Search results for: Chaudhary Farrukh Javed
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 155

Search results for: Chaudhary Farrukh Javed

65 Association of Preoperative Pain Catastrophizing with Postoperative Pain after Lower Limb Trauma Surgery

Authors: Asish Subedi, Krishna Pokharel, Birendra Prasad Sah, Pashupati Chaudhary

Abstract:

Objectives: To evaluate an association between preoperative Nepali pain catastrophizing scale (N-PCS) scores and postoperative pain intensity and total opioid consumption. Methods: In this prospective cohort study we enrolled 135 patients with an American Society of Anaesthesiologists physical status I or II, aged between 18 and 65 years, and scheduled for surgery for lower-extremity fracture under spinal anaesthesia. Maximum postoperative pain reported during the 24 h was classified into two groups, no-mild pain group (Numeric rating scale [NRS] scores 1 to 3) and a moderate-severe pain group (NRS 4-10). The Spearman correlation coefficient was used to compare the association between the baseline N-PCS scores and outcome variables, i.e., the maximum NRS pain score and the total tramadol consumption within the first 24 h after surgery. Logistic regression models were used to identify the predictors for the intensity of postoperative pain. Results: As four patients violated the protocol, the data of 131 patients were analysed. Mean N-PCS scores reported by the moderate-severe pain group was 27.39 ±9.50 compared to 18.64 ±10 mean N-PCS scores by the no-mild pain group (p<0.001). Preoperative PCS scores correlated positively with postoperative pain intensity (r =0.39, [95% CI 0.23-0.52], p<0.001) and total tramadol consumption (r =0.32, [95% CI 0.16-0.47], p<0.001). An increase in catastrophizing scores was associated with postoperative moderate-severe pain (odds ratio, 1.08 [95% confidence interval, 1.02-1.15], p=0.006) after adjusting for gender, ethnicity and preoperative anxiety. Conclusion: Patients who reported higher pain catastrophizing preoperatively were at increased risk of experiencing moderate-severe postoperative pain.

Keywords: nepali, pain catastrophizing, postoperative pain, trauma

Procedia PDF Downloads 93
64 Comparative Study of Amyloidogenic Potential of AgNO3 and Freund's Adjuvant (AF) with That of Vitamin Free Casein, on Spatio-Temporal Pattern of Experimental Amyloidosis in Mice

Authors: Alireza Javed, Keivan Jamshidi

Abstract:

Reactive amyloidosis is a condition that complicates a long list of chronic inflammation, chronic infectious, malignant, and hereditary disorders. In the present study the potential effects of two amyloidogenic substances: ie. AgNO3 and Freund's Adjuvant (AF) with that of vitamin free casein, on spatio-temporal pattern of experimental amyloidosis in mice, were compared. For this purpose, a total of 40 male Swees mice, obtained from Pasteur Institute Tehran, after being weighted were randomly divided into 4 groups including 2 treatments, 1 control (vitamin free casein) and 1 positive control (normal saline). At the end of 3rd, 5th and 7th weeks of experiment 3 mice were randomly selected and euthnised. Spleen sample of each animal obtained and preserved in 10% neutral buffer formalin. Sample were then processed through different stages of dehydration, clearing and impregnation and finally embedded in paraffin blocks. Sections of 5µm thickness then cut and stained by alkaline Congo red techniques. Spleen weights and the data obtained from the microscopic quantitative analysis did show no significant differences between groups A and B, A and C, and B and C. However, significant differences were observed between groups A and D, B and D, and C and D respectively. It is concluded that two compounds ie; AgNO3 and Freund's Adjuvant have the same potential, as does vitamin free casein have, in spatio – temporal pattern of experimental amyloidosis in mice.

Keywords: amyloidosis, mice, AgNO3, Freund's Adjuvant

Procedia PDF Downloads 345
63 Computer Countenanced Diagnosis of Skin Nodule Detection and Histogram Augmentation: Extracting System for Skin Cancer

Authors: S. Zith Dey Babu, S. Kour, S. Verma, C. Verma, V. Pathania, A. Agrawal, V. Chaudhary, A. Manoj Puthur, R. Goyal, A. Pal, T. Danti Dey, A. Kumar, K. Wadhwa, O. Ved

Abstract:

Background: Skin cancer is now is the buzzing button in the field of medical science. The cyst's pandemic is drastically calibrating the body and well-being of the global village. Methods: The extracted image of the skin tumor cannot be used in one way for diagnosis. The stored image contains anarchies like the center. This approach will locate the forepart of an extracted appearance of skin. Partitioning image models has been presented to sort out the disturbance in the picture. Results: After completing partitioning, feature extraction has been formed by using genetic algorithm and finally, classification can be performed between the trained and test data to evaluate a large scale of an image that helps the doctors for the right prediction. To bring the improvisation of the existing system, we have set our objectives with an analysis. The efficiency of the natural selection process and the enriching histogram is essential in that respect. To reduce the false-positive rate or output, GA is performed with its accuracy. Conclusions: The objective of this task is to bring improvisation of effectiveness. GA is accomplishing its task with perfection to bring down the invalid-positive rate or outcome. The paper's mergeable portion conflicts with the composition of deep learning and medical image processing, which provides superior accuracy. Proportional types of handling create the reusability without any errors.

Keywords: computer-aided system, detection, image segmentation, morphology

Procedia PDF Downloads 113
62 Population Structure Analysis of Pakistani Indigenous Cattle Population by Using High Density SNP Array

Authors: Hamid Mustafa, Huson J. Heather, Kim Eiusoo, McClure Matt, Khalid Javed, Talat Nasser Pasha, Afzal Ali1, Adeela Ajmal, Tad Sonstegard

Abstract:

Genetic differences associated with speciation, breed formation or local adaptation can help to preserve and effective utilization of animals in selection programs. Analyses of population structure and breed diversity have provided insight into the origin and evolution of cattle. In this study, we used a high-density panel of SNP markers to examine population structure and diversity among ten Pakistani indigenous cattle breeds. In total, 25 individuals from three cattle populations, including Achi (n=08), Bhagnari (n=04) and Cholistani (n=13) were genotyped for 777, 962 single nucleotide polymorphism (SNP) markers. Population structure was examined using the linkage model in the program STRUCTURE. After characterizing SNP polymorphism in the different populations, we performed a detailed analysis of genetic structure at both the individual and population levels. The whole-genome SNP panel identified several levels of population substructure in the set of examined cattle breeds. We further searched for spatial patterns of genetic diversity among these breeds under the recently developed spatial principal component analysis framework. Overall, such high throughput genotyping data confirmed a clear partitioning of the cattle genetic diversity into distinct breeds. The resulting complex historical origins associated with both natural and artificial selection have led to the differentiation of numerous different cattle breeds displaying a broad phenotypic variety over a short period of time.

