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Objectives: To determine the frequency of pre-hospital aspirin use in patients presenting with ST- segment elevation myocardial infarction and to assess the demographic and clinical characteristics of the patients taken pre-hospital aspirin. Methodology: It was a prospective study conducted at tertiary care hospital for the duration of six months. About 657 patients aged between 18-80 years, of either gender and diagnosed with ST-elevation myocardial infraction were included in the study. Use of pre-hospital aspirin after symptoms was assessed in all patients, then followed and outcomes such as discharge status and length of hospital in days were evaluated. Results: Overall mean age was 54.60±12.06 years and most of them were males (79.1%). About 254 patients (38.7%) received aspirin before transfer to hospital and 403 patients (61.3%) received aspirin after arrival in hospital. Frequency of pre-hospital use of aspirin was significantly associated with gender (p=0.001), educational status (p=0.006), and monthly income (p=0.003). The mean rank of length of hospital stay was similar significantly lower in STEMI patients who received pre-hospital aspirin as compared to those who did not receive pre-hospital aspirin (p=0.001). Moreover, the death rate was lower in patients with pre-hospital aspirin administration as compared to those who did not receive pre-hospital aspirin (1.2%vs2%). However, the difference between pre-hospital aspirin use and discharge status was not statistically significant (p=0.434). Conclusion: Frequency of pre-hospital aspirin use was lower in patients with STEMI. Gender, educational status, and socio-economic status were the significant factors for pre-hospital aspirin use.

Objectives: Post-dilatation with non-compliant (NC) balloons is a commonly used strategy to improve inadequate stent expansion but this strategy carries an increased risk of slow flow/no-reflow (SF/NR) due to distal embolization. Therefore, our objective was to evaluate the demographic, clinical, angiographic, and procedure characteristics among patients undergoing primary percutaneous coronary intervention (PCI) who developed slow flow/no-reflow (SF/NR) after post-dilatation with non-compliant (NC) balloons. Methodology: In this cross-sectional observational study, we included consecutive patients with SF/NR after post-dilatation using NC balloon post stent deployment during primary PCI. The demographic, clinical, angiographic, and procedure characteristics were evaluated. Results: In the sample of 107 patients, male were 77.6% (83) and mean age was 56.94 ± 10.47 years. The median chest pain to ER (emergency room) arrival time was 292 [180-394] minutes. A majority of the patients (66.4%) had multi-vessel disease. Mean length NC balloon was 10.57±1.98 mm and diameter was 3.5±0.26 mm. The mean number of inflation were 3.62±1.08, at mean maximal pressure of 20.43±2.49 mmHg, proximal edge pressure of 19.25±2.74 mmHg, and distal edge pressure of 14.64±2.01 mmHg. A total of 5.6% (6) patients developed adverse events and final TIMI (thrombolysis in myocardial infarction) III flow was achieved in 89.7% (96) of the patients. Conclusion: SF/NR after post-dilatation during primary PCI is associated with a significant rate of adverse events and sub-optimal (

The level of uric acid level in blood is maintained by hepatic production and renal excretion. Hyperuricemia is caused by a decrease in urate excretion. Manyconditions like obesity, high cholesterol, and insulin resistance are disorders of the metabolic syndrome that are related to hyperuricemia. It occurs due to an increase in production and decrease in its excretion of urea due to renal failure which leads to further complications. The aim of study was to correlate the body weight with hyperuricemia. A cross-sectional study was conducted from September 2021 to March 2022. The total number of collected samples were 272 from patients visiting Umer Clinical Lab, Kot Adu, Pakistan and subjected for uric acid results under Microlab 300 in laboratory. Body Mass Index was calculated by measuring the weight and height. Total 272 individuals were included in this study among them, 131 (48%) were female and 141 (52%) were male. Body mass index of 272 individuals involved in this study was calculated. Out of 272 individuals, 4.04% were underweight, 32.72% were normal, 33.82% were overweight and 29.41% were obese. Serum uric acid levels were measured in 131 females and out of them 3.82% had hypouricemia, 85.50% had normal uric acid level and 10.69% had hyperuricemia. The serum uric acid levels in 141 males were measured and out of 141 males, 10.64% had hypouricemia, 82.98% had normal uric acid levels and 6.38% had hyperuricemia. Hyperuricemia in age group 41 to 60 years of both male and female were 2.84% and 6.11%, respectively. Serum uric acid levels were elevated in overweight and obese patients as compared to those who had normal weight and underweight. The majority of the participants of the study had normal weight. However, uric levels were independently associated with gender.

