Nature of Complex Network of Dengue Epidemic as a Scale-Free Network / 대한의료정보학회지

OBJECTIVES: Dengue epidemic is a dynamic and complex phenomenon that has gained considerable attention due to its injurious effects. The focus of this study is to statically analyze the nature of the dengue epidemic network in terms of whether it follows the features of a scale-free network or a random network. METHODS: A multifarious network of Aedes aegypti is addressed keeping the viewpoint of a complex system and modelled as a network. The dengue network has been transformed into a one-mode network from a two-mode network by utilizing projection methods. Furthermore, three network features have been analyzed, the power-law, clustering coefficient, and network visualization. In addition, five methods have been applied to calculate the global clustering coefficient. RESULTS: It has been observed that dengue epidemic follows a power-law, with the value of its exponent γ = −2.1. The value of the clustering coefficient is high for dengue cases, as weight of links. The minimum method showed the highest value among the methods used to calculate the coefficient. Network visualization showed the main areas. Moreover, the dengue situation did not remain the same throughout the observed period. CONCLUSIONS: The results showed that the network topology exhibits the features of a scale-free network instead of a random network. Focal hubs are highlighted and the critical period is found. Outcomes are important for the researchers, health officials, and policy makers who deal with arbovirus epidemic diseases. Zika virus and Chikungunya virus can also be modelled and analyzed in this manner.

Frequency of esotropia and exotropia among patients between 3 to 25 years of age

To find out the occurrence of esotropia and exotropia in patients among the age group of [3 to 25 years] attending out-patient department at Holy Family Hospital Rawalpindi. Descriptive Cross-Sectional study. A total of 100 consecutive strabismus patients were examined out of 3430 patients attending the out-patient department within the time period of three months, according to the set criteria. Data was recorded on a proforma. Detailed strabismus evaluation was done including VA measurement with Snellen acuity chart, Cover and Krimsky test. All these tests were performed without glasses and with glasses and at near and distance both. Cycloplegic refraction was performed on children, by instilling 1% cyclopentolate eyedrops. Overall frequency of esotropia was 63% and exotropia 27%. Esotropia was found more frequent in females, while exotropia was found more frequent in male patients. Strabismus was more common in children with 78% patients within the age of 1-14 years and 22% patients within the age of 15-25 years, supporting that strabismus is predominantly an anomaly of childhood. The most common type of strabismus is of horizontal type, i-e Comitant strabismus, with ET occurring more frequently than XT. Esotropia is found more common in females and exotropia in males. Strabismus is more common in children as compared to adults

Comparative study of non-cycloplegic and cycloplegic objective refraction in hypermetropic patients between 5-15 years of age

Purpose: The purpose of this study was to compare the results of objective refraction obtained by non-cycloplegic and cycloplegic method in hypermetropic children between 5 to 15 years of age, and then prove the effectiveness of cycloplegia for children refraction

Study Design: Descriptive Cross-Sectional Comparative study

Subject and Method: 100 patients between ages of 5 to 15 years presented at out-patient department of Benazir Bhutto Hospital Rawalpindi during 1st October 2012 to 31st December 2012 and were included in this study. After complete refraction in non-cycloplegic and cycloplegic condition respectively, complete data was recorded and compared to test the null hypothesis

Results: The significant difference between non-cycloplegic and cycloplegic refraction was observed in 73% children. The mean difference was evaluated as 1D. There was more significant effect of cycloplegia in children between age group of 5 to 10 years as compared to children between 11 to 15 years of age

Conclusion: This study showed that cycloplegic method of refraction is very important in young hyperopic children below 15 years of age. So this method should always be adopted when performing refraction of young children

Are acute coronary syndrome patients admitted during off-duty hours treated differently? an analysis of the Saudi Project for assessment of acute coronary syndrome [space] study

It is often suggested that acute coronary syndrome [ACS] patients admitted during off-duty hours [OH] have a worse clinical outcome than those admitted during regular working hours [RH]. Our objective was to compare the management and hospital outcomes of ACS patients admitted during OH with those admitted during RH. Prospective observational study of ACS patients enrolled in the Saudi Project for Assessment of Acute Coronary Syndrome study from December 2005 to December 2007. ACS patients with available date and admission times were included. RH were defined as weekdays, 8 AM-5 PM, and OH was defined as weekdays 5 PM-8 AM, weekends, during Eid [a period of several days marking the end of two major Islamic holidays], and national days. Of the 2825 patients qualifying for this analysis, 1016 [36%] were admitted during RH and 1809 [64%] during OH. OH patients were more likely to present with heart failure and ST elevation myocardial infarction [STEMI] and to receive fibrinolytic therapy, but were less likely to undergo primary percutaneous coronary interventions [PCI]. The median door to balloon time was significantly longer [P<.01] in OH patients [122 min] than in RH patients. No differences were observed in hospital outcomes including mortality between the two groups, except for higher heart failure rates in OH patients [11.1% vs 7.2%, P<.001]. STEMI patients admitted during OH were disadvantaged with respect to use and speed of delivery of primary PCI but not fibrinolytic therapy. Hospitals providing primary PCI during OH should aim to deliver it in a timely manner throughout the day

Ureteroscopic pneumatic versus extracorporeal shock wave lithotripsy for lower ureteral stones

