Intrauterine growth restriction (IUGR) is found in 1-10% of all pregnancies, and among women with risk factors even twice often. It is connected to worse obstetric results, and its complications can arise long time after delivery. In the paper we described etiology, diagnostics and monitoring of IUGR and its consequences for the child and for the course of neonatal periode.

Intrauterine growth restriction

Background: Lack of information about economic burden of COPD is a major cause of lack of attention to this chronic condition from governments and policymakers. Objective: To find the economic burden of COPD in Asia, USA and Europe, and to identify the key cost driving factors in management of COPD patients. Methodology: Relevant studies assessing the cost of COPD from patient perspective or societal perspective were retrieved by thoroughly searching PUBMED, SCIENCE DIRECT, GOOGLE SCHOLAR, SCOPUS, and SAGE Premier Databases. Results: In the USA annual per patient direct medical cost and hospitalization cost were reported as $10,367 and $6852, respectively. In Asia annual per patient direct medical cost in Iran, Korea and Singapore was reported as $1544, $3077, and $2335, respectively. However, annual per patient hospitalization cost in Iran, Korea, Singapore, India, China, and Turkey was reported as $865, $1371, $1868, $296, $1477 and $1031, respectively. In Europe annual per patient direct medical cost was reported as $11,787, $10,552, $8644, $8203, $7760, $3190, $1889, $2162, and $2254 in Norway, Denmark, Germany, Italy, Sweden, Greece, Spain, Belgium, and Serbia, respectively. Conclusion: Limiting the disease to early stage and preventing exacerbations may reduce the cost of management of COPD.

The economic burden of chronic obstructive pulmonary disease (COPD) in the USA, Europe, and Asia: results from a systematic review of the literature.

Blood pressure and cardiovascular disease in the Asia Pacific region

Diabetes mellitus and diabetic foot ulcer: Etiology, biochemical and molecular based treatment strategies via gene and nanotherapy.

through most of these stages before admission, was presented to us in the little girl Catherine Bates, aged 12. In her we had universal dulness; faint and rapid action of the heart; a pulse of 120; anasarca, both of the legs and face; and respirations to the number of not less than 58 in the minute, yet all these were happily subdued by the antimonial treatment, as beautifully indicated in the descent of the respirations from day to day, first to 50, then to 40, and to 20, 18, and 16 successively. In the case of Eliza Sleuth we witnessed the total disappearance of the left lung under phthisis, the greater part of the right involved in it, and the remaining portion rendered useless by a concluding attack of inflammation. Also, in the instance of Ann West, whose left lung was likewise reduced, by tubercle, to a mere pouch at the top, the same as Sleuth's, we found the right one intensely inflamed, even after the patient seemed to have improved a good deal under the cod-liver oil. The latter onset was very sudden; she had little stamina to bear much active treatment, and would have sunk very soon under depressants. The chief features here, during the termination of life were,-blueness of the countenance, anasarca, small pulse, cold feet, and large universal mucous rattles. Most of the phthisical cases that terminate abruptly, prove fatal from the supersention of pneumonia in the remaining sound portions of lung, and therefore it becomes of great consequence to watch for its approaches throughout the whole treatment. In the remarkably favourable case of Hannah Lewis, decided measures were resorted to, even under all the weakness of phthisis, and the successful termination of that case must strengthen this view of the subject. In the first stage of engorgement, although the lung is found of a brilliant scarlet colour, and exuding blood at every cut of the knife, yet it is not altogether deprived of air, for, upon being squeezed, numerous bubbles make their appearance, along with the blood; but in the latter stage of consolidation there is a complete closure of the proper spongy structure of the organ, at first from excess of blood, compared to the structure of liver, and so named the red hepatization, afterwards, from a disappearance of the red particles, becoming grey, and, lastly, quite a pale pink, like the simple fibrinous organization. If such exudations be rapidly enough broken down, and absorbed, before the proper texture be obliterated, then the lung may be restored almost to its pristine condition; but, if permitted to press on the delicate walls so long as to have caused them, on the contrary, to be absorbed or atrophied, the adventitious tissue will remain as a fixture through life, and deprive the individual of a certain proportion of air at each inspiration The respirations will, therefore, become habitually increased in number, while local dulness will be apparent. As already remarked, this dulness will sometimes lead, under other acute attacks, to sundry mistakes as to the presence of tubercle or actually existing inflammation. Such mistakes are chiefly to be avoided by a consideration of the general history and constitution of the patient; yet the certain fact can never be demonstrated until death reveals the existence of some ancient solidification of the above kind. Thus, in the case of John Schofield, who was admitted with flushed and puffy countenance; much heat of skin, especially on the chest; great dyspnoea, so as to require propping up in bed, with pain on inspiration; anasarca, rusty sputum, and a pulse of 120; we had dulness, much more extensive than seemed consistent with the recentness of the attack. Pleuropneumonia was at once diagnosticated, and for that he was treated with blisters and antimony, but, though the more positive symptoms of acute inflammation were soon thereby subdued, the same dulness remained. It was now a questioiu whether this dulness arose from a deposit of tubercle or plastic lymph. The general feebleness and flabbiness of the body seemed to plead, in some degree, for the first, but at the same time the absence of emaciation rather pointed to the second. After having rallied from the pleuro-pneumonia, however, he imprudently exposed himself, half naked, to the cold air; this induced a return of the malady, under which he very rapidly sank, and, on examining the lungs, a most beautiful and interesting spectacle was displayed of pneumonia in all its stages, from the brilliant scarlet of the recent attack, to the red, the grey, and the tawny hepatization of former ones. It was obvious that he had had the disease in past times, again and again, and that, being not arrested, it had run on to its natural result of consolidation. As, however, he could give no definite history of his former ailments, a doubt necessarily existed as to the precise natuire of the solid matter; fortunately this doubt was not of a nature to interfere with the course of treatment. The management of these disorders will be the subject of another lecture.

