Sustainable coatings for green solar photovoltaic cells: performance and environmental impact of recyclable biomass digestate polymers.

The underutilization of digestate-derived polymers presents a pressing environmental concern as these valuable materials, derived from anaerobic digestion processes, remain largely unused, contributing to pollution and environmental degradation when left unutilized. This study explores the recovery and utilization of biodegradable polymers from biomass anaerobic digestate to enhance the performance of solar photovoltaic (PV) cells while promoting environmental sustainability. The anaerobic digestion process generates organic residues rich in biodegradable materials, often considered waste. However, this research investigates the potential of repurposing these materials by recovering and transforming them into high-quality coatings or encapsulants for PV cells. The recovered biodegradable polymers not only improve the efficiency and lifespan of PV cells but also align with sustainability objectives by reducing the carbon footprint associated with PV cell production and mitigating environmental harm. The study involves a comprehensive experimental design, varying coating thickness, direct normal irradiance (DNI) (A), dry bulb temperature (DBT) (B), and relative humidity (C) levels to analyze how different types of recovered biodegradable polymers interact with diverse environmental conditions. Optimization showed that better result was achieved at A = 8 W/m2, B = 40 °C and C = 70% for both the coated material studied. Comparative study showed that for enhanced cell efficiency and cost effectiveness, EcoPolyBlend coated material is more suited however for improving durability and reducing environmental impact NanoBioCelluSynth coated material is preferable choice. Results show that these materials offer promising improvements in PV cell performance and significantly lower environmental impact, providing a sustainable solution for renewable energy production. This research contributes to advancing both the utilization of biomass waste and the development of eco-friendly PV cell technologies, with implications for a more sustainable and greener energy future. This study underscores the pivotal role of exploring anaerobic digestate-derived polymers in advancing the sustainability and performance of solar photovoltaic cells, addressing critical environmental and energy challenges of our time.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 7 Given name: [Ashok] Last name [Kumar Yadav]. Also, kindly confirm the details in the metadata are correct.correct.

4-E analysis and multiple objective optimizations of a novel solar-powered cogeneration energy system for the simultaneous production of electrical power and heating.

Owing to its natural and rich advantages, exploration of solar energy technology has become increasingly popular in recent years to counter the growing crude oil prices. However, its universal adoption is still limited, not only due to environmental restrictions but also due to lower overall efficiency. Rankine cycle is optimised to conduct 4-E (Exergy, Energy, Economic and Ecological) analysis. Furthermore, three sets (R-113, R-11, and R-1233zd) of refrigerants are prioritised and ranked on the basis of 4-E analysis as outcomes. The contemporary study addressed all critical factors and explains the impact of solar irradiance, mass flow rate of molten salt and steam, turbine inlet pressure, and turbine inlet temperature which are eventually weighed and prioritised using combined multi-criteria decision making (MCDM) techniques. The energy efficiency, exergetic efficiency, power/ cost of electricity, and ecological emissions are taken as the indicators of the combined cycle, respectively. The energy efficiency of the hybrid system is improved to 75.07% after including cogeneration cycle, with an increment of 54.58%. In comparison to conventional thermal powerplant setups, the power/cost of electricity and ecological efficiency have been reduced by 68% and upgraded by 16%, correspondingly. Direct normal radiation is the most critical factor followed by turbine inlet temperature. Further, the result indicates that maximum exergy destruction that occurs in the central receiver declines to 39.92%, followed by heliostat and steam turbine which was 27% and 9.32% respectively. In conclusion, the hybrid cycle can furnish cheaper electricity, with lower carbon imprint in sustainable manner with better efficiency.

Experimental investigation and multi-performance optimization of the leachate recirculation based sustainable landfills using Taguchi approach and an integrated MCDM method.

