A GIS-based approach to determining optimal location for decentralized inner city smart filters: Toward net zero cities.

Climate change has already begun to take visible effect globally in recent years. Given the climate change paradox and urbanization trends, cities' success would not only depend on smartness and sustainability, but also resilience to all forthcoming economic, environmental, or behavioral changes. Numerous technologies have surfaced and proved effective in CO2 removal from the local environment. However, the optimal placement of these smart filters is a complex task and require logical and strategic decision-making. Determining the optimal location is one of the key factors for establishing a network of smart air filters. This study used a GIS-based suitability analysis for identifying optimal locations for smart filters based on pollution hotspots (population and spatial proximity to industry, commercial centers, roads, high-traffic areas, and intersections). The spatial analysis involves the determination and preparation of input layers, ranking layers, assigning weights to each criterion, and generation of a suitability map. The sites with a higher suitability score (7 or above) are optimum sites for air filters. The sites are spatially distributed over different regions. The findings revealed that GIS-based suitability analysis can be an effective technique for placing smart filters within an urban environment. These findings can help decision-makers to prioritize the location considering environmental constraints. The proposed solution aims to pave the way for fostering resilient, smart, and sustainable cities through a community sensing platform targeting hotspots within spatial variations.

Optimizing test and treat options for vivax malaria: An options assessment toolkit (OAT) for Asia Pacific national malaria control programs.

Designing policy in public health is a complex process requiring decision making that incorporates available evidence and is suitable to a country's epidemiological and health system context. The main objective of this study was to develop an options assessment toolkit (OAT) to provide a pragmatic and evidence-based approach to the development of policies for the radical cure (prevention of relapse) of vivax malaria for national malaria control programs in the Asia-Pacific region. The OAT was developed using participatory research methods and a Delphi process using a sequential multi-phase design, adapted with a pre-development phase, a development phase, and a final development phase. In the pre-development phase, a literature review was conducted to inform the toolkit development. Data collection in the development phase consisted of core research team discussions, multiple rounds of consultation with participants from National Malaria Control Programs (NMP) (online and in person), and two separate modified e-Delphi processes with experts. The final development phase was the piloting of the toolkit during the annual meeting of the Asia Pacific Malaria Elimination Network (APMEN) Vivax Working Group. We developed a tool kit containing the following elements: i) Baseline Assessment Tool (BAT) to assess the readiness of NMPs for new or improved coverage of radical cure, ii) eight scenarios representative of Asia Pacific region, iii) matching test and treat options based on available options for G6PD testing and radical cure for the given scenarios, iv) an approaches tool to allow NMPs to visualize considerations for policy change process and different implementation strategies/approaches for each test and treat option. The OAT can support vivax radical cure policy formulation among NMPs and stakeholders tailoring for their unique country context. Future studies are needed to assess the utility and practicality of using the OAT for specific country context.

The diagnostic accuracy of preoperative perfusion index as a predictor of postspinal anesthesia hypotension in parturients undergoing cesarean delivery: A prospective non-blinded observational study.

Background and Objectives: Spinal anesthesia is the technique of choice for elective cesarean section with a prominent side effect of postspinal anesthesia hypotension (PSH). This needs an early prediction to avoid feto-maternal complication. This study aimed to assess the diagnostic accuracy of perfusion index (PI) and inferior vena cava collapsibility index (IVCCI) in the prediction of PSH. Material and Methods: Thirty parturients of American Society of Anesthesiologists Physical Status (ASA-PS) 1 and two undergoing cesarean delivery participated in the study. IVCCI, PI, baseline systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), and heart rate (HR) were noted in the preoperative period. The fall of MBP by 20% from baseline or below 65 mm Hg was considered PSH. After spinal anesthesia, SBP, DBP, MBP, and HR were noted again for diagnosing PSH. Results: It did not show any statistical difference when comparing the PI between the PSH and non-PSH groups in both the PSH definition groups. IVCCI was significantly higher when PSH was considered MBP <65 mm Hg (P = 0.01). However, IVCCI was found to be statistically insignificant if PSH was considered a 20% reduction in baseline MBP. The correlation matrix between IVCCI and PI showed Pearson's r-value of 0.525, indicating a substantial relationship between the two (P = 0.003). Multivariate logistic regression analysis had shown that neither IVCCI nor PI was a good predictor of PSH in parturients for both definition groups for PSH. Conclusion: Although there is a modest correlation between PI and IVCCI, both cannot be used to predict postspinal hypotension in parturients undergoing elective lower-segment cesarean section (LSCS).