Keywords: Pakistan, cattle, genetic diversity, population structure

Procedia PDF Downloads 586
61 Analysis of Saudi Breast Cancer Patients’ Primary Tumors using Array Comparative Genomic Hybridization

Authors: L. M. Al-Harbi, A. M. Shokry, J. S. M. Sabir, A. Chaudhary, J. Manikandan, K. S. Saini

Abstract:

Breast cancer is the second most common cause of cancer death worldwide and is the most common malignancy among Saudi females. During breast carcinogenesis, a wide-array of cytogenetic changes involving deletions, or amplification, or translocations, of part or whole of chromosome regions have been observed. Because of the limitations of various earlier technologies, newer tools are developed to scan for changes at the genomic level. Recently, Array Comparative Genomic Hybridization (aCGH) technique has been applied for detecting segmental genomic alterations at molecular level. In this study, aCGH was performed on twenty breast cancer tumors and their matching non-tumor (normal) counterparts using the Agilent 2x400K. Several regions were identified to be either amplified or deleted in a tumor-specific manner. Most frequent alterations were amplification of chromosome 1q, chromosome 8q, 20q, and deletions at 16q were also detected. The amplification of genetic events at 1q and 8q were further validated using FISH analysis using probes targeting 1q25 and 8q (MYC gene). The copy number changes at these loci can potentially cause a significant change in the tumor behavior, as deletions in the E-Cadherin (CDH1)-tumor suppressor gene as well as amplification of the oncogenes-Aurora Kinase A. (AURKA) and MYC could make these tumors highly metastatic. This study validates the use of aCGH in Saudi breast cancer patients and sets the foundations necessary for performing larger cohort studies searching for ethnicity-specific biomarkers and gene copy number variations.

Keywords: breast cancer, molecular biology, ecology, environment

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60 Optical Emission Studies of Laser Produced Lead Plasma: Measurements of Transition Probabilities of the 6P7S → 6P2 Transitions Array

Authors: Javed Iqbal, R. Ahmed, M. A. Baig

Abstract:

We present new data on the optical emission spectra of the laser produced lead plasma using a pulsed Nd:YAG laser at 1064 nm (pulse energy 400 mJ, pulse width 5 ns, 10 Hz repetition rate) in conjunction with a set of miniature spectrometers covering the spectral range from 200 nm to 720 nm. Well resolved structure due to the 6p7s → 6p2 transition array of neutral lead and a few multiplets of singly ionized lead have been observed. The electron temperatures have been calculated in the range (9000 - 10800) ± 500 K using four methods; two line ratio, Boltzmann plot, Saha-Boltzmann plot and Morrata method whereas, the electron number densities have been determined in the range (2.0 – 8.0) ± 0.6 ×1016 cm-3 using the Stark broadened line profiles of neutral lead lines, singly ionized lead lines and hydrogen Hα-line. Full width at half maximum (FWHM) of a number of neutral and singly ionized lead lines have been extracted by the Lorentzian fit to the experimentally observed line profiles. Furthermore, branching fractions have been deduced for eleven lines of the 6p7s → 6p2 transition array in lead whereas the absolute values of the transition probabilities have been calculated by combining the experimental branching fractions with the life times of the excited levels The new results are compared with the existing data showing a good agreement.

Keywords: LIBS, plasma parameters, transition probabilities, branching fractions, stark width

Procedia PDF Downloads 256
59 Assessment of Delirium, It's Possible Risk Factors and Outcome in Patient Admitted in Medical Intensive Care Unit

Authors: Rupesh K. Chaudhary, Narinder P. Jain, Rajesh Mahajan, Rajat Manchanda

Abstract:

Introduction: Delirium is a complex, multifactorial neuropsychiatric syndrome comprising a broad range of cognitive and neurobehavioral symptoms. In critically ill patients, it may develop secondary to multiple predisposing factors. Although it can be transient and irreversible but if left untreated may lead to long term cognitive dysfunction. Early identification and assessment of risk factors usually help in appropriate management of delirium which in turn leads to decreased hospital stay, cost of therapy and mortality. Aim and Objective: Aim of the present study was to estimate the incidence of delirium using a validated scale in medical ICU patients and to determine the associated risk factors and outcomes. Material and Method: A prospective study in an 18-bed medical-intensive care unit (ICU) was undertaken. A total of 357 consecutive patients admitted to ICU for more than 24 hours were assessed. These patients were screened with the help of Confusion Assessment Method for Intensive Care Unit -CAM-ICU, Richmond Agitation and Sedation Scale, Screening Checklist for delirium and APACHE II. Appropiate statistical analysis was done to evaluate the risk factors influencing mortality in delirium. Results: Delirium occurred in 54.6% of 194 patients. Risk of delirium was independently associated with a history of hypertension, diabetes but not with severity of illness APACHE II score. Delirium was linked to longer ICU stay 13.08 ± 9.6 ver 7.07 ± 4.98 days, higher ICU mortality (35.8% % vs. 17.0%). Conclusion: Our study concluded that delirium poses a great risk factor in the outcome of the patient and carries high mortality, so a timely intervention helps in addressing these issues.

Keywords: delirium, risk factors, outcome, intervention

Procedia PDF Downloads 137
58 Consultation Liasion Psychiatry in a Tertiary Care Hospital

Authors: K. Pankaj, R. K. Chaudhary, B. P. Mishra, S. Kochar

Abstract:

Introduction: Consultation-Liaison psychiatry is a branch of psychiatry that includes clinical service, teaching and research. A consultation-liaison psychiatrist plays a role in having an expert opinion and linking the patients to other medical professionals and the patient’s bio-psycho-social aspects that may be leading to his/her symptoms. Consultation-Liaison psychiatry has been recognised as 'The guardian of the holistic approach to the patient', underlining its pre-eminent role in the management of patients who are admitted in a tertiary care hospital. Aims/ Objectives: The aim of the study was to analyse the utilization of psychiatric services and reasons for referrals in a tertiary care hospital. Materials and Methods: The study was done in a tertiary care hospital. The study included all the cases referred from different Inpatient wards to the psychiatry department for consultation. The study was conducted on 300 patients over a 3 month period. International classification of diseases 10 was used to diagnose the referred cases. Results: The majority of the referral was from the Medical Intensive care unit (22%) followed by general medical wards (18.66%). Majority of the referral was taken for altered sensorium (24.66%), followed by low mood or unexplained medical symptoms (21%). Majority of the referrals had a diagnosis of alcohol withdrawal syndrome (21%) as per International classification of diseases criteria, followed by unipolar Depression and Anxiety disorder (~ 14%), followed by Schizophrenia (5%) and Polysubstance abuse (2.6%). Conclusions: Our study concludes the importance of utilization of consultation-liaison psychiatric services. Also, the study signifies the need for sensitization of our colleagues regarding psychiatric sign and symptoms from time to time and seek psychiatric consult timely to decrease morbidity.