Objectives: Gender has been reported to be an independent predictor of stent thrombosis (ST), however, very limited data are available regarding gender disparities in the incidence of ST after primary percutaneous coronary intervention (PCI). Therefore, the objective of this study was to compare the incidence of ST among males and females after primary PCI. Methodology: In this study, we included consecutive patients diagnosed with ST-elevation myocardial infarction undergoing primary PCI. The incidence of ST and short-term major adverse cardiovascular events (MACE) were compared between male and female cohorts. Results: The gender distribution was 21% (368) female and 79% (1388) male patients. In the unmatched cohorts of females and males, the incidence of ST was 3.3% (12) vs. 5.3% (74); p=0.102, respectively. Short-term all-cause mortality rate was 12.2% (45) vs. 8.6% (119); p=0.032 among female and male patients, respectively. After propensity matching of the baseline characteristics, the incidence of stent thrombosis was 3.3% (12) vs. 4.9% (18); p=0.263 among females and male counterparts, respectively. The short-term all-cause mortality rate was 12.2% (45) vs. 10.6% (39); p=0.487 among female and propensity-matched male cohorts, respectively. Conclusion: There are no gender-based disparities in the incidence of ST as well as short-term MACE after primary PCI. The gender of the patient itself does not determine the prognosis of the patient, but longer ischemic time, older age, and consequently higher burden of risk factors confound the effect of the female gender.

Objective: To determine the frequency of ventricular septal rupture in patients of acute myocardial infarction presented at the adult cardiology department of National Institute of Cardiovascular Disease (NICVD), Karachi. Methods: A cross-sectional study was conducted at the National Institute of Cardiovascular Disease, Karachi, Pakistan for a period of six months. A total of 384 patients with acute myocardial Infarction diagnosed within 4 weeks duration were included in this study. ECG and transthoracic echocardiogram (TTE) was formed. Patients were followed for 7 days and the study outcome. Data was collected on a pre-designed structured questionnaire. Results: The average age of the patients was 54.40±7.99 years. Frequency of ventricular septal rupture in patients of acute myocardial infarction was observed in 1.3% (5/384) in which defect in Inter ventricular septum was observed in 60%, Evidence of left-to-right shunt 40%. Conclusion: Our study revealed a ventricular septal rupture (VSR) rate of 1.3%. The study further revealed a correlation between smoking and rate of VSR.A multidisciplinary team of researchers must work together to develop a plan that is specific to each patient.

Objective: To determine the frequency of anemia among the patients presented with myocardial infarction (MI) at a tertiary care hospital of Karachi, Pakistan. Study Design: A cross-sectional study. Place and Duration: Adult Cardiology Department of National Institute of Cardiovascular Disease (NICVD), Karachi from February 2022 to July 2022. Methodology: A total of 253 patients diagnosed with MI were included. Demographic and clinical characteristics of the patients were recorded. Hemoglobin level was obtained at the time of admission. Results: In a total of 253 patients, the mean age was 54.36±8.21 years. There were 187 (73.9%) male and 66 (26.1%) female. Frequency of anemia among the patients presented with myocardial infarction was found to be in 72 (28.5%). Frequency of anemia among patients presenting with MI was noted. Practical Implications: Anemia in myocardial infarction patients has affected the patency of vessel so this single most essentially and easily treatable component should be corrected in these patients.. Conclusion: High prevalence of anemia in patients presenting with MI was noted. Keywords: Anemia, hemoglobin, ischemic heart disease, myocardial infarction

Background: The metabolic syndrome is linked to several conventional and rising pro-thrombotic and pro-inflammatory cardiac risks. Most patients with cardiovascular disease have metabolic syndrome; however, the occurrence and connection of its various elements aren't obvious. There isn't any research regarding the occurrence of Metabolic Syndrome in young patients with acute STEMI. Objective: The purpose of this study was to figure out the occurrence of metabolic syndrome (MS) in young patients shown ST-Elevation Myocardial Infarction (STEMI) at a tertiary care hospital in Karachi, Pakistan. Material and Methods: The research was conducted on 170 patients with STEMI. Body mass index was measured. Smoking level, metabolic syndrome (MS), and aspects of the metabolic syndrome (BMI >23 kg meter per square, high blood pressure, hypertriglyceridemia, low-plasma HDLc, and affected fasting plasma glucose) were noted. Descriptive statistics were used, and stratification was done in the study. Fisher exact test and post-stratification by square test were used during the research study. P-value ≤0.05 was regarded as significant. Results: There were 42.2% women and 57.6% men with a mean age of 29.84±7.96 years. Metabolic syndrome (MS) was positive in 64.7 per cent of sufferers. BMI >23 kg meter per square was noticed in 97.1 per cent of patients. High blood pressure in 72.4 per cent of patients. Hypertriglyceridemia in 77.65 per cent of patients, Low plasma HDLc in 44.1 per cent of individuals, and affected fasting plasma glucose in 47.1 per cent of patients. Conclusion: It had been determined by research findings that the occurrence of metabolic syndrome in young patients having STEMI was higher. The common element was BMI >23 kg/m2, Hypertension, and Hypertriglyceridemia. Keywords: Prevalence, Young Patients, Metabolic Syndrome (MS), STEMI, Aspects of MS

