The isoprene rubber is very much like natural rubber but made artificially or synthetically. Essentially similar to natural rubber in properties, this rubber may be somewhat weaker because it is not 100% the cis-isomer. This rubber is used in the same type of products as natural rubber. About 95% of isoprene production is used to produce cis-1,4-polyisoprene, a synthetic version of natural rubber. The growing demand for fuel efficiency and eco-friendly tires is driving the tire industry and in turn the demand for polyisoprene in the tire industry. The Isoprene Market was valued at USD 1.93 billion in 2015 and is projected to reach USD 2.96 billion by 2021. The isoprene demand in Pakistan will increase up to 24.8% from 2018 to 2025 reportedly. The isoprene market is increasing due to its increasing applications in tires, conveyor belts, hoses, molded rubber, and also in medical equipment such as gloves and balloons. Isoprene can manufacture from four different processes at commercial scale, but Isoprene from formaldehyde is the prevailing process in the industries. This process has disadvantage of low yield and by-products. So this process is further modified to improve the yield and the operating conditions. But still byproducts are the main problems which decreases the selectivity and yield. To overcome these issues, manufacturing of Isoprene from propylene is studied in plant design project. It is found that this process has 65% yield and have selectivity of 95%. A cost Analysis was made after the design of different plant equipment, and it is found that a plant of 12000 tons per year has payback period of approximately 4 years.

IntroductionIndividuals with schizophrenia are at a high risk of physical health comorbidities and premature mortality. Cardiovascular and metabolic causes are an important contributor. There are gaps in monitoring, documenting and managing these physical health comorbidities. Because of their condition, patients themselves may not be aware of these comorbidities and may not be able to follow a lifestyle that prevents and manages the complications. In many low-income and middle-income countries including Pakistan, the bulk of the burden of care for those struggling with schizophrenia falls on the families.ObjectivesTo determine the rate of self-reported physical health disorders and risk factors, like body mass index (BMI) and smoking, associated with cardiovascular and metabolic disorders in cases of schizophrenia compared with a group of mentally healthy controls.DesignA case-controlled, cross-sectional multicentre study of patients with schizophrenia in Pakistan.SettingsMultiple data collection sites across the country for patients, that is, public and private psychiatric OPDs (out patient departments), specialised psychiatric care facilities, and psychiatric wards of teaching and district level hospitals. Healthy controls were enrolled from the community.ParticipantsWe report a total of 6838 participants’ data with (N 3411 (49.9%)) cases of schizophrenia compared with a group of healthy controls (N 3427 (50.1%)).ResultsBMI (OR 0.98 (CI 0.97 to 0.99), p=0.0025), and the rate of smoking is higher in patients with schizophrenia than in controls. Problems with vision (OR 0.13 (0.08 to 0.2), joint pain (OR 0.18 (0.07 to 0.44)) and high cholesterol (OR 0.13 (0.05 to 0.35)) have higher reported prevalence in controls. The cases describe more physical health disorders in the category ‘other’ (OR 4.65 (3.01 to 7.18)). This captures residual disorders not listed in the questionnaire.ConclusionsParticipants with schizophrenia in comparison with controls report more disorders. The access in the ‘other’ category may be a reflection of undiagnosed disorders.

Background: Studies are available on the use of inflammatory biomarkers for profiling and patient prognosis, but literature for tocilizumab monitoring parameters is scarce. Thus, we aim to evaluate different inflammatory markers that can relate to the effectiveness of tocilizumab in hospitalized patients suffering from severe covid. Method: We analyzed a retrospective cohort of 227 patients who were admitted due to SAR-Co2 in one of the largest hospitals in Pakistan, Lady Reading Hospital. Using in-hospital mortality as the primary parameter for the effectiveness of tocilizumab. Wilcoxon rank-sum test, chi-square test and ROC curve analysis were performed to evaluate inflammatory biomarkers. The p- values less than 0.05 were considered statistically significant. Result: A total of 1639 tests were identified from 227 patients admitted to the hospital. CRP (28%), LDH (27.3%) were the most commonly prescribed and 40% of the total test were prescribed pre-dose. D-dimer, ferritin and CRP were found to have a clinically significant impact of the dose.  Conclusion: D-dimer, ferritin and LDH do not seem to relate proportionally with tocilizumab effectiveness. CRP can be utilized for monitoring tocilizumab effectiveness.

Purpose: To figure out the prevalence of malnutrition among patients with Type-2 Diabetes Mellitus (T2DM) in tertiary care hospital Methodology: The study adopted a cross-sectional study.  The study took place in Endocrine and Medicine Departments of Lady Reading Hospital, Peshawar, Pakistan from September 2019 to March 2020. A total number of 259 patients of T2DM were screened for screened for nutritional assessment with the help of nurse and supporting staff. The data was recorded with the help of question are and Subjective Global Assessment form (SGA). The nutritional risk parameters and malnutrition status was figured out and the data collected was statistically analyzed with the help of MS Excel and SPSS 22.0. Findings: The results of the current findings revealed that 123 patients out of 259 were at moderate risk of malnutrition, while 136 patients were highly at malnutrition risk. Similarly, 162 patients were sorted out to have the status of moderate malnutrition while 97 patients were severely mal-nourished. Among various categories of BMI the highest frequency has been shown by Obese Class-I with highest risk malnutrition risk and severe malnourished frequency. The Correlation Coefficient R2 value of 0.923. The Chi-Square value of 187.69 and p-value (1.214e-38) nullifies the Null hypothesis. Conclusion: Based on the findings of this study, it may be concluded that a wholesome ratio of T2DM are at nutritional risk or having the status of malnutrition in hospitalized patients. Secondly, it may also be inferred that the largest number of T2DM could be assumed at Obese Class-I of BMI distribution.

Objectives: The present study aims to evaluate the nutritional status of diabetic patients using Subjective Global Assessment (SGA) tool. Methods: A prospective cross-sectional study was conducted at Endocrine and Medicine Department of Lady Reading Hospital from September 2019 to March 2020. A total of 359 patients diagnosed with Type-2 Diabetes Mellitus (T2DM) were included in the study. The malnutrition status was assessed using SGA, and clinical parameters including albumin and total leukocyte count (TLC). Results: We have observed mild to moderate malnutrition among 48.2% patients, and severe malnutrition in 10.6% patients as per the SGA scoring. Among the factors associated with nutritional status were BMI (p<0.01), and presence of CAD (DM complication) (p=0.015). As per the correlation analysis, BMI had a significant negative correlation with nutritional status (r=-0.351; p