A Systematic Review and Meta-Analysis of the Efficacy and Safety of Combined Mechanical Circulatory Support in Acute Myocardial Infraction Related Cardiogenic Shock.

Background: Acute myocardial infarction-related cardiogenic shock (AMICS) is a severe complication associated with exceedingly high mortality rates. While mechanical circulatory support (MCS) has emerged as a potential intervention, the evidence base for independent MCS use remains weak. In contrast, systematic reviews of observational studies have revealed significant mortality reduction when a combination of MCS was used: VA-ECMO in conjunction with a left ventricular (LV) unloading device (Impella or IABP).

Coronary Artery Fistula: A Diagnostic Dilemma.

Coronary artery fistula (CAF), although one of the rare coronary anomalies, is becoming increasingly more detectable in the recent years due to advancements in cardiac diagnostic imaging. Its long-term prognostic implications and importance for the cardiovascular system remain a dilemma for cardiologists and patients. Based on a variety of haemodynamic symptoms and complications, cardiologists must be aware of the characteristics of CAF and the diagnostic importance of multi-slice CT in evaluation, pre-procedural management and follow-up.

Acute Cardiac Manifestations of SARS-CoV-2 Infection: Spotting the Clot.

A middle-aged gentleman presented with a one-week history of progressive dyspnoea on minimal exertion, persistent haemoptysis, and right calf swelling. His only past medical history of note was a recently positive SARS-CoV-2 nasopharyngeal swab performed as part of a workplace outbreak screening. A CT pulmonary angiogram (CTPA) showed bilateral pulmonary thrombi, extensive consolidation, and a left ventricular (LV) thrombus.

Renal Denervation as a Complementary Treatment Option for Uncontrolled Arterial Hypertension: A Situation Assessment.

Uncontrolled arterial hypertension is a major global health issue. Catheter-based renal denervation has shown to lower blood pressure in sham-controlled trials and represents a device-based, complementary treatment option for hypertension. In this situation assessment, the authors, who are practicing experts in hypertension, nephrology, general practice and cardiology in the Republic of Ireland, discuss the current evidence base for the BP-lowering efficacy and safety of catheter-based renal denervation with different modalities.

Composition and structure of plant communities in the Moist Temperate Forest Ecosystem of the Hindukush Mountains, Pakistan.

Here, we investigated the relationship between Plant communities and the environment from the moist temperate vegetation of Lakoo mountainous forest District Swat. We sampled data from 162 sampling units (Quadrates) using 1x1m2 for herbs 5x5m2 and shrubs, while 10 x10m2 for trees, systematically considering six elevation gradients between the altitudinal from 1970m to 3095m. We performed statistical analysis like Canonical correspondence analysis (CCA) and TWINSPAN (two-way indicator species analysis) for ecological assessment and clustering of plant communities.

Lead Perforation Into the Left Internal Mammary Artery Causing Circulatory Collapse After Pacemaker Insertion.

A 66-year-old woman underwent a pacemaker implantation following a symptomatic pause. The pacemaker lead inadvertently punctured the ventricle during implantation, penetrating through to the left internal mammary artery, causing slow hemorrhage. There was subsequent circulatory collapse with shock.

Limiting amino acids supplementation in low crude protein diets and their impacts on growth performance and carcass composition in Labeo rohita (rohu) adult fish.

Ninety days study was conducted in hapas installed in earthen ponds. Fish of an average initial weight (220g) were evenly distributed in triplicate groups within fifteen hapas. Five experimental diets labeled as T1 (25% CP and NRC recommended amino acid level) as control diet, T2 (with 2% low protein and 5% amino acid supplementation), T3 (with 2% low protein and 10% amino acid supplementation), T4 (with 4% low protein and 10% amino acid supplementation) and T5 (with 4% low protein and 20% amino acid supplementation) were prepared.

Rural and urban variation in psychological distress among adults: results of the 2014-2015 Eastern Townships Population Health Survey (ETPHS).

Objective: A growing number of people live in urban areas. Urbanization has been associated with an increased prevalence of mental disorders, but which mechanisms cause this increase is unknown. Psychological distress is a good indicator of mental health.

An overview of radioactivity measurement studies in Pakistan.

In our environment, various naturally occurring radionuclides are present (both underground and overground) in several places, which results in lifelong human exposure. The radiation dose received by human beings from the radiation emitted by these naturally occurring radionuclides is approximately 87%. Exposure to radiation poses radiological health hazards.

Molecular occurrence of canine babesiosis in rural dog population in Pakistan.

Canine babesiosis is an important tick-borne protozoal disease of dogs that poses major health problem worldwide. Farm dogs in rural areas are the companion animals, that not only watch the livestock herds but also guard the house of the owners. Each farmer keeps his companion dog to get all the services.

Assessment of national dosimetry quality audits results for teletherapy machines from 1989 to 2015.

The purpose of this study was to ensure accuracy in radiation dose delivery, external dosimetry quality audit has an equal importance with routine dosimetry performed at clinics. To do so, dosimetry quality audit was organized by the Secondary Standard Dosimetry Laboratory (SSDL) of Pakistan Institute of Nuclear Science and Technology (PINSTECH) at the national level to investigate and minimize uncertainties involved in the measurement of absorbed dose, and to improve the accuracy of dose measurement at different radiotherapy hospitals. A total of 181 dosimetry quality audits (i.

Intercomparison of environmental gamma doses measured with A NaI (Tl) survey meter and thermoluminescent dosimeters (TLDs) in the Poonch division of Azad Kashmir, Pakistan.

