Diffusion Weighted MR Imaging of Ring Enhancing Brain Lesions

Objective: To evaluate the role of diffusion weighted imaging in differentiating the cause of ring enhancing brain lesions. Study Design: Analytical, descriptive study. Place and Duration of Study: Department of Radiology, The Aga Khan University Hospital, Karachi, from March 2007 to July 2011. Methodology: Diffusion weighted imaging (DWI) was performed on 37 patients having ring enhancing lesions on their post-contrast brain MRI scans. These lesions were characterized into neoplastic and abscess cavity on the basis of diffusion restriction. Correlation of all these findings was done with histopathology obtained in all these patients. Sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of DWI were calculated. Comparisons of mean ADC values of abscess and neoplastic lesions were also done using t-test. Results: DWI had a sensitivity of 94.73%, specificity of 94.44%, positive predictive value of 94.73%, and negative predictive value of 94.44% and diagnostic accuracy of 94.5% in differentiating brain abscess from neoplastic brain lesions. Mean ADC value in central cavity and wall of neoplastic lesions and brain abscesses were calculated with significant p-value of 0.001 and 0.025 respectively. Conclusion: Diffusion weighted imaging is non-invasive method with high sensitivity and specificity which can help in differentiation of ring enhancing neoplastic lesions and brain abscesses. This modality should be read in conjunction with conventional imaging

Automatic seat belt

Motor vehicle accidents have grown to be a major cause of death and injuries. We are developed occupant safety feature with an intension to reduce accidental injuries to occupants. After studying number of design plans and research papers, we have concluded to design and develop seat belt safety mechanism using spring and rope mechanism. In case of accidents, passenger lives can be saved greatly by use of seat belts and airbags in the automobiles. The safety implications of these systems and the stringent safety regulations in the world have brought a growing market to these products. The purpose of developing the project is to design alternate method of seat belt safety mechanism without changing the available space in the car and also to provide safety to occupants in those cars in which air bags and other safety system could not be implemented due to increase in cost.The actuating system design includes three point seat belt, spring, wire rope ,solenoid and locking mechanism

Cardiac involvement in kawasaki disease in Pakistani children

Introduction: Coronary artery involvement is the most dreaded long-term complication of Kawasaki disease. Our aim was to look at the pattern of cardiovascular involvement in Pakistani children admitted with Kawasaki disease.Methods: This study included children admitted with Kawasaki disease at the Aga Khan University Hospital Karachi over a period of 14 years from January 1997 to December 2010. Information gathered included patient demographics, clinical features, investigations, echocardiographic findings, treatment and follow-up. Those with coronary artery involvement on initial echocardiogram remained on long-term follow-up with clinical examination and echocardiogram.Results: A total of 56 patients were admitted. (Mean age at diagnosis 33 ± 30 months, age range 2 months to 9 years). 18% of patients had incomplete features. Twenty-five percent (14/56) patients presented after 10 days of fever. Cardiac examination was normal except for tachycardia. Abnormal coronary arteries were seen in 23 patients (41%) - left main coronary artery in 23 (41%), left anterior descending and right main coronary artery in 20 (36%), circumflex branch in 17 (30%). Risk factors for cardiac involvement were male sex, fever \u3e10 days duration at the time of initial presentation and neutrophil percentage \u3e75% in the initial white blood cell counts. Fifty four of 56 cases received intravenous immunoglobulin (IVIG), Seventy-five percent of the patients received IVIG within 10 days of illness. Mean duration of follow-up was 2.5 years. Eight percent of the patients still continue to have abnormal coronaries. There was no mortality.Conclusions: A higher incidence of coronary artery involvement was found in our study. Presentation after 10 days of illness increases the risk of coronary artery involvement. High index of suspicion among the general pediatricians about the disease can possibly be helpful for early referral and treatment