Flexible graphene oxide (GO) microsheets with attached positively charged polymers, termed GOX microsheets, are efficient at bacterial adsorption, as they bind electrostatically to bacterial membranes��� negative surface charge. The authors explore an antimicrobial water filter application for GOX's extremely high surface area and its previously described efficient bacterial adsorption.Cellulose-fiber carrier material is functionalized with GOX microsheets to create an adsorption-based bacteria filtration material. The morphology and charge density (7.8 �� 1019 g���1) of the prepared GOX fibers are determined by scanning electron microscopy and dye adsorption assay, and widefield fluorescence microscopy is used to visualize the adsorption of stained Escherichia coli bacterial cells on the fibers. GOX fibers are tested in filtration setups to investigate their bacteria removal performance. The experimental results, with 100 mg of GOX fibers filtering 2.4 �� 109 colony-forming units (CFU) from an E. coli bacterial culture with 99.5% bacterial reduction, demonstrate the fibers��� high bacteria loading capacity. The electrostatic adsorption-based filtration mechanism allows the filter to be operated at higher flow rates than micropore membrane filters, while maintaining 3-log bacterial reduction. GOX filter materials removing bacteria via adsorption are a high flow rate alternative to current water filtration processes that rely on size-exclusion.

In this paper, we investigate an automatic repeat request (ARQ) for reliable transmission over half-duplex links. We design a method based on grouped packet coding (GPC) that combines a stop-and-wait (S&W) ARQ procedure with random linear packet coding and selective acknowledgments applied to groups of coded packets. Our goal in doing so is to boost the throughput efficiency on poor-quality links with long delay. Such links are notably encountered in underwater acoustic channels, where the bit error rate may be as high as $10^{-3}$ and round-trip delays can be measured in thousands of bits. To quantify the benefits of the proposed S&W-GPC method, we evaluate its throughput efficiency analytically and compare it with the throughput efficiency of standard S&W methods, as well as the benchmark efficiency of full-duplex methods. Our results show that S&W-GPC outperforms all other techniques on half-duplex links with long delay, as well as rateless packet coding on full-duplex links with long delay. We present results for a point-to-point link, as well as for a multicast network. In addition to the performance analysis, we offer guidelines for an optimal system design, which involves a judicious choice of the packet size, packet coding, and grouping parameters.

A hybrid Highly elliptical orbit (HEO)-based regional navigation system is optimized by examining the impact of variation of orbital parameters on navigation performance of the system. The principle of optimization is based on the following requirements: L and S band carrier frequency (user/receiver segment) link budget, satellite accessibility and dwell time over the area of interest, geometric configuration of the system, navigation accuracy, and constellation stability. The optimization algorithm is partnered with a dynamic simulation process. The optimal parameters (semi-major axis, inclination, eccentricity, right ascension of ascending node, etc.) of the HEO-based regional navigation system have been selected based on the results of the optimization process. The proposed hybrid system with four HEO and one geostationary earth orbit (GEO) satellite is a cost-efficient and high-accuracy navigation solution as compared with other regional systems.

