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Objectives: The objective of the current study was to determine the frequency of anxiety and depression among patients diagnosed with acute coronary syndrome (ACS) at a tertiary care cardiac center in Pakistan. Methodology: This cross-sectional study was conducted at a tertiary care cardiac center in Pakistan from May to November 2019. We included patients of either gender, between 30 and 70 years of age, diagnosed with ACS, and presented within 72 hours of onset of symptoms. After the standard treatment of the condition, the Beck Depression Inventory Scale (BDI) and Beck Anxiety Inventory (BAI) were used to assess post-AMI depression and anxiety. The BDI =17 was categorized as depression and BAI =11 was taken as anxiety. Results: In the selected sample of 122 patients, the mean age was 58.7 ± 10.2 years and 88 (72.1%) patients were male. Diabetes mellitus was detected in 76 (62.3%) patients and 64 (52.5%) patients were smokers. The mean BDI score was 28.6 ± 6.5 and mean BAI score was 19.5 ± 5.1. Anxiety and depression were observed in 36 (29.5%) and 51 (41.8%) patients, respectively. Conclusion: Depression and anxiety are a common remnants of ACS, hence, in our day to day clinical practice, appropriate consideration should be given to the psychological wellbeing of patients in addition to the management of ACS. [ABSTRACT FROM AUTHOR]

Objectives: To determine the frequency of Acute Mitral Regurgitation in Post Percutaneous Transvenous Mitral Commissurotomy (PTMC) patients with severe mitral stenosis (MS). Methodology: A cross-sectional study was conducted at the Tabba Heart Institute, Karachi, Pakistan between September 2019 and April 2021. All patients irrespective of gender, aged between 19-80 years, and those who did not undergo PTMC were eligible to partake in the study. Patients with mitral regurgitation along with mitral stenosis, or those with clot in left atrium, or those suffering with the last stage of renal disease were excluded from the study. A predefined Proforma was used as a research instrument through which medical records of patients of PTMC are collected. The variables of the Proforma include patient's age, name, sex, echo findings, treatment procedure, post-procedure data and complications. Results: A mean age of 40.6 ± 12.63 years was reported. 86 (81.9%) of the patients developed 'no complications', 15 (14.3%) of the PTMC patients suffered from 'severe mitral regurgitation', 2 (1.9%) had local hematoma, and one patient had a cardiac tamponade after the procedure. Only one patient died post-procedure. Post-stratification analysis showed that the majority of the female patients and 83% of the patients with no previous commissurotomy history did not have any complications. While a total of 14.7% who had no history of previous commissurotomy suffered from severe MR. Conclusion: Our study revealed that only a small number of patients who underwent PTMC suffered from severe mitral regurgitation. Overall, the procedure is safe with a good outcome. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess breastfeeding support provided to urban working doctor mothers at their workplace. METHODS: This cross-sectional study was carried out among four tertiary level urban hospitals of Pakistan, between January-June 2017. Through random sampling, 215 working female doctors who were breastfeeding (3-24 months) were included. Data was collected using structured questionnaire based upon "World Alliance for Breastfeeding in Action" guidelines. The data was analyzed using SPSS software version 24. Breastfeeding facilities at workplaces were taken as outcome variables. RESULTS: Among non-physical facilities, 89% of the doctor mothers received at least 03 months fully paid maternity-leave, 15% received enough breastfeeding breaks, and almost 12% of the mothers were offered flexible-job and information with regards to breastfeeding support options at workplace (hospitals). Regarding physical facilities, breastfeeding corner and onsite nursery for childcare was accessible to 5% and 2.3% of doctor mothers. However, none of the hospitals supported mothers with refrigerator for storing mother's milk and breast milk pump. Additionally, statistically significant difference (<0.001) was observed by type of employer (government or private) breastfeeding breaks, lactation corner, and fully paid maternity leave. CONCLUSION: Enabling and supportive environment to working doctor mothers for breastfeeding at workplaces was missing in majority of the healthcare facilities. Female doctors having positive practical experience with solutions can be instrumental for their patients (working mother) in preventing early weaning. [ABSTRACT FROM AUTHOR]