/pdf/on-epilepsy-a-paper-read-before-the-midland-branch-of-the-3hjh64p2qg.pdf

On Epilepsy: A Paper read before the Midland Branch of the Provincial Medical and Surgical Association, at Derby, December 4th, 1851

Background: Health-care systems in Asian countries are diverse. The economic evaluation provides information on how to make efficient use of the resources available to obtain the maximum benefits. In Asia, diseases such as cardiovascular diseases (CVDs), diabetes mellitus (DM), tuberculosis (TB) and epilepsy generate a heavy economic burden. The objective of this article is to provide a review of the economic burden of health to patients in Asian countries. Areas covered: All data were collected from already published research article and review papers. The databases searched were Science Direct, PubMed, MEDLINE and Google scholar. We found a total of 4456 articles on health economics. After reviewing the title, only 876 relevant articles were considered. Only 92 (n = 92) articles were considered on the basis of inclusion and exclusion criteria. Expert opinion: Available data give evidence that diseases are linked to the low socio-economic status of the Asian population. The cost per capita is high in Asian countries due to insufficient health-care facilities. The cost per capita in Asian countries ranges from $23 (Pakistan) to $1775 (Taiwan). The per capita cost of Malaysia, China, Singapore, and Thailand is $27 $83, $75, and $27, respectively.

Increased burden of disease and role of health economics: Asia-pacific region

Intrauterine growth restriction (IUGR) is a clinical definition applied to neonates born with clinical features of malnutrition and in-utero growth retardation irrespective of their birth weight percentile. This study was aimed to determine the frequency of pulmonary hypertension (PH) in neonates with IUGR. In this descriptive cross-sectional study, we followed 96 neonates with IUGR (≤28 days) and 38 neonates without IUGR born in the department of the neonatal intensive care unit children hospital complex Multan, Pakistan. We analyzed certain factors such as gender, gestational age (GA) (weeks), birth weight (BW in kg), weight percentile (WP) for GA, meconium aspiration syndrome (MAS), birth asphyxia (BA) and respiratory distress syndrome (RDS) for pulmonary hypertension (PH) in IUGR and non-IUGR group. GA was measured by the Ballard scoring system. Echocardiography was performed for all patients by the pediatric cardiologist to measure pulmonary arterial (PA) pressure using Bernoulli’s equation. Out of total 96 IUGR neonates, 33.3% (n = 32) suffered from PH, of which 65.3% (n = 18) were male and 43.7% (n = 14) were female. The percentages of IUGR neonates with BA, MAS and RDS were 34.4%, 18.8% and 22.9% respectively. The data were analyzed using the SPSS-16 software to test the statistical significance of the results. A p-value less than 0.05 was considered significant. When the chi-square test was applied, it depicted that MAS was significantly associated with PH in IUGR neonates (p = 0.0001) compared to non-IUGR neonates. Our findings suggested an increased chance of PH in IUGR neonates and MAS may be a strong factor.