Search of new strategies for the inhibition of respiratory viruses is one of the urgent health challenges worldwide, as most of the current therapeutic agents and treatments are inefficient. Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has caused a pandemic and has taken lives of approximately two million people to date. Even though various vaccines are currently under development, virus, and especially its spike glycoprotein can mutate, which highlights a need for a broad‐spectrum inhibitor. In this work, inhibition of SARS‐CoV‐2 by graphene platforms with precise dual sulfate/alkyl functionalities is investigated. A series of graphene derivatives with different lengths of aliphatic chains is synthesized and is investigated for their ability to inhibit SARS‐CoV‐2 and feline coronavirus. Graphene derivatives with long alkyl chains (>C9) inhibit coronavirus replication by virtue of disrupting viral envelope. The ability of these graphene platforms to rupture viruses is visualized by atomic force microscopy and cryogenic electron microscopy. A large concentration window (10 to 100‐fold) where graphene platforms display strongly antiviral activity against native SARS‐CoV‐2 without significant toxicity against human cells is found. In this concentration range, the synthesized graphene platforms inhibit the infection of enveloped viruses efficiently, opening new therapeutic and metaphylactic avenues against SARS‐CoV‐2., Present work shows that both electrostatic and hydrophobic interactions play a key role at the graphene/coronavirus interfaces and such materials can efficiently protect cells from coronavirus infections. While electrostatic interactions are responsible for the capturing of viruses, hydrophobic long alkyl chains can disrupt the envelop of the captured virions via hydrophobic interactions leading to a dual effect.

In this study, a review of research literature has been carried out to investigate Hybrid Time and wavelength Division Multiplexing techniques with respect to reach, split ratio, and speed of the network. This was done to overcome challenges presented by Passive Optical Networks, such as the reach and the high split ratio. A comparison of different methods clarifies that Hybrid PassiveOptical Networks have a high power-budget that ensure efficient signal transmission. The Optisys software has been used to analyze the performance of the different techniques.

Multi-drug resistant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) cause nosocomial infections that can have deleterious effects on human health. Thus, it is imperative to find solutions to treat these detrimental infections as well as to control their spread. We tested the effect of two different antimicrobial materials, functionalised graphene oxide (GOX), and AGXX® coated on cellulose fibres, on the growth and transcriptome of the clinical MRSA strain S. aureus 04-02981. In addition, we investigated the effect of a third material as a combination of GOX and AGXX® fibres on S. aureus 04-02981. Standard plate count assay revealed that the combination of fibres, GOX-AGXX® inhibited the growth of S. aureus 04-02981 by 99.98%. To assess the effect of these antimicrobials on the transcriptome of our strain, cultures of S. aureus 04-02981 were incubated with GOX, AGXX®, or GOX-AGXX® fibres for different time periods and then subjected to RNA-sequencing. Uncoated cellulose fibres were used as a negative control. The antimicrobial fibres had a huge impact on the transcriptome of S. aureus 04-02981 affecting the expression of 2650 genes. Primarily genes related to biofilm formation and virulence (such as agr, sarA, and those of the two-component system SaeRS), and genes crucial for survival in biofilms (like arginine metabolism arc genes) were repressed. In contrast, the expression of siderophore biosynthesis genes (sbn) was induced, a probable response to stress imposed by the antimicrobials and the conditions of iron-deficiency. Genes associated with potassium transport, intracellular survival and pathogenesis (kdp) were also differentially expressed. Our data suggest that the combination of GOX and AGXX® acts as an efficient antimicrobial against S. aureus 04-02981. Thus, these materials are potential candidates for applications in antimicrobial surface coatings.

Two novel antimicrobial surface coatings were assessed for their lasting antibacterial effect under simulated space conditions during the SIRIUS-19 study. Because long-term space travel can affect the human immune system, astronauts are particularly susceptible to infectious disease. Moreover, the space flight environment can alter the composition of microbial communities within the spacecraft and increase bacterial virulence and resistance to antibiotics. In addition to protecting the crew from infection by human pathogens, prevention and elimination of bacterial contamination is important to avoid corrosion and damage of the technical equipment. The antimicrobial coating AGXX(R)consists of micro-galvanic cells composed of silver and ruthenium which damage bacterial cells through the release of reactive oxygen species. Over the last years, several studies on the antimicrobial effect of AGXX(R)have demonstrated an effective inhibition of growth and even complete elimination of many pathogenic bacteria - including multiresistant microorganisms - as well as their biofilms. The second antimicrobial coating, GOX, consists of chemically modified graphene oxide. Through a positive surface charge and its flexible scaffold, GOX can multivalently bind and immobilize bacteria via electrostatic attraction. Here, AGXX(R)and GOX were applied to non-metallic carriers not previously tested. The antimicrobial coated materials, as well as uncoated control samples, were exposed in the SIRIUS artificial space module and analyzed at different time points during the 4-months isolation study. Survival and growth of airborne heterotrophic, aerobic bacteria on the surfaces were assessed by cultivation-based methods, employing growth conditions suitable for potential human pathogens. Human-associated, biofilm-forming Staphylococcus spp. (S. hominis, S. haemolyticus, and S. epidermidis) strongly dominated at all time points, most were resistant against erythromycin, kanamycin, and ampicillin. AGXX(R)coatings completely inhibited growth of these opportunistic pathogens on all tested surface materials. Particularly, AGXX(R)-cellulose fleece achieved a clear reduction in bacterial load able to recover post contact. GOX-cellulose fleece effectively immobilized bacteria. Sequence analysis of 16S rRNA gene amplicons revealed that the isolated Staphylococcus spp. did not dominate the overall bacterial community, accounting for only 0.1-0.4% of all sequences. Instead, molecular data revealed Lactobacillus, Comamonas, Pseudomonas, Sporosarcina, and Bacillusas the dominant genera across all samples and time points.

