Clinical Presentation, Diagnosis, Treatment, and Outcomes of Myocarditis in Children: A Tertiary Care Hospital Experience.

Background Clinical presentation, diagnosis, and treatment of myocarditis in children can be highly challenging, and results can vary greatly. Research on the precise processes of myocardial injury, including the effects of viral infections and newly identified variables like COVID-19, is still underway. Though treatment approaches, such as immunosuppressive therapy, are still debatable, diagnostic methods such as cardiac MRI and biomarkers show promise in improving diagnostic accuracy. The purpose of this study is to describe the spectrum of pediatric acute myocarditis, assess existing therapy approaches, and develop regional guidelines based on the experience of a tertiary care institution.  Methods Children diagnosed with acute myocarditis over a six-month period were included in this retrospective and descriptive hospital-based study. Data on demographics, clinical presentations, diagnostic tests, treatments, and results were gathered and examined. Descriptive statistics, non-parametric tests for categorical variables, and Spearman's correlation tests for continuous data were used in the statistical analysis, with a significance level of p < 0.05.  Results Of the 99 patients included, the mean age was 2.37 years, with males making up the majority (n = 54, 54.55%). Clinical symptoms typically included shortness of breath (n = 998, 99.0%), vomiting (n = 63, 63.6%), and chest pain (n = 6, 6.1%). High levels of troponin I (n = 70, 70.7%), cardiomegaly on a chest X-ray (n = 97, 97.0%), and different degrees of ventricular dysfunction were found in the laboratory and in imaging studies. Methylprednisolone (n = 84, 84.8%) and IV immunoglobulin (n = 54, 54.5%) were the most often used treatment modalities, and there were no appreciable differences in the two treatment groups' outcomes. A weak negative association (Spearman's rho = -0.211, p = 0.036) was found in the correlation study between the administration of methylprednisolone and length of stay (LOS), indicating possible benefits in terms of shortening hospital stays.  Conclusion This research offers a significant understanding of the clinical manifestation, treatment, and complications of acute myocarditis in children. Methylprednisolone administration seems to be linked to a shorter length of stay (LOS), despite disagreements over treatment approaches. To confirm these results and provide guidance for evidence-based management guidelines for pediatric myocarditis in our setup, more studies are necessary.

Dose-Response Study of Caffeine on Postnatal Weight Gain in Premature Neonates-A Retrospective Cohort Study.

Background: Caffeine citrate (CC)-induced excessive energy expenditure, diuresis, natriuresis, and other CC-associated potential side effects (CC-APSEs) result in lower daily weight gain (WG) in premature neonates. This study aimed to assess higher CC-doses' effect on the mean daily-WG (MD-WG) and CC-APSE development, considering 5 mg/kg/day as the standard regimen. Method: This retrospective cohort study included neonates of ≤36 weeks gestational age and received CC-therapy. The same participants were followed for data analysis in two postnatal phases: 15-28 and 29-42 days of life (DOL). Based on daily CC-dose, formed group-I=(5 mg/kg/day), group-II=(>5-7 mg/kg/day), and group-III=(>7 mg/kg/day). Data was analyzed separately for group-II and group-III using group-I as the standard. Results: The study included 284 neonates. During phase-I, the MD-WG was significantly higher in group-I than group-II (19.9 ± .88 g/kg/d vs 17.5 ± .49, P = .031) and group-III (19.9 ± .88 g/kg/d vs 16.7 ± .71, P < .001). During 29-42 DOL, the MD-WG of group-I was only significantly higher than group-III (21.5 ± .42 g/kg/d vs 18.1 ± .39 g/kg/d, P = .003) and comparable with group-II. During 15-28 DOL, CC-APSEs were significantly higher in group-II and group-III but during 29-42 DOL was significant only in group-III. Conclusion: Exposure to higher caffeine doses in this study cohort is associated with lower postnatal WG in preterm neonates than standard daily doses may be due to its catabolic effects and CC-APSEs.

Utilizing Nanostructured Materials for Hydrogen Generation, Storage, and Diverse Applications.

