Six centuries of Upper Indus Basin streamflow variability and its climatic drivers.

Our understanding of the full range of natural variability in streamflow, including how modern flow compares to the past, is poorly understood for the Upper Indus Basin (UIB) because of short instrumental gauge records. To help address this challenge, we use Hierarchical Bayesian Regression (HBR) with partial pooling to develop six centuries long (1394-2008 C.E.) streamflow reconstructions at three UIB gauges (Doyian, Gilgit, and Kachora), concurrently demonstrating that HBR can be used to reconstruct short records with interspersed missing data. At one gauge (Partab Bridge), with a longer instrumental record (47 years), we develop reconstructions using both Bayesian Regression (BR) and the more conventionally used Principal Components Regression (PCR). The reconstructions produced by PCR and BR at Partab Bridge are nearly identical and yield comparable reconstruction skill statistics, highlighting that the resulting tree-ring reconstruction of streamflow is not dependent on the choice of statistical method. Reconstructions at all four reconstructions indicate flow levels in the 1990s were higher than mean flow for the past six centuries. While streamflow appears most sensitive to accumulated winter (January-March) precipitation and summer (MJJAS) temperature, with warm summers contributing to high flow through increased melt of snow and glaciers, shifts in winter precipitation and summer temperatures cannot explain the anomalously high flow during the 1990s. Regardless, the sensitivity of streamflow to summer temperatures suggests that projected warming may increase streamflow in coming decades, though long-term water risk will additionally depend on changes in snowfall and glacial mass balance.

Multidisciplinary team (MDT) meeting and Radiologist workload, a prospective review in a tertiary care hospital.

OBJECTIVE: To quantify the increase in workload associated with multidisciplinary team meetings for radiologists in a tertiary care hospital over a period of 15 months. METHODS: Data was collected prospectively regarding number of multidisciplinary team meetings, number of clinical cases discussed, number of individual imaging studies reviewed, and preparation time of residents, senior registrar and consultants and the delivery time of meeting. RESULTS: Total 223 meetings were held over 15 months (April 2014 to June 2015) for 12 clinical specialty areas. There were 1120 clinical case discussions and a total of 2759 documented individual imaging studies reviewed. Resident's preparation time was 74.6 hours/month, senior registrar's preparation time was 47.93 hours/month, consultant's preparation time was 18.67 hours/month and the total duration time for meetings was 18 hours/month. CONCLUSION: Multidisciplinary team meetings now represent a significant workload of radiology and has reduced the time for other academic activities within the department.

Vascular complications in cases of acute pancreatitis - CT scan based study.

OBJECTIVE: To record the incidence of vascular complications in cases of acute pancreatitis. METHODS: This retrospective, cross-sectional study was performed at the Liaquat National Hospital, Karachi, from October 31, 2012 to October 31, 2014, and comprised computerised records and computerised tomography scan images related to cases of pancreatitis. RESULTS: Of the 210 patients included, 97(46.19%) were men and 113(53.81%) were women. A total of 24(11.4%) patients had thrombosis of splanchnic vasculature, of which the most frequently thrombosed vessel was the splenic vein, in 17(70.8%) patients; followed by the portal vein, 11(45.8%); and the superior mesenteric vein,4(16.7%). CONCLUSIONS: The incidence of vascular thrombosis was low, but not uncommon in patients of severe acute pancreatitis.

Dynamics of some common epidemics in Karachi, Pakistan.

OBJECTIVE: To examine the severity, frequency, monthly variability and grouping of some common epidemics and its relation to hygienic conditions and life style of the people in Karachi. METHODS: This ecological study was conducted from 2006 to 2009. Data was obtained from five different localities of Karachi. In each area, physician clinics were selected and questionnaire forms filled by professionals at the clinics, regarding health problems of patients. Multivariate analyses were used to summarize the data, for comparison and grouping the spread of epidemics. RESULTS: The severity of different epidemics varied among months and localities. The effective diseases potential areas with decreasing order were: Lines Area, Korangi, Malir, Metroville and Maymar. In all these areas cough, allergy, asthma, flu, fever and skin rashes were the widely distributed epidemics while the prevalence of other six epidemics prevailed to a lesser extent. Lines Area/Korangi and Malir/Metroville differed considerably with respect to prevalence of epidemics (P < 0.05) into a lesser, while Gulshan-e-Maymar was significantly different (P < 0.001) from the other four areas. Among four distinct groups i.e. 1) allergy/cough, 2) asthma/flu, 3) fever/skin rashes, 4) bronchitis, malaria, typhoid, diarrhoea, rhinitis and sinusitis, the first three groups were widely distributed. CONCLUSION: January was the most crucial month with highest number of patients. Certain epidemics were parallel in different areas with almost similar population size. Multivariate analysis disclosed the four distinct groups of epidemics in which first three groups were widely distributed.