Current navigation satellite systems (Global Positioning System (GPS), GLObal'naya NAvigatsionnaya Sputnikovaya Sistema (GLONASS) and BeiDou-2) have enabled quality of life improvements on a global scale. The applications include in the fields of transportation, military, aviation and security etc. Annual business market value of Global Navigation Satellite System user equipment and related components has been estimated at billions of US dollars. To reap the benefits maximally, various countries are developing their Regional Navigation Satellite Systems (RNSSs). Independent RNSS guarantees uninterrupted and reliable services with an advantage of the customised coverage. This study presents the design of two constellation models, including a Highly Elliptical Orbit/Geostationary Orbit (HEO/GEO) and a Geostationary Orbit/Inclined Geosynchronous (GEO/IGS) constellation for Pakistan's regional navigation system. The performance analysis of the navigation ability of designed constellations is carried out by analysing various parameters such as number of satellites, Dilution of Precision and navigation accuracy in a constrained environment and comparing these parameters with the GPS using dynamic simulations. Navigation link budget of both constellations is theoretically calculated, verified and compared with that of the GPS. Parametric analysis proposes that HEO/GEO and GEO/IGS orbit-based constellations can be adopted as replacement of the GPS for independent navigation within Pakistan.

Rally vehicle dynamics design is a quintessential part of motorsports in today’s do-it-yourself world. An aspiring hobbyist aims to design and implement a robust build which is simulated initially using software tools and furthermore, developed as a large-scale manufacturable product. This report aims to discuss the ABC’s of a professional vehicle build which incorporates the use of all the aforementioned features of development. Consequently, the final build is an integration of many modern and futuristic features and hacks that are supposedly a niche requirement in today’s automobile industry. The features highlight the modifications and improvements to the essential sub-systems of a typical commercial vehicle. Subsequently, the vehicle can then be used in rallying, off-roading and as a means of transportation in rugged and tough terrains.This report elaborates a basic proof of concept of the features thereby implementable, a design summary of the wholistic build of such a vehicle, the adaptations performed and a conceptual generalized calculation that can be implemented on any generic vehicle. Some of the features elaborated are: On- demand drive change mechanism, Independent wheel braking system, An Onboard diagnostics tool which is configurable to any required engine specification and a contrast of independent and partially dependent suspension.

We consider random linear packet coding for fading channels with long propagation delays, such as underwater acoustic channels. We propose a scheme in which the number of coded packets to transmit is determined to achieve a prespecified outage/reliability criterion and investigate joint power and rate control with constrained resources. Using the channel state information that is obtained via feedback from the receiver, the transmitter adjusts its power and the number of coded packets so that the average energy per successfully transmitted bit of information is minimized. Two optimization constraints are imposed: 1) the transmit power should not exceed a maximum level; and 2) the number of coded packets should not exceed a maximum value dictated by the desired throughput and delay. We further extend the results to take into account the effect of inevitable channel estimation errors, and consider the case in which the transmitter has only an estimate of the channel gain. We design adaptation policies for such a case based on minimum mean square error (MMSE) channel estimation, taking into account the effect of channel estimation errors in an optimal manner to satisfy the required outage/reliability criterion. Finally, we compare the proposed technique to standard automatic repeat request (ARQ) protocols for underwater communications in terms of the throughput efficiency. Analytical results show that substantial energy savings and improvements in throughput efficiency are available from adaptive power/rate control. We also present experimental results obtained using channel gains measured during the Surface Process Acoustic Communication Experiment (SPACE-08), an at-sea underwater experiment conducted off the coast of Martha's Vineyard in fall 2008.

