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Background: Anxiety may be defined as “apprehension, uneasiness or tension that stems from an anticipation of danger, which may be external or internal”. Amputation is “A removal of the limb or its part owing to medical causes/reasons”. Low-level of social support, religiosity & self-efficacy, may have a role in commencement and continuation of mental health condition. Empathy & support are imperative for helping amputees to cope-up with an uncertainty, emotions, mobility issues, and to en-able them to adjust to new normality. Objective: The aim of study was to find an impact of duration and social support on anxiety amongst amputees. Study Design: Cross-sectional study. Place and duration of Study: Physical Rehabilitation Centers of Quetta. Duration of this study was 3 months. Methodology: Primary data was taken from all amputees visiting rehabilitation centers, through structured adopted questionnaire “Hospital Anxiety and Depression Scale” (HADS), with the help of trained data collectors along with principal investigator. Results: 54 subjects were included in this research, of whom. Majority 49 were earning/receiving up to 30000 Pk Rs monthly. Regarding no of dependents, majority (57.5%) had 9 or above no of dependents.

Acute hypokalemic paralysis (AHP) is a life-threatening emergency. It is exceptionally unusual for hypothyroidism to present with AHP. This association can be either primary or secondary through distal renal tubular acidosis. We report two cases who presented with acute quadriplegia. The succeeding investigations revealed severe hypokalemia and autoimmune hypothyroidism. The second case was found to have Sjogren’s syndrome additionally. The underlying etiology of hypokalemia in both cases was found to be dRTA. The combination of such conditions is reported sporadically. Here we also discuss the potential association of AHP with autoimmune conditions by proxy through dRTA.

Objective: To find out the causes and factors of anxiety among amputees suffering from traumatic and non-traumatic causes. Methodology: This descriptive cross-sectional study was conducted in Quetta from the month of May 2018 to July 2018. This study included those clients with amputations as a result of Traumatic & non-traumatic causes and the data was collected from them. This study involved a total of 54 participants. All amputees who visited the three Physical Rehabilitation Centre were included during data collection process. A structured adopted questionnaire using the Hospital Anxiety and Depression Scale (HADS) according to the inclusion & exclusion criteria & then tabularized and analyzed by applying Chi square test. Results: This study involved a total of 54 participants of whom 7(13%) were females and 47(87%) males. Among amputees 36(66.7 %), amputations were due to Traumatic injuries and 18(33.3%) were due to non-traumatic amputations. In traumatic, the majority was due to RTA with 25(46.3 %) and in non-traumatic causes diabetes stood first with 13(24.1%) amputation. Traumatic are more anxious than non-traumatic. There is a significant relationship between marital status and anxiety level (p-value 0.047). Statistically significant relationships between amputation and anxiety level were noticed, p value=0.049. Conclusion: Amputation has a significant association with anxiety level. Traumatic experiences make people feel more anxious than non-traumatic ones. Socio-demographics has association with levels of anxiety. It is recommended to do regular or annual screening of these patients following amputation.

The Internet of Things (IoT) has experienced significant growth in recent years, with IoT connections surpassing those of traditional connected devices in the last few years. However, with this growth comes an increased risk of IoT security breaches as cybercriminals take advantage of lax security measures at the endpoint level. One of the main challenges in IoT security is the lack of proper protocols, policies, and procedures to protect these devices from malware and malicious software. This review article focuses on the recent advancements in machine learning-based malware detection techniques for IoT devices. We discuss the challenges of detecting malware in IoT devices, including the limited resources and processing power, as well as the diversity of device types and operating systems. We also review recent machine learning-based malware detection techniques for IoT devices, including deep learning, ensemble learning, and transfer learning, and evaluate their efficiency. This review aims to provide a comprehensive understanding of the current state-of-the-art machine learning-based malware detection techniques for IoT devices, highlighting the potential and limitations of these techniques and the role of analytics in future research directions.