Landfill leachates contain harmful substances viz. chemicals, heavy metals, and pathogens, that pose a threat to human health and the environment. Unattended leachate can also cause ground water contamination, soil pollution and air pollution. This study focuses on management of leachate, by recirculating the rich, nutrient-filled fluid back into the landfills, turning it to a bioreactor, thereby maximising the performance parameters of landfills favourable for electricity production by the waste to energy plants. This study demonstrates a sustainable alternative method for utilising the fluid, rather than treating it using an extremely expensive treatment process. Further, it also experimentally investigates the effect of varying levels of five input parameters of the landfill including waste particle size, waste addition, inorganic content in waste, leachate recirculation rate, and landfill age, each at five levels, on the multiple performance of the landfill using Taguchi's L25 standard orthogonal array. Experimental results are analysed using an integrated MCDM approach i.e. MEREC-PIV method and statistical techniques such as analysis of mean (ANOM) and analysis of variance (ANOVA). The results indicate that the optimal setting of the input parameters is waste particle size at 9 ppm, waste addition at 80 Ktoe, inorganic content in waste at 2%, leachate recirculation rate at 250 l/day and landfill age at 3 years. Further, inorganic content waste is found to be the most significant parameter for the multiple performance of the landfill. This study presents a novel approach to produce input parameters for power plants which may enhance their profitability and sustainability.

Modelling of compression ignition engine by soft computing techniques (ANFIS-NSGA-II and RSM) to enhance the performance characteristics for leachate blends with nano-additives.

Integrating nanoparticles in waste oil-derived biodiesel can revolutionize its performance in internal combustion engines, making it a promising fuel for the future. Nanoparticles act as combustion catalysts, enhancing combustion efficiency, reducing emissions, and improving fuel economy. This study employed a comprehensive approach, incorporating both quantitative and qualitative analyses, to investigate the influence of selected input parameters on the performance and exhaust characteristics of biodiesel engines. The focus of this study is on the potential of using oils extracted from food waste that ended up in landfills. The study's results are analysed and compared with models created using intelligent hybrid prediction approaches including adaptive neuro-fuzzy inference system, Response surface methodology-Genetic algorithm, and Non sorting genetic algorithm. The analysis takes into account engine load, blend percentage, nano-additive concentration, and injection pressure, and the desired responses are the thermal efficiency and specific energy consumption of the brakes, as well as the concentrations of carbon monoxide, unburned hydrocarbon, and oxides of nitrogen. Root-mean-square error and the coefficient of determination were used to assess the predictive power of the model. Comparatively to Artificial Intelligence and the Response Surface Methodology-Genetic Algorithm model, the results provided by NSGA-II are superior. This is because it achieved a pareto optimum front of 24.45 kW, 2.76, 159.54 ppm, 4.68 ppm, and 0.020243% for Brake Thermal Efficiency, Brake Specific Energy Consumption, Oxides of nitrogen, Unburnt Hydro Carbon, and Carbon monoxide. Combining the precision of ANFIS's prediction with the efficiency of NSGA-optimization II's gives a reliable and thorough evaluation of the engine's settings. The qualitative assessment considered practical aspects and engineering constraints, ensuring the feasibility of applying the parameters in real-world engine applications.

From Theory to Practice: A Sustainable Solution to Water Scarcity by Using a Hybrid Solar Distiller with a Heat Exchanger and Aluminum Oxide Nanoparticles.

The study presently conducted focused on analyzing a solar-powered desalination setup that had a double slope. It can recycle blackish water into drinking water with solar energy. Not only does this result in a significant decrease in carbon emissions but it also represents an environmentally beneficial alternative that is particularly suited for arid locations that are lacking of electrical infrastructure. This system was equipped with a PVT system which makes the system self-sustainable and a CPC collector and implemented the use of aluminum oxide (Al2O3) nanoparticles to enhance its energy efficiency. Energy matrices, economic analysis, and life cycle conversion efficiency were evaluated. The study was conducted annually in New Delhi, with input data provided by IMD in Pune, India. MATLAB was used for the analytical calculations. Energy and exergy were utilized to determine the average annual energy output, which was found to be 8.5%. Additionally, the average energy payback time was calculated to be 16.16%, the average energy payback factor was 13.91%, and the average life cycle cost conversion efficiency was 7.15% higher. The proposed system demonstrated superior performance compared to the previous system in terms of annual yield, energy payback time (EPBT), efficiency of life cycle cost (LCCE), and factor of energy payback (EPBF). The hybrid system has the potential to meet the future demand for potable water and become self-sustainable.

