Evaluation of visual outcomes with toric intraocular lens implantation using digital marker during cataract surgery.

Objectives: To assess the visual improvement and mean residual astigmatism in patients who underwent cataract surgery with toric intraocular lens. METHODS: The retrospective, observational study was conducted at the Department of Ophthalmology, Aga Khan University Hospital, Karachi, and comprised data from January 1, 2018, to December 31, 2020, related to adult patients who had regular astigmatism of at least 0.75D and underwent cataract surgery with toric intraocular lens implantation using a digital marker. The patients were followed up on post-operative days 1, 7, 30, 90 and 180. Along with age, the degree of astigmatism was noted. The visual acuity was calculated pre- and post-operatively. The mean residual astigmatism was then noted for all patients post-operatively. Data was analysed using SPSS 22. RESULTS: The sample comprised 240 eyes of 177 patients; 99(55.9%) males and 78(44.1%) females. The mean age of the sample was 62.5±10.6 years. The mean unaided visual acuity improved post-operatively from 0.57±0.38 to 0.07±0.22 at 90 days. At the 30-day follow-up, mean residual astigmatism had reduced from 1.52±0.84 to 0.01±0.09 (p<0.001). The mean intraocular lens rotation from the intended axis was 0.73°±0.92° on day 30. CONCLUSIONS: Toric intraocular lens implantation using a digital marker could effectively reduce the post-operative cylinder, and improve the unaided visual acuity following cataract surgery.

Consumption of chewing tobacco alters the serum metal contents in pregnant women at Tandojam and adjoining areas.

Chewing tobacco may play a contributing role in complications during pregnancy as it contains various kinds of toxic metals such as lead (Pb), cadmium (Cd), cobalt (Co), manganese (Mn), chromium (Cr), and can cause alteration in serum metal concentration. Hence, the present study aimed to explore the effects of chewing tobacco consumption on serum metal contents in pregnant women. A total number of 200 chewing tobacco consumer pregnant women and 200 age-matched non-consumer pregnant women were selected for the study from the outpatient department of gynaecology at Rural Health Centre Tandojam, Pakistan. After obtaining the sociodemographic characteristics of all participants, 10 ml of venous blood was also drawn for serum metal analysis by atomic absorption spectroscopy. Different chewing tobacco samples consumed by consumer pregnant women were collected from local shops of Tandojam, Pakistan. Drinking water samples from the residential areas of consumer and non-consumer pregnant women were prepared and analysed for the same metal contents. In present study, serum Pb, Cd, K and Co were found significantly increased in CPW as compared to NCPW. Serum Pb was found significantly increased in gutkha consumers in comparison to mainpuri consumers. Serum Pb, Cd, and Co were present with significantly increased concentration in serum of CPW who were taking canal and well water for drinking purpose when compared with NCPW. Significant negative strong correlation of serum Pb with K and Cr of drinking water and Na of chewing tobacco samples were observed. Strong positive correlation of serum Cd and Cr with Co of drinking water had been observed. Whereas, serum maternal Co was strongly negatively correlated with Mn of chewing tobacco samples, and serum Cu of CPW had a strong positive correlation with K and Cr of drinking water and Na of chewing tobacco samples. In conclusion, consumption of chewing tobacco alters the serum metal contents in pregnant women at Tandojam and adjoining areas, Pakistan.

An Ensemble Learning Method for Emotion Charting Using Multimodal Physiological Signals.

Emotion charting using multimodal signals has gained great demand for stroke-affected patients, for psychiatrists while examining patients, and for neuromarketing applications. Multimodal signals for emotion charting include electrocardiogram (ECG) signals, electroencephalogram (EEG) signals, and galvanic skin response (GSR) signals. EEG, ECG, and GSR are also known as physiological signals, which can be used for identification of human emotions. Due to the unbiased nature of physiological signals, this field has become a great motivation in recent research as physiological signals are generated autonomously from human central nervous system. Researchers have developed multiple methods for the classification of these signals for emotion detection. However, due to the non-linear nature of these signals and the inclusion of noise, while recording, accurate classification of physiological signals is a challenge for emotion charting. Valence and arousal are two important states for emotion detection; therefore, this paper presents a novel ensemble learning method based on deep learning for the classification of four different emotional states including high valence and high arousal (HVHA), low valence and low arousal (LVLA), high valence and low arousal (HVLA) and low valence high arousal (LVHA). In the proposed method, multimodal signals (EEG, ECG, and GSR) are preprocessed using bandpass filtering and independent components analysis (ICA) for noise removal in EEG signals followed by discrete wavelet transform for time domain to frequency domain conversion. Discrete wavelet transform results in spectrograms of the physiological signal and then features are extracted using stacked autoencoders from those spectrograms. A feature vector is obtained from the bottleneck layer of the autoencoder and is fed to three classifiers SVM (support vector machine), RF (random forest), and LSTM (long short-term memory) followed by majority voting as ensemble classification. The proposed system is trained and tested on the AMIGOS dataset with k-fold cross-validation. The proposed system obtained the highest accuracy of 94.5% and shows improved results of the proposed method compared with other state-of-the-art methods.