Probing impact on magnetic behavior of cobalt layer grown on thick MoS 2 layer.

Understanding the metal-semiconductor heterostructure interface is crucial for the development of spintronic devices. One of the prospective candidates and extensively studied semiconductors is molybdenum disulfide (MoS 2 ). Herein, utilizing Kerr microscopy, we investigated the impact of thick MoS 2 on the magnetic properties of the 10 nm Co layer. A comparative study on Co / MoS 2 and Co/Si shows that coercivity increased by 77% and the Kerr signal decreased by 26% compared to Co grown on Si substrate. In addition, the Co domain structure significantly changed when grown on MoS 2 . The plausible reason for the observed magnetic behavior can be that the Co interacts differently at the interface of MoS 2 as compared to Si. Therefore, our studies investigate the interfacial effect on the magnetic properties of Co grown on thick MoS 2 layer. Furthermore, our results will help in developing next-generation spintronic devices.

Biological structural study of emerging shaped nanoparticles for the blood flow in diverging tapered stenosed arteries to see their application in drug delivery.

The magnetic force effects and differently shaped nano-particles in diverging tapering arteries having stenoses are being studied in current research via blood flow model. There hasn't been any research done on using metallic nanoparticles of different shapes with water as the base fluid. A radially symmetric but axially non-symmetric stenosis is used to depict the blood flow. Another significant aspect of our research is the study of symmetrical distribution of wall shearing stresses in connection with resistive impedance, as well as the rise of these quantities with the progression of stenosis. Shaping nanoparticles in accordance with the understanding of blood flow in arteries offers numerous possibilities for improving drug delivery, targeted therapies, and diagnostic imaging in the context of cardiovascular and other vascular-related diseases. Exact solutions for different flow quantities namely velocity, temperature, resistance impedance, boundary shear stress, and shearing stress at the stenosis throat, have been assessed. For various parameters of relevance for Cu-water, the graphical results of several types of tapered arteries (i.e. diverging tapering) have been explored.

An overview of green synthesized silver nanoparticles towards bioactive antibacterial, antimicrobial and antifungal applications.

Present review emphatically introduces the synthesis, biocompatibility, and applications of silver nanoparticles (AgNPs), including their antibacterial, antimicrobial, and antifungal properties. A comprehensive discussion of various synthesis methods for AgNPs, with a particular focus on green chemistry mediated by plant extracts has been made. Recent research has revealed that the optical properties of AgNPs, including surface plasmon resonance (SPR), depend on the particle size, as well as the synthesis methods, preparation synthesis parameters, and used reducing agents. The significant emphasis on the use of synthesized AgNPs as antibacterial, antimicrobial, and antifungal agents in various applications has been reviewed. Furthermore, the application areas have been thoroughly examined, providing a detailed discussion of the underlying mechanisms, which aids in determining the optimal control parameters during the synthesis process of AgNPs. Furthermore, the challenges encountered while utilizing AgNPs and the corresponding advancements to overcome them have also been addressed. This review not only summarizes the achievements and current status of plant-mediated green synthesis of AgNPs but also explores the future prospects of these materials and technology in diverse areas, including bioactive applications.

Genomic characterization of Puccinia triticina using molecular marker technology / Caracterização genômica de Puccinia triticina usando tecnologia de marcadores moleculares

Leaf rust, caused by Puccinia triticina, is the most common rust disease of wheat. The fungus is an obligate parasite capable of producing infectious urediniospores. To study the genetic structure of the leaf rust population 20 RAPD primers were evaluated on 15 isolates samples collected in Pakistan. A total of 105 RAPD fragments were amplified with an average of 7 fragments per primer. The number of amplified fragments varied from 1 to 12. GL Decamer L-07 and GL Decamer L-01 amplified the highest number of bands (twelve) and primer GL Decamer A-03 amplified the lowest number of bands i.e one. Results showed that almost all investigated isolates were genetically different that confirms high genetic diversity within the leaf rust population. Rust spores can follow the migration pattern in short and long distances to neighbor areas. Results indicated that the greatest variability was revealed by 74.9% of genetic differentiation within leaf rust populations. These results suggested that each population was not completely identical and high gene flow has occurred among the leaf rust population of different areas. The highest differentiation and genetic distance among the Pakistani leaf rust populations were detected between the leaf rust population in NARC isolate (NARC-4) and AARI-11and the highest similarity was observed between NARC isolates (NARC-4) and (NARC-5). The present study showed the leaf rust population in Pakistan is highly dynamic and variable.

