Cerebral Venous Sinus Thrombosis in Children: A Multicenter Cohort From the United States

This study presents a large multicenter cohort of children with cerebral venous thrombosis from 5 centers in the United States and analyzes their clinical findings and risk factors. Seventy Patients were included in the study (25 neonates, 35%). The age ranged from 6 days to 12 years. Thirty-eight (55%) were younger than 6 months of age, and 28 (40%) were male. Presenting features included seizures (59%), coma (30%), headache (18%), and motor weakness (21%). Common neurological findings included decreased level of consciousness (50%), papilledema (18%), cranial nerve palsy (33%), hemiparesis (29%), and hypotonia (22%). Predisposing factors were identified in 63 (90%) Patients. These included infection (40%), perinatal complications (25%), hypercoagulable/hematological diseases (13%), and various other conditions (10%). Hemorrhagic infarcts occurred in 40% of the Patients and hydrocephalus in 10%. Transverse sinus thrombosis was more common (73%) than sagittal sinus thrombosis (35%). Three children underwent thrombolysis, 15 Patients received anticoagulation, and 49 (70%) were treated with antibiotics and hydration. Nine (13%) Patients (6 of them neonates) died. Twenty-nine Patients (41%) were normal, whereas 32 Patients (46%) had a neurological deficit at discharge. Seizures and coma at presentation were poor prognostic indicators. In conclusion, cerebral venous thrombosis predominantly affects children younger than age 6 months. Mortality is high (25%) in neonatal cerebral venous thrombosis. Only 18 (25%) Patients were treated with anticoagulation or thrombolysis

Socio-Legal Significance of Family Waqf in Islamic Law: Its Degeneration and Revival

From a Shari’ah perspective, no essential difference is noticed between public welfare waqf and a waqf created for the benefit of individuals such as descendants and family of a person, and both are treated as recommended avenues for voluntary gratuitous transfer of benefits. Over the centuries, family awqaf have degenerated due to various social and political factors.  Under the influence of the English law that regards family trusts as non-charitable, family awqaf have been treated as non-charitable institutions, and have been deprived of the privileges and immunities granted to charitable awqaf.  In this context, the current article discusses the essential nature of such awqaf with regard to their position in Islamic law and history as well as their social significance, and attempts to shed light on the degeneration that took place in the recent past, while exploring means of revival.  It finds that the creation of endowments for specific beneficiaries such as waqf for those related to the endower is a recognised form of charity in Islamic law, that function as public serving entities directly or indirectly.  Issues encountered in such awqaf do not necessitate denying their multiple advantages.  Providing the necessary legal regulation and administrative framework as well as tax exemption for all awqaf could go a long way in promoting the cause of waqf.

The influence of menopause on urinary incontinence in the women of the community: a cross-sectional study from North India

Background: Urinary incontinence is defined as the complaint of any involuntary loss of urine that is a social or hygienic problem.  Worldwide, over 200 million people are living with urinary incontinence and as the life expectancy of women is increasing, more number of women are bound to suffer from it. The aim of the present study is to find out the effect of menopause on the occurrence of Urinary Incontinence in women and to find out risk factors in post-menopausal women associated with Urinary Incontinence.Methods: It was a community based cross-sectional study involving post-menopausal women living in the urban and rural areas registered under Community Medicine, J.N. Medical College, Aligarh, India. A total of 530 women were taken for this study. Descriptive statistics as well as simple proportion were calculated with SPSS 20.0. Tests of significance and Binary Logistic regression analysis were used for analysis.Results: Significant differences were found in the association of Urinary Incontinence with increasing age groups and consequent years spent in menopause, rural area of residence, illiteracy, lower socio-economic class, inadequate housing standards, obesity, smoking, parity, history of hysterectomy, and co-morbidities such as Urinary Tract Infection and Pelvic organ prolapse.Conclusions: From a public health perspective, there is considerable opportunity to improve women's quality of life by increasing health education about urinary incontinence and its treatment by taking steps for life style modifications

MUCOADHESIVE MICROSPHERES FOR CONTROLLED DELIVERY OF DRUGS

ABSTRACTMicrospheres constitute an important part of the novel drug delivery system by virtue of their small size and efficient carrying capacity. Due to theirlong residence time, bioadhesive characteristics mucoadhesion can be coupled to microspheres to develop mucoadhesive microspheres. Bioadhesioncan be defined as the state in which two materials, at least one of which is biological in nature, are held together for a prolonged time period bymeans of interfacial forces. Microspheres are the carrier linked drug delivery system in which particle size is ranges from 1 to 1000 μm range indiameter having a core of drug and entirely outer layers of polymer as a coating material. Mucoadhesive microspheres have advantages like efficientabsorption and improved bioavailability of the drugs due to a high surface to volume ratio, a much more intimate contact with the mucus layer,controlled and sustained release of drug from dosage form and exact targeting of drugs to the absorption site. The present study aims to provide anoverview of various aspects of mucoadhesive microspheres, methodology of preparation of mucoadhesive microspheres, method of evaluation, andtheir applications in drug delivery.Keywords: Mucoadhesion, Mucoadhesive microsphere, Controlled release