Keywords: consultation-liaison, psychiatry, referral, tertiary care hospital

Procedia PDF Downloads 119
57 Mitigating the Aggregation of Human Islet Amyloid Polypeptide with Nanomaterials

Authors: Ava Faridi, Pouya Faridi, Aleksandr Kakinen, Ibrahim Javed, Thomas P. Davis, Pu Chun Ke

Abstract:

Human islet amyloid polypeptide (IAPP) is a hormone associated with glycemic control and type 2 diabetes. Biophysically, the chirality of IAPP fibrils has been little explored with respect to the aggregation and toxicity of the peptide. Biochemically, it remains unclear as for how protein expression in pancreatic beta cells may be altered by cell exposure to the peptide, and how such changes may be mitigated by nanoparticle inhibitors for IAPP aggregation. In this study, we first demonstrated the elimination of the IAPP nucleation phase and shortening of its elongation phase by silica nanoribbons. This accelerated IAPP fibrillization translated to reduced toxicity, especially for the right-handed silica nanoribbons, as revealed by cell viability, helium ion microscopy, as well as zebrafish embryo survival, developmental and behavioral assays. We then examined the proteomes of βTC6 pancreatic beta cells exposed to the three main aggregation states of monomeric, oligomeric and amyloid fibrillar IAPP, and compared that with cellular protein expression modulated by graphene quantum dots (GQDs). A total of 29 proteins were significantly regulated by different forms of IAPP, and the majority of these proteins were nucleotide-binding proteins. A regulatory capacity of GQDs against aberrant protein expression was confirmed. These studies have demonstrated the great potential of employing nanomaterials targeting the mesoscopic enantioselectivity and protein expression dysregulation in pancreatic beta cells.

Keywords: graphene quantum dots, IAPP, silica nanoribbons, protein expression, toxicity

Procedia PDF Downloads 111
56 PPRA Regulates DNA Replication Initiation and Cell Morphology in Escherichia coli

Authors: Ganesh K. Maurya, Reema Chaudhary, Neha Pandey, Hari S. Misra

Abstract:

PprA, a pleiotropic protein participating in radioresistance, has been reported for its roles in DNA replication initiation, genome segregation, cell division and DNA repair in polyextremophile Deinococcus radiodurans. Interestingly, expression of deinococcal PprA in E. coli suppresses its growth by reducing the number of colony forming units and provides better resistance against γ-radiation than control. We employed different biochemical and cell biology studies using PprA and its DNA binding/polymerization mutants (K133E & W183R) in E. coli. Cells expressing wild type PprA or its K133E mutant showed reduction in the amount of genomic DNA as well as chromosome copy number in comparison to W183R mutant of PprA and control cells, which suggests the role of PprA protein in regulation of DNA replication initiation in E. coli. Further, E. coli cells expressing PprA or its mutants exhibited different impact on cell morphology than control. Expression of PprA or K133E mutant displayed a significant increase in cell length upto 5 folds while W183R mutant showed cell length similar to uninduced control cells. We checked the interaction of deinococcal PprA and its mutants with E. coli DnaA using Bacterial two-hybrid system and co-immunoprecipitation. We observed a functional interaction of EcDnaA with PprA and K133E mutant but not with W183R mutant of PprA. Further, PprA or K133E mutant has suppressed the ATPase activity of EcDnaA but W183R mutant of PprA failed to do so. These observations suggested that PprA protein regulates DNA replication initiation and cell morphology of surrogate E. coli.

Keywords: DNA replication, radioresistance, protein-protein interaction, cell morphology, ATPase activity

Procedia PDF Downloads 34
55 PPRA Controls DNA Replication and Cell Growth in Escherichia Coli

Authors: Ganesh K. Maurya, Reema Chaudhary, Neha Pandey, Hari S. Misra

Abstract:

PprA, a pleiotropic protein participating in radioresistance, has been reported for its roles in DNA replication initiation, genome segregation, cell division and DNA repair in polyextremophile Deinococcus radiodurans. Interestingly, expression of deinococcal PprA in E. coli suppresses its growth by reducing the number of colony forming units and provide better resistance against γ-radiation than control. We employed different biochemical and cell biology studies using PprA and its DNA binding/polymerization mutants (K133E & W183R) in E. coli. Cells expressing wild type PprA or its K133E mutant showed reduction in the amount of genomic DNA as well as chromosome copy number in comparison to W183R mutant of PprA and control cells, which suggests the role of PprA protein in regulation of DNA replication initiation in E. coli. Further, E. coli cells expressing PprA or its mutants exhibited different impact on cell morphology than control. Expression of PprA or K133E mutant displayed a significant increase in cell length upto 5 folds while W183R mutant showed cell length similar to uninduced control cells. We checked the interaction of deinococcal PprA and its mutants with E. coli DnaA using Bacterial two-hybrid system and co-immunoprecipitation. We observed a functional interaction of EcDnaA with PprA and K133E mutant but not with W183R mutant of PprA. Further, PprA or K133E mutant has suppressed the ATPase activity of EcDnaA but W183R mutant of PprA failed to do so. These observations suggested that PprA protein regulates DNA replication initiation and cell morphology of surrogate E. coli.