Aiming at the overall negative surface charge of bacteria, a new strategy of antibacterial agents based on large polymer-modified graphene oxide (GO) sheets is assessed. The presented flexible, polycationic Sheets match the size and charge density of the Escherichia coli surface charge density (2 × 1014 cm−2). These matching parameters create an unspecific but very strong bacteria adsorber by multivalent, electrostatic attraction. Their interaction with bacteria is visualized via atomic force and confocal microscopy and shows that they effectively bind and wrap around E. coli cells, and thereby immobilize them. The incubation of Gram-negative and -positive bacteria (E. coli and methicillin-resistant Staphylococcus aureus, MRSA) with these polycationic sheets leads to the inhibition of proliferation and a reduction of the colony forming bacteria over time. This new type of antibacterial agent acts in a different mode of Action than classical biocides and could potentially be employed in medicinal, technical, or agriculture applications. The presented microsheets and their unspecific binding of cell interfaces could further be employed as adsorber material for bacterial filtration or immobilization for imaging, analysis, or sensor technologies.

Organizations flourish with a satisfied workforce. There is little known information on demographic characteristics and motivators for job satisfaction among Pakistani postgraduate trainees in surgery. Job satisfaction is predicted by intrinsic motivators (personal growth and perceived ability to work) and extrinsic motivators (perceived social support). Work family interference/enhancement and job stressors (workload and long working hours) also impacts job satisfaction; predicting overall life satisfaction. This study aims at examining life satisfaction predicted by personal and professional characteristics..The postgraduate trainees in the public and private hospitals of Rawalpindi and Islamabad were surveyed using validated measures of life satisfaction, personal growth, perceived social support, perceived ability to work, work family interference/enhancement, job stressors, co-workers support, supervisors support, and job satisfaction from September 15 to December 28, 2017.Personal growth, perceived ability to work, availability of social support, and work family enhancement positively correlate to job and life satisfaction. Work life interference and job stressors negatively relate to job and life satisfaction. Job satisfaction is also partially mediated by intrinsic and extrinsic motivators on life satisfaction, whereas job stressors weakened the relationship between job satisfaction and life satisfaction. Long working hours is negatively related to job satisfaction and life satisfaction.Life satisfaction is predicted by job satisfaction that is characterized intrinsic and extrinsic motivators. Healthcare organizations face challenge of providing reduced working hours, increased salaries, supportive working environment, and increased supervision to enhance the job satisfaction of employees and to improve the functioning of the healthcare environment.

In article number 2007091, Ievgen S Donskyi, Chuanxiong Nie, Kai Ludwig, Jakob Trimpert, and co-workers report an idea of designing a graphene-based nanostructure that can rupture corona virions This study shows that a combination of two different mechanisms at nanobiointerfaces by manipulation of the functionality of nanoplatform is an efficient way to control and accelerate biointeractions and to produce new vectors for future antiviral applications

Background: Many herbs and plant products have been claimed to have a significant analgesic action. However, not much work has been reported on the pharmacological evaluation of such plant-based products for the analgesic effects claimed in traditional medicine. Aim and Objective: The study aimed to assess the analgesic potential of the aqueous extract of Nigella sativa Linn (NSL) in albino rats by the hot plate and tail-flick method and to compare it with the standard drug indomethacin. Materials and Methods: Four groups of randomly divided albino rats were made. Group 1 was given oral normal saline (0.1 mg/kg) (control group). Group 2 was given indomethacin 25 mg/kg orally (standard group). Groups 3 and 4 (test groups) were administered NSL 300 mg/kg body weight (BW) and 600 mg/kg BW orally, respectively. The hot plate and tail-flick method were used to screen for analgesic potential. Results: Our study revealed a uniform increase in reaction time in both test groups which received NSL. Maximum analgesic activity was noted at 120 min. NSL has good analgesic activity in comparison with the control. However, indomethacin has significantly better activity than NSL at both doses. NSL at 600 mg/kg BW has analgesic activity comparable to indomethacin only at 20 min. Conclusion: NSL has analgesic potential, but comparatively, indomethacin is a more potent analgesic drug.

