Ischemic stroke is the most commonly occurring type of stroke and one of the most communal causes for disability and death in the world as per World Health Organization. Multiple factors such as hypertension, diabetes, arterial fibrillation, heart diseases, transient ischemic strokes, etc. contribute to ischemic stroke susceptibility. There is a compelling need for follow up checkups and post analysis to prevent further strokes. Apart from clinical tests, a lot of research is being carried out on computer based automated techniques and mechanisms for estimation of ischemic stroke risk. Ultrasound images of the carotid artery are used for development of noninvasive image based methods for stroke risk estimation however; carotid artery morphology, noise and artifacts in the ultrasound images can lead to false classification. Carotid intima media thickness is an indicator of future ischemic stroke. In this research, we have proposed an automatic ischemic stroke risk estimation approach using carotid intima media thickness from longitudinal carotid B-mode ultrasound images. Based on carotid intima media thickness, a classification scheme is proposed to associate the carotid artery stenosis with ischemic stroke risk. The proposed approach is tested and clinically validated on a data set of 100 longitudinal ultrasound images of the carotid artery. There is no significant difference between intima media thickness measurements obtained using our approach and the manual measurements by experts. The intra-observer error of 0.088, a Coefficient of Variation of 12.99%, Bland-Altman plots with small differences between experts (0.01 and 0.03 for Expert 1 and Expert 2, respectively) and Figure of Merit of 98.5% are obtained. The proposed approach makes the risk estimation process automatic and yet reduces the risk of subjectivity and operator variability for intima media thickness measurement. Additionally, some of stroke cases are suspected to be genetic as the patients do not suffer from the conventional risk factors. Extensive research has been conducted to investigate the unknown factors other than the conventional ones and their relationship with genetics. We have analyzed genotype data for stroke risk estimation. Nine classification models are used on the SNPs data to analyze and classify individuals. An accuracy of 88.16% is achieved by the proposed approach. Ischemic stroke risk has been correlated with genetic distances. For this purpose phylogenetic trees have been used. Analysis suggests that given two populations might be genetically close but they might be far with respect to ischemic stroke risk. Proposed research has addressed both the medical image analysis and genetic data analysis for stroke risk estimation. The proposed approach has achieved higher accuracy, specificity and sensitivity values when compared to existing approaches.
مولانا اخلاق حسین قاسمی دہلوی؍ حکیم عزیز الرحمان مؤی؍ ڈاکٹر مقتدی حسن ازہری افسوس ہے کہ گذشتہ دنوں ہماری مجلس علم و دانش کو مولانا اخلاق حسین قاسمی دہلوی، حکیم عزیز الرحمان مؤی اور ڈاکٹر مقتدی حسن ازہری جیسی اہم شخصیتوں سے محروم ہونا پڑا، قرآن مجید اور علوم دینیہ کی تبلیغ، تفہیم اور توسیع میں ان کی خدمات لائق تحسین رہیں، دارالمصنفین سے ان حضرات کا تعلق اخلاص و تعاون کا تھا، معارف میں ان تینوں کی نگارشات آتی رہیں، افسوس ہے کہ اب ان کی جگہ لینے والے نظر نہیں آتے، اﷲ تعالیٰ ان تمام مرحومین کے حسنات کو قبول کرے اور جنت الفردوس کی نعمت سے نوازے، معارف میں ان کا ذکر تفصیل سے آنا چاہیے، آئندہ شماروں میں شاید یہ ضرورت پوری کی جاسکے۔ ( عمیر الصدیق دریابادی ندوی ، نومبر ۲۰۰۹ء)
It is generally believed that the contemporary world of academia is divided between Divine and non-Divine philosophies. By considering the Divine theory in accordance to the human behavior, advocates of theory take it in the best interest of mankind. They argued that the Creator Himself guides the human being in right direction. Islam unlike modern concept of governance does not separate religion from politics and fulfills its legislative needs by means of Divine Law or Shariah. In Islamic system, the state through Caliph will have to establish Shariah of God by working on the restrictions set by Him and in conformity with His orders and commands. Yet he is allowed only to give lawful command and the people are also bound to follow only the lawful commands. In Islam there is no place for such a political order where a solitary individual or a group of persons have authoritarian or dictatorial rule. However, the Muslims, in all circumstances, must cling to the state authorities and are obliged to submit to the ultimate source of law given by the Almighty Allah in the Quran. Non-Divine theories, on the other hand mainly stress upon rationalization of human development and behavior in a certain direction. Leaving those theories aside, current study will focus on the political philosophy of Islam as prescribed by the teachings of Quran and Sunnah. The subject matter of the study is to see the possibilities regarding implementation of Islamic values in the contemporary state and society.
Background: Liver disease is an emerging management problem in human immunodeficiency virus (HIV) infected patients. The incidence of chronic Hepatitis B infection, which accelerates the progression of chronic liver disease and development of liver fibrosis, is ten times higher in patients with HIV than the general population. Staging of liver fibrosis provides essential information in management of these patients.
Objective: To determine the prevalence of significant liver fibrosis in patients with HIV mono-infection versus those with HIV-HBV co-infection as assessed with shear wave elastography (SWE).
Methods: This was a cross-sectional study whereby HIV infected patients attending the HIV clinic at AKUH, N were consecutively recruited into the study. A total of 105 patients, 70 with HIV mono-infection and 35 with HIV-HBV co-infection, had liver elastography obtained using SWE to assess for presence of significant fibrosis the cut-off of which was 5.6 kPa. The prevalence of significant liver fibrosis was compared between the two groups. Assessment of APRI score (a non-invasive serum biomarker of liver fibrosis) in these patients was also done.
Results: The prevalence of advanced liver fibrosis was significantly higher (p <0.0001) in patients with HIV-HBV co-infection, 25.7%, compared to those with HIV mono-infection, 7.1%. APRI score was higher in patients with HIV-HBV co-infection than those with HIV mono-infection.
Discussion: The prevalence of significant liver fibrosis observed in the two proportions in the current study is comparable to those reported in other studies. HIV co-infection with HBV accelerates progression to significant liver fibrosis. Association of low CD 4 count with advanced fibrosis supports earlier starting of antiretroviral therapy to prevent rapid progression of liver disease in HIV positive patients. Higher APRI scores in the HIV-HBV co-infected group was as a result of higher AST levels.
Conclusion/recommendations: In view of the high prevalence of liver fibrosis in patients with HIV-HBV co-infection, regular monitoring of the disease progression is recommended. A study involving follow up of HIV-HBV co-infected patients to assess for effects of therapy is also recommended.