Keywords: DNA replication, radioresistance, protein-protein interaction, cell morphology, ATPase activity

Procedia PDF Downloads 34
54 Using Geo-Statistical Techniques and Machine Learning Algorithms to Model the Spatiotemporal Heterogeneity of Land Surface Temperature and its Relationship with Land Use Land Cover

Authors: Javed Mallick

Abstract:

In metropolitan areas, rapid changes in land use and land cover (LULC) have ecological and environmental consequences. Saudi Arabia's cities have experienced tremendous urban growth since the 1990s, resulting in urban heat islands, groundwater depletion, air pollution, loss of ecosystem services, and so on. From 1990 to 2020, this study examines the variance and heterogeneity in land surface temperature (LST) caused by LULC changes in Abha-Khamis Mushyet, Saudi Arabia. LULC was mapped using the support vector machine (SVM). The mono-window algorithm was used to calculate the land surface temperature (LST). To identify LST clusters, the local indicator of spatial associations (LISA) model was applied to spatiotemporal LST maps. In addition, the parallel coordinate (PCP) method was used to investigate the relationship between LST clusters and urban biophysical variables as a proxy for LULC. According to LULC maps, urban areas increased by more than 330% between 1990 and 2018. Between 1990 and 2018, built-up areas had an 83.6% transitional probability. Furthermore, between 1990 and 2020, vegetation and agricultural land were converted into built-up areas at a rate of 17.9% and 21.8%, respectively. Uneven LULC changes in built-up areas result in more LST hotspots. LST hotspots were associated with high NDBI but not NDWI or NDVI. This study could assist policymakers in developing mitigation strategies for urban heat islands

Keywords: land use land cover mapping, land surface temperature, support vector machine, LISA model, parallel coordinate plot

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53 Critical Success Factors Quality Requirement Change Management

Authors: Jamshed Ahmad, Abdul Wahid Khan, Javed Ali Khan

Abstract:

Managing software quality requirements change management is a difficult task in the field of software engineering. Avoiding incoming changes result in user dissatisfaction while accommodating to many requirement changes may delay product delivery. Poor requirements management is solely considered the primary cause of the software failure. It becomes more challenging in global software outsourcing. Addressing success factors in quality requirement change management is desired today due to the frequent change requests from the end-users. In this research study, success factors are recognized and scrutinized with the help of a systematic literature review (SLR). In total, 16 success factors were identified, which significantly impacted software quality requirement change management. The findings show that Proper Requirement Change Management, Rapid Delivery, Quality Software Product, Access to Market, Project Management, Skills and Methodologies, Low Cost/Effort Estimation, Clear Plan and Road Map, Agile Processes, Low Labor Cost, User Satisfaction, Communication/Close Coordination, Proper Scheduling and Time Constraints, Frequent Technological Changes, Robust Model, Geographical distribution/Cultural differences are the key factors that influence software quality requirement change. The recognized success factors and validated with the help of various research methods, i.e., case studies, interviews, surveys and experiments. These factors are then scrutinized in continents, database, company size and period of time. Based on these findings, requirement change will be implemented in a better way.

Keywords: global software development, requirement engineering, systematic literature review, success factors

Procedia PDF Downloads 173
52 Utilization of Bio-Glycerol to Synthesize Fuel Additive in Presence of Modified Mesoporous Heterogeneous Catalysts

Authors: Ala’a H. Al-Muhtaseb, Farrukh Jamil, Sandeep K. Saxena

Abstract:

The fast growth rate of energy consumption along with world population expected to demand 50% more energy by 2030 than nowadays. At present, the energy demand is mostly provided by limited fossil fuel sources such as oil, natural gas, and coal that are resulting in dramatic increase in CO2 emissions from combustion of fossil fuels. The growth of the biodiesel industry over the last decade has resulted in a price drop because glycerol is obtained as a by-product during transesterification of vegetable oil or animal fats, which accounts for one tenth of every gallon of biodiesel produced. The production of oxygenates from glycerol gains much importance due to the excellent diesel-blending property of the oxygenates that not only improve the quality of the fuel but also increases the overall yield of the biodiesel in helping to meet the target for energy production from renewable sources for transport in the energy utilization directives. The reaction of bio-glycerol with bio-acetone was carried out in a magnetically stirred two necked round bottom flaskS. Condensation of bio-glycerol with acetone in the presence of various modified forms of beta zeolite has been done for synthesizing solketal (AB-2 modified with nitric acid, AB-3 modified with oxalic acid). Among all modified forms of beta zeolite, AB-2 showed the best performance for maximum glycerol conversion 94.26 % with 94.21 % solketal selectivity and minimum acetal formation 0.05 %. The physiochemical properties of parent beta zeolite and all its modified forms were analyzed by XRD, SEM, TEM, BET, FTIR and TPD. It has been revealed that AB-2 catalysts with high pore volume and surface area gave high glycerol conversion with maximum solketal selectivity. Despite this, the crystallinity of AB-3 was lower than AB-2 which helps to provide the shorter path length for reactants and product but due high pore volume AB-2 was preferred which gave maximum bio-glycerol conversion. Temperature does matter the glycerol conversion and selectivity of solketal, as it increases from 40 ºC to 60 ºC the conversion of glycerol rises from 80.04 % to 94.26 % and selectivity of solketal from 80.0 % to 94.21 % but further increase in temperature to 100 ºC glycerol conversion reduced to 93.06 % and solketal selectivity to 92.08 %. AB-2 was found to be highly stable as up to 4 repeated experimental runs there was less than 10% decrease in its activity. This process offers an attractive route for converting bio-glycerol, the main by-product of biodiesel to solketal with bio-acetone; a value-added green product with potential industrial applications as a valuable green fuel additive or combustion promoter for gasoline/diesel engines.

Keywords: beta-zeolite, bio-glycerol, catalyst, solketal

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51 Patients' Understanding of Their Treatment Plans and Diagnosis during Discharge in Emergency Ward at B. P. Koirala Institute of Health Sciences

Authors: Ajay Kumar Yadav, Masum Paudel, Ritesh Chaudhary

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Background: Understanding the diagnosis and the treatment plan is very important for the patient which reflects the effectiveness of the patient care as well as counseling. Large groups of patients do not understand their emergency care plan or their discharge instructions. With only a little more than 2/3ʳᵈ of the adult population is literate and poorly distributed health service institutions in Nepal, exploring the current status of patient understanding of their diagnosis and treatment would help identify interventions to improve patient compliance with the provided care and the treatment outcomes. Objectives: This study was conducted to identify and describe the areas of patients’ understanding and confusion regarding emergency care and discharge instructions at the Emergency ward of B. P. Koirala Institute of Health Sciences teaching hospital, Dharan, Nepal. Methods: A cross-sectional study was conducted among 426 patients discharged from the emergency unit of BPKIHS. Cases who are leaving against medical advice absconded cases and those patients who came just for vaccination are excluded from the study. Patients’ understanding of the treatment plan and diagnosis was measured. Results: There were 60% men in this study. More than half of the participants reported not being able to read English. More than 90% of the respondents reported they could not read their prescription at all. While patient could point out their understanding of their diagnosis at discharge, most of them could not tell the names and the dosage of all the drugs prescribed to them at discharge. More than 95% of the patients could not tell the most common side effects of the drugs that they are prescribed. Conclusions: There is a need to further explore the factors influencing the understanding of the patients regarding their treatment plan. Interventions to understand the health literacy needs and ways to improve the health literacy of the patients are needed.

