Optimal Path Routing Protocol for Warning Messages Dissemination for Highway VANET.

In vehicular ad hoc networks (VANETs), helpful information dissemination establishes the foundation of communication. One of the significant difficulties in developing a successful dissemination system for VANETs is avoiding traffic fatalities. Another essential success metric is the transfer of reliable and secure warning messages through the shortest path, particularly on highways with high mobility. Clustering vehicles is a general solution to these challenges, as it allows warning alerts to be re-broadcast to nearby clusters by fewer vehicles. Hence, trustworthy cluster head (CH) selections are critical to decreasing the number of retransmissions. In this context, we suggest a clustering technique called Optimal Path Routing Protocol for Warning Messages (OPRP) for dissemination in highway VANETs. OPRP relies on mobility measured to reinforce cluster creation, evade transmission overhead, and sustain message authenticity in a high mobility environment. Moreover, we consider communication between the cluster heads to reduce the number of transmissions. Furthermore, the cluster head is chosen using the median technique based on an odd or even number of vehicles for a stable and lengthy cluster life. By altering traffic densities and speeds, OPRP is compared with prominent schemes. Simulation results revealed that OPRP offers enhanced throughput, end-to-end delay, maximizing packet delivery ratio, and message validity.

Performance assessment of aquatic macrophytes for treatment of municipal wastewater.

The objective of the study was to evaluate the performance of three different aquatic macrophytes for treatment of municipal wastewater collected from Taxila (Pakistan). A physical model of treatment plant was constructed and was operated for six experimental runs with each species of macrophyte. Every experimental run consist of thirty days period. Regular monitoring of influent and effluent concentrations were made during each experimental run. For the treatment locally available macrophyte species i.e. water hyacinth, duckweed & water lettuce were selected to use. To evaluate the treatment performance of each macrophyte, BOD5, COD, and Nutrients (Nitrogen and Phosphorus) were monitored in effluent from model at different detention time of every experimental run after ensuring steady state conditions. The average reduction of effluent value of each parameter using water hyacinth were 50.61% for BOD5, 46.38% for COD, 40.34% for Nitrogen and 18.76% for Phosphorus. For duckweed the average removal efficiency for selected parameters were 33.43% for BOD5, 26.37% for COD, 17.59% for Nitrogen and 15.25% for Phosphorus and for Water Lettuce the average removal efficiency were 33.43% for BOD5, 26.37% for COD, 17.59% for Nitrogen and 15.25% for Phosphorus. The mechanisms of pollutant removal in this system include both aerobic and anaerobic microbiological conversions, sorption, sedimentation, volatilization and chemical transformations. The rapid growth of the biomass was measured within first ten days detention time. It was also observed that performance of macrophytes is influenced by variation of pH and Temperature. A pH of 6-9 and Temperature of 15-38°C is most favorable for treatment of wastewater by macrophytes. The option of macrophytes for treatment of Municipal sewage under local environmental conditions can be explored by further verifying the removal efficiency under variation of different environmental conditions. Also this is need of time that macrophyte system should be used for treatment of wastewater because their performance is comparable to conventional wastewater treatment plants and also the system has very low O&M costs.

Evaluation of patients with coronary artery disease for major modifiable risk factors for ischemic heart disease.

BACKGROUND: Incidence of cardiovascular diseases is on the rise in developing countries. Deaths due to ischemic heart disease can be reduced by modifying the risk factors. The present study was conducted to evaluate the patients scheduled for Coronary Artery Bypass Surgery for the presence of major modifiable risk factors for ischemic heart disease (IHD). METHODS: It was a descriptive study. All patients who underwent elective Coronary Artery Bypass cardiac surgery between November 1, 2008 and February 28, 2009 at Rehman Medical Institute, Peshawar, were included in the study. Presence of Diabetes, Hypertension, Smoking, Dyslipidemia, Sedentary life style, and Obesity was looked for in these patients. RESULTS: A total of 104 patients were studied during this period. Majority (97.11%) of patients had at least one major modifiable risk factor for IHD. Sedentary life style (53.84%) was the most common risk factor present in these patients followed by hypertension and dyslipidemia (47.11% each), smoking (43.27%), diabetes (35.57%), and obesity (9.61%). Multiple risk factors (two or more) were found in 78 (75.0%) of patients. CONCLUSION: Most of the patients with coronary artery disease, severe enough to warrant coronary artery bypass grafting, have at least one of the major modifiable risk factors for IHD. Modification of these factors may well reduce the disease burden of CAD and reduce the cardiovascular mortality.

Drug-eluting balloon (DEB) for de-novo coronary artery disease and in-stent restenosis: immediate and intermediate term results from a prospective registry.

