Smartphone Thermal Imaging for Preoperative Perforator Mapping in Perforator Based Flaps.

OBJECTIVE: To determine the diagnostic accuracy of smartphone thermal imaging for preoperative perforator mapping in perforator-based flaps, taking visual inspection as gold standard. METHODOLOGY: It was a cross-validation study conducted at the Department of Plastic Surgery, Dr. Ruth K. Pfau Civil Hospital, Karachi, Pakistan, from August 2022 to January 2023. All adult patients aged 18 to 40 years of either gender undergoing perforator flap surgery were included. Each patient followed the same treatment regimen, which involved the preoperative identification of the perforator location using the FLIR One camera. Subsequently, confirmation was achieved during the surgical procedure through visual inspection. A two-by two table was used to calculate sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy. RESULTS: The mean age of the patients was 30.10±6.87 years, ranging from 18 to 40 years. Most of the patients were males (58.7%), and 41.3% were females. Almost 80.4% were pedicle flaps, and 19.6% were free flaps. The accuracy of thermal imaging was found to be 83.2%, with a sensitivity of 84.3%, a specificity of 80%, a PPV of 92.9%, and a NPV of 62.2%, respectively. CONCLUSION: Smartphone-based thermal imaging is useful for the diagnosis of perforators and has high sensitivity and specificity.

A Single Centre, Randomized Control Trial Of Donor Site Wound Dressings After Split-Thickness Skin Grafting.

BACKGROUND: Split-thickness skin grafting (STSG) is a widely employed technique for repairing wounds, such as ulcers, trauma, or in reconstructive surgeries. The objective was to compare the efficacy of different dressing materials for healing donor-site wounds after split-thickness skin grafting. METHODS: A single center, randomized controlled trial was conducted at the Department of Plastic Surgery, Civil Hospital Karachi, Pakistan, over a period of six months. The study included patients aged 18 years and above, of both genders, who underwent single donor-site wounds after split-skin grafting with a surface area larger than 10 cm². The eligible patients were randomly divided into six groups: Film, Alginate, Gauze, Hydrofiber, Hydrocolloid, and Silicone. Pain, itching, scarring, complications, and patient satisfaction were evaluated after 12 weeks using standardized assessment scales. RESULTS: The median time to complete wound healing and re-epithelialization varied among the different dressing groups, with hydrofiber and silicone dressings demonstrating the shortest healing time. Statistical analysis revealed a significant difference in the median time to complete wound healing among the dressing groups (p-value=0.019). However, no significant differences were observed in pain, itching, scarring (POSAS observer and patient), or patient satisfaction among the different dressings (p-value>0.05). CONCLUSIONS: Although the dressing type did not significantly affect pain, itching, scarring, or patient satisfaction, variations were observed in the time to complete wound healing. These findings contribute to the selection of appropriate donor site dressings for optimizing outcomes in split-skin grafting procedures.

Investigating the Effects of Capital Structure and Corporate Governance on Firm Performance: An Analysis of the Sugar Industry.

The objective of this paper is to investigate the impact of capital structure and corporate governance on firm performance. To test the hypothesis of study, data was collected from annual reports of sugar sector companies listed in PSX. This study data covers from 2015 to 2020. The results of study showed that both proxies of capital structure, i.e., D/A and D/E negatively influence the company performance. Whereas two out of three proxies of corporate governance, i.e., board size and chairman/CEO duality negatively indicate association with company performance while audit committee size has a positive impact on the company performance.

Investigating the existence of asymmetric environmental Kuznets curve and pollution haven hypothesis in China: Fresh evidence from QARDL and quantile Granger causality.

This study aims to analyze the asymmetric long-run relationship between economic growth (EG), foreign direct investment (FDI), and carbon emissions (CO2) within the context of the environmental Kuznets curve (EKC) and the pollution haven hypothesis (PHH) in China. Employing the quarterly data from 1982Q1 to 2018Q4, we have used novel techniques to meet the stated objectives of our study, named quantile ARDL and quantile Granger causality. The study provides novel outcomes using the advanced quantile ARDL and quantile Granger causality tests. The significant implication of this method is that it provides locational asymmetry. We find strong evidence of the EKC and PHH for China based on the empirical results of linear and nonlinear ARDL models. Similarly, findings of quantile Granger causality validate the bidirectional relationship among all variables in upper and lower quantiles. Moreover, the results of the Wald test confirm the asymmetric long-run relationship between FDI and carbon emissions (CO2). Thus, legal measures must be enhanced, accepted, rigorously imposed, and monitored in all provinces to assure a further reduction in carbon emissions. This study will be conducive for the policymakers to combat environmental contamination concerning economic growth and FDI inflow in China.