Background: Cirrhosis of the liver is a widespread chronic illness that kills more people from non-malignant diseases than any other condition. In the case of cirrhosis, the liver has sustained long-term damage and is unable to operate normally. The VITRO score is a noninvasive instrument that can forecast whether cirrhotic patients would experience problems. Objective: To determine the prognostic accuracy of VITRO score in predicting the mortality in patient with decompensated liver cirrhosis Material & Methods: Study Design: Descriptive Study Setting: Liver Clinic, Services Hospital, Lahore Duration: 06 months January 2022 to June 2022. One Hundred Ninety cirrhotic patients were recruited after meeting the inclusion criteria. Both informed consent and demographic data were collected. Blood samples were drawn and were sent to a certain facility in order to test for VWF-Ag and thrombocyte count. The VITRO-score was estimated by dividing the VWF-Ag to thrombocyte count. Patient followed for 3 months after which it was determined whether patients survived or died of cirrhosis complications. Results: The mean age of the patients was 51.42±9.98 years, 103(54.50%) were male. The mean VITRO score of the patients was 6.15±6.08. The VITRO scores the prediction of mortality was noted in 148(77.9%) patients. The sensitivity was 96.08%, specificity was 28.78%, and diagnostic accuracy of VITRO score was 46.84% for assessment of mortality taking mortality occurred within 3 months as gold standard. Practical implication: The prognosis of patients could be improved by using accurate prognostic scoring systems to assist clinicians in earlier diagnosis and therapy selection. Conclusion: According to this study the prognostic accuracy of VITRO score in predicting the mortality is approximately 50% in patient with decompensated liver cirrhosis, however the sensitivity of it is very high Keywords: Prognostic Accuracy, VITRO score, Mortality, Cirrhosis, decompensated liver disease

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In this study, a versatile method for the manufacturing of chitosan-grafted porous poly (L-lactic acid) (P-PLLA) nanofibrous membrane by using polydopamine (PDA) as an intermediate layer has been developed. P-PLLA fibreswere electrospun and collected as nano/micro fibrous membranes. Highly porous fibres could serve as a substrate for chitosan to adsorb heavy metal ions. Moreover, PDA was used to modify P-PLLA surface to increase the coatinguniformity and stability of chitosan. Due to the very high surface area of P-PLLA membranes and abundant amine groups of both PDA and chitosan, the fabricated membranes were utilized as adsorbent for removal of copper(Cu2+) ions from the wastewater. The adsorption capability of Cu2+ ions was examined with respect to the PDA polymerization times, pH, initial metal ion concentration and time. Finally, the equilibrium adsorption data of chitosan-grafted membranes fitted well with the Langmuir isotherm with the maximum adsorption capacity of 270.27 mg/g.

In this research article, the PVDF (polyvinylidene fluoride)–PANI (polyaniline)–titanium nanotube (TNT) based nanocomposite membranes were synthesised through phase inversion method. The composition and structural properties of nanocomposite membranes were characterised by X-ray photoelectron spectroscopy (XPS), Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), atomic force microscopy (AFM) and scanning electron microscope (SEM). The significant properties of synthesised membranes such as distribution of pore size, thermal properties, mechanical properties, and photocatalytic behaviour of membranes were also studied. The hydrophilic properties of the composite membranes increased with filler content (PANI-TNT) and results in improved pure water flux (484.8 ± 2.9 L/m2 h−1) compared to that (312.0 ± 1.91 L/m2 h−1) of the pure PVDF membrane. The pure PVDF and nanocomposite membrane were further analysed in terms of their filtration properties such as adsorption of dyes (methyl orange, Allura red) and UV self-cleaning properties. The newly developed nanocomposite membranes showed excellent pollutant removal efficiency (~90%). The synthesised nanocomposite membranes also showed photocatalytic activities due to the presence of TNTs, and adsorption of methyl orange (MO) reduces significantly with the UV light irradiations. The UV self-cleaning property of the composite membrane was further confirmed due to their high flux recovery ratio of about 94%. The results show that embedded PANI-TNT within nanocomposite was photo-catalytically active and degrade the dye molecules from the surface of the nano composite membrane.