A ferrugem da folha, causada por Puccinia triticina, é a ferrugem mais comum do trigo. O fungo é um parasita obrigatório, capaz de produzir urediniósporos infecciosos. Para estudar a estrutura genética da população de ferrugem da folha, 20 primers RAPD foram avaliados em 15 amostras de isolados coletadas no Paquistão. Um total de 105 fragmentos RAPD foram amplificados com uma média de 7 fragmentos por primer. O número de fragmentos amplificados variou de 1 a 12. GL Decamer L-07 e GL Decamer L-01 amplificaram o maior número de bandas (doze), e o primer GL Decamer A-03 amplificou o menor número de bandas, ou seja, um. Os resultados mostraram que quase todos os isolados investigados eram geneticamente diferentes, o que confirma a alta diversidade genética na população de ferrugem da folha. Os esporos de ferrugem podem seguir o padrão de migração em distâncias curtas e longas para áreas vizinhas. Os resultados indicaram que a maior variabilidade foi revelada por 74,9% da diferenciação genética nas populações de ferrugem. Esses resultados sugeriram que cada população não era completamente idêntica e um alto fluxo gênico ocorreu entre a população de ferrugem da folha de diferentes áreas. A maior diferenciação e distância genética entre as populações de ferrugem da folha do Paquistão foram detectadas entre a população de ferrugem da folha no isolado NARC (NARC-4) e AARI-11 e a maior similaridade foi observada entre os isolados NARC (NARC-4) e (NARC-5). O presente estudo mostrou que a população de ferrugem da folha no Paquistão é altamente dinâmica e variável.

Continuous Real-Time Detection of Serotonin Using an Aptamer-Based Electrochemical Biosensor.

Serotonin (5-HT) is a critical neurotransmitter involved in many neuronal functions, and 5-HT depletion has been linked to several mental diseases. The fast release and clearance of serotonin in the extracellular space, low analyte concentrations, and a multitude of interfering species make the detection of serotonin challenging. This work presents an electrochemical aptamer-based biosensing platform that can monitor 5-HT continuously with high sensitivity and selectivity. Our electrochemical sensor showed a response time of approximately 1 min to a step change in the serotonin concentration in continuous monitoring using a single-frequency EIS (electrochemical impedance spectroscopy) technique. The developed sensing platform was able to detect 5-HT in the range of 25-150 nM in the continuous sample fluid flow with a detection limit (LOD) of 5.6 nM. The electrochemical sensor showed promising selectivity against other species with similar chemical structures and redox potentials, including dopamine (DA), norepinephrine (NE), L-tryptophan (L-TP), 5-hydroxyindoleacetic acid (5-HIAA), and 5-hydroxytryptophan (5-HTP). The proposed sensing platform is able to achieve high selectivity in the nanomolar range continuously in real-time, demonstrating the potential for monitoring serotonin from neurons in organ-on-a-chip or brain-on-a-chip-based platforms.

Comparative Study of TiO2, ZnO, and Nb2O5 Photoanodes for Nitro-Substituted Naphthoquinone Photosensitizer-Based Solar Cells.