Inferior Vena Cava Thrombosis and Pulmonary Embolism in a Patient With Behcet Disease: A Rare Presentation.

Behcet syndrome is a systemic vasculitic syndrome. Vascular involvement in Behcet syndrome affects both arterial and venous vascular systems, contributing to significant morbidity and mortality. However, diagnosing vascular lesions can be challenging due to their resemblance to common vascular diseases, leading to potential misdiagnoses. This case report emphasizes the importance of recognizing atypical manifestations of this disease to ensure a prompt and accurate diagnosis. This case report describes a unique presentation of Behcet syndrome in a 23-year-old male patient who presented with per rectal bleeding, abdominal distension, right quadrant abdominal pain, pleuritic chest pain, and fever. The patient also reported a history of recurrent oral and genital ulcers, skin lesions, and a previous episode of dural venous sinus thrombosis. Extensive investigations revealed the involvement of the inferior vena cava and right hepatic vein, representing an atypical vascular manifestation of Behcet syndrome. Prompt diagnosis by a multidisciplinary team led to appropriate treatment with cyclophosphamide and steroids, resulting in the resolution of vascular thrombosis. In this particular case, the patient presented with involvement of the inferior vena cava and right hepatic vein, a rare and unusual manifestation of the disease. This case highlights the diverse nature of vascular complications in Behcet syndrome and underscores the importance of considering this diagnosis in patients with unexplained vascular abnormalities. Overall, this case report highlights the importance of considering Behcet syndrome in the differential diagnosis of patients with unexplained vascular manifestations. It also emphasizes the need for a comprehensive clinical evaluation and collaborative approach to ensure timely and effective management.

Acute-Onset Achalasia Following a Recent COVID-19 Infection: A Case Report.

Achalasia is a rare esophageal motility disorder that leads to dysphagia, regurgitation, and several other symptoms. While the etiology of achalasia is not completely understood, studies have suggested an immune reaction to viral infections, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as a potential cause. Here, we present a case report of a previously healthy 38-year-old male who presented to the emergency room with severe shortness of breath, recurrent vomiting, and dry cough, that had progressively worsened over five days. The patient was diagnosed with coronavirus disease 2019 (COVID-19), and a chest CT also revealed prominent features of achalasia with a markedly dilated esophagus and areas of narrowing at the distal esophagus. The initial management of the patient included IV fluids, antibiotics, anticholinergics, and corticosteroid inhalers which improved his symptoms. This case report highlights the importance of considering the acute-onset of achalasia in COVID-19 patients and the need for further research on the potential association between SARS-CoV-2 and achalasia.

Application of artificial intelligence in green building concept for energy auditing using drone technology under different environmental conditions.

Thermal losses through weak building envelope is responsible for global current energy crises. Application of artificial intelligence and drone setups in green buildings can help in providing the sustainable solution the world is striving for years. The contemporary research incorporates a novel concept of measuring the wearing thermal resistances in the building envelope with the aid of a drone system. The above procedure conducts a throughout building analysis by considering three prime environmental parameters such as wind speed (WS), relative humidity (RH) and dry bulb temperature (DBT) with the aid of drone heat mapping procedure. The novelty of the study can be interpreted by the fact that prior researches have never explored the building envelope through a combination of drone and climatic conditions as variables in building areas difficult to access, thereby providing an easier, risk free, cost effective and efficient reading. Validation of the formula is authenticated by employing artificial intelligence-based software's which are applied for data prediction and optimization. Artificial models are established to validate the variables for each output from the specified number of climatic inputs. The pareto-optimal conditions attained after analysis are 44.90% RH, 12.61 °C DBT and 5.20 km/h WS. The variables and thermal resistance were validated with response surface methodology method, thereby presenting lowest error rate and comprehensive R2 value, which are 0.547 and 0.97, respectively. Henceforth, employing drone-based technology in estimating building envelope discrepancies with the novel formula, yields consistent and effective assessment for development of green building, simultaneously reducing time and cost of the experimentation.