To compare the efficacy of ureteroscopic pneumatic lithotripsy [URS] and extracorporeal shock wave lithotripsy [ESWL] in the treatment of lower ureteric stones in terms of stone-free rates. Randomized trial. Department of Urology, Government Institute of Kidney Diseases and Transplant, Hayatabad, Peshawar, from September 2010 to March 2011. Patients [n=136] presented with lower ureteric stones and fulfilling the inclusion criteria for the study were included. They were divided equally into two groups. Division of patients was done by lottery method. Patients in group A were treated with ureteroscopic pneumatic lithotripsy [URS] as compared to those in group B, who were dealt with extracorporeal shock wave lithotripsy [ESWL]. There were 46 males [67.6%] and 22 females [32.3%] with a ratio of 2.1:1 in group A as compared to 50 males [72%] and 18 females [26.4%] with a ratio of 2.8:1 in group B. Mean age was 35.2 +/- 9.5 years in group A and 35.4 +/- 9.2 years in group B. The mean stone size in group A was 12.8 +/- 3.7 [range 5 - 25 mm] and 12.82 +/- 3.5 [range 5 - 25 mm] in group B. Mean hospital stay in group A was 2.07 +/- 0.6, while patients in group B were all day-cases. The statistical difference was significant in terms of repeat procedure, auxiliary procedure postoperative analgesia and stone free status at 3 months [p=0.043, 0.020, 0.000, 0.001] respectively, while it was not significant in respect of complications of procedure [p=0.753]. URS proved more effective than ESWL for the treatment of ureteric calculi. However, ESWL performed as an outpatient procedure showed fewer complications

Baseline characteristics, management practices, and in-hospital outcomes of patients with acute coronary syndromes: Results of the Saudi project for assessment of coronary events [SPACE] registry

The Saudi Project for Assessment of Coronary Events [SPACE] registry is the first in Saudi Arabia to study the clinical features, management, and in-hospital outcomes of acute coronary syndrome [ACS] patients. We conducted a prospective registry study in 17 hospitals in Saudi Arabia between December 2005 and December 2007. ACS patients included those with ST-elevation myocardial infarction [STEMI], non-ST elevation myocardial infarction and unstable angina; both were reported collectively as NSTEACS [non-ST elevation acute coronary syndrome]. 5055 patients were enrolled with mean age +/- SD of 58 +/- 12.9 years; 77.4% men, 82.4% Saudi nationals; 41.5% had STEMI, and 5.1% arrived at the hospital by ambulance. History of diabetes mellitus was present in 58.1%, hypertension in 55.3%, hyperlipidemia in 41.1%, and 32.8% were current smokers; all these were more common in NSTEACS patients, except for smoking [all P < 0.0001]. In-hospital medications were: aspirin [97.7%], clopidogrel [83.7%], beta-blockers [81.6%], angiotensin converting enzyme inhibitors/angiotensin receptor blockers [75.1%], and statins [93.3%]. Median time from symptom onset to hospital arrival for STEMI patients was 150 min [IQR: 223], 17.5% had primary percutaneous coronary intervention [PCI], 69.1% had thrombolytic therapy, and 14.8% received it at less than 30 min of hospital arrival. In-hospital outcomes included recurrent myocardial infarction [1.5%], recurrent ischemia [12.6%], cardiogenic shock [4.3%], stroke [0.9%], major bleeding [1.3%]. In-hospital mortality was 3.0%. ACS patients in Saudi Arabia present at a younger age, have much higher prevalence of diabetes mellitus, less access to ambulance use, delayed treatment by thrombolytic therapy, and less primary PCI compared with patients in the developed countries. This is the first national ACS registry in our country and it demonstrated knowledge-care gaps that require further improvements

Bilateral orchiectomy with or without flutamide for advanced carcinoma prostate

To assess the effects of flutamide in patients suffering from advanced carcinoma of the prostate who underwent bilateral orchiectomy. Institute of Kidney Diseases, Hayatabad Medical Complex, Peshawar, from March 2008 to July 2009. A total of 100 patients having advanced carcinoma prostate who had undergone bilateral orchiectomy were divided into two groups .Group A consisted of 50 patients who were treated with flutamide while group B having 50 patients received placebo. Relief of bone pain was more in group A than B. No significant difference was seen in the occurrence of adverse effects like nausea, vomiting, hot flashes and anemia between the groups. Eight patients in each group were lost to follow up. The benefit of combined androgen blockade was better in relief of bone pain

Malignant tumors of head and neck region - a retrospective analysis

To evaluate the spectrum of malignant tumors of head and neck region. Design: A department-based retrospective study. Place and Duration of Study: It was carried out at the Department of Pathology, Allama Iqbal Medical College, Lahore, over a period of two years [1997-1999]. Subject and The data of total 375 neoplastic lesions of both the sexes between 8-70 years of age was collected and compared with the findings reported from centers in other parts of the country. Among the total 375 cases of neoplastic lesions, 148 were benign whereas 227 proved to be malignant histologically in 155 male and 72 female patients. Squamous cell carcinoma [SCC] was the most frequently encountered histological category [45.8%] followed by lymphoma [14.5%], basal cell carcinoma [10.5%], carcinoma thyroid [10.5%] and salivary gland tumors [8.80%]. These were followed by infrequently encountered tumors including nasopharyngeal carcinoma [n=5], small blue round cell tumors [n=3], undifferentiated carcinoma [n=3], retinoblastoma [n=2] and transitional carcinoma nose [n=1]. The anatomical regions involved with this tumor were larynx [53.5% of all SCC] followed by pharynx [18.7%], tongue [10.71%], oral cavity [4.4%], metastasis [5.3%] and skin [2.60%].The frequency of the various malignancies was found comparable to the findings reported from other centres in Punjab and SCC was found to be the most common cause of malignancy