[en] Smokeless tobacco is considered one of the major risk factors for oral cancer. It is estimated that over 90% of the global smokeless tobacco use burden is in South Asia. This paper aims to systematically review publications reporting epidemiological observational studies published in South Asia from 1984 till 2013. Methods. An electronic search in “Medline” and “ISI Web of Knowledge” yielded 734 publications out of which 21 were included in this review. All publications were assessed for quality using a standard quality assessment tool. Effect estimates (odds ratios (OR)) were abstracted or calculated from the given data. A random effects meta-analysis was performed to assess the risk of oral cancer with the use of different forms of smokeless tobacco. Results and Conclusion. The pooled OR for chewing tobacco and risk of oral cancer was 4.7 [3.1-7.1] and for paan with tobacco and risk of oral cancer was 7.1 [4.5-11.1]. The findings of this study suggest a strong causal link between oral cancer and various forms of smokeless tobacco. Public health policies in affected countries should consider SLT specific cessation programs in addition to campaigns and activities incorporated into smoking cessation programs.

[en] Worldwide move towards renewable energy sources, environmental concerns and decentralization of the power sector have made net metering an attractive option for power generation at small scale. This paper discusses the net metering, economical issues of renewable sources in Pakistan, technical aspects, installation suitability according to varying terrain, existing utility rules and formulation of legislation for net metering making it economically attractive. (author)

[en] Wireless Sensor Networks (WSNs) are memory and bandwidth limited networks whose main goals are to maximize the network lifetime and minimize the energy consumption and transmission cost. To achieve these goals, different techniques of compression and clustering have been used. However, security is an open and major issue in WSNs for which different approaches are used, both in centralized and distributed WSNs' environments. This paper presents an adaptive cryptographic scheme for secure transmission of various sensitive parameters, sensed by wireless sensors to the fusion center for further processing in WSNs such as military networks. The proposed method encrypts the sensitive captured data of sensor nodes using various encryption procedures (bitxor operation, bits shuffling, and secret key based encryption) and then sends it to the fusion center. At the fusion center, the received encrypted data is decrypted for taking further necessary actions. The experimental results with complexity analysis, validate the effectiveness and feasibility of the proposed method in terms of security in WSNs. (author)

[en] Lithofacies and granulometric analysis were carried out to decipher the depositional environment of the Fort Member of the Jurassic Jaisalmer Formation. Based on field data nine lithofacies have been identified including trough cross-bedded sandstones, planar cross-bedded sandstones, matrix supported conglomerates, thinly bedded siltstone and sandstones, herringbone cross-bedded sandstones, wave rippled sandstones, laminated sandstones, hummocky cross-bedded sandstones, limestones and shales. Granulometric analysis of the sandstones samples has been carried out for their statistical and textural parameters. Bivariant plots of textural parameters such as graphic skewness versus graphic standard deviation and kewness versus standard deviation confirm the high energy (beach) origin of sandstones. These results suggest a wide spectrum of marine environments ranging from inner shelf to upper shoreface for the Fort Member sandstones.

[en] Optical modeling of multilayer thin films constructed with oppositely charged nanoparticles help us to understand phenomenon such as surface plasmon resonance, absorbance, transmittance and reflectance. This work reports the application of Maxwell-Garnett effective medium theory in quasi-static limit to colloidal suspensions consisting of host material silica and the inclusion material -gold nanoparticles. Layer-by-layer deposition method was used to self-assemble these nanoparticles to build multilayer composite films. By varying the number and thickness of the layers and the size and spacing of the metal inclusion, a facilitative optical design is modeled to build multilayers of nanosized materials targeted for desired applications. (author)

[en] To observe the pattern and mortality of Congo-Crimean Hemorrhagic Fever (CCHF) in Balochistan. Two hundred and twenty-six febrile patients with bleeding of sudden onset, with initial signs and symptoms including headache, high fever, back pain, joint pain, stomach pain, vomiting, red eyes, flushed face, red throat and petechiae on the palate of both sexes were screened for CCHF over a period of 10 years. Clinical criteria for initial diagnosis directed the subsequent diagnostic work-up. The ages of these patients ranged from 7 years to 74 years. Sixty-three percent of these patients were positive for CCHF. Males were 68% of the total patients. Over the years, CCHF showed a gradual increase ranging from 43% to 80%. Total mortality was 15%, all being secondary cases. Death was not observed in primary CCHF cases. In this study, suspicion of viral hemorrhagic fever was raised in 62% cases at the time of admission and the patients were immediately isolated, noninvasive procedures were instigated and barrier nursing was implemented. None of the family and hospital staff members who had close contact with the patient became ill, while those who were not suspected initially (38%) infected the health care workers and the family members. Although CCHF is rare, this study stresses the need for proper health facilities in Pakistan and to include VHF (viral hemorrhagic fevers) in the differential diagnosis of unexplained fever with hemorrhagic tendencies of sudden onset. (author)