Comparative Study of Soft Computing and Metaheuristic Models in Developing Reduced Exhaust Emission Characteristics for Diesel Engine Fueled with Various Blends of Biodiesel and Metallic Nanoadditive Mixtures: An ANFIS-GA-HSA Approach.

Since the discovery of petrol-based products, a surge in energy-requiring equipment has been established across the world. Recent depletion of the existing crude oil resources has motivated researchers to opt for and analyze potential fuels that could potentially provide a cost-effective and sustainable solution. The current study selects a waste plant known as Eichhornia crassipes through which biodiesel is generated, and its blends are tested in diesel engines for feasibility. Different models using soft computing and metaheuristic techniques are employed for the accurate prediction of performance and exhaust characteristics. The blends are further mixed with nanoadditives, thereby exploring and comparing the changes in performance characteristics. The input attributes considered in the study comprise engine load, blend percentage, nanoparticle concentration, and injection pressure, while the outcomes are brake thermal efficiency, brake specific energy consumption, carbon monoxide, unburnt hydrocarbon, and oxides of nitrogen. Models were further ranked and chosen based on their set of attributes using the ranking technique. The ranking criteria for models were based on cost, accuracy, and skill requirement. The ANFIS harmony search algorithm (HSA) reported a lower error rate, while the ANFIS model reported the lowest cost. The optimal combination achieved was 20.80 kW, 2.48047, 150.501 ppm, 4.05025 ppm, and 0.018326% for brake thermal efficiency (BTE), brake specific energy consumption (BSEC), oxides of nitrogen (NOx), unburnt hydrocarbons (UBHC), and carbon monoxide (CO), respectively, thereby furnishing better results than the adaptive neuro-fuzzy interface system (ANFIS) and the ANFIS-genetic algorithm model. Henceforth, integrating the results of ANFIS with an optimization technique with the harmony search algorithm (HSA) yields accurate results but at a comparatively higher cost.

Compliance To Colonoscopy In Patients Visiting The Department Of Gastroenterology At Lady Reading Hospital, Peshawar.

Background: Colorectal cancer is the largest cause of mortality in patients admitted to any Gastroenterology units. Diagnostic colonoscopy is a valuable tool for the disease's diagnosis and proper treatment but its compliance has been historically low. Our main objective was to find out social, cultural, and psychological barriers among those patients who finally did not show up for their colonoscopy appointment and, make a comparative analysis with those who did. Methods: A cross-sectional study was conducted in the Lady Reading Hospital, Peshawar from October 2021 to March 2022, selecting 224 patients through consecutive sampling. Results: Out of the 224 patients included, males (48.2%) were more likely to show up for the procedure than females (51.8%) (p<0.05). Overall, the most recurring barrier was a lack of knowledge with 116 (51.7%) for both the groups, but especially more for the non-compliant patients (p<0.05). Fear of results, fear of complications of the procedure, and affordability issues stood out as important differences between the compliant and non-compliant patients. Conclusion: For the country's healthcare to be able to overcome these problems, and enter an era where screening colonoscopy is a norm, mass education regarding the issue is imperative.

Papillary Renal Cell Carcinoma As An Abdominal Cystic Mass.