The rapid advancement of refined nanostructures and nanotechnologies offers significant potential to boost research activities in hydrogen storage. Recent innovations in hydrogen storage have centered on nanostructured materials, highlighting their effectiveness in molecular hydrogen storage, chemical storage, and as nanoconfined hydride supports. Emphasizing the importance of exploring ultra-high-surface-area nanoporous materials and metals, we advocate for their mechanical stability, rigidity, and high hydride loading capacities to enhance hydrogen storage efficiency. Despite the evident benefits of nanostructured materials in hydrogen storage, we also address the existing challenges and future research directions in this domain. Recent progress in creating intricate nanostructures has had a notable positive impact on the field of hydrogen storage, particularly in the realm of storing molecular hydrogen, where these nanostructured materials are primarily utilized.

Recent Advances in Bimetallic Catalysts for Methane Steam Reforming in Hydrogen Production: Current Trends, Challenges, and Future Prospects.

As energy demand continues to rise and the global population steadily grows, there is a growing interest in exploring alternative, clean, and renewable energy sources. The search for alternatives, such as green hydrogen, as both a fuel and an industrial feedstock, is intensifying. Methane steam reforming (MSR) has long been considered a primary method for hydrogen production, despite its numerous advantages, the activity and stability of the conventional Ni catalysts are major concerns due to carbon formation and metal sintering at high temperatures, posing significant drawbacks to the process. In recent years, significant attention has been given to bimetallic catalysts as a potential solution to overcome the challenges associated with methane steam reforming. Thus, this review focuses on the recent advancements in bimetallic catalysts for hydrogen production through methane steam reforming. The review explores various aspects including reactor type, catalyst selection, and the impact of different operating parameters such as reaction temperature, pressure, feed composition, reactor configuration, and feed and sweep gas flow rates. The analysis and discussion revolve around key performance indicators such as methane conversion, hydrogen recovery, and hydrogen yield.

Frequency of Congenital Cardiac Disease in Various Divisions of Khyber Pakhtunkhwa (KPK) Based on a Six-Month Analysis of Inpatients at a Tertiary Care Hospital's Pediatric Cardiology Unit.

OBJECTIVE: To identify the frequency of congenital heart disease (CHD) in various Khyber Pakhtunkhwa (KPK) divisions. MATERIALS AND METHODS: To perform this research, we reviewed the medical records of pediatric cardiology patients hospitalized between January 2022 and July 2022. Data was taken from the cardiology department's computerized data system between January 1 and July 31, 2022. To prevent any errors in diagnosis and address them during input by the ward clerk, patients' addresses, diagnoses, and gender were verified with the computerized medical record. Data were analyzed, and frequency and percentages were calculated. Per the digital mapping of KPK districts, we stratified and examined the data among various KPK divisions. RESULTS: Out Of the 371 patients with CHD who were admitted, 36.98% (137) were from the Peshawar division, 28.84% (107) from the Malakand division, 16.71% (62) from the Mardan division, 6.1% (23) from the Kohat division, 4.3% (16) from the Bannu division, 3.5% (13) from the Dera Ismail Khan division, and 3.5% (13) from the Hazara division. A total of 371 had CHD, of which 234 (63.07%) were cyanotic and 137 (36.92%) were cyanotic. The most prevalent acynotic congenital heart defect was patent ductus arteriosus (PDA) at 36.32% (85), followed by a ventricular septal defect (VSD) at 35.04 (82). The most frequent acyanotic congenital cardiac abnormality was tetralogy of Fallot (TOF) at 49.63% (68), which was followed by transposition of the great arteries (TGA) at 33.57% (46). CONCLUSION: In KPK, congenital heart disease is most prevalent in the divisions of Peshawar and Malakand, while it is least prevalent in Hazara.

Chemical Upcycling of Waste Plastics to High Value-Added Products via Pyrolysis: Current Trends, Future Perspectives, and Techno-Feasibility Analysis.