[en] Castleman's disease is a rare disorder of unknown etiology and different clinical manifestations, occurring in young adults (usually prior to age 30 years). In this case report we present one such case who was a 16 years old male with abdominal pain, weight loss, cervical lymph adenopathy and hepatosplenomegaly. Lymph node biopsy revealed hyaline-vascular type of Castleman's disease. He was put on chemotherapy but was lost to follow-up. (author)

[en] Juvenile nasopharyngeal angiofibroma (JNA) is an uncommon tumour constituting less than 1% of all head and neck tumours. This tumour has an aggressive local behaviour if left untreated. Surgery is the mainstay of treatment with no common consensus on a single approach. Tumour stage and surgical approaches are the major determinants of outcome. The objective of this study was to evaluate the influence of surgical approaches on tumour recurrence in patients with nasopharyngeal angiofibroma. Methods: This descriptive study was conducted in the Department of ENT and Head and Neck Surgery, PIMS, Islamabad and Ayub Medical Institution, Abbottabad from Jan 2010 to Jan 2014 consisting of 34 diagnosed cases of nasopharyngeal angiofibroma. All patients were treated surgically while radiotherapy was given in a few. All patients were followed up for one year. Results: Among 34 patients, 25 were treated by lateral rhinotomy approach with medial maxillectomy, 5 by mid-facial degloving approach and 3 by transpalatine approach. One patient with cavernous sinus involvement was treated by radiotherapy. Patients were followed up for one year both by clinical examination and imaging if needed. Recurrence was found in 15% (5/33) patients and postop radiotherapy was given to them. Conclusion: Lateral rhinotomy approach with medial maxillectomy is highly effective even in advanced stage JNA for complete removal of the disease. Postoperative radiotherapy is an effective adjuvant. (author)

[en] To estimate the frequency of Vitamin D deficiency (VDD) among the patients presented to a public sector facility. Methodology: This cross sectional study was conducted at Department of Pathology, Dow International Medical College, Karachi. Vitamin D (25[OH] D) level was checked from July 2012 to June 2016. Results: A total Out of 7838 samples, 5890 (75.1%) belonged to males and 1948 (24.9%) to females. Among total subjects, 58.2%, 13.8% and 28.0% were found deficient, insufficient and sufficient, respectively. The highest frequency of VDD was found among 34 to 39 (23.0%) years of age group. Conclusion: VDD was observed in all age groups. Focused health care education and public awareness programs are needed to improve the situation. Encouraging the healthy lifestyle, optimum sun exposure and prompt diagnosis of VDD would be beneficial to alleviate the magnitude of prevalence of VDD in Pakistan. (author)

[en] Objective: To describe the management and outcome of patients with penile fracture. Study Design: Case series. Place and Duration of Study: Department of Urology and Renal Transplantation, Jinnah Hospital, Lahore, from March 2008 to March 2011. Methodology: Sixteen patients presenting with clinical findings / history of penile fracture were included in this study. Diagnosis was made on the basis of history and clinical findings. Surgical exploration and repair was done on the same day. In all patients, a subcoronal circumferential degloving incision was made. Rent location and dimensions management and postoperative complication were noted. Postoperatively, erection was suppressed for 4 - 5 days. All patients were discharged with advice of avoidance of sex for about 8 weeks. Patients were followed-upto 6 months. Results: Majority of the patients (87.5%) were married and 13 (81.25%) were aged 18 - 45 years. The typical findings recorded in 100.0% patients were erection at time of fracture, detumescence, swelling and ecchymosis. Audible crackling sound and pain was present in 13 (81.25%) patients. Ten (62.5%) patients had rent in the proximal part of penile shaft and right lateral tear was present in 11 (68.75%) patients. Blood clots were evacuated and closure of rent was done with vicryl 2/0 (interrupted stitches). 100.0% patients had uneventful recovery with only 3 (18.75%) patients developed right chordae of erect penis after treatment. All (100.0%) patients were potent and without any problem of erection. Conclusion: Penile fracture is under-reported. A trauma to erect penis is essential to cause fracture. Surgical exploration and repair is the treatment of choice. (author)