Analyzing the trends of natural resources rents of Pakistan

An attempt was made to reveal the trends of natural resources in graphical form. Rental incomes which contribute to GDP were taken into account. For this purpose, economic statistics of Pakistan was taken from World Bank’s published data source. Data was put in SPSS-20 and comparative analysis chart was created to obtain the objectives. Results revealed no significant constant or linear trends in any factor of natural resources. It was concluded that oil and natural gas contributed significantly in the start of 21st Century. Mineral has been treated as neglected factor in contributing to GDP. A research can further expand to explore more trends of rental incomes in different regions of world. We would like to express our gratitude towards initial reviewer of draft and thank to people who helped us in completion of this study

Analyzing the trends of natural resources rents of Pakistan

An attempt was made to reveal the trends of natural resources in graphical form. Rental incomes which contribute to GDP were taken into account. For this purpose, economic statistics of Pakistan was taken from World Bank’s published data source. Data was put in SPSS-20 and comparative analysis chart was created to obtain the objectives. Results revealed no significant constant or linear trends in any factor of natural resources. It was concluded that oil and natural gas contributed significantly in the start of 21st Century. Mineral has been treated as neglected factor in contributing to GDP. A research can further expand to explore more trends of rental incomes in different regions of world. We would like to express our gratitude towards initial reviewer of draft and thank to people who helped us in completion of this study

Hyperlipidemia Patterns in Newly Diagnosed Young Diabetic Patients

Objective: To analyze hyperlipidemia patterns among newly diagnosed young diabetic patients. Study Design: A descriptive cross-sectional study Place and Duration: Study was conducted in DHQ Teaching Hospital, DG Khan, Bahawal Victoria hospital, Bahawalpur, and Sheikh Zayd Hospital, Rahim Yar Khan from July 2017 to July 2018.Methodology: All the patients were young and newly diagnosed with Diabetes Mellitus. Data collection was done via non probability consecutive sampling included patients’ demographics, past medical history, co-morbidities, and lab findings were assessed. SPSS version 24 was used to analyze data. P value ≤ 0.05 was taken as significant.Results: Eighty patients were included in this study. Diabetic nephropathy, diabetic retinopathy, macrovascular complications, hyperglycemic hyperosmolar non-ketotic coma history, family history and hypertension were noted in n=12 (15%), n=6 (7.5%), n=9 (11.3%), n=1 (1.3%), n=34 (42.5%) and n=11 (13.8%) respectively. The mean hyperlipidemia, hypertriglyceridemia, of the patients was 4.54±0.52 mmol/L, 2.59±1.13 mmol/L, 1.39±0.80 mmol/L, 1.03±0.59 mmol/L respectively. Conclusion: the study has shown that the prevalence of increased levels of triglycerides is more than increased LDL cholesterol levels among these patients. As it has been established that hypertriglyceridemia is a known risk factor for causing cardiovascular disorders among diabetic patients, it should be addressed and managed accordingly at the onset of diabetes. Keywords: Hyperlipidemia, Diabetes Mellitus, low density lipoproteins, high density lipoproteins, insulin.

The Efficacy of Ivabradine Alone, Metoprolol Alone and Combination of Ivabradine and Metoprolol in Reducing Heart Rate Among Patients Undergoing Computed Tomography Coronary Angiography

Objectives: to determine the efficacy of Ivabradine alone, Metoprolol alone and Combination of Ivabradine and Metoprolol in reducing heart rate among patients undergoing Computed Tomography Coronary Angiography (CTCA). Methodology: it was a randomized controlled trial comprised of 200 patients. Patients undergoing CTCA having heart rates greater than 80 bpm were divided into three groups. Group A was given Ivabradine and a placebo, Group B received Metoprolol and placebo while Group C was administered with Ivabradine and Metoprolol an hour prior to the scan. The scan was carried under similar situations. Heart rate and variability was recorded before and during the scan. Results: The mean heart rate variability and mean reduction in heart rate of Group A was 3.13±1.01 and 19.02±2.05 respectively. The mean heart rate variability and mean reduction in heart rate of Group B was 4.27±1.08 and 12.11±2.45 respectively. While, the mean heart rate variability and mean reduction in heart rate of Group C was 1.88±0.42 and 25.03±2.74 respectively. Conclusion: Ivabradine is an effective and safe drug for reducing heart rate in patients having CTCA, especially among patients who are unable to tolerate calcium channel blockers and beta blockers owing to their side effects. Keywords: Ivabradine, Metoprolol, Computed tomography coronary angiography, heart rate reduction, heart rate variability