Chemical upcycling of waste plastics into high-value-added products is one of the most effective, cost-efficient, and environmentally beneficial solutions. Many studies have been published over the past few years on the topic of recycling plastics into usable materials through a process called catalytic pyrolysis. There is a significant research gap that must be bridged in order to use catalytic pyrolysis of waste plastics to produce high-value products. This review focuses on the enhanced catalytic pyrolysis of waste plastics to produce jet fuel, diesel oil, lubricants, aromatic compounds, syngas, and other gases. Moreover, the reaction mechanism, a brief and critical comparison of different catalytic pyrolysis studies, as well as the techno-feasibility analysis of waste plastic pyrolysis and the proposed catalytic plastic pyrolysis setup for commercialization is also covered.

Strategies for improving the photocatalytic performance of metal-organic frameworks for CO2 reduction: A review.

Photocatalytic CO2 reduction is an appealing strategy for mitigating the environmental effects of greenhouse gases while simultaneously producing valuable carbon-neutral fuels. Numerous attempts have been made to produce effective and efficient photocatalysts for CO2 reduction. In contrast, the selection of competitive catalysts continues to be a substantial hindrance and a considerable difficulty in the development of photocatalytic CO2 reduction. It is vital to emphasize different techniques for building effective photocatalysts to improve CO2 reduction performance in order to achieve a long-term sustainability. Metal-organic frameworks (MOFs) are recently emerging as a new type of photocatalysts for CO2 reduction due to their excellent CO2 adsorption capability and unique structural characteristics. This review examines the most recent breakthroughs in various techniques for modifying MOFs in order to improve their efficiency of photocatalytic CO2 reduction. The advantages of MOFs using as photocatalysts are summarized, followed by different methods for enhancing their effectiveness for photocatalytic CO2 reduction via partial ion exchange of metal clusters, design of bimetal clusters, the modification of organic linkers, and the embedding of metal complexes. For integrating MOFs with semiconductors, metallic nanoparticles (NPs), and other materials, a number of different approaches have been also reviewed. The final section of this review discusses the existing challenges and future prospects of MOFs as photocatalysts for CO2 reduction. Hopefully, this review can stimulate intensive research on the rational design and development of more effective MOF-based photocatalysts for visible-light driven CO2 conversion.

Congenital Heart Disease and Its Association in Children With Down Syndrome.

Objective The objective is to determine the frequency of different congenital heart diseases and their association in children with Down syndrome (DS). Methodology This cross-sectional observational study was conducted in the pediatric department of Peshawar Institute of Cardiology, Peshawar, Pakistan from August 2021 to July 2022. A total of 123 children with DS and congenital heart disease (CHD) were included in this cross-sectional study. Detailed history and examination were performed, and findings were documented on performed pro forma. Diagnosis of CHD was confirmed through two-dimensional (2D) and Doppler echocardiography performed by a pediatric cardiologist. Patients were managed according to standard protocols and guidelines. The data including age, gender, mother's age at the time of birth, type of CHD and growth failure were documented and analyzed. Percentages were used to express frequencies. Results The mean age was 2.2 years ± 3.4 years (interquartile range (IQR): 10 days to 14 years). There were 65 (52.8%) male and 58 (47.1%) female patients. Out of 123 patients, 101 (82.1%) had acyanotic CHD and 22 (17.8%) had cyanotic CHD. Among acyanotic CHD, isolated ventricular septal defect (VSD) was the most common observation in 23 (22.3%) and among cyanotic CHD, tetralogy of Fallot (TOF) in seven (31.8%) patients. The most common associations of CHD were VSD+ patent ductus arteriosus (PDA) in 11 (9%) patients and atrial septal defect (ASD)+PDA in nine (7.3%) patients. The median age of the mother at delivery was 31 years (interquartile range (IQR): 20 years to 45 years). Growth failure was seen in 70 (56.9%) patients. Conclusion Based on our data, VSD is the most common CHD followed by a complete atrio-VSD (CAVSD) in children with DS. The most common association of CHD in DS is VSD with PDA. Growth failure is seen in most of the patients with DS having a CHD.

Organic amendments and conservation tillage improve cotton productivity and soil health indices under arid climate.