Background: The purpose of teaching is to facilitate effective learning. The commonly used instructional methods in pharmacology include lectures, case studies or clinical pharmacology problems, practicals, and tutorials. The aim of this study was to determine the perceptions and experiences of second-year MBBS students towards tutorials in pharmacology. Methods: This cross-sectional study was carried out by the department of pharmacology at Kamineni Academy of Medical Sciences and Research Centre (KAMSRC), Hyderabad, Telangana, India. A total of 120 second-year MBBS students were interviewed with a structured questionnaire on tutorials. Responses to questions were expressed as percentage (%) of the total number of participants. Results: 88% of the learners admitted that it was necessary to have tutorials and only 57% accepted for it to be made mandatory. On being questioned to mention reasons for not attending tutorials, 58% stated that they were not prepared and lazy and 22% learners were afraid of individual questioning. 80% suggested that the teacher and students should mutually decide the topic for tutorials. When asked about the environment during the tutorials, 48% students pointed out that only a few students dominated the tutorials. However, 34% considered that the atmosphere was friendly. On being enquired upon how the tutorial was conducted, 83% noticed that both the teacher and students participated during the tutorial session. Conclusions: The suggestions based on feedback from learners, should be kept in mind while conducting tutorials to make it fruitful experience for MBBS students.

There is a limited data on the association between serum uric acid (SUA) and cardiovascular disease (CVD) among the very elderly population.We evaluated the association of SUA, highly sensitive C-reactive protein (hs-CRP, a marker of vascular and systemic inflammation), and coronary artery calcification (CAC, a marker of subclinical CVD) in a cohort of Brazilian octogenarians (≥80 years) free from known clinical CVD.208 individuals were included and evaluated for an association between increasing tertiles of SUA, elevated hs-CRP (3 mg/dL), the presence and burden of CAC (CAC 0 and CAC 400).The median hs-CRP was 1.9 (IQR = 1.0-3.4) mg/L and mean SUA was 5.3 (±1.4) mg/dL. The overall prevalence of elevated hs-CRP (3 mg/dL) was 31 %. A significant increase in the prevalence of hs-CRP was noted across the higher SUA tertiles (p 0.001) with 3.4 times the odds of having elevated hs-CRP in the highest SUA tertile (3.40; CI = 1.27-9.08). No association was noted with either the CAC presence and/or CAC burden (CAC 0 or CAC 400) across the increasing SUA tertiles.In the healthy octogenarians, higher SUA levels are associated with vascular inflammation (hs-CRP) but not with coronary atherosclerosis (CAC); markers for the subclinical CVD.

CONTEXT: Pharmacology is one of the most fundamental subjects in the field of medicine and a good grasp of this subject is vital for any clinical practitioner. The teaching of pharmacology in medical and dental colleges of India has evolved from mere didactic lectures to audio-visual aid based lectures and computer based learning. Evolution of teaching methods is an on- going process and a docent needs proper feedback from the pupils regarding their opinion on what is satisfactory and what needs improvement. AIMS: By way of this survey-based study we aim to grasp the MBBS and BDS students' opinion regarding the teaching practices in pharmacology and changes recommended for the betterment of the same. METHODS AND MATERIALS: After obtaining due approval of the Institutional Ethics Committee, the study was conducted amongst 2nd year exam going MBBS and BDS students of M R Medical College and S Nijalingappa Dental College, Gulbarga, Karnataka in the Department of Pharmacology M R Medical College. An exhaustive questionnaire based survey was prepared of 17 questions with choices ranging from 3-8 different options. RESULTS AND CONCLUSION: The result of our study favours the need for pharmacology as a subject to be more clinically oriented as well as being technologically sound. The students overall have a positive outlook of pharmacology (53%) and consider lectures as the most appropriate and helpful teaching method (62%). Introduction of group discussion is one change that is warranted by students overwhelmingly (41%), followed by introduction of clinical pharmacology exercises (31%). A vast majority of the students (70%) found the lectures in pharmacology to be interesting and want them to be more clinically oriented. The importance of pharmacology in clinical decision making is well understood by the majority of students and they aim to act in that behest. Also, we find that computer based learning is a new and important tool coming up in the arsenal of the pharmacology teacher.