PROMOTING EXPORT OF ICT BASED SERVICES THROUGH THE IMPLEMENTATION OF EXPORT POLICY IN BANGLADESH

ICT has been identified as one of the major sub-sectors in the service sector in Bangladesh. Export policy of Bangladesh, designed for 2015-2018, has included 12 highest priority sectors considering their special export potentials, where software and ICT enabled service is one of them. The policy has some certain goals for promoting export of ICT based services. The broad objective of the study is to analyze export policy of Bangladesh related with ICT based service and the overall situation of policy implementation and under this broad objective specific objectives are (1) to evaluate the role of export policy of Bangladesh in promoting ICT based service export and (2) to find if there is gap between Bangladesh export policy for ICT based service and implementation of the policy. Both qualitative and quantitative methods have been used to conduct this research. The study found that the policy lacks some very important issues needed to be addressed for capitalizing high potentials ICT based service export sector. But there is no policy statement for supporting ICT entrepreneurs to have better access to national and international arena. Among the variables that affect policy implementation, political will and support have been appreciated by the ICT entrepreneurs. The goals which are not being implemented are probably being hampered by lack of required amount of financial allocation, lack of technical skill and knowledge of the implementers, and lack of related policies complementing this policy. Increased participation of entrepreneurs in this sector will be helpful to harvest the benefit from policy implementation.  Article visualizations

IoT based MPPT techniques for photovoltaic frameworks management under different environmental conditions: a review

Solar energy (SE) is the most attractive form of renewable energy (RE) source for electrification. To harness SE, the photovoltaic (PV) system is required towards converting sunlight into direct electricity. The PV frameworks can be placed in areas with high energy potential. The performance of PV frameworks is complex work which depends on various parameters of the frameworks and their operations. The performance of PV frameworks can be evaluated using MATLAB/Simulink platform and real-time implementation. In this research article, the internet of things (IoT) is investigated to regulate and monitor PV system performance in various environments. IoT-based maximum power point tracking (MPPT) technology improves the response of real-time operating characteristics which makes it possible to control remote PV systems management, quickly diagnose problems and maintain them effectively. Additionally, it allows for recording production and performance data for analysis

One Dimensional Steady Flow Analysis Using HECRAS – A case of River Jhelum, Jammu and Kashmir

Floods have been recurrent phenomena in the study area. A heavy precipitation, usually coming during the end months of the summer season in association with sudden cloudburst, leads to severe flooding in the study area. By now the catchment area of the river is already saturated and the high run-off swells the rivers beyond their capacity. The present study describes the application of HEC RAS Model for flood studies in the river Jhelum Kashmir valley. The peak flood records were used as inputs into HEC RAS model to find out the resultant expected flood levels. The resultant output generated by the model shows an overflow at maximum locations of the river under study for 50 years and above return period. This purpose is to give a hand to policy makers, planners and insurers, to develop a robust strategy for the development of flood mitigation measures and plans to minimise the losses associated with the disaster in the study area

Hurricane risk assessment in a multi-hazard context for Dominica in the Caribbean

Hurricanes can trigger widespread landslides and flooding creating compound hazards and multiple risks for vulnerable populations. An example is the island of Dominica in the Caribbean, where the population lives predominantly along the coast close to sea level and is subject to storm surge, with steep topography rising behind, with a propensity for landslides and flash river flooding. The simultaneous occurrence of the multiple hazards amplifies their impacts and couples with physical and social vulnerabilities to threaten lives, livelihoods, and the environment. Neglecting compound hazards underestimates overall risk. Using a whole island macroscale, (level-I) analysis, susceptibility scenarios for hurricanes, triggered landslides, and floods were developed by incorporating physical process parameters. The susceptibilities were combined with vulnerability indicators to map spatial patterns of hurricane multi-risks in Dominica. The analysis adopted a coupled approach involving the frequency ratio (FR), analytic hierarchy process (AHP), and geographic information system (GIS). Detailed hazard modelling was done at selected sites (level-II), incorporating storm surge estimates, landslide runout simulations, and steady flow analysis for floods. High-resolution terrain data and simulation models, the Rapid Mass Movement Simulation (RAMMS) and the hydrologic engineering center’s river analysis system (HEC-RAS), were employed. Ground validation confirmed reasonable agreement between projected and observed scenarios across different spatial scales. Following the United Nations Office for disaster risk reduction (UNDRR) call for the inclusion of local, traditional, and indigenous knowledge, feedback, and expert opinion to improve understanding of disaster risk, 17 interviews with local experts and 4 participatory workshops with residents were conducted, and findings were incorporated into the analysis, so as to gain insights into risk perceptions. The study’s outcomes encompass projections and quantification of hurricane compound hazards, vulnerabilities, accumulated risks, and an understanding of local priorities. These findings will inform decision-making processes for risk mitigation choices and community actions by providing a new framework for multi-hazard risk assessment that is easy to implement in combining different data forms