Long-term different tillage system field trials can provide vital knowledge about sustainable changes in soil health indices and crop productivity. This study examined cotton productivity and soil health indices under different tillage systems and organic materials. The present study was carried out at MNS University of Agriculture, Multan to explore the effect of different tillage systems: conventional tillage (T1), conservation tillage (T2), and organic materials: control (recommended dose of synthetic fertilizers; 160:90:60 kg ha-1NPK), poultry manure (10 t ha-1 PM), compost (10 t ha-1 CM), farmyard manure (20 t ha-1 FYM), and biochar (7 t ha-1 BC) on cotton productivity and soil health indices. Two years field trials showed that different tillage systems and organic materials significantly improved the growth, morphological, and yield attributes of cotton and soil health indices. The cotton showed highest seed cotton yield (3692-3736 kg ha-1), and soil organic matter (0.809-0.815%), soil available nitrogen (74.3-74.6 mg kg-1), phosphorus (7.29-7.43 mg kg-1), and potassium (213-216 mg kg-1) under T2 in comparison to T1 system during both years of field experiment, respectively. Similarly, PM (10 t ha-1) showed highest seed cotton yield (3888-3933 kg ha-1), and soil organic matter (0.794-0.797%), nitrogen (74.7-75.0 mg kg-1), phosphorus (7.39-7.55 mg kg-1), and potassium (221-223 mg kg-1) when these are compared to FYM (20 t ha-1), CM (10 t ha-1), and BC (7 t ha-1) during both years of field experiment, respectively. These findings indicate that conservation tillage system with application of 10 t ha-1 PM are the best practices for the sustainable cotton production and to ensure improvement in the soil health indices under arid climatic conditions.

A new spatiotemporal two-stage standardized weighted procedure for regional drought analysis.

Drought is a complex phenomenon that occurs due to insufficient precipitation. It does not have immediate effects, but sustained drought can affect the hydrological, agriculture, economic sectors of the country. Therefore, there is a need for efficient methods and techniques that properly determine drought and its effects. Considering the significance and importance of drought monitoring methodologies, a new drought assessment procedure is proposed in the current study, known as the Maximum Spatio-Temporal Two-Stage Standardized Weighted Index (MSTTSSWI). The proposed MSTTSSWI is based on the weighting scheme, known as the Spatio-Temporal Two-Stage Standardized Weighting Scheme (STTSSWS). The potential of the weighting scheme is based on the Standardized Precipitation Index (SPI), Standardized Precipitation Evapotranspiration Index (SPEI), and the steady-state probabilities. Further, the STTSSWS computes spatiotemporal weights in two stages for various drought categories and stations. In the first stage of the STTSSWS, the SPI, SPEI, and the steady-state probabilities are calculated for each station at a 1-month time scale to assign weights for varying drought categories. However, in the second stage, these weights are further propagated based on spatiotemporal characteristics to obtain new weights for the various drought categories in the selected region. The STTSSWS is applied to the six meteorological stations of the Northern area, Pakistan. Moreover, the spatiotemporal weights obtained from STTSSWS are used to calculate MSTTSSWI for regional drought characterization. The MSTTSSWI may accurately provide regional spatiotemporal characteristics for the drought in the selected region and motivates researchers and policymakers to use the more comprehensive and accurate spatiotemporal characterization of drought in the selected region.

A new comprehensive approach for regional drought monitoring.