PREDICTIVE VALUE OF EARLY VIRIOLOGICAL RESPONSE FOR SUSTAINED VIRIOLOGICAL RESPONSE IN CHRONIC HEPATITIS WITH CONVENTIONAL INTERFERON THERAPY.

BACKGROUND: Hepatitis is a major public health problem in Pakistan due to its strong association with liver failure and hepatocellular carcinoma. In Pakistan, conventional interferon therapy along with Ribavirin is favoured especially in Government funded programs for treatment of Hepatitis C, over the more expensive Pegylated Interferon and Ribavirin combination therapy as recommended by Pakistan society of Gastroenterology and GI endoscopy due to its favourable results observed in genotype 3 which is the dominant genotype of this region. Objective of our study was to assess the virological responses with standard interferon therapy and to determine the predictive values of early virological response (EVR) for Sustained Virological Response (SVR) in chronic hepatitis C patients treated with standard interferon therapy. METHODS: A cross sectional study was conducted on patients with chronic hepatitis C having received standard interferon and ribavirin therapy for six months. EVR and SVR were noted for analysis. Positive and negative predictive values of EVR on SVR were calculated. RESULTS: Out of the total sample (N = 3075), 1946 (63.3%) patients were tested for EVR. 1386 (71.2%) were positive while 560 (28.8%) were negative while 516 (16.8%) were tested for SVR. Two hundred and eighty-five (55.2%) were positive while 231 (44.8%) were negative. EVR and SVR tested were n=117. Positive predictive value of EVR on SVR was 67.1% and negative predictive value was 65.8%. Statistically significant association between EVR and SVR was determined with Chi square statistic of 11.8 (p-value < 0.0001). CONCLUSION: EVR is a good predictor of response of patients to standard interferon and ribavirin therapy. In the absence of an EVR, it seems imperative to stop further treatment. Virlogical responses with conventional interferon therapy are comparable to those of pegylated interferon therapy so adoption of conventional INF therapy is justified in terms of its cost effectiveness especially in resource constrained nations like Pakistan.

CHARACTERISTICS OF PATIENTS WITH MEASLES ADMITTED TO ALLIED HOSPITALS RAWALPINDI MEDICAL COLLEGE.

BACKGROUND: Measles, a virus borne droplet infection, is one of the leading causes of death among young children worldwide despite presence of a safe and cost-effective vaccine. Objective of our study was to identify the characteristics of measles patients admitted to Allied Hospitals, Rawalpindi. METHODS: This cross-sectional study was conducted amongst patients admitted with measles in paediatric units of Rawalpindi Medical College Allied Hospitals, Rawalpindi. A standard pro forma was used to collect data from the respondents. RESULTS: A total of 55 patients (mean age-29.36 months) with measles were included in the i study. 65.5% children were vaccinated while 34.5% were not vaccinated. Among those vaccinated 14 were male. Out of the vaccinated children 52.6% were residents of middle class areas, 31.6% lower middle class area, 10.5% upper middle class areas and 5.3% rural areas. In 55.0% of patients who were vaccinated with at least one dose of measles at nine month of age the estimated calendar months of vaccination was March to April while in 30% the overall climatic period of vaccination was of summer (May to September). Twenty one study subjects were exposed to a case of measles in the family and thirty five out of all developed at least one known complication of the disease. Pneumonia was the most common complication reported in patients (63.6%) followed by diarrhoea (27.3%). CONCLUSION: Majority of the patients suffering from measles were not vaccinated and the most common reason for failure to immunize children was lack of awareness. Educated and well off fathers were more likely to get their children immunized. The vaccinated children who developed measles majority were vaccinated during months of March, April and May.