This study presents the intercomparison of the outdoor environmental gamma dose rates measured using a NaI (Tl) based survey meter along with thermoluminescent dosimeters (TLDs) and estimation of excess lifetime cancer risk (ELCR), for the inhabitants of Poonch division of the Azad Kashmir, Pakistan. CaF2: Dy (TLD-200) card dosimeters were installed at height of 1 m from ground at fifteen different locations covering the entire Poonch division comprising of three districts. During three distinct two month time periods within the six month study period, all the installed dosimeters were exposed to outdoor environmental gamma radiations, retrieved and read out at Radiation Dosimetry Laboratory, Health Physics Division, PINSTECH laboratory, Islamabad.

Evaluation of hemodynamically severe coronary stenosis as determined by fractional flow reserve with frequency domain optical coherence tomography measured anatomical parameters.

Objectives: The main objective of this study is to determine the correlation between fractional flow reserve (FFR)- and frequency domain optical coherence tomography (FD-OCT)-measured lumen parameters, and to determine the diagnostic competence of FD-OCT concerning the identification of severe coronary stenosis.

Methods: A total of 41 coronary stenoses in 30 patients were assessed consecutively by quantitative coronary angiography (QCA), FFR, and FD-OCT. Stenoses were labeled severe if FFR ≤ 0.

Indoor radon monitoring near an in situ leach mining site in D G Khan, Pakistan.

Indoor radon and its decay products are considered to be the second leading cause of lung cancer after cigarette smoking. This is why extensive radon surveys have been carried out in many countries of the world, including Pakistan. In this context, 25 spots were selected at workplaces in the vicinity of the uranium mining site in Dera Ghazi Khan District for indoor radon measurement.

Exposure of population from residential radon: a case study for district Hattian, Azad Kashmir, Sub-Himalayas, Pakistan.

Indoor air quality has acquired considerable importance in recent years. Tighter buildings with poorer ventilation systems have led towards higher levels of indoor air pollution. Radon is considered to be most significant perilous gas among the various air contaminants found in the residential environment.

Radiological hazards due to naturally occurring radionuclides in the selected building materials used for the construction of dwellings in four districts of the Punjab Province, Pakistan.

This paper presents the finding of a study undertaken to determine the naturally occurring radionuclides present in commonly used building materials for dwellings and workplaces in four districts of the Punjab Province, Pakistan. The concentrations of (226)Ra, (232)Th and (40)K were measured by using gamma-ray spectroscopy. A total of 80 samples of building materials were collected from various manufacturers and suppliers of the studied area.

Measurement of natural radioactivity in sand samples collected along the bank of rivers Indus and Kabul in northern Pakistan.

Radioactivity is a part of the natural environment. The presence of natural radioactivity in sand and other building materials results in internal and external exposure to the general public. Therefore, it is desirable to determine the concentration of naturally occurring radionuclides, namely (232)Th, (226)Ra and (40)K in sand, bricks and cement which are commonly used as building materials in Pakistan.

Assessment of indoor radon doses received by the students in the Azad Kashmir schools, Pakistan.

Several epidemiological studies conducted on thousands of underground miners suggest that long- term exposure to high radon concentration can increase the risk of lung cancer. Keeping in view the importance of the subject, numerous studies throughout the world have been carried out to measure indoor radon concentration and its resulting doses at occupational and non-occupational sites. The purpose of the current study was to measure indoor radon concentration and its resulting doses received by the students of Azad Kashmir government schools.

Assessment of computerized treatment planning system accuracy in calculating wedge factors of physical wedged fields for 6 MV photon beams.

Wedge filters are commonly used in external beam radiotherapy to achieve a uniform dose distribution within the target volume. The main objective of this study was to investigate the accuracy of the beam modifier algorithm of Theraplan plus (TPP version 3.8) treatment planning system and to confirm that either the beam hardening, beam softening and attenuation coefficients along with wedge geometry and measured wedge factor at single depth and multiple fields sizes can be the replacement of wedged profile and wedged cross-sectional data or not.

Determination of boron contents in water samples collected from the Neelum valley, Azad Kashmir, Pakistan.

Intake of boron from food and drinking water may pose a risk to the public health above a certain concentration level. Therefore, knowledge of boron concentration in drinking water and food items is essential. In this context, samples of drinking water were collected from natural springs of the Neelum valley, Azad Kashmir, hit by devastating earthquake in 2005.

Studying wedge factors and beam profiles for physical and enhanced dynamic wedges.

This study was designed to investigate variation in Varian's Physical and Enhanced Dynamic Wedge Factors (WF) as a function of depth and field size. The profiles for physical wedges (PWs) and enhanced dynamic wedges (EDWs) were also measured using LDA-99 array and compared for confirmation of EDW angles at different depths and field sizes. WF measurements were performed in water phantom using cylindrical 0.

Erratum to "Technical note: Accuracy checks of physical beam modifier factors algorithm used in computerized treatment planning system for a 15 MV photon beam" [Rep. Pract. Oncol. Radiother. 14 (2009) 214-220].

[This corrects the article DOI: 10.1016/j.rpor.

Indoor radon concentrations and assessment of doses in four districts of the Punjab Province - Pakistan.

Seasonal indoor radon measurement studies have been carried out in four districts, namely, Jhelum, Chakwal, Rawalpindi and Attock of the Punjab Province. In this regard, CR-39 based detectors were installed in bedrooms, drawing rooms and kitchens of 40 randomly selected houses in each district. After exposing to radon in each season, CR-39 detectors were etched in 6M NaOH at 80 degrees C and counted under an optical microscope.

External dose assessment from the measured radioactivity in soil samples collected from the Islamabad capital territory, Pakistan.

It is a well known fact that natural radionuclides are the major contributors towards the gamma ray exposure received by the general public. In this context, soil samples were collected from the Islamabad capital territory and activities due to (226)Ra, (232)Th, (40)K and (137)Cs were measured using gamma ray spectrometry: activities ranged from 41.5-106.