The Standardized Precipitation Index (SPI) is a vital component of meteorological drought. Several researchers have been using SPI in their studies to develop new methodologies for drought assessment, monitoring, and forecasting. However, it is challenging for SPI to provide quick and comprehensive information about precipitation deficits and drought probability in a homogenous environment. This study proposes a Regional Intensive Continuous Drought Probability Monitoring System (RICDPMS) for obtaining quick and comprehensive information regarding the drought probability and the temporal evolution of the droughts at the regional level. The RICDPMS is based on Monte Carlo Feature Selection (MCFS), steady-state probabilities, and copulas functions. The MCFS is used for selecting more important stations for the analysis. The main purpose of employing MCFS in certain stations is to minimize the time and resources. The use of MCSF makes RICDPMS efficient for drought monitoring in the selected region. Further, the steady-state probabilities are used to calculate regional precipitation thresholds for selected drought intensities, and bivariate copulas are used for modeling complicated dependence structures as persisting between precipitation at varying time intervals. The RICDPMS is validated on the data collected from six meteorological locations (stations) of the northern area of Pakistan. It is observed that the RICDPMS can monitor the regional drought and provide a better quantitative way to analyze deficits with varying drought intensities in the region. Further, the RICDPMS may be used for drought monitoring and mitigation policies.

Pattern of Vascular Anomalies Associated With Sinus Venosus Atrial Septal Defect.

Objective To evaluate children with sinus venosus atrial septal defect (SV-ASD) for associated vascular anomalies. Methodology A total of 72 children with sinus venosus atrial septal defect with partial anomalous pulmonary venous return who presented to pediatric cardiology unit, Lady Reading Hospital Peshawar, from January 2019 till June 2021 were included in this cross-sectional study. Diagnosis of sinus venosus atrial septal defect was confirmed through two-dimensional (2D) and Doppler echocardiography performed by a pediatric cardiologist. Cardiac CT angiography was performed and assessed by a pediatric cardiac interventionist and radiologist. Patients were managed according to standard protocols and guidelines. The data were entered and analyzed with Statistical Package for the Social Sciences (SPSS) version 20. Percentages were used to express frequencies. Results Mean age was 8.3 ± 2.7 years (interquartile range (IQR): two months to 18 years). There were 37 (51.4%) male and 35 (48.6%) female patients. Out of 72 patients, 64 (88.8%) patients had superior sinus venosus atrial septal defect, while inferior sinus venosus atrial septal defect was found in eight (11.1%) patients. In six (8.3%) patients, associated secundum atrial septal defect was identified. Bilateral superior vena cava was found in seven (9.7%) patients. Left aortic arch was seen in 70 (97.2%) patients, whereas two (2.7%) patients had right aortic arch. Conclusion Sinus venosus ASD is a rare type of atrial septal defect which is also associated with both pulmonary and systemic vascular anomalies. Diagnosing these vascular anomalies is of paramount importance before any corrective intervention can be done. Recognizing the pattern of these anomalies should be known to every interventional cardiologist, radiologist, and cardiac surgeon. Echocardiography alone is not a good tool to assess these extracardiac structures. Imaging modalities like CT angiography and MRI have refined our preoperative workup which is essential for the ultimate outcome of the corrective intervention.

The Outcome of Trans-catheter Closure of Patent Ductus Arteriosus: A Single-Center Experience.

Objective The objective is to share our experience of trans-catheter device closure of patent ductus arteriosus (PDA) and review its efficacy and immediate complications. Methodology This cross-sectional observational study was done in the Department of Pediatric cardiology, Lady Reading Hospital, Peshawar from January 2020 to December 2020. A total of 51 patients with isolated PDA, who underwent PDA device closure, were enlisted in this study through consecutive sampling methods, irrespective of their age and gender. Data of the patients were collected on preformed pro forma. Data was entered in SPSS 20 (SPSS Inc., Chicago, IL, USA). Descriptive statistics like mean ± SD for numerical data (age, weight, and hospital stay), while frequency and percentage for categorical variables (Device type, complication, hospital stay, and type of anesthesia given) were calculated. Results Among total 51 patients (33 [64.7%] females and 18 [35.3%] males) with mean age 8.19 ± 6.96 years underwent attempted trans-catheter PDA device closure. In all cases PDA was successfully occluded with appropriate size devices. General anesthesia was given in 38 (74.5%) patients. Complications occurred in only four (7.8%) patients in the form of hemolysis followed by acute kidney injury in one patient, another had device embolization to descending aorta, which was retrieved in cath lab, one had device embolization to the right pulmonary artery, which was retrieved in cath lab and one had mild left ventricular systolic dysfunction. The mean duration of hospital stay was 22.0 ± 10.2 h. Conclusion Trans-catheter PDA device closure is a safe procedure with a high success rate and little morbidity.