Hypertrophic cardiomyopathy is a commonly occurring cardiovascular disease resulting primarily from changes in proteins participating in muscle contraction in the heart, including the cardiac actin protein. Changes in cardiac actin located exclusively in the myosin binding site are called M-class variants and include the H88Y, R95C, and E99K substitutions and F90Δ deletion. The prevailing hypothesis for these mutations is that hypertrophic cardiomyopathy is the result of increased calcium sensitivity of contraction in the myocardium. To test this hypothesis, we studied the activity of myosin at varying calcium concentrations in the presence of regulated thin filaments containing M-class cardiac actin variants. We found that all M-class cardiac actin variants exhibit increased calcium sensitivity, with the R95C variant also displaying significant decreases in maximal myosin activity. This work represents the first characterization of all M-class variant proteins and suggests that drugs targeting contraction specifically to treat hypertrophic cardiomyopathy must consider the impact on both calcium sensitivity and maximal myosin activity on overall heart health. • We show the first direct comparison of M-class cardiac actin variant calcium sensitivity in regulated thin filaments. • All M-class cardiac actin variants exhibited increased calcium sensitivity. • Increased calcium sensitivity may be a common mechanism for disease development for M-class variants. [ABSTRACT FROM AUTHOR]

The tradition of fastening planked boats using sewing is characteristic of the Indian Ocean region. Despite known disadvantages of sewn boats, including that perishable materials need regular maintenance and repair, operators of boats used in the sand‐mining industry of Goa still see potential in discarded sewn boats. The problems, raw materials used, technology, and process of re‐sewing and repairing these boats to give them a second life are reported and discussed here. [ABSTRACT FROM AUTHOR]

In the present article, a new adsorbent synthesized from Salvadora persica (miswak) powder with chemical activation has been applied to remove Acid Violet 17 dye from aqueous solution. Characterization of the synthesized adsorbent was carried out using the techniques of FTIR, SEM, BET, zeta potential and DLS. The effect of pH, adsorbent dose, contact time, initial dye concentration and temperature were assessed in batch operation. Maximum removal was favored at pH of 2, adsorbent dose of 2 g/L and temperature as 333 K. Chemical activation has increased surface area of raw adsorbent from 58.38 to 124.99 m2/g. Nonlinear regression has been applied for the model fitting of the experimental data. Kinetic data was well described by pseudo-second-order model. Weber-Morris model established involvement of multiple steps in governing the adsorption mechanism. Isotherm data was well described by Freundlich model. Root mean square error analysis was also applied to check the best model fitting. Maximum adsorption capacity values were obtained as 74.28 and 141.30 mg/g for raw adsorbent and activated adsorbent, respectively. Thermodynamic calculations established endothermic and feasible nature of the adsorption. The obtained removal of 97.24 ± 0.69% for simulated solution reduced to 91.17 ± 0.86% in case of real effluent containing 100 mg/L of dye solution as attributed to other compounds present in the actual industrial effluent which can compete on adsorption sites along with the targeted dye. Reusability study performed using ethanol as an eluent confirmed suitability of synthesized adsorbent for dye removal from wastewater. The obtained maximum adsorption capacity along with good reusability results depicted that activated Salvadora persica could be used as an efficient adsorbent for sequestration of Acid Violet 17 from the aqueous phase. • H 2 SO 4 activated Salvadora persica applied for treatment of synthetic and real industrial dye effluent. • Pseudo-second order model fitted well to the obtained kinetic data. • Freundlich model fitted well to the obtained isotherm data. • Maximum adsorption capacity estimated as 141.30 mg/g for activated adsorbent. • Reusability study confirmed potential of the adsorbent for Acid Violet 17 dye removal. [ABSTRACT FROM AUTHOR]