Seasonal Fluctuations of N, P and K in Leaves Influenced Nutrient Requirement During Fruit Development Stages in Different Olive Genotypes

Abstract: Olive is grown in semi-arid climatic conditions; however, little is known about mineral changes in olive plant and nutrient requirements during the production period. Hence, the current study was conducted under Pothwar agro-climatic conditions in order to select appropriate stage of macronutrients (N, P, K) application in relation to soil and leaf nutritional status during 2017 and 2018 growing seasons. Soil and leaf analysis were performed at four different phenological stages (i.e. flowering, fruit setting, fruit enlargement and fruit maturity stages). The results revealed that the assessed macronutrient in leaf and soil varied significantly among varieties, phenological stages and growing year. The results revealed also that nitrogen level was found to decrease from fruit set (1.56%) to fruit enlargement stage (1.47%). Leaf and soil N, P and K contents were found higher before the flowering (stage 1) and depleted after fruit harvesting (stage 4), regardless of olive varieties. However, high yielding varieties showed lower nutrients after fruit harvesting (stage 4). Therefore, N content in leaf and soil gradually decreased during fruit growth and development. Whereas, K content in leaf and soil sharply declined from fruit maturity to fruit ripening stage. Overall, the trend of nutrient depletion showed that plants need phosphorus for fruit setting, nitrogen before and after fruit setting, and potash after pit hardening or at oil accumulation stages.

Co-variance nexus between COVID-19 mortality, humidity, and air quality index in Wuhan, China: New insights from partial and multiple wavelet coherence.

The worldwide outbreak of COVID-19 disease has caused immense damage to our health and economic and social life. This research article helps to determine the impact of climate on the lethality of this disease. Air quality index and average humidity are selected from the family of climate variables, to determine its impact on the daily new cases of COVID-19-related deaths in Wuhan, China. We have used wavelet analysis (wavelet transform coherence (WTC), partial (PWC), and multiple wavelet coherence (MWC), due to its advantages over traditional time series methods, to study the co-movement nexus between our selected data series. Findings suggest a notable coherence between air quality index, humidity, and mortality in Wuhan during a recent outbreak. Humidity is negatively related to the COVID-19-related deaths, and bad air quality leads to an increase in this mortality. These findings are important for policymakers to save precious human lives by better understanding the interaction of the environment with the COVID-19 disease.

Frequency and the risk factors of hepatitis C virus in pregnant women; A hospital based descriptive study in Gadap Town Karachi.

OBJECTIVE: To determine the frequency and the risk factors of hepatitis C virus in pregnant women at Al-Tibri Medical College & Hospital in Gadap Town Karachi. METHODS: This was a descriptive cross sectional study conducted at Obstetrics & Gynecology OPD of Al-Tibri Medical College & Hospital, Isra University Karachi Campus from 10th June to 10th September 2016. A total of 400 pregnant women of 16-45 years of age, who came in outpatient department for antenatal checkup were selected for the study. The diagnosed cases of Hepatitis C were excluded from the study. Detailed history including age, parity, risk factor like history of transfusion, previous surgeries, vaginal deliveries was taken and relevant examination was performed. Patients on routine antenatal investigation if found to have Anti HCV positive on Immunochromatography Test (ICT) method were further confirmed by Elisa. A well designed proforma was used for data collection. RESULTS: During the period of 3 months 400 women in antenatal clinic were tested for hepatitis C, out of which 27 (6.6%) were positive for HCV antibodies. The age of the women included ranges from 16-45 years. Thirteen (7.9%) pregnant women having HCV +ve antibodies fell in 26-30 years of age group. From 27 HCV +ve patients, 19 (70.3%) were multigravida & 8 (29.6%) were primigravida. Majority of the patients (77%) had history of injections. CONCLUSION: There is high prevalence of Hepatitis C infection among pregnant female in our setup. The possible risk factors are injection, blood transfusion and surgery.