Papillary renal cell carcinoma comprises around 15% of all renal cell carcinomas. Patients are usually asymptomatic, and 25 percent of individuals have advanced locoregional disease at presentation. Papillary renal cell carcinoma presenting as a huge abdominal cystic mass is uncommon and is reported rarely in literature. We present a case of renal cell carcinoma presenting with abdominal pain, distention, and constipation. A retroperitoneal cystic lesion measuring 23.4×23.8 cm cyst was reported on ultrasonography as potential cause of the symptoms. We now talk about the case of a 57- year-old male who presented to us with abdominal pain, distension, and constipation. He also had a history of on and off low-grade fever for the last seven months. A computed topography (CT scan) of the abdomen and pelvis with intravenous and oral contrast revealed a large retroperitoneal cystic mass extending from the left hypochondrium to the left kidney and into the pelvis crossing the midline. Internal calcific foci, enhancing septa, irregularly thickened walls and hyperdense nodules were also demonstrated. A radical left nephrectomy via a midline laparotomy was performed electively. The cystic mass was excised and the specimen was sent for histopathological evaluation which revealed papillary renal cell carcinoma with PAX-8 and CK-7 positivity. Patient made an uneventful recovery post-operatively and was discharged. Cystic tumors of renal origin can rarely present as a huge abdominal cystic mass confusing them for masses of intestinal or hepatic origin. Timely diagnosis can be made with a detailed history, examination, imaging studies and histopathology, and instigate timely intervention.

An Overview of Systemic Lupus Erythematosus (SLE) Pathogenesis, Classification, and Management.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease with multisystem involvement. It is multifactorial and involves epigenetic, genetic, ecological, and environmental factors. Primarily it leads to activation of both innate and adaptive immunity, which consequently leads to autoreactive B cell activation by T cells and leads to immune complexes deposition in tissues leading to an autoimmune cascade that may be limited to the single organ or can cause a widespread systemic involvement. SLE is heterogeneous in presentation, with a broad spectrum of clinical manifestations ranging from clinically mild self-resolving symptoms to severe life-threatening organ involvement. Clinical and serological heterogeneity are critical features in SLE, posing a significant challenge in its diagnosis. Antinuclear antibodies (ANA) are the telltale serological marker in more than 95% of SLE patients. The improved set of European Alliance of Associations for Rheumatology (EULAR) classification enabled accurate diagnosis of SLE. The treatment focuses on remission, preventing organ damage, and improving the overall quality of life.

Experimental analysis of solar powered disinfection tunnel mist spray system for coronavirus prevention in public and remote places.

There is a pressing need to accelerate the development of advanced technologies to prevent Coronavirus in large gatherings. The present system is an integration of tunnel disinfectant spray system and solar setup which utilises the solar energy to power a pump which pushes the required amount of chemical mixture into the nozzles of the spray system in order to eliminate any incoming virus or bacteria on the clothes of a particular person without wetting it. Data was gathered for a mall in New Delhi related to occupancy levels before and after lockdown. A 47% and 35% spike in energy and disinfectant mixture to pump was evaluated on weekends. A 70% reduction in operating cost was registered for solar based system in comparison to non-solar setup. Optimum conditions by considering efficiency and cost effectiveness evaluated are 8 number of nozzles, nozzle angle 55 degrees spray pressure 200 bar, and pressure 200 bar.

6TiSCH on SCµM: Running a Synchronized Protocol Stack without Crystals.

We report the first time-synchronized protocol stack running on a crystal-free device. We use an early prototype of the Single-Chip micro Mote, SCµM, a single-chip 2×3 mm 2 mote-on-a-chip, which features an ARM Cortex-M0 micro-controller and an IEEE802.15.4 radio. This prototype consists of an FPGA version of the micro-controller, connected to the SCµM chip which implements the radio front-end. We port OpenWSN, a reference implementation of a synchronized protocol stack, onto SCµM. The challenge is that SCµM has only on-chip oscillators, with no absolute time reference such as a crystal. We use two calibration steps - receiving packets via the on-chip optical receiver and RF transceiver - to initially calibrate the oscillators on SCµM so that it can send frames to an off-the-shelf IEEE802.15.4 radio. We then use a digital trimming compensation algorithm based on tick skipping to turn a 567 ppm apparent drift into a 10 ppm drift. This allows us to run a full-featured standards-compliant 6TiSCH network between one SCµM and one OpenMote. This is a step towards realizing the smart dust vision of ultra-small and cheap ubiquitous wireless devices.