Keywords: discharge instruction, emergency ward, health literacy, treatment plan

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50 Dilution of Saline Irrigation Based on Plant's Physiological Responses to Salt Stress Following by Re-Watering

Authors: Qaiser Javed, Ahmad Azeem

Abstract:

Salinity and water scarcity are major environmental problems which are limiting the agricultural production. This research was conducted to construct a model to find out appropriate regime to dilute saline water based on physiological and electrophysiological properties of Brassica napus L., and Orychophragmus violaceus (L.). Plants were treated under salt-stressed concentrations of NaCl (NL₁: 2.5, NL₂: 5, NL₃: 10; gL⁻¹), Na₂SO₄ (NO₁: 2.5, NO₂: 5, NO₃: 10; gL⁻¹), and mixed salt concentration (MX₁: NL₁+ NO₃; MX₂: NL₃+ NO₁; MX₃: NL₂+ NO₂; gL⁻¹) and 0 as control, followed by re-watering. Growth, physiological and electrophysiology traits were highly restricted under high salt concentration levels at NL₃, NO₃, MX₁, and MX₂, respectively. However, during the rewatering phase, growth, electrophysiological, and physiological parameters were recovered well. Consequently, the increase in net photosynthetic rate was noted under moderate stress condition which was 44.13, 37.07, and 43.01%, respectively in Orychophragmus violaceus (L.) and 44.94%, 53.45%, and 63.04%, respectively were found in Brassica napus L. According to the results, the best dilution point was 5–2.5% for NaCl and Na₂SO₄ alternatively, whereas it was 10–0.0% for the mixture of salts. Therefore, the effect of salinity in O. violaceus and B. napus may also be reduced effectively by dilution of saline irrigation. It would be a better approach to utilize dilute saline water for irrigation instead of applies direct saline water to plant. This study provides new insight in the field of agricultural engineering to plan irrigation scheduling considering the crop ability to salt tolerance and irrigation water use efficiency by apply specific quantity of irrigation calculated based on the salt dilution point. It would be helpful to balance between irrigation amount and optimum crop water consumption in salt-affected regions and to utilize saline water in order to safe freshwater resources.

Keywords: dilution model, plant growth traits, re-watering, salt stress

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49 Geostatistical Simulation of Carcinogenic Industrial Effluent on the Irrigated Soil and Groundwater, District Sheikhupura, Pakistan

Authors: Asma Shaheen, Javed Iqbal

Abstract:

The water resources are depleting due to an intrusion of industrial pollution. There are clusters of industries including leather tanning, textiles, batteries, and chemical causing contamination. These industries use bulk quantity of water and discharge it with toxic effluents. The penetration of heavy metals through irrigation from industrial effluent has toxic effect on soil and groundwater. There was strong positive significant correlation between all the heavy metals in three media of industrial effluent, soil and groundwater (P < 0.001). The metal to the metal association was supported by dendrograms using cluster analysis. The geospatial variability was assessed by using geographically weighted regression (GWR) and pollution model to identify the simulation of carcinogenic elements in soil and groundwater. The principal component analysis identified the metals source, 48.8% variation in factor 1 have significant loading for sodium (Na), calcium (Ca), magnesium (Mg), iron (Fe), chromium (Cr), nickel (Ni), lead (Pb) and zinc (Zn) of tannery effluent-based process. In soil and groundwater, the metals have significant loading in factor 1 representing more than half of the total variation with 51.3 % and 53.6 % respectively which showed that pollutants in soil and water were driven by industrial effluent. The cumulative eigen values for the three media were also found to be greater than 1 representing significant clustering of related heavy metals. The results showed that heavy metals from industrial processes are seeping up toxic trace metals in the soil and groundwater. The poisonous pollutants from heavy metals turned the fresh resources of groundwater into unusable water. The availability of fresh water for irrigation and domestic use is being alarming.

Keywords: groundwater, geostatistical, heavy metals, industrial effluent

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48 Informational Support, Anxiety and Satisfaction with Care among Family Caregivers of Patients Admitted in Critical Care Units of B.P. Koirala Institute of Health Sciences, Nepal

Authors: Rosy Chaudhary, Pushpa Parajuli

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Background and Objectives: Informational support to family members has a significant potential for reducing this distress related to hospitalization of their patient into the critical care unit, enabling them to cope better and support the patient. The objective of the study is to assess family members’ perception of informational support, anxiety, satisfaction with care and to reveal the association with selected socio-demographic variables and to investigate the correlation between informational support, anxiety and satisfaction with care. Materials and Methods: A descriptive cross-sectional study was conducted in 39 family caregivers of patients admitted in critical care unit of BPKIHS(B.P. Koirala Institute of Health Sciences). Consecutive sampling technique was used wherein data was collected over duration of one month using interview schedule. Descriptive and inferential statistics were used. Results: The mean age of the respondents was 34.97 ± 10.64 and two third (66.70%) were male. Mean score for informational support was 25.72(SD = 5.66; theoretical range of 10 - 40). Mean anxiety was 10.41 (SD = 5.02; theoretical range of 7 - 21). Mean score for satisfaction with care was 40.77 (SD = 6.77; theoretical range of 14 - 64). A moderate positive correlation was found between informational support and satisfaction with care (r = 0.551, p < .001) and a moderate negative correlation was found between anxiety and satisfaction with care (r = -0.590; p = 0.000). No relationship was noted between informational support and anxiety. Conclusion: The informational support and satisfaction of the family caregivers with the care provided to their patients was satisfactory. More than three fourth of the family caregivers had anxiety; the factors associated being educational status of the caregivers, the family income and duration of visiting hours. There was positive correlation between informational support and satisfaction with care provided justifying the need for comprehensive information to the family caregivers by the health personnel. There was negative correlation between anxiety and satisfaction with care.