OBJECTIVES: To study the safety and short and intermediate term efficacy of drug-eluting balloon (DEB) in the treatment of de-novo and in-stent restenotic coronary artery disease (CAD). METHODS: Of the total 100 patients so far enrolled in a prospective DEB registry using a Paclitaxel-coated balloon at our hospital, 36 patients were studied for short and intermediate term i.e. 12 months outcomes. All patients with symptomatic coronary artery disease (CAD) including de-novo lesions or in-stent restenosis (ISR) requiring percutaneous intervention (PCI) with a DEB were included. Clinical follow-up was conducted at 3, 6 and 12 months. Primary outcome was a composite of major adverse cardiac events (MACE). RESULTS: Procedural success was achieved in all (100%) patients. Mean age was 53.2 +/- 12 years, 61.1% presented with acute coronary syndrome (ACS) and 47.2% had triple vessel CAD. Sixty six percent were classified as having ACC/AHA B-2 or C type coronary arteries including 22.2% with bifurcation lesions. DEB intervention for de-novo CAD was done in 77.7% patients and 22.2% for ISR. All de-novo lesions required a bare- metal stent (BMS) after DEB dilatation. Mean DEB diameter was 2.73 +/- 0.06 mm and mean length was 19.58 +/- 0.81 mm. Coronary dissections occurred in 5 patients which were successfully treated with additional stents. At 3 (n=36), 6 (n=31) and 12 (n=31) months follow-up, no MACE was observed in any patient. CONCLUSION: The short and intermediate term outcomes from this prospective DEB registry showed excellent results with 0% target lesion revascularization (TLR) for both de-novo and ISR lesions.

Report: frequency of aspirin resistance in patients with coronory artery disease in Pakistan.

Aspirin resistance is an emerging clinical entity. However the data available on aspirin resistance in Asian population is scarce. This study was initiated to prospectively evaluate the frequency of aspirin resistance in patients with stable coronary artery disease (CAD) in Pakistan. A cross sectional prospective study was conducted in cardiology and hematology departments at Shifa International Hospital, Islamabad from January to December 2007. Two hundred and fifty patients were enrolled from cardiology out patient department having met the specific inclusion criteria. Details were entered on a pre-designed questionnaire and aspirin response assay was performed on IMPACT-R (Dia Med AG 1785 Cressier Morat, Switzerland). Data was analyzed using SPSS V12. Aspirin resistance was observed in 12% of patients. 73.2% of study population were male and 26.8% were female, with a mean age of 57.2 years. There was no significant correlation of aspirin resistance with traditional risk factors like diabetes mellitus (DM), hypertension or dyslipidemia. 84% of aspirin non responders were taking 75 mg per day and 16% were on 150 mg per day. A positive trend was noted between aspirin resistance and cigarette smoking. Aspirin resistance is a real phenomenon in Pakistani population with an estimated frequency of 12%. Large scale prospective randomized trials with long term follow up are needed to assess the impact of different doses and the clinical significance of this biochemical entity.

Role of inferior vena cava filter implantation in preventing pulmonary embolism.

A retrospective review of all patients undergoing IVC filter implantation at Shifa International Hospital, Islamabad, from June 2004 to June 2006 was conducted to study the indications of inferior vena cava (IVC) filter use and impact on short-term morbidity/mortality. A total of 17 patients received IVC filters. Five patients were excluded due to data loss. One month clinical follow-up was available for 12 patients and 6 months follow-up was also available for 4 of 12 patients. The underlying disease was deep venous thrombosis (DVT) with pulmonary embolism (PE) in 6 (50%), DVT without PE in 4 (33.3%) and PE with negative duplex scan for DVT in 2 (16.6%) patients, respectively. Indications for IVC filter implantation were DVT and/or PE with contraindication to anticoagulation in 8 (66.7%) and DVT and/or PE with complications of anticoagulation in 4 (33.3%) patients. No procedure-related complications were noted in all 17 patients. Three patients (25%) died of non-PE related causes during the 1st month. There were no PE related mortalities at 6 months. This data set indicates that IVC filter implantation is a safe procedure with no short-term morbidity/mortality and potential long-term mortality benefit.

Plasma levels of B-type natriuretic Peptide in patients with unstable angina pectoris or acute myocardial infarction: prognostic significance and therapeutic implications.

Plasma B-type natriuretic peptide (BNP) levels were obtained from 146 patients with unstable angina pectoris, non-ST-segment elevation myocardial infarction (MI), or ST-segment elevation MI to determine their value in predicting the presence of new heart failure, recurrent MI or ischemia, or death 1 month after the index event. Patients with elevated plasma BNP levels (>80 pg/mL) had a significantly higher incidence of new heart failure and all-cause mortality than those with a normal plasma BNP level (

Rheumatic mitral stenosis presenting as acute abdominal aortic occlusion and foot drop.

Systemic thromboembolism in not an infrequent complication of rheumatic mitral stenosis. We report a case of acute abdominal aortic occlusion due to rheumatic mitral stenosis, in the absence of atrial fibrillation, mimicking spinal cord compression. Systemic streptokinase given 48 hours after symptom's onset lead to rapid and dramatic recovery with limb salvage.