To find and analyse the associated determinants of mortality in admitted patients in cirrhotic patients with MELD score18 presenting in emergency department with variceal bleeding.Cross-sectional study.Department of Emergency Medicine, King Sultan Military Hospital Riyadh, Kingdom of Saudi Arabia, from July 2017 to January 2018.A total of 235 patients fulfilling the inclusion criteria were enrolled in the study. Diagnosis of cirrhosis was made if the patients had platelets150000/μl, PT3 sec (prolonged), biochemical (reversal of ALT, AST ratio, albumin3.5 g/dl) and ultrasongraphic coarse echotexture of liver and splenomegaly; and presence of all of the above variables and for at least six months. Variceal bleeding diagnosed on presentation and emergency endoscopy. MELD score was calculated by following formula. MELD = 3.78 [Ln serum bilirubin (mg/dL)] +11.2 [Ln INR] +9.57 [Ln serum creatinine (mg/dl)] +6.430 NR. Outcome of patients treatment was to record associated morbidity and mortality during follow-up period of one month.There were 156 (66.4%) male and 79 (33.6%) female cirrhotic patients. The mean age was 47.8 ±8.7 years. Out of 235 patients of liver cirrhosis, 47 (20.0%) expired during the hospital stay, while 188 (80.0%) patients survived and discharged from the hospital. Most of the cirrhotic patients were experienced with MELD score 18-20, i.e. 144 (61.3%) followed by 70 (29.8%) in 21-25 and 21 (8.9%) had the range of 26-30. In-hospital mortality rate was statistically insignificant (p0.05) with respect to MELD scores. Probability of survival was 0.80.Liver cirrhosis with MELD score18 and variceal bleeding is highly prevalent in young adult patients, more likely in male patients having duration of disease since1 year to 3 years such that every 1 of 5 patients expired during the hospital stay. Probability of survival was 80%.

Objective: The study aimed to assess the safety profile of Direct Acting Anti-Viral’s (DAAs) among patients with chronic Hepatitis C Virus (HCV). Methods: This multicenter, analytical cross-sectional study was conducted in six gastroenterology and Hepatology centers including Liver Center Faisalabad, Allama Iqbal Medical Institute and Liver Center DHQ Hospital Sialkot, Isra Hospital Hyderabad, Allied Hospital Faisalabad and Rehman Medical Institute Peshawar, between May 2018 and May 2019. The data regarding patient demographics, treatment plan and the frequency of Adverse Events (AEs), and their severity was collected using a pre-designed questionnaire and analyzed through SPSS version 20.0. Results: A total of 511 HCV patients were enrolled, with an overall male majority. Around 66.3% patients experienced a total of 419 AEs, out of which 61 events were suspected from DAAs while remaining 317 events were associated with Ribavirin. Pyrexia (24.6%) and fatigue (14.8%) were the most commonly reported AEs among patients receiving DAAs. Factors such as Ribavirin-based treatments and the presence of Cirrhosis were more likely to promote AEs occurrence OR [95%CI] i.e. 5.2(2.3-9.1) and 1.9(1.1-3.1) respectively (p < 0.05). Conclusion: It is concluded from the study results that DAAs have displayed promising outcomes due to the minimal and minor AEs reported. doi: https://doi.org/10.12669/pjms.37.2.3400 How to cite this:Hashmi ZY, Zia MQ, Bajwa A, Ahmed M, Anwer N, Raza M, et al. New drugs and new concerns: Gaining insight through Pharmacovigilance of direct acting Anti-Viral’s in chronic HCV patients. Pak J Med Sci. 2021;37(2):299-304. doi: https://doi.org/10.12669/pjms.37.2.3400 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Byssinosis is a chronic obstructive pulmonary disease very common in textile cotton workers due to inhalation of fine cotton dust and gram negative bacteria. A three layer composite respiratory filter was developed for Byssinosis prevention by using the combination of polypropylene (PP) based meltblown layers and chitosan nanofibres (CSNF). Filtration efficiency against fine particulates ranges from 100 nm to 2.5 μm and anti-bacterial activity against Pantoea agglomerans were investigated. Chitosan nanofibres were produced by using the electrospinning process and were sandwiched between two PP layers to improve the overall surface area of the filter as well as providing a protective barrier against bacterial pathogens. The filter sample with just 2 hour’s CSNF coating showed more than 99% filtration efficiency with a low pressure drop of 71.6 Pa and a high quality factor value 0.082. The antibacterial performance of CSNF layers achieved up to 91% against the Pantoea agglomerans. Finally, results concluded that the developed respiratory filter can potentially reduce Byssinosis in textile workers.