Keywords: anxiety, caregivers, critical care unit, informational support, family

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47 Hyper-Production of Lysine through Fermentation and Its Biological Evaluation on Broiler Chicks

Authors: Shagufta Gulraiz, Abu Saeed Hashmi, Muhammad Mohsin Javed

Abstract:

Lysine required for poultry feed is imported in Pakistan to fulfil the desired dietary needs. Present study was designed to produce maximum lysine by utilizing cheap sources to save the foreign exchange. To achieve the goal of lysine production through fermentation, large scale production of lysine was carried out in 7.5 L stirred glass vessel fermenter with wild and mutant Brevibacterium flavum (B. flavum) using all pre-optimized conditions. The identification of produced lysine was carried out by TLC and amino acid analyzer. Toxicity evaluation of produced lysine was performed before feeding to broiler chicks. During biological trial concentrated fermented broth having 8% lysine was used in poultry rations as a source of Lysine for test birds. Fermenter scale studies showed that the maximum lysine (20.8 g/L) was produced at 250 rpm, 1.5 vvm aeration, 6.0% inoculum under controlled pH conditions after 56 h of fermentation with wild culture but mutant (BFENU2) gave maximum yield of lysine 36.3 g/L under optimized condition after 48 h. Amino acid profiling showed 1.826% Lysine in fermented broth by wild B. flavum and 2.644% by mutant strain (BFENU2). Toxicity evaluation report showed that the produced lysine is safe for consumption by broilers. Biological evaluation results showed that produced lysine was equally good as commercial lysine in terms of weight gain, feed intake and feed conversion ratio. A cheap and practical bioprocess of Lysine production was concluded, that can be exploited commercially in Pakistan to save foreign exchange.

Keywords: lysine, fermentation, broiler chicks, biological evaluation

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46 The Role of Community Museum in Ethnic Identity: A Case of Tharu Cultural Museum and Research Center in Chitwan Nepal

Authors: Birendra Mahato, Shiva Narayan Chaudhary

Abstract:

Tharus are indigenous inhabitants of the Tarai, the narrow strip of flat and fertile land that lies at the foothills of the Himalayas. They have unique rituals, festivals, and music, while their clothes and ornaments are similar to some ethnic groups of India. After the control of malaria in the Terai between 1955 to 1965, (with the help of the U.S. Government, the WHO and the government of Nepal) the rate of in-migration skyrocketed, particularly of Nepal’s hill people, whose culture, along with the use of the Western education system, was gradually adopted by the Tharus. Among the many challenges, the Tharus face is their assimilation into the dominant Nepali culture. .The Tharus are thus under threat of slowly losing their ethnic identity and cultural values. In order to preserve the indigenous Tharu Culture, Tharu Cultural Museum, and Research Center. It is a community based non-governmental and non-profitable museum established in 2005 by Tharu intellectuals, traditional leaders and youths. The main goal of the museum is to preserve Tharu culture through different activities with direct and indirect involvement of community people. It aims to preserve arts, culture, handicrafts, and artifacts related to Indigenous Tharu People. Similarly, the museum displays an exhibition about the Tharu histories, lives, culture, and their indigenous knowledge and skills. The paper aims to demonstrate that community museums can be one of the key hubs for the preservation of culture with the collection and promotion of cultural objects, artifacts, and intangible cultural heritages. The preservation of culture not only has contributed to establishing their ethnic identity but also has contributed to establishing their recognition of their political space in the mainstream politics - the constitution of Nepal has recognized Tharus to provide reservation for the political space.

Keywords: community museum, tharu, , identity, culture

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45 Differential Response of Cellular Antioxidants and Proteome Expression to Salt, Cadmium and Their Combination in Spinach (Spinacia oleracea)

Authors: Rita Bagheri, Javed Ahmed, Humayra Bashir, M. Irfan Qureshi

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Agriculture lands suffer from a combination of stresses such as salinity and metal contamination including cadmium at the same time. Under such condition of multiple stresses, plant may exhibit unique responses different from the stress occurring individually. Thus, it would be interesting to investigate that how plant respond to combined stress at level of antioxidants and proteome expression, and identifying the proteins which are involved in imparting stress tolerance. With an approach of comparative proteomics and antioxidant analysis, present study investigates the response of Spinacia oleracea to salt (NaCl), cadmium (Cd), and their combination (NaCl+Cd) stress. Two-dimensional gel electrophoresis was used for resolving leaf proteome, and proteins of interest were identified using PDQuest software. A number of proteins expressed differentially, those indicated towards their roles in imparting stress tolerance, were digested by trypsin and analyzed on mass spectrometer for peptide mass fingerprinting (PMF). Data signals were then matched with protein databases using MASCOT. Results show that NaCl, Cd and both together (NaCl+Cd) induce oxidative stress which was highest in combined stress of Cd+NaCl. Correspondingly, the activities of enzymatic antioxidants viz., SOD, APX, GR and CAT, and non-enzymatic antioxidants had highest changes under combined stress compares to single stress over their respective controls. Among the identified proteins, several interesting proteins were identified that may be have role in Spinacia oleracia tolerance in individual and combinatorial stress of salt and cadmium. The functional classification of identified proteins indicates the importance and necessity of keeping higher ratio of defence and disease responsive proteins.

Keywords: Spinacia oleracea, Cd, salinity, proteomics, antioxidants, combinatorial stress

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44 Nanomaterial Based Electrochemical Sensors for Endocrine Disrupting Compounds

Authors: Gaurav Bhanjana, Ganga Ram Chaudhary, Sandeep Kumar, Neeraj Dilbaghi

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Main sources of endocrine disrupting compounds in the ecosystem are hormones, pesticides, phthalates, flame retardants, dioxins, personal-care products, coplanar polychlorinated biphenyls (PCBs), bisphenol A, and parabens. These endocrine disrupting compounds are responsible for learning disabilities, brain development problems, deformations of the body, cancer, reproductive abnormalities in females and decreased sperm count in human males. Although discharge of these chemical compounds into the environment cannot be stopped, yet their amount can be retarded through proper evaluation and detection techniques. The available techniques for determination of these endocrine disrupting compounds mainly include high performance liquid chromatography (HPLC), mass spectroscopy (MS) and gas chromatography-mass spectrometry (GC–MS). These techniques are accurate and reliable but have certain limitations like need of skilled personnel, time consuming, interference and requirement of pretreatment steps. Moreover, these techniques are laboratory bound and sample is required in large amount for analysis. In view of above facts, new methods for detection of endocrine disrupting compounds should be devised that promise high specificity, ultra sensitivity, cost effective, efficient and easy-to-operate procedure. Nowadays, electrochemical sensors/biosensors modified with nanomaterials are gaining high attention among researchers. Bioelement present in this system makes the developed sensors selective towards analyte of interest. Nanomaterials provide large surface area, high electron communication feature, enhanced catalytic activity and possibilities of chemical modifications. In most of the cases, nanomaterials also serve as an electron mediator or electrocatalyst for some analytes.