Health literacy is pre-requisite for better health outcomes. Health literacy is an unexplored concept in Pakistan. This study aimed to assess concept-based health literacy level in the adult population of Karachi. A cross-sectional survey was conducted in 2015, the respondents were recruited from three randomly selected towns of Karachi. A multistage random sampling technique was used to recruit 315 adult participants who were interviewed on validated the Health Literacy Survey Questionnaire (HLS-Asia-Q). Basic demographics, responses of each question and health literacy matrix were used to compile the results. The health literacy was limited in the majority (82.4%) of the population. Health Promotion domain scored least on the matrix (24.3±9.8) irrespective of gender, age, education, and profession. Most of the respondents (70%) faced difficulty in finding and understanding health information for their well-being. The health educators (health care professionals) can play a major role in helping to enhance the health literacy and act as an advocate for health education. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding is considered to be an important measure to achieve optimum health outcomes for children, women's return to work has frequently been found to be a main contributor to the early discontinuation of breastfeeding. The aim of the study is to assess workplace breastfeeding support provided to working mothers in Pakistan. Method: A workplace based cross-sectional survey was conducted from April through December 2014. Employers from a representative sample of 297 workplaces were interviewed on pre-tested and structured questionnaire. The response rate was 93.7 %. Prevalence of workplace breastfeeding facilities were assessed in the light of World Alliance for Breastfeeding Action (WABA) guidelines. Results: Among non-physical facilities, all workplaces offered 3 months paid maternity leave, 45 % of the sites were offering task adjustment to mothers during lactation period. Only 15 % of the sites were offering breastfeeding breaks to working mothers. Physical facilities that include a breastfeeding corner, refrigerator for storing breast milk, breast milk pump and nursery for childcare were provided in less than 7 % of the sites. Multinational organizations provided better support compared to national organizations. Conclusion: Support for continuation of breastfeeding by working women at workplaces is inadequate; hence, women discontinue breastfeeding earlier than planned. Policies need to be developed and enforced, employers and employees need to be educated and supportive environment needs to be created to encourage and facilitate breastfeeding friendly worksite environment. [ABSTRACT FROM AUTHOR]

The study of traditional boats has enhanced our knowledge of the maritime past. Traditional boats are both river- and sea-worthy. They have been used in rivers for transporting cargo to inland ports from ships anchored at sea, and have often been used in naval warfare. In this paper an attempt has been made to study the sewn-plank boats of Goa, their building techniques and other features in order to understand their quality and how they were used in the past for an inland river-transport system. © 2011 The Authors [ABSTRACT FROM AUTHOR]

Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia (ARVD) is regarded to be one of the highest common cause of death especially in athletes due to sudden cardiac arrest. Epidemiologically, 1 among 5000 populations has estimated prevalence of ARVD. ARVD clinical indications or symptoms before the age of 12 are difficult to diagnose and it is also rare to acquire ARVD symptoms after the age of 60. 34-year-old male patient with noknown co-morbid received at Emergency Department of PNS Shifa Hospital Karachi. This case report is a typical case of ARVD in stage 4 with bi ventricular involvement. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of cardiogenic shock in patients with acute non-ST-elevation myocardial infarction (NSTEMI). Study Design: Cross sectional study. Place and Duration of Study: Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Karachi Pakistan, from Apr 2018 to Oct 2019. Methodology: All patients with NSTEMI were included in the study after taking informed consent. Patients with recurrent NSTEMI or previous NSTEMI, patients with valvular heart disease or neurological problems, and those with comorbid conditions such as renal failure were excluded. All patients underwent ECG in order to assess the cardiogenic shock. Data was collected on a semi-structured questionnaire. The first part of the questionnaire consisted of demographic information such as gender, age, body weight and height, and their comorbidity status. Second part of the questionnaire assessed cardiogenic shock. Results: Mean ± SD of age was 56.9 ± 9.2 years. Out of 203 patients, 131 (64.5%) were male while 72 (35.5%) were female. Hypertension was noted in 111 (54.7%) patients. Cardiogenic shock was found to be positive in 17 (8.4%) patients while negative in 186 (91.6%). Duration of symptoms was significantly associated with the occurrence of cardiogenic shock (p=0.05). Conclusion: It is concluded that cardiogenic shock is somewhat common in NSTEMI patients. The necessity of a stroke unit is highly appreciated to increase the care and decrease morbidities and mortalities. [ABSTRACT FROM AUTHOR]

Thermal issues in microprocessors have become a major design constraint because of their adverse effects on the reliability, performance and cost of the system. This article proposes an improvement in earliest deadline first, a uni-processor scheduling algorithm, without compromising its optimality in order to reduce the thermal peaks and variations. This is done by introducing a factor of fairness to earliest deadline first algorithm, which introduces idle intervals during execution and allows uniform distribution of workload over the time. The technique notably lowers the number of context switches when compare with the previous thermal-aware scheduling algorithm based on the same amount of fairness. Although, the algorithm is proposed for uni-processor environment, it is also applicable to partitioned scheduling in multi-processor environment, which primarily converts the multi-processor scheduling problem to a set of uni-processor scheduling problem and thereafter uses a uni-processor scheduling technique for scheduling. The simulation results show that the proposed approach reduces up to 5% of the temperature peaks and variations in a uni-processor environment while reduces up to 7% and 6% of the temperature spatial gradient and the average temperature in multi-processor environment, respectively. [ABSTRACT FROM AUTHOR]