at our department from December 2009 to May 2017 were reviewed retrospectively. Patients were placed into 2 age groups including children ≤7 years old (group 1) and those ≥7 years (group 2). Twenty-seven patients were put in preschool group with mean age of 4.8±2.1 years while 32 patients in school age group having mean age of 11.8±4.6 years.

Results: Stone size was calculated showing mean 309±55 mm2 in preschool and 324±63 mm2 in school age group respectively (p=0.1). The mean operative time was 150.1±38.7 minutes and 166.3±39.6 minutes in the preschool and school age children respectively (p=0.1). The mean length of hospital stay was 3.1±1.4 days and 2.9±1.3 days in preschool and school going children (p=0.5). The stone clearance with PCNL was seen in 96.3% (pre-school group) and 93.75% (school age group) as monotherapy (p=0.1), which increased to 100% after combining it with extracorporeal shock wave lithotripsy.

Conclusions: PCNL is equally effective in both pre-school and school age groups in terms of stone free rates. Complication rates were not different between the two groups.
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January 2020
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