Keywords: electrochemical, endocrine disruptors, microscopy, nanoparticles, sensors

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43 An Investigation into Slow ESL Reading Speed in Pakistani Students

Authors: Hina Javed

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This study investigated the different strategies used by Pakistani students learning English as a second language at secondary level school. The basic premise of the study is that ESL students face tremendous difficulty while they are reading a text in English. It also purports to dig into the different causes of their slow reading. They might range from word reading accuracy, mental translation, lexical density, cultural gaps, complex syntactic constructions, and back skipping. Sixty Grade 7 students from two secondary mainstream schools in Lahore were selected for the study, thirty being boys and thirty girls. They were administered reading-related and reading speed pre and post-tests. The purpose of the tests was to gauge their performance on different reading tasks so as to be able to see how they used strategies, if any, and also to ascertain the causes hampering their performance on those tests. In the pretests, they were given simple texts with considerable lexical density and moderately complex sentential layout. In the post-tests, the reading tasks contained comic strips, texts with visuals, texts with controlled vocabulary, and an evenly distributed varied range of simple, compound, and complex sentences. Both the tests were timed. The results gleaned through the data gathered corroborated the researchers’ basic hunch that they performed significantly better than pretests. The findings suggest that the morphological structure of words and lexical density are the main sources of reading comprehension difficulties in poor ESL readers. It is also confirmed that if the texts are accompanied by pictorial visuals, it greatly facilitates students’ reading speed and comprehension. There is no substantial evidence that ESL readers adopt any specific strategy while reading in English.

Keywords: slow ESL reading speed, mental translation, complex syntactic constructions, back skipping

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42 Affect of Reservoir Fluctuations on an Active Landslide in the Xiangjiaba Reservoir Area, Southwest China

Authors: Javed Iqbal

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Filling of Xiangjiaba Reservoir Lake in Southwest China triggered and re-activated numerous landslides due to water fluctuation. In order to understand the relationship between reservoirs and slope instability, a typical reservoir landslide (Dasha landslide) at right bank of Jinsha River was selected as a case study for in-depth investigations. The detailed field investigations were carried out in order to identify the landslide with respect to its surroundings and to find out the slip-surface. Boreholes were drilled in order to find out the subsurface lithology and the depth of failure of Dasha landslide. The in-situ geotechnical tests were performed, and the soil samples from exposed slip surface were retrieved for geotechnical laboratory analysis. Finally, stability analysis was done using 3D strength reduction method under different conditions of reservoir water level fluctuations and rainfall conditions. The in-depth investigations show that the Dasha landslide is a bedding rockslide which was once activated in 1986. The topography of Dasha landslide is relatively flat, while the back scarp and local terrain are relatively steep. The landslide area is about 29 × 104 m², and the maximum thickness of the landslide deposits revealed by drilling is about 40 m with the average thickness being about 20 m, and the volume is thus estimated being about 580 × 10⁴ m³. Bedrock in the landslide area is composed of Suining Formation of Jurassic age. The main rock type is silty mudstone with sandstone, and bedding orientation is 300~310° ∠ 7~22°. The factor of safety (FOS) of Dasha landslide obtained by 3D strength reduction cannot meet the minimum safety requirement under the working condition of reservoir level fluctuation as designed, with effect of rainfall and rapid drawdown.

Keywords: Dasha landslide, Xiangjiaba reservoir, strength reduction method, bedding rockslide

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41 Fabrication and Characterization of Folic Acid-Grafted-Thiomer Enveloped Liposomes for Enhanced Oral Bioavailability of Docetaxel

Authors: Farhan Sohail, Gul Shahnaz Irshad Hussain, Shoaib Sarwar, Ibrahim Javed, Zajif Hussain, Akhtar Nadhman

Abstract:

The present study was aimed to develop a hybrid nanocarrier (NC) system with enhanced membrane permeability, bioavailability and targeted delivery of Docetaxel (DTX) in breast cancer. Hybrid NC’s based on folic acid (FA) grafted thiolated chitosan (TCS) enveloped liposomes were prepared with DTX and evaluated in-vitro and in-vivo for their enhanced permeability and bioavailability. Physicochemical characterization of NC’s including particle size, morphology, zeta potential, FTIR, DSC, PXRD, encapsulation efficiency and drug release from NC’s was determined in vitro. Permeation enhancement and p-gp inhibition were performed through everted sac method on freshly excised rat intestine which indicated that permeation was enhanced 5 times as compared to pure DTX and the hybrid NC’s were strongly able to inhibit the p-gp activity as well. In-vitro cytotoxicity and tumor targeting was done using MDA-MB-231 cell line. The stability study of the formulations performed for 3 months showed the improved stability of FA-TCS enveloped liposomes in terms of its particles size, zeta potential and encapsulation efficiency as compared to TCS NP’s and liposomes. The pharmacokinetic study was performed in vivo using rabbits. The oral bioavailability and AUC0-96 was increased 10.07 folds with hybrid NC’s as compared to positive control. Half-life (t1/2) was increased 4 times (58.76 hrs) as compared to positive control (17.72 hrs). Conclusively, it is suggested that FA-TCS enveloped liposomes have strong potential to enhance permeability and bioavailability of hydrophobic drugs after oral administration and tumor targeting.

Keywords: docetaxel, coated liposome, permeation enhancement, oral bioavailability

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40 Re-Visiting Rumi and Iqbal on Self-Enhancement for Social Responsibility

Authors: Javed Y. Uppal

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The background of this study is the great degree of stress that the world is experiencing today, internationally among the countries, within a community among people, and even individually within one’s own self. The significance of the study is the attempt to find a solution of this stress in the philosophy of the olden times of Jalaluddin Rumi and comparatively recently of that of Allama Iqbal. The methodology adopted in this paper is firstly exploration of the perspectives of these philosophers that are being consolidated by a number of psychic and spiritual experts of today, who are being widely read but less followed. This paper further goes on presenting brief life sketches of Rumi and Iqbal. It expounds the key concepts proposed by them and the social change that was resulted in the times of the two above mentioned metaphysical philosophers. It is further amplified that with the recent advancements, in both metaphysics and the physical sciences, the gap between the two is closing down. Both Rumi and Iqbal emphasized their common essence. The old time's concepts, postulates, and philosophies are hence once again becoming valid. The findings of this paper are that the existence of human empathy, affection and mutual social attraction among humans is still valid. The positive inner belief system that dictates our thoughts and actions is vital. As a conclusion, empathy should enable us solving our problems collectively. We need to strengthen our inner communication system, to listen to the messages that come to our inner-selves. We need to get guidance and strength from them. We need to value common needs and purposes collectively to achieve results. Spiritual energy among us is to be harnessed and utilized. Connectivity is to be recognized to unify and strengthen ties among people. Mutual bonding at small and large group levels is to be employed for the survival of the disadvantaged, and sustainability of the empowering trends. With the above guidelines, hopefully, we can define a framework towards a brave and happy new humane world.

