PurposeAbnormalities in serum magnesium levels have been seen in obesity and its related diseases. Our aim is to determine the mean magnesium levels in overweight and obese children as compared to the levels in normal weight controls to study its relationship with obesity and overweight. The study was done at a tertiary care hospital.MethodsA case-control study was conducted at the Department of Pediatrics, Combined Military Hospital, Peshawar, over a 12-month period from August 7, 2015 to August 6, 2016. A total of 140 children between 2-14 years of age were included in the study. They were divided into two equal groups of 70 children each. Both of the groups were matched according to their age and sex. Children with a body mass index (BMI) greater than or equal to 85th centile and 95th centile were placed in the overweight and obese category, respectively, and termed as cases while the other 70 children with a BMI greater than or equal to 5th centile but less than 85th centile were categorized as the normal weight group and termed controls. The serum magnesium levels of both case and control groups were calculated.ResultsThe serum magnesium levels were significantly lower in the overweight and obese group (2.08 ± 0.211 mg/dl) as compared to the normal weight group (2.55 ± 0.155 mg/dl, p<0.001). A significantly strong inverse relationship was seen between serum magnesium levels and body mass index.ConclusionMean serum magnesium levels in overweight and obese children are lower than those in normal weight children. Further studies are required to see the effect of supplementation of diet with this essential micronutrient on the weight of children.

Organophosphate (OP) poisoning is a commonly seen condition in many countries. OP poisoning classically presents with symptoms of cholinergic excess. It can rarely affect other organ systems but when it does, it can worsen a patient's overall prognosis. We present a case of a 23-year-old man with an extremely rare case of acute kidney injury due to OP, who was successfully treated with a combination of hemodialysis, atropine and pralidoxime days after OP poisoning with reservations on the aging process.

Lightweight, hybrid parts are extensively used in the manufacturing of modern aerospace or automobile structures like fiber metal laminates (FMLs) to replace the monolithic metallic parts. Presently, smaller and complex-shaped FML parts are made by applying the stamp-forming techniques. However, due to limited strain of the composite fibers, such techniques are unfit for forming complex profile laminated parts. This study focuses on the use of hydro-mechanical deep drawing (HMDD) for the three layers simultaneous forming of the metallic blanks to fabricate a hemispherical structure which will then be used to make a FML part. Orthogonal test strategy is formulated to investigate the influence of variables such as cavity/pre-bulging pressures, pre-bulging height, and die-binder gap to optimize the forming conditions. FE-based experimental study is done to research the thickness distribution and spring back of the formed multilayer structure. Results show that the research is sufficient in predicting these attributes and can provide a basis to understand the fundamental phenomenon for three-layered, simultaneously formed structures. Hybrid parts fabricated by using multilayer forming can expand the application areas of FMLs.

Objective The objective of this study is to find a correlation between internal jugular vein (IJV) and common carotid artery (CCA) diameter ratio and central venous pressure (CVP) measurement and find a cut-off value for the IJV/CCA ratio to predict low CVP i.e. < 10 cm H 2 0, for estimating the volume status in critically ill patients. Methods This prospective cross-sectional study was conducted at the critical care department of Shifa International Hospital, Islamabad, from July to December 2017. A sample of 49 patients ≥ 18 years with intrathoracic central venous catheters (CVCs) who underwent bedside sonographic assessments of IJV and CCA diameter were included in this study using convenient sampling. The IJV/CCA diameter ratio was calculated and correlated with CVP and the predictive value of the IJV/CCA diameter ratio to predict CVP < 10 cm H 2 O was explored by calculating the area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, and positive and negative predictive values. Results A total of 49 patients, 30 males (61.2%) and 19 females (38.8%) with a mean age of 56.00±16.11 years were included in the study. The mean CVP was 8.98±2.37cm H 2 O in ventilated (51%) and 10.7± 6.01 cm H 2 O in non-ventilated (49%) patients. The mean IJV/CCA diameter ratio was 1.60±0.55 at expiration and 1.41±0.56 at inspiration. There was a significant correlation between the IJV/CCA diameter ratio and CVP at expiration (r=0.401, p=0.004). The correlation between IJV/CCA and CVP was significant in non-ventilated patients at expiration (r=0.439, p=0.032). The area under the ROC curve for the IJV/CCA diameter ratio for predicting CVP < 10 cm H 2 O was 0.684 (p=0.028). The predictive value of the IJV/CCA diameter ratio for CVP < 10 cm H 2 0 at the cutoff value of < 2 was insignificant. A new cut-off < 1.75 was taken for the IJV/CCA diameter ratio from the coordinates of the ROC curve. The sensitivity, specificity, PPV, and NPV of an IJV/CCA diameter ratio of < 1.75 for predicting a CVP < 10 cm H 2 0 were 84.62%, 52.17%, 66.67%, and 75.00%, respectively. Conclusion The assessment of volume status by the IJV/CCA diameter ratio with a sonographic device may be a useful noninvasive alternative for a central venous catheterization with a cut-off < 1.75.

Stamp forming method used for forming of relatively smaller and complex-shaped fiber metal laminate (FML) parts has inherent constraints such as fiber sheet rupture, metallic layers quantity, and repeated heating/ solidification of thermoplastic (TP) resin/tooling. As an alternate and efficient strategy, simultaneous forming of multiple blanks has been studied by using hydro-mechanical deep drawing (HDD) method. Also, the effect of process variables such as cavity pressure and blank holding force (BHF) and their role in wrinkles formation, thinning, edges movement and formability for the HDD process (performed with and without applying the cavity pressure) has been deliberated. Blanks made of Al 2024-O alloy sheet were used and the formability attributes, based on Barlat 2000 yield criteria, were estimated using DYNAFORM/LS-DYNA and compared with the experimental results. The results show that application of cavity pressure within certain limits has a positive effect on the quality of three-layer formed part as well as leads to higher depths as compared with the process when no cavity pressure was applied. Good agreement has been found between the predicted and the experimental results. The simultaneous forming strategy can give the advantage of eradicating the strict process controls which are needed in the conventional stamp forming method and can expand the application areas of FML parts for the aerospace and automobile industries.