This research focuses on the first demonstration of NO2Lw (2-hydroxy-3-nitronaphthalene-1,4-dione) as a photosensitizer and TiO2, ZnO, and Nb2O5 as photoanode materials for dye-sensitized solar cells (DSSCs). The metal-free organic photosensitizer (i.e., nitro-group-substituted naphthoquinone, NO2Lw) was synthesized for this purpose. As a photoanode material, metal oxides, such as TiO2, ZnO, and Nb2O5, were selected. The synthesized NO2Lw contains an electron-withdrawing group (-NO2) and anchoring groups (-OH) that exhibit absorption in the visible range. The UV-visible absorbance spectrum of NO2Lw demonstrates the absorption ascribed to ultraviolet and visible region charge transfer. The NO2Lw interacts with the TiO2, ZnO, and Nb2O5 photoanode, as shown by bathochromic shifts in wavelengths in the photosensitizer-loaded TiO2, ZnO, and Nb2O5 photoanodes. FT-IR analysis also studied the bonding interaction between NO2Lw and TiO2, ZnO, and Nb2O5 photoanode material. The TiO2, ZnO, and Nb2O5 photoanodes loaded with NO2Lw exhibit a shift in the wavenumber of the functional groups, indicating that these groups were involved in loading the NO2Lw photosensitizer. The amount of photosensitizer loading was calculated, showing that TiO2 has higher loading than ZnO and Nb2O5 photoanodes; this factor may constitute an increased JSC value of the TiO2 photoanode. The device performance is compared using photocurrent-voltage (J-V) curves; electrochemical impedance spectroscopy (EIS) measurement examines the device's charge transport. The TiO2 photoanode showed higher performance than the ZnO and Nb2O5 photoanodes in terms of photoelectrochemical properties. When compared to ZnO and Nb2O5 photoanodes-based DSSCs, the TiO2 photoanode Bode plot shows a signature frequency peak corresponding to electron recombination rate toward the low-frequency region, showing that TiO2 has a greater electron lifetime than ZnO and Nb2O5 photoanodes based DSSCs.

Modification in Toxicity of l-Histidine-Incorporated ZnO Nanoparticles toward Escherichia coli.

This paper presents a comparative study of the toxicity of pristine-ZnO and l-histidine-incorporated ZnO toward Escherichia coli (E. coli) as a Gram-negative model organism. Pristine-ZnO and l-histidine-incorporated ZnO with different l-histidine concentrations were synthesized using an open aqueous solution bath technique. XRD studies revealed the formation of polycrystalline wurtzite ZnO. The average crystallite size of the synthesized l-histidine-incorporated ZnO decreased as the concentration of l-histidine increased. The FTIR spectra showed the presence of Zn-O, CO2-/CO3-, and C-N (only in l-histidine-incorporated ZnO samples) and -OH bond vibration signals in all samples. The chemical purity of all the samples was ensured using XPS analysis. The microbial activity of these samples was investigated using E. coli. The solution with 100 µg/mL ZnO in sterile distilled water showed up to 94% growth inhibition of E. coli, establishing antibacterial activity. However, l-histidine incorporated in ZnO showed reduced antibacterial activity with the increase of the concentration of l-histidine in ZnO. Furthermore, flow cytometry studies during the interaction of ZnO and E. coli confirmed the generation of reactive oxygen species (ROS), validating its antibacterial activity. The interaction of l-histidine-incorporated ZnO and E. coli showed declining ROS with the increase in the l-histidine concentration, indicating a ZnO toxicity reduction.

Short Term Outcome of Laparoscopic Anterior Resection for Rectal Carcinoma.

Colorectal cancer is the second most common malignancy in the western countries and the rectum is the most frequent site involved. Carcinoma in the rectosigmoid junction, upper and middle 3rd of the rectum is now successfully managed by laparoscopic AR and postoperative morbidities are less and recovery is uneventful. The advantages of laparoscopic surgery are smaller incisions, shorter recovery time and less wound related complications. However the narrow confines and angulations of the bony pelvis and the standard practice of autonomic nerve sparing total mesorectum excision has made laparoscopic surgery in the setting of rectal cancer more challenging. This study was carried out in the Colorectal surgery Department, Bangabandhu Sheikh Mujib Medical University, Dhaka from April 2018 to March 2019. Forty (40) cases were selected according to inclusion criteria. Twenty (20) patients treated by conventional open AR were known as control group and rest 20 patients treated by laparoscopic AR were known as Experimental group. Patient's particulars, pre operative diagnosis, operative findings were recorded in a pre designed data sheet and postoperative follow up and early outcomes of the patients of both groups were recorded by the same manner to find out general and local complications till discharge. Postoperatively all the patients were referred to oncology department and advised to come for follow up after 2 weeks (1st follow up). Mean age of experimental group was 43.40 and standard deviation was 13.59. In both age groups, age was not a contraindication. In the both groups number of male is slightly higher than female. Laparoscopic anterior resection can be performed safely and effectively. During post-operative follow up no significant morbidities and complications were observed in post-operative period in both groups of population. Degree of pain along with use of analgesia is also less after laparoscopic AR. Ambulation, stoma function, feeding liquid and feeding solid all occurred earlier for experimental group. Mean length of hospital stay for experimental group was found to be shorter than that of control group. Early hospital discharge was possible after laparoscopic AR. Oncological parameters were equivalent to those of open procedures. Laparoscopic AR is acceptable for rectal carcinoma.