Adhatoda vasica and Calotropis procera as a resource of novel chemical compounds, their biological bioluminescence assay, and investigation of morphological features of bacterial growth through advanced technologies.

This article reports the three principal groups of compounds for the first time from Adhatoda vasica and Calotropis procera plants species using nuclear magnetic resonance methods in which aliphatic, oxy heterocyclic, and tannins compounds were detected from these plants. The leaves of both species were subjected to testing tyrosinase inhibition and antioxidant activities. ATP bioluminescence use for indirect measurement of the amount of organic residue on the surface of the leaves that provide support to microbial growth. The distinguishing characteristics and intraoperative findings of bacterial diseases involved in treatments were conducted against the positive and negative microbial strains using a scanning electron microscope (SEM). The methanolic extracts of leaves of both species were applied to bacterial strains through broth microdilution method to determine the minimum inhabitation concentrations (MICs) for both species. It was concluded that both plants are a rich resource of bioactive compounds. Their extract may also be used to treat various bacterial diseases and in drug manufacturing. HIGHLIGHTS: New chemical compounds of oxy-heterocyclic, aliphatic, and tannins derivatives are isolated from herbal plants as a source of various drugs. 1 H NMR spectrum and 13 C NMR spectrum of each new derivate were calculated. NMR-spectral analysis of new compound of chemistry class was studied and further applied in various bacterial strains. Tyrosinase inhibition property of bacteria strains by application of active compounds on these strains. Agar overlay bioassays were used to evaluate intercellular morphological features of strains applied on extracts by electron microscope (SEM). a-Glucosidase inhibition assay determined with antioxidants activity through FRAP assay methods.

Recent Breakthroughs and Advancements in NOx and SOx Reduction Using Nanomaterials-Based Technologies: A State-of-the-Art Review.

Nitrogen and sulpher oxides (NOx, SOx) have become a global issue in recent years due to the fastest industrialization and urbanization. Numerous techniques are used to treat the harmful exhaust emissions, including dry, traditional wet and hybrid wet-scrubbing techniques. However, several difficulties, including high-energy requirement, limited scrubbing-liquid regeneration, formation of secondary pollutants and low efficiency, limit their industrial utilization. Regardless, the hybrid wet-scrubbing technology is gaining popularity due to low-costs, less-energy consumption and high-efficiency removal of air pollutants. The removal/reduction of NOx and SOx from the atmosphere has been the subject of several reviews in recent years. The goal of this review article is to help scientists grasp the fundamental ideas and requirements before using it commercially. This review paper emphasizes the use of green and electron-rich donors, new breakthroughs, reducing GHG emissions, and improved NOx and SOx removal catalytic systems, including selective/non-catalytic reduction (SCR/SNCR) and other techniques (functionalization by magnetic nanoparticles; NP, etc.,). It also explains that various wet-scrubbing techniques, synthesis of solid iron-oxide such as magnetic (Fe3O4) NP are receiving more interest from researchers due to the wide range of its application in numerous fields. In addition, EDTA coating on Fe3O4 NP is widely used due to its high stability over a wide pH range and solid catalytic systems. As a result, the Fe3O4@EDTA-Fe catalyst is projected to be an optimal catalyst in terms of stability, synergistic efficiency, and reusability. Finally, this review paper discusses the current of a heterogeneous catalytic system for environmental remedies and sustainable approaches.

Emergency Department Presentation and Outcome of Children With Cyanotic Congenital Heart Diseases.