Characteristics and outcome of viral pneumonia caused by influenza and Middle East respiratory syndrome-coronavirus infections: A 4-year experience from a tertiary care center.

BACKGROUND: After the emergence of new influenza viruses, the morbidity and mortality of viral pneumonia have received a great attention. OBJECTIVES: The objective of this study is to describe the epidemiologic, clinical and laboratory changes, and outcomes of viral pneumonia caused by influenza and the Middle East respiratory syndrome-coronavirus (MERS-CoV) infections. METHODS: In a retrospective cohort study, the medical records of all patients diagnosed with viral pneumonia at Prince Sultan Military Medical City, Riyadh, Saudi Arabia, during the period from January 2012 to December 2015 were screened. Cases who were > 18 years old and were confirmed by a respiratory viral panel to have viral pneumonia either MERS-CoV or influenza viruses were included in the analysis. Sociodemographic, clinical, laboratory, and outcome data were extracted from patients' medical files. The data were analyzed descriptively and inferentially to identify the predictors of poor outcome. RESULTS: A total of 448 patients with confirmed viral pneumonia were included, of those, 216 (48.2%) were caused by influenza A (non H1N1)/influenza B, 150 (33.5%) by H1N1, and 82 (18.3%) by MERS-CoV. The majority of patients presented with fever (82%), shortness of breath (64%), and flu-like symptoms (54.9%), particularly in MERS-CoV infected cases (92%). The peak incidence of viral pneumonia was in early spring and autumn. The mortality rate was 13.8%, and it was significantly higher among MERS-CoV cases. The predictors of death were age > 65 years, male gender, and associated comorbidities particularly diabetes mellitus, hypertension, and chronic kidney diseases. The number of comorbid illnesses was directly related to the increase in mortality in this group of patients. CONCLUSION: Viral pneumonia caused by influenza and MERS-CoV carries a high mortality rate, particularly among MERS-CoV infected cases. Old age, male gender, and comorbid illnesses are predictors of poor outcome. Routine testing for newly emergent viruses is warranted for adults who have been hospitalized with pneumonia.

Role of passive smoking in non-smoking related chronic obstructive pulmonary disease.

OBJECTIVE: To determine the association between passive smoking and chronic obstructive pulmonary disease. METHODS: The cross-sectional study was conducted from October 2015 to March 2016 at the Ojha campus of Dow University Hospital, Karachi, and comprised individuals who denied past or current active smoking and exposure to bio-mass fuel. The subjects were attendants coming with patients, hospital staff, faculty and medical students aged 15-64 years. Each subject undertook pulmonary function tests via spirometer after filling a proforma based on assessment and quantification of the exposure to second- hand smoke and common symptoms of chronic obstructive pulmonary disease. Data was analysed using SPSS20. RESULTS: Out of 307 subjects, 196(63.84%) were currently exposed to passive smoke either at home or at workplace or at both, and 24(12.24%) of them had chronic obstructive pulmonary disease, diagnosed by means of spirometry. Out of these subjects, 5(20.8%) had stage I, 9(37.5%) had stage II, 8(33.3%) had COPD stage III and 2(8.3%) had stage IV disease. A significant association was found between density of passive smoke inhaled over a period of time and chronic obstructive pulmonary disease (p<0.05). CONCLUSIONS: Passive smokers were found to be at risk of chronic obstructive pulmonary disease.

Utilization of high FFA landfill waste (leachates) as a feedstock for sustainable biodiesel production: its characterization and engine performance evaluation.