/pdf/the-frequency-of-pulmonary-hypertension-in-newborn-with-4me1cab30b.pdf

The frequency of pulmonary hypertension in newborn with intrauterine growth restriction.

W (Triticum aetsivum L.) is the staple food of Pakistan and it ranked 1st among crops. It is an important cereal crop of Pothwar Region of Pakistan. It contributes about 10% to the agriculture and 2.1% to total GDP of the Country (ESP, 2014-2015). Average grain yield of wheat is 2.845 t ha-1 which is very low (ESP, 2016-2017). The main reasons of this low yield of wheat in Pakistan are uncertainty of rainAbstract | Weeds infestation is the serious problems of wheat crop of Pothwar Region in Pakistan. To find out the remedy of the said issues a field experiment was conducted at University Research Farm, Chakwal Road, Rawalpindi during 2015-16 to investigate the effect of different herbicides and sowing methods on wheat productivity and population dynamics of weeds. Different wheat sowing methods (S) were Broadcasting, Line sowing, Ridge sowing, Bed sowing and herbicides used were Ally Max, Clean wave, Starane M. and Buctril Super 60 Ec. The experiment was laid out in RCBD with split plot arrangement having three replications. Hand weeded (weed free), and weedy check (control) plots were also maintained for comparison in each replication. The recorded data were analyzed using Fishers analysis of variance technique and means were compared by using the least significant differences test (LSD) at 5% level of significance. Most of the studied parameters showed significant results (P≤0.05) for yield and weed indices. The results showed that highest weed control efficiency (41.86%) was recorded for hand weeding followed by Ally Max (30.8%) which were significantly different from each other; while, in case of sowing methods, weed control efficiency was maximum (24.08%) for ridge sowing method. Similarly, grain yield was maximum (3.09 t ha-1) under the plot where hand weeding was performed followed by the plot where Ally max (2.68 t ha-1) was applied; whereas, highest yield was (2.84 t ha-1) obtained from line sowing method. So, it is concluded and recommended that for controlling broadleaved weeds hand weeding otherwise Ally Max herbicide through line sowing method results in a good yield of rain fed wheat. Abid Muhammad Shah1, Safdar Ali1*, Ijaz Ahmad2, Gulzada Wazir1, Obaidullah Shafique1, Muhammad Amir Hanif1, Bashir Ahmad Khan3 and Sumaira Zareen4

Weeds Population Studies and Wheat Productivity as Influenced by Different Sowing Techniques and Herbicides

Objective: To compare the efficacy of intravenous midazolam and diazepam in the management of status epilepticus seizures in children.
Method: The comparative study was conducted in the paediatric neurological emergency unit of The Children’s Hospital and the Institute Of Child Health, Multan, Pakistan, from December 15, 2018, to May 14, 2019, and comprised paediatric patients of status epilepticus seizures whi were divided into Diazepam and Midazolam groups.  Data was analysed using Graph-Pad Prism 5.
Results: Of the 164 patients, 82(50%) were in each of the two groups. There was no significant difference between the groups in terms of weight, age, residence area of patients and mean duration of seizures (p>0.05). Status epilepticus seizures subsided after intravenous midazolam administration in 77(93.90%) cases, while success in the diazepam group 64(78.05%) (p<0.05). Mean time taken by midazolam to halt seizures was significantly shorter than diazepam (p<0.05) and less cases of treatment failure were observed with intravenous midazolam (p<0.05). Somnolence was observed after diazepam administration in 47(57.3%) cases (p=0.0001).
Conclusion: Intravenous midazolam was found to be superior in efficacy than intravenous diazepam in controlling status epilepticus seizures.
Key Words: Diazepam, Midazolam, Status epilepticus, Seizures

A comparison of intravenous midazolam and diazepam in management of status epilepticus in children

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Increased burden of disease and role of health economics: Asia-pacific region

The frequency of pulmonary hypertension in newborn with intrauterine growth restriction.

Weeds Population Studies and Wheat Productivity as Influenced by Different Sowing Techniques and Herbicides

A comparison of intravenous midazolam and diazepam in management of status epilepticus in children