Objective This study aimed to assess the outcome and see the spectrum of presenting symptoms of children with cyanotic congenital heart diseases (CHDs) admitted through the emergency department in Lady Reading Hospital (LRH) in Peshawar, Pakistan. Materials and methods This cross-sectional study included 104 children with cyanotic CHD admitted through the emergency department in the pediatric cardiology unit of LRH from February 2019 to January 2020. Diagnosis of cyanotic CHD was confirmed through two-dimensional echocardiography. Patients were treated according to standard protocols for their presenting symptoms. The data were analyzed using Statistical Package for the Social Sciences (SPSS), version 20.0 (IBM Corp., Armonk, NY) and frequencies were expressed as percentages. Results The study included 65 male cases (62.5%) and 39 female cases (37.5%), and participant ages ranged from 10 days to 15 years (mean, 2.7 ± 3.4 years). Of 104 patients, 70 presented with cyanotic spells (84.5%), 53 with fever (10.7%), 28 with respiratory distress (26.5%), 11 with loose stools (10.5%), 10 with hemiplegia (9.6%), and eight with seizures (7.6%). Pneumonia was a precipitating factor in 13 patients (12.5%), infective endocarditis in 12 patients (11%), gastroenteritis in 11 (11%), brain abscess and cerebrovascular accidents in seven patients each (6% each), meningitis in six patients (6%), and tuberculous pericardial effusion in one patient (<1%). The primary CHD was tetralogy of Fallot (TOF) in 52 patients, tricuspid atresia in 14 patients, pulmonary atresia in 13 patients, double outlet right ventricle in 10 patients, transposition of great arteries (TGA) in seven patients, and total anomalous pulmonary venous return (TAPVR), truncus arteriosus, congenitally corrected TGA, and critical pulmonary stenosis in two patients each. Twenty-six patients received treatment of the acute problem and instructions for follow-up monitoring. Twelve patients died during their hospital stay, and three left against medical advice. Fifteen patients received patent ductus arteriosus stenting, and six received right ventricular outflow tract stenting. One patient received a Blalock-Taussig (BT) shunt stent, and one received a left pulmonary artery stent. Two patients received a balloon pulmonary valvotomy, and one received pericardial effusion drainage. Eleven patients received surgical correction of TOF, 11 received surgical correction for BT shunt, four received surgical correction for brain abscess drainage, and two received TAPVR repair. Conclusion TOF was the most common cyanotic heart disease in our study. Cyanotic spells or increased cyanosis was the most common presenting concern. Cyanotic CHDs present with variable extracardiac signs and symptoms in emergencies. Appropriate assessment, immediate management of the acute problem, and timely intervention or surgical management result in good outcomes.

Use of non-homogeneous Poisson process for the analysis of new cases, deaths, and recoveries of COVID-19 patients: A case study of Kuwait.

The coronavirus disease spread out rapidly in China and then in the whole world. Kuwait is one of those countries which are positively affected by this pandemic. Objective : The current study aims to provide an appropriate and novel framework for the analysis of the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infected patient's counts and rate of change in these counts with respect to time. Therefore, we considered the number of SARS- CoV-2 patients, i.e., confirmed cases, deaths, and recoveries for Kuwait, ranging from the 24th of February 2020 to the 25th of August 2020. Method : Here, we used the Markov Chain Monte Carlo (MCMC) simulation methods for the data analysis of SARS-CoV-2 to develop the Bayesian analysis of the Non-Homogeneous Poisson Process (NHPP). For this purpose, we used the two unique models of NHPP: the linear intensity function and the power law process. The discrimination methods are also discussed to select a better model for daily basis data of confirmed cases, deaths, and recoveries of SARS-CoV-2 patients. The appropriate model is selected based on the Deviance Information Criteria (DIC). Results : The value of DIC indicates that the power-law process performs better than the linear intensity functions for estimating and presenting all the study variables. The current study explored the usefulness and significance of the proposed research framework to analyze the SARS-CoV-2 new confirmed cases, recoveries, and deaths in a specific area. Conclusion : The findings of the study will be helpful for the health organizations or authorities to develop the approaches based on the current resources and situations due to the pandemic. The provided framework could be beneficial in analyzing the second and third layers of COVID-19 in the area. The analysis of the counts for each study variable and for each variable a comparative analysis of all the three layers is the aim of our future study.

Optimizing sowing date for peanut genotypes in arid and semi-arid subtropical regions.