Postoperative Outcome of Fistulotomy with Marsupialization in the Surgical Management of Simple Anal Fistula Comparison between Fistulotomy-layopen Procedures.

Assess the wound healing time and early post-operative outcome of fistulotomy with marsupialization, as a surgical treatment of simple fistula-in-ano. This interventional study was performed at the Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University, Bangladesh from July 2017 to June 2018. Total 30 cases of simple anal fistula were selected according to inclusion criteria. Patients were non-randomly divided in two groups. Fifteen (15) cases were undergone a fistulotomy-lay open (control group) and another 15 cases undergone a fistulotomy with marsupialization (experimental group). The result was tested by t-test, chi-square test. Statistical significance was set at p<0.05. The mean age of the study population was 42.07±13.69 years in fistulotomy-lay open group and 46.00±12.99 years in fistulotomy with marsupialization group. In both group, number of male was higher. Perianal discharge and induration or swelling at perianal skin was most common findings. Mean healing time was earlier in fistulotomy with marsupialization group (16.60±11.15 days) than lay open group (27.07±14.28 days) due to marsupialization technique, the matter of fact that the deep, unepithelized wound has become smaller. No significant difference of postoperative pain, bleeding, wound infection and fecal incontinence in both group. The study shows marsupialization of the wound after fistulotomy for simple fistula in ano results in significantly faster healing in comparison with lay open-fistulotomy, less bleeding without increasing postoperative pain and the infections.

A comprehensive study on the effect of hybridization and stacking sequence in fabricating cotton-blended jute and pineapple leaf fibre biocomposites.

Developing biocomposites by hybridization, which is the combination of two or more materials, can be a potential solution for improving material recyclability and sustainability. This study focuses on creating a hybrid biocomposite reinforced with cotton-blended pineapple leaf fibre (PALF) fabric (174 GSM) and jute fibre fabric (265 GSM) which are thrown away by textile factories. The mechanical, moisture absorption, and vibration characteristics of four stacking sequences of hybrid composites and two unhybridized composites were analyzed. Results indicated that hybridization improved tensile and flexural characteristics compared to pineapple leaf fibre reinforced polymer (PFRP) composites. The jute fibre reinforced polymer (JFRP) composite exhibited the maximum tensile strength of 35.16 MPa, while the hybrid composites achieved a maximum of 32.16 MPa. Among the hybrid composites, jute layers on the outer plies (4P5J-2) demonstrated the maximum tensile modulus of 1.315 GPa. Additionally, the hybrid composite with three layers of jute plies between alternating layers of jute-pineapple plies showed the highest elongation at 15.94%. Among the hybrids, alternate stacking of jute/PALF plies (4P5J-1) gave a maximum flexural strength of 44.36 MPa, which is similar to JFRP (44.91 MPa) and a 78.57% increase in flexural modulus compared to PFRP composite, despite having the lowest tensile strength. Although the JFRP composite exhibited the highest impact strength, the hybrids still outperformed the PFRP composites. With hybridization, moisture absorption decreased, with a maximum of 29.50% compared to the JFRP composite. Furthermore, due to the spiral-like orientation of the yarns, stacking PALF plies on the outside can cause critical damping. Therefore, it is shown in this paper that both hybridization and stacking sequence can significantly influence composite performance. These findings also implies the utilization of textile industry's natural fibres to develop hybrid composites for automotive applications, like brake and accelerator pedals, for a greener future and effective waste material utilization.

Enhanced wave overtopping simulation at vertical breakwaters using machine learning algorithms.