In present study, biodiesel was produced from landfill waste-derived oil by chemical transesterification process, to evaluate its potential as a renewable energy source for the first time. The free fatty acid percentage (FFA) in landfill waste oil is considered to be high, which was reduced by treating it with two different acids as catalyst, muriatic acid and phosphoric acid, in order to build a comparison between fatty acid methyl ester (FAME) contents. Further, it was treated with a base catalyst potassium hydroxide (KOH) to produce the final product. The FAME value of landfill oil when treated with muriatic acid was found to be 92.59%. The quality of biodiesel produced was analyzed by gas chromatography (GC), which indicated above 25.7% of conversion of oil into biodiesel when muriatic acid was used as a catalyst. The properties of the produced biodiesel were found to be in good agreement with ASTM D 6751 and EN 14214 standards. Various test fuels were prepared for the engine test by blending 10%, 20%, and 100% of landfill waste biodiesel in diesel on volumetric basis and designated as B10, B20, and B100, respectively. The brake thermal efficiency (BTE) of the engine was more while the exhaust emission was less except NOx with biodiesel and its blend (B10 and B20). Thus, landfill waste is a potential source of biodiesel, and blends of landfill waste up to 20% can be used for realizing better performance from the engine.

Post-football Gonathrosis: Injuries and Surgeries are A Risk.

Football is one of the most popular sports in the world. Many studies have shown there is a high incidence of gonarthrosis in football players. The reason for this increase is said to be injuries to the meniscus, the anterior cruciate ligament (ACL) and the resulting surgeries. The incidence is significantly increased in players with knee injuries. The knee is also the most commonly injured site in football and the most common cause of surgery in football players. Together these injuries, particularly of the ACL or meniscus and the resulting surgeries, increase the risk of developing gonarthrosis in post-football years.

Early Detection of Chronic Obstructive Pulmonary Disease in Apparently Healthy Attendants of Tertiary Care Hospital and Assessment of its Severity.

OBJECTIVE: Early detection of Chronic Obstructive Pulmonary Disease in apparently healthy attendants of tertiary care hospital and assessment of its severity. STUDY DESIGN: Cross-sectional, observational study. PLACE AND DURATION OF STUDY: Study was conducted from January 2015 to July 2015 at Dow University Hospital, Ojha campus. METHODOLOGY: Ascreening method was designed for apparently healthy individuals including attendants of patients, hospital staff, faculty and students, belonging to age group 18-60 years after excluding severe obesity and already diagnosed respiratory and cardiovascular diseases by means of history. Each participant performed pulmonary function tests via spirometer after filling a questionnaire based on various risk factors and symptoms of chronic obstructive pulmonary disease (COPD). Data was entered and analysed by SPSS-20. RESULTS: Out of the 517 participants, 122 (23.6%) were found to have COPD diagnosed by means of spirometry. Out of these, 23 (4.4%) had COPD stage I, 42 (8.1%) had COPD II, 34 (6.6%) had COPD III, and 23 (4.4%) had COPD IV. Exposure to smoking, wooden stoves, pesticides, biomass fuel, aerosol sprays, gas grill and vehicle exhaust were found to be statistically significant factors in relation to development of COPD. CONCLUSION: Apparently healthy individuals may have underlying COPD and active screening by means of spirometry plays vital role in early detection of COPD. Smoking and exposure to certain hazardous environmental pollutants are responsible for the development and progression of COPD.

Giant cell arteritis or tension-type headache?: A differential diagnostic dilemma.

Giant cell arteritis (GCA) or Temporal arteritis (TA) is an autoimmune disease and the most common type of vasculitis in the elderly. It causes inflammation of the medium and large arteries in the upper part of the body. GCA is an under-recognized cause of  head aches in the elderly, especially when it presents itself with atypical features, resulting in delayed or incorrect diagnosis. Since GCA is a treatable condition, an accurate diagnosis is crucial to prevent the most serious complication of CGA, permanent vision loss. The diagnosis can be further complicated as GCA may present with features of other painful neurological conditions. The present case is an 81-year-old woman diagnosed with GCA, who initially presented with features similar to tension-type headache. Due to overlapping features of these conditions, the diagnosis of GCA was delayed, resulting in irreversible vision loss. Although previous research highlights diagnostic dilemmas featuring GCA and other disease states, this case is exclusive in describing a unique dilemma where tension-type headache mimics GCA.