Peanut (Arachis hypogea L.) is an important nut crop extensively grown in rainfed regions of Pakistan. The crop requires low inputs; thus, could grow successfully under diverse environmental conditions. Due to pegging ability, peanut grows aggressively in sandy and sandy-loam soils. However, it has not introduced to Thal region of southern Punjab, Pakistan. A two-year field experiment was conducted to optimize sowing dates for two peanut genotypes ('BARI-2016' and 'NO-334') in Thal region (Layyah). Similarly, a yield trial was conducted at Chakwal where both genotypes are extensively grown. Five sowing dates (10th April, 1st May, 20th May, 10th June and 30th June) were included in the study. The highest seed yield was obtained with early sown crop (10th April) during both years. Pod formation reduced with increasing atmospheric temperature and no pods were formed on the plants sown on 30th June. Decreased pod formation seemed a major reason for low yield in late-sown crop. The highest yield was observed for the crop sown on 10th April, which was decreased by 40% for the crop sown on 1st May. Genotype 'BARI-2016' performed better for seed yield at both locations compared with 'NO-334'. The results suggested that genotype 'BARI-2016' is more adaptive to arid and semi-arid condition under rainfed or irrigated conditions. Sowing peanut at optimum time would increase seed yield in arid and semi-arid regions. Nonetheless, 'BARI-2016' can be grown under rainfed and irrigated conditions successfully.

Association of Early-onset Androgenetic Alopecia and Metabolic Syndrome.

OBJECTIVE:  To evaluate the association of early-onset AGA (androgenetic alopecia) and metabolic syndrome in the younger male population. STUDY DESIGN: Case-control study. PLACE AND DURATION OF STUDY:  Department of Dermatology, Mayo Hospital Lahore, from October 2017 to March 2018. METHODOLOGY: A total of 202 patients were enrolled, 101 male patients with early-onset AGA (cases with a alopecia between 20-36 years of age), and were matched with 101 controls. All measurements regarding BMI, metabolic syndrome, and grades of alopecia were recorded on a pre-designed proforma. RESULTS: Of the 101 cases (mean age 27.77 ± 5.04 years), 27 (26.7%) had grade 3, 41 (40.6%) had grade 4, 29 (28.7%) had grade 5 and 4 (4%) had grade 6 AGA. Patients of AGA had an approximate four times increased frequency of metabolic syndrome. Of the cases 12 (11.9%) had metabolic syndrome whereas it was found in 3 (3%) of the control group. A significant association was found between cases of AGA and metabolic syndrome (p=0.016). CONCLUSION: This study suggests a significant association of AGA with metabolic syndrome. Key Words: Androgenetic alopecia, Metabolic syndrome, Early-onset alopecia, Cardiovascular disease.

Recent advances in hybrid wet scrubbing techniques for NOx and SO2 removal: State of the art and future research.

Recently, the discharge of flue gas has become a global issue due to the rapid development in industrial and anthropogenic activities. Various dry and wet treatment approaches including conventional and hybrid hybrid wet scrubbing have been employing to combat against these toxic exhaust emissions. However, certain issues i.e., large energy consumption, generation of secondary pollutants, low regeneration of scrubbing liquid and high efficieny are hindering their practical applications on industrial level. Despite this, the hybrid wet scrubbing technique (advanced oxidation, ionic-liquids and solid engineered interface hybrid materials based techniques) is gaining great attention because of its low installation costs, simultaneous removal of multi-air pollutants and low energy requirements. However, the lack of understanding about the basic principles and fundamental requirements are great hurdles for its commercial scale application, which is aim of this review article. This review article highlights the recent developments, minimization of GHG, sustainable improvements for the regeneration of used catalyst via green and electron rich donors. It explains, various hybrid wet scrubbing techniques can perform well under mild condition with possible improvements such as development of stable, heterogeneous catalysts, fast and in-situ regeneration for large scale applications. Finally, it discussed recovery of resources i.e., N2O, NH3 and N2, the key challenges about several competitive side products and loss of catalytic activity over time to treat toxic gases via feasible solutions by hybrid wet scrubbing techniques.