Accurate prediction of wave overtopping at sea defences remains central to the protection of lives, livelihoods, and infrastructural assets in coastal zones. In addressing the increased risks of rising sea levels and more frequent storm surges, robust assessment and prediction methods for overtopping prediction are increasingly important. Methods for predicting overtopping have typically relied on empirical relations based on physical modelling and numerical simulation data. In recent years, with advances in computational efficiency, data-driven techniques including advanced Machine Learning (ML) methods have become more readily applicable. However, the methodological appropriateness and performance evaluation of ML techniques for predicting wave overtopping at vertical seawalls has not been extensively studied. This study examines the predictive performance of four ML techniques, namely Random Forest (RF), Gradient Boosted Decision Trees (GBDT), Support Vector Machines-Regression (SVR), and Artificial Neural Network (ANN) for overtopping discharge at vertical seawalls. The ML models are developed using data from the EurOtop (2018) database. Hyperparameter tuning is performed to curtail algorithms to the intrinsic features of the dataset. Feature Transformation and advanced Feature Selection methods are adopted to reduce data redundancy and overfitting. Comprehensive statistical analysis shows superior performance of the RF method, followed in turn by the GBDT, SVR, and ANN models, respectively. In addition to this, Decision Tree (DT) based methods such as GBDT and RF are shown to be more computationally efficient than SVR and ANN, with GBDT performing simulations more rapidly that other methods. This study shows that ML approaches can be adopted as a reliable and computationally effective method for evaluating wave overtopping at vertical seawalls across a wide range of hydrodynamic and structural conditions.

The development of a grey relational analysis-based composite index for environmental sustainability assessment: Towards a net-zero emissions strategy in Saudi Arabia.

Climate change and environmental sustainability assessment are essential in city planning, design, and smart city advancement. Despite Saudi Arabia's high global greenhouse gas (GHG) emissions ranking, a comprehensive review of extant studies revealed insufficient tools enhancing the policymaking and comprehension of climate change and environmental performance. This paper developed a hybrid green city index (GCI) and grey relational analysis (GRA) composite index for appraising national environmental sustainability via a robust, efficient, effective, and replicable grading process. The index is designed based on two primary considerations. The first is the selection of quality underlying indicators/categories, while the second is the adoption of GRA for conducting the normalization, weighting and aggregation process. These two considerations influenced the proposed composite index, which was later applied to Saudi Arabia as a study area. The results revealed that the environmental sustainability of Saudi Arabia is not significant, with the most outstanding of 0.3127 for 2010. At the category level, the favourable environmental sustainability ranking is between the 2010 and 2012 assessment period, with a gradual decline till 2018. This study's findings are unique as no studies within the context of Saudi Arabia and the Gulf region have utilized this study's research approach. Although not all indicators of the proposed index were used in the study area, this study's methodology and outcomes have the beneficial impact of assisting Saudi Arabia's decision-makers across the cities in monitoring the status and progress of implementing its net zero carbon emissions by 2060.

Study on Myocardial Infarction in Young Adults: Risk Factor Analysis.

Coronary heart disease (CHD) imposes a significant burden on health care systems because of high morbidity and mortality. There is documented evidence that South Asian people develop CHD at a higher rate and at an early age. If the affected individual is 40 years old or below, the tragic consequences are catastrophic. Identifying risk factors could be important for health promotion. The objectives of this study were to determine the frequency of risk factors in young patients with acute myocardial infarction and thus with ischemic heart disease (IHD) aged 40 years and below in our population. It was a descriptive observational study which was carried out at Coronary Care Unit of Rajshahi Medical college Hospital, Rajshahi, Bangladesh in 61 patients from January 2011 to June 2011. All patients who fulfilled the inclusion criteria admitted to coronary care unit (CCU) with a diagnosis of Acute MI were included. Their detailed history was then taken including symptoms at presentation and their risk factors were assessed according to the Framingham Risk Scoring System with the help of history and laboratory investigations. Mean age ±SD of the patients was 36±3.7 year. Most of the patients were male. Smoking was the major risk factor (73.8%) followed by family history of IHD (44.3%). Other risk factors were dyslipidaemia (39.35%), hypertension (37.7%), obesity (11.5%) and diabetes mellitus (8.2%). Majority of the patients were adopted in sedentary lifestyle. 91.8% patient presented with chest pain. Other symptoms were dyspnoea (37.7%), palpitation (59.0%), sweating (77.0%), nausea, vomiting (50.8%) and impaired consciousness (19.7%) etc. Most frequent risk factor for acute myocardial infarction (MI) at young age is smoking followed by family history of MI and dyslipidaemia. Majority of the patients had two or more than two identifiable antecedent risk factors.