Keywords: belief system, connectivity, human empathy, inner-self, mutual bonding, spiritual energy

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39 Emergence of Ciprofloxacin Intermediate Susceptible Salmonella Typhi in India

Authors: Meenakshi Chaudhary, V .S. Randhawa, M. Jais, R. Dutta

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Introduction: An outbreak of Multi drug resistant S. Typhi (i.e. resistance to chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole) occurred in 1990's in India which peaked in 1992-93 and resulted in the change of drug of choice from chloramphenicol to ciprofloxacin for enteric fever. Currently an emergence of Ciprofloxacin susceptible S. Typhi isolates in the region is being reported which appears to be chromosomally mediated. Methodology: Six hundred sixty four strains were randomly selected from the time period between January 2008-December 2011 at the National Salmonella Phage Typing Centre, LHMC, New Delhi. The strains were representative of the north, central and south zones of India. All isolates were subjected to serotyping, biotyping, phage typing and then to antimicrobial susceptibility testing by CLSI disk diffusion (CLSI) technique to Ciprofloxacin, Cefotaxime, Ampicillin, Chloramphenicol, Trimethoprim-Sulfomethoxazole and Tetracycline. Subsequently MIC of the isolates was determined by E-test (AB-Biodisc). Results: More than 80% of the tested strains had intermediate susceptibility to ciprofloxacin. The E test revealed the MIC (Ciprofloxacin) of these strains to be in the range of 0.12 to 0.5 µg/ml. Sixty nine percent of ciprofloxacin intermediate susceptible strains belonged to Phage type E1 and fourteen percent of these were Vi- Negative i.e these could not be typed by the phage typing scheme of Craigie and Yen. All the strains remained susceptible to cefotaxime. Conclusion: Predominant isolation of intermediate susceptible S. Typhi strains from India would alter the recommendations of empiric treatment of enteric fever in the region. Alternative to the low cost ciprofloxacin will have to be sought or increased dosage and/or duration of ciprofloxacin will have to be recommended. The reasons for the trend of increase in percentage of intermediate susceptible S. Typhi strains are not clear but may be attributed partly to the revision of CLSI guidelines in 2013.

Keywords: salmonella typhi, decreased ciprofloxacin susceptibility, ciprofloxacin, minimum inhibitory concentration

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38 Computational Screening of Secretory Proteins with Brain-Specific Expression in Glioblastoma Multiforme

Authors: Sumera, Sanila Amber, Fatima Javed Mirza, Amjad Ali, Saadia Zahid

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Glioblastoma multiforme (GBM) is a widely spread and fatal primary brain tumor with an increased risk of relapse in spite of aggressive treatment. The current procedures for GBM diagnosis include invasive procedures i.e. resection or biopsy, to acquire tumor mass. Implementation of negligibly invasive tests as a potential diagnostic technique and biofluid-based monitoring of GBM stresses on discovering biomarkers in CSF and blood. Therefore, we performed a comprehensive in silico analysis to identify potential circulating biomarkers for GBM. Initially, six gene and protein databases were utilized to mine brain-specific proteins. The resulting proteins were filtered using a channel of five tools to predict the secretory proteins. Subsequently, the expression profile of the secreted proteins was verified in the brain and blood using two databases. Additional verification of the resulting proteins was done using Plasma Proteome Database (PPD) to confirm their presence in blood. The final set of proteins was searched in literature for their relationship with GBM, keeping a special emphasis on secretome proteome. 2145 proteins were firstly mined as brain-specific, out of which 69 proteins were identified as secretory in nature. Verification of expression profile in brain and blood eliminated 58 proteins from the 69 proteins, providing a final list of 11 proteins. Further verification of these 11 proteins further eliminated 2 proteins, giving a final set of nine secretory proteins i.e. OPCML, NPTX1, LGI1, CNTN2, LY6H, SLIT1, CREG2, GDF1 and SERPINI1. Out of these 9 proteins, 7 were found to be linked to GBM, whereas 2 proteins are not investigated in GBM so far. We propose that these secretory proteins can serve as potential circulating biomarker signatures of GBM and will facilitate the development of minimally invasive diagnostic methods and novel therapeutic interventions for GBM.

Keywords: glioblastoma multiforme, secretory proteins, brain secretome, biomarkers

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37 Robotic Mini Gastric Bypass Surgery

Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

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36 Impact Analysis of Quality Control Practices in Veterinary Diagnostic Labs in Lahore, Pakistan

Authors: Faiza Marrium, Masood Rabbani, Ali Ahmad Sheikh, Muhammad Yasin Tipu Javed Muhammad, Sohail Raza

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More than 75% diseases spreading in the past 10 years in human population globally are linked to veterinary sector. Veterinary diagnostic labs are the powerful ally for diagnosis, prevention and monitoring of animal diseases in any country. In order to avoid detrimental effects of errors in disease diagnostic and biorisk management, there is a dire need to establish quality control system. In current study, 3 private and 6 public sectors veterinary diagnostic labs were selected for survey. A questionnaire survey in biorisk management guidelines of CWA 15793 was designed to find quality control breaches in lab design, personal, equipment and consumable, quality control measures adopted in lab, waste management, environmental monitoring and customer care. The data was analyzed through frequency distribution statistically by using (SPSS) version 18.0. A non-significant difference was found in all parameters of lab design, personal, equipment and consumable, quality control measures adopted in lab, waste management, environmental monitoring and customer care with an average percentage of 46.6, 57.77, 52.7, 55.5, 54.44, 48.88 and 60, respectively. A non-significant difference among all nine labs were found, with highest average compliance percentage of all parameters are lab 2 (78.13), Lab 3 (70.56), Lab 5 (57.51), Lab 6 (56.37), Lab 4 (55.02), Lab 9 (49.58), Lab 7 (47.76), Lab 1 (41.01) and Lab 8 (36.09). This study shows that in Lahore district veterinary diagnostic labs are not giving proper attention to quality of their system and there is no significant difference between setups of private and public sector laboratories. These results show that most of parameters are between 50 and 80 percent, which needs some work and improvement as per WHO criteria.

Keywords: veterinary lab, quality management system, accreditation, regulatory body, disease identification

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