The WHO in 1977 provided the proper definition of drug utilization. It has been defined as the marketing, distribution, prescription and use of drugs in society with special emphasis on the resulting medical and social consequences. Antibiotics are a commonly prescribed group of drugs and the problem of their overuse is a global phenomenon. Studies from India have shown that the use of antimicrobial agents varies from 24 to 67 percent. Primary Health care is integral part of any country's health care delivery system, its importance is vital when considered for the developing countries. AIMS: To evaluate prescription pattern and criteria for selection of antimicrobial agents (AMAs) in Primary Health Centre and to analyze rationality among the prescriptions. To monitor Adverse Drug Reactions (ADRs) encountered during the course of the study. METHODS AND MATERIALS: This prospective, observational and analytical study was done to assess the pattern of antimicrobial agent (AMA) use in patients attending Mahagaon Primary Health Centre (PHC) in Gulbarga district, Karnataka. The reason for AMA use, criteria for selection, AMA susceptibility, efficacy and tolerability of AMAs and treatment outcome of AMAs were evaluated. Patients receiving AMA therapy of either gender, of any age, seeking out-patient treatment from Mahagaon PHC, were included in this study. The study was carried out between March, 2014 and May, 2014 (3 months). Three hundred (300) consecutive patients receiving AMAs, were included in the study. RESULTS AND CONCLUSION: The results indicate that a satisfactory standard has been maintained in several areas in the studied PHC. Even more judicious use of antibiotics is recommended and specific therapy should be promoted over empirical therapy.

CONTEXT: Adverse Drug Reactions (ADRs) are a growing problem throughout the world causing significant patient morbidity and mortality, therefore, its monitoring has become exceedingly important in today's practice of medicine. In a country with limited medical and financial resources such as ours, eliminating or even reducing this potential source of morbidity and mortality is a worthy challenge. The primary source of information for pharmacovigilance is from spontaneous reporting by health care professionals. Spontaneous reporting of ADRs has played a major role in the detection of unsuspected, serious and unusual ADRs previously undetected during the clinical trial phases. The Pharmacovigilance Program of Indian (PvPI) was started with an aim of generation of ADR database in the Indian population subset. One of the major hurdles faced by PvPI was the under- reporting of ADRs. India, with its sizeable population and varied diseases and treatments, is still not a major contributor to the international ADR database. AIMS: The aim of our study is to deduce by a survey the knowledge, attitude and practice of pharmacovigilance amongst the various cadres of medical healthcare professionals (interns, postgraduate students and teaching faculty) in a tertiary care hospital. As spontaneous reporting forms the backbone of pharmacovigilance, especially in developing countries like India which lack a more structured approach, proper training in the know- hows of ADR reporting is mandatory for the healthcare professionals at the grass root level. We intend to investigate whether our healthcare professionals are inclined to, and are properly equipped to spontaneously and properly report ADRs. METHODS AND MATERIALS: This questionnaire based survey was conducted in Basaveshwar Teaching and General Hospital (BTGH), attached to M.R Medical College, Gulbarga, Karnataka. The study was conducted in the month of March-April 2014 on a total of one hundred (100) participants, comprising of interns, postgraduate students and teaching faculty of various clinical departments of BTGH. The study instrument was a pre designed questionnaire which was structured to obtain information on the knowledge of the ADRs reporting, the attitudes towards the reporting, and the factors that in practice could hinder the reporting among the doctors. RESULTS AND CONCLUSION: Our study revealed that the doctors in this tertiary care hospital were inadequately aware about the aim and methods of pharmacovigilance. Moreover, the primary tool of pharmacovigilance, that is spontaneous ADR reporting, was poorly understood by a vast majority of the participants. The International landscape of pharmacovigilance has changed from "reactive" nature, where it looked into safety as a mere regulatory requirement, to a more "proactive" approach which helps get safer drugs in the market.

Cataloged from PDF version of article. In this paper, we explore design aspects of adaptive modulation based on orthogonal frequency-division multiplexing (OFDM) for underwater acoustic (UWA) communications, and study its performance using real-time at-sea experiments. Our design criterion is to maximize the system throughput under a target average bit error rate (BER). We consider two different schemes based on the level of adaptivity: in the first scheme, only the modulation levels are adjusted while the power is allocated uniformly across the subcarriers, whereas in the second scheme, both the modulation levels and the power are adjusted adaptively. For both schemes we linearly predict the channel one travel time ahead so as to improve the performance in the presence of a long propagation delay. The system design assumes a feedback link from the receiver that is exploited in two forms: one that conveys the modulation alphabet and quantized power levels to be used for each subcarrier, and the other that conveys a quantized estimate of the sparse channel impulse response. The second approach is shown to be advantageous, as it requires significantly fewer feedback bits for the same system throughput. The effectiveness of the proposed adaptive schemes is demonstrated using computer simulations, real channel measurements recorded in shallow water off the western coast of Kauai, HI, USA, in June 2008, and real-time at-sea experiments conducted at the same location in July 2011. We note that this is the first paper that presents adaptive modulation results for UWA links with real-time at-sea experiments. © 2013 IEEE.