Chitosan crosslinked with 3-aminopropyltriethoxysilane was coated on porous poly (L-lactic acid) nanofibrous membrane to remove dyes from wastewater in the present study. The adsorption capacity of the composite membrane for the removal of methylene blue and rhodamine B was comprehensively studied. Large porous framework provided a high surface area to effectively immobilize the cross-linked chitosan on nanofibrous membranes. Batch trials were performed to evaluate the adsorption behaviour of membranes with variable crosslinking ratio, pH, initial concentration, temperature and time. Moreover, the adsorbent membranes before and after adsorption were characterized using scanning electron microscopy, x-ray energy dispersive analysis, and Fourier transform infrared spectrophotometer. Under optimum parameters, the adsorbent showed the removal capacity of 86.43 and 82.37 mg/g for rhodamine B and methylene blue, respectively. Isothermal and kinetic experiments showed that Langmuir isotherm and pseudo second order kinetics correlated best with adsorption data. Finally, the mechanism of adsorption and reusability of membrane for five cycles was studied.

Porous poly(L-lactic acid) (PLLA) nanofibrous membrane with the high surface area was developed by electrospinning and post acetone treatment and used as a substrate for deposition of chitosan. Chitosan was coated onto porous nanofibrous membrane via direct immersion coating method. The porous PLLA/chitosan structure provided chitosan a high surface framework to fully and effectively adsorb heavy metal ions from water and showed higher and faster ion adsorption. The composite membrane was used to eliminate copper ions from aqueous solutions. Chitosan acts as an adsorbent due to the presence of aminic and hydroxide groups which are operating sites for the capture of copper ions. The maximum adsorption capacity of copper ions reached 111.66 ± 3.22 mg/g at pH (7), interaction time (10 min) and temperature (25 °C). The adsorption kinetics of copper ions was established and was well agreed with the second-order model and Langmuir isotherm. Finally, the thermodynamic parameters were studied.

The aim of this study was to develop statistical models for the effect of binder concentration and curing temperature and time on the air permeability, tear strength, tensile strength, and crocking fastness of pigment-printed nonwoven polypropylene fabric. The design and analysis of the experimental work were carried out using Minitab® statistical software according to the Box–Behnken design of response surface methodology. Models were successfully developed. It was found that binder concentration improves the wet crocking and tensile strength while having a negative impact on all other responses. Increase in curing temperature and time affects the fabric tear strength negatively but has a positive effect on wet crocking fastness and fabric tensile strength. It could be concluded that pigment prints of good dry crocking fastness may be obtained on polypropylene nonwovens without deterioration in the mechanical strength and air permeability to a commercially unacceptable level. However, further work is required to improve the wet crocking fastness properties.

In situ deposition of TiO2 nanoparticles on polyester fabric has been carried out using hydrothermal method by changing the process conditions. The morphology and crystalline structure of as-deposited particles has been studied by using SEM and XRD. The chemical composition of nanoparticles was determined using energy dispersive spectroscopy. The treated sample exhibited photocatalytic solution discoloration and good washing fastness properties. The study of UV protection and moisture management of fabric showed that it had excellent UV protection factor and comfort properties.

Living donor liver transplantation (LDLT) involves healthy individuals undergoing voluntary major hepatic resection. LDLT program only started in 2012 in Pakistan and its impact on donor’s quality of life (QOL) post resection is not known. The objective of this study was to determine health-related QOL in donors who underwent hepatectomy in country’s first liver transplant program. A total of 60 donors who underwent hepatectomy between 2012 and 2014 with a minimum follow-up of 6 months were included in the study. Short form (SF-36) and Profile of mood states (POMS-65) was used to assess QOL. In addition scores were compared between patients who did and did not develop complications. Mean time duration between hepatectomy and administration of questionnaire was 15 ± 5.1 months. Median age was 28 (19–45) years. Mean BMI was 24.4 ± 3.7. A total of 7 (11.6 %) Grade 3 and above complications were observed in donors. Donors exceeded a score of 90 in 6 out of 8 evaluated categories on SF-36. The highest mean score was recorded for emotional role limitation 95.5 ± 17.1 and lowest for energy 84.8 ± 17.5. The mean score for anger was 6.6 ± 7.5. Donors also did well on the POMS vigor score with a mean of 22.7 ± 5. No significant difference in scores was observed between donors with and without complications for any of the categories except tension. Donors who developed complications post-operatively had a significantly low mean tension score of 1.5 versus 3.8 for donors without complications. Acceptable post donation QOL was achieved and surgical complications did not adversely affect SF-36 and POMS scores.

Many changes have been made in sensor fields which are different for different applications and there are many more which are under development. It is under research to develop sensor nodes which utilize low power and are of low cost. In this paper we have overviewed different data centric protocols and their up gradation. After this there is comparison in some of the latest data centric protocols on different performance metrics that affect the application or wireless sensor network.