Surgical Outcome of Endoscopic Third Ventriculostomy in Patients Having High ETV Success Score: One-Year Experience at a Tertiary Care Hospital

Background & Objective:  Endoscopic third Ventriculostomy (ETV) is an accepted alternative to VP shunt in patients with obstructive hydrocephalus. We will share our experience and outcome. Materials & Methods:  Thirty consecutive ETV cases performed by a single surgeon during 1 year in patients with an ETV success score of 60 or higher were included in this study. Patients’ demographics, outcomes, and complications are reported. Results:  (60%) were male and 12 (40%) were female. The mean age in our study was 6.1 years ± 9 (mean ± SD). Posterior fossa tumor was the most common etiology in our series (46.6%) followed by aqueductal stenosis (23.3%). Eighty percent of our patients did not experience an ETV failure. The complication rate was 20%. Inadequate ventriculostomy in 6.6% of the patients was the commonest complication. Conclusion:  ETV is safe and effective in patients with high ETV success scores

Majoon-E-Piyaz: A Potent Unani Formulation for Premature Ejaculation

Surʻat-e-Inzāl (Premature Ejaculation) is the most prevalent male sexual dysfunction affecting 25 - 40% global population of men. It is a universal disorder and is independent of age, social or marital status. It has a significant impact on both- patients and their partners, causing distress, anxiety and relationship difficulties affecting the quality of life. Several aetiologies have been proposed by various researchers which are not evidence-based but speculative. Accordingly the International Society for Sexual Medicine (ISSM) issued treatment guidelines for Premature Ejaculation (PE) recommending Serotonergic Antidepressants (SSRIs) and Local Anaesthetics (LA) for its management in modern medicine. However, these treatments were not actually developed for PE, and have limitations associated with their off-label use. Furthermore, nearly all the recommended drugs have a wider spectrum of adverse effects and serious drug interactions which sometimes could be fatal. On the other hand, centuries old Unani medicine offers a complete line of treatment for Surʻat-e-Inzāl based on traditional knowledge and experience. Unani physicians devised a large number of poly-herbal recipes which are still in vogue.  Majoon-e-Piyaz (MP) is one of the compound Unani formulations which are in use for the treatment of premature ejaculation since centuries. This article is an attempt to summarize scientific investigations in support of the claim made by Unani physicians regarding Majoon-e-Piyaz (MP).  Keywords: Surʻat-e-Inzāl, Premature Ejaculation, Majoon-e-Piyaz, Unani Medicin

Role of multidetector computed tomography (MDCT) in patients with ovarian masses

Objective:To evaluate the diagnostic accuracy of multidetector 64-slice computed tomography (MDCT) in the diagnosis and differentiation of benign and malignant ovarian masses using histopathology and surgical findings as the gold standard. Material And Methods: This study was conducted in Aga Khan University Hospital, Karachi, Pakistan. Data was reviewed retrospectively from 1 November 2008 to 12 December 2009. One hundred Patients found to have ovarian masses on CT scan were included in the study. CT scan was performed in all these Patients after administration of oral and IV contrast. Ovarian masses were classified as benign and malignant on scan findings. Imaging findings were compared with histopathologic results and surgical findings. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of MDCT were calculated. Results: MDCT was found to have 97% sensitivity, 91% specificity, and an accuracy of 96% in the differentiation of benign and malignant ovarian masses, while PPV and NPV were 97% and 91%, respectively. Conclusion: MDCT imaging offers a safe, accurate and noninvasive modality to differentiate between benign and malignant ovarian masses