2016, over 47 million people worldwide have dementia and this number is expected to rise to more than 131 million by 2050 [1]. In 2015 58% of the total dementia population is estimated to reside in Low and Middle Income Countries (LMICs) which is expected to rise to 63% by 2030 and 68% by 2050 [2]. Dementia and related issues in LMICs are different than in the West including assessment, diagnosis, awareness, caregiver characteristics, resources, and policy and strategies. Therefore research done in the West may not be applicable to LMICs in all aspects and contextualized research is needed for tailored solutions in such settings [3].Pakistan is a low middle income country in South East Asia with a rapidly aging population. It is currently the sixth most populous country in the world and is expected to become the third most populous by 2050 [4,5] and 10% of the country's total population is estimated to be over 60 years of age [6]. Islam is the religion of the state with 97 % of the population being Muslim [7], with a very low literacy rate of 56% and low GDP per capita [8]. Among several factors identified as contributors to people's understanding of different medical conditions, religious and cultural beliefs, level of education and living arrangements are also important ones that play a role in explanatory models of disease symptomatology [9] and outcomes [10]. In Pakistan, joint family system prevails and people with dementia are mostly cared for at home by family members and informal caregivers. A qualitative study conducted in Lahore, Pakistan interviewed 8 dementia caregivers to explore thinking patterns, physical health; identified maladaptive cognitive patterns fatigue and sleep disturbances as causes of caregiver distress [11]. Caregiver distress is also often associated with type, severity, and frequency of dementia symptoms [12]. Caregiver characteristics and relationship with patient may also differ in different geographical regions, affecting the dynamics, quality of care and care burden [11]. In Pakistan, caregiver role is usually assigned to women [13] who may be spouses, daughters or daughter in laws of the affected person. Due to the unique characteristics of this society and dearth of dementia related research, it is important to study people's knowledge about dementia, cultural beliefs, most common and difficult to manage symptoms and resources available.We designed a 15 item questionnaire survey to be filled out by the participants of a dementia awareness program in Karachi to study patients' knowledge, care arrangement and caregiver characteristics. MethodsAga Khan University Hospital (AKUH) is a private teaching hospital located in a densely populated area of Karachi. The hospital is considered to be one of the most sophisticated in the country and regularly organizes CME sessions, awareness events and capacity building exercises for trainees, physicians and general public in the city and the country. The hospital has the only trained neuropsychiatrist (Khan Q) in the country. As a part of ...

Background: Kidney biopsy is one of the most important tools in the assessment of kidney disease. Knowing the histopathology is important for immediate clinical management. It helps in predicting the long term prognosis and in planning for prevention of chronic kidney disease. Methods: This is a cross section study of percutaneus biopsies of the native kidneys of patients, who presented to the Aga Khan University Hospital Karachi Pakistan, over ten year period from 2003 to 2012. Age range was 16 to 77 years. Results: Total number of 435 biopsies were included in the study. The most common histopathological findings, regardless of the indication of biopsy were Tubulo Interstitial Nephritis in 15 percent, followed by Membranous Nephropathy in 12 percent, Focal Segmental Glomerulosclerosis in 8 percent and Membrano Proliferative Glomerulonephritis also in 8 percent. Conclusion: This study will help in better understanding the spectrum of renal disease in Pakistan. It will guide the clinician in the management and provide a data base or a starting point for the researchers for conducting the controlled and population base studies.

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In vehicular systems, driving is considered to be the most complex task, involving many aspects of external sensory skills as well as cognitive intelligence. External skills include the estimation of distance and speed, time perception, visual and auditory perception, attention, the capability to drive safely and action-reaction time. Cognitive intelligence works as an internal mechanism that manages and holds the overall driver's intelligent system.These cognitive capacities constitute the frontiers for generating adaptive behaviour for dynamic environments. The parameters for understanding intelligent behaviour are knowledge, reasoning, decision making, habit and cognitive skill. Modelling intelligent behaviour reveals that many of these parameters operate simultaneously to enable drivers to react to current situations. Environmental changes prompt the parameter values to change, a process which continues unless and until all processes are completed. This paper model intelligent behaviour by using a 'driver behaviour model' to obtain accurate intelligent driving behaviour patterns. This model works on layering patterns in which hierarchy and coherence are maintained to transfer the data with accuracy from one module to another. These patterns constitute the outcome of different modules that collaborate to generate appropriate values. In this case, accurate patterns were acquired using ANN static and dynamic non-linear autoregressive approach was used and for further accuracy validation, time-series dynamic backpropagation artificial neural network, multilayer perceptron and random sub-space on real-world data were also applied.

Objectives The study aimed to evaluate and compare various commercially available local anesthetic solutions. Materials and Methods A total of 150 commercially available local anesthetic cartridges of similar composition (2% lidocaine with epinephrine 1:100,000) were randomly collected and divided into 3 groups. The designations of groups were selected from their product names such that each group consisted of 60 cartridges. Group S (Septodont, France) Group M (Medicaine, Korea) and Group H (HD-Caine, Pakistan). The samples were divided into five sub-groups, each consisting of 10 cartridges from each group to investigate each parameter. Results The acquired data was statistically analyzed and compared (using SPSS version 12). Compositional analysis revealed a non-significant (P>0.05) difference when the three Groups were compared with standard lidocaine and epinephrine solutions. The mean pH values of samples from group S, M and H respectively fell within the range of pH values of commercially available solutions. Non-significant difference in EPT values of Group S and H was found when efficacy was compared (p = 0.3), however a significant difference (p < 0.01) was observed in contrast to Group M. Anti-bacterial activity was observed in all the group and a non-significant difference in cell viability values of Group S and M was found (p = 0.6), while the difference was significant in comparison to Group H. Conclusion Within the limitations of these investigations, it appears that the properties of different manufacturers fall within the recommended ranges as mentioned in literature and do not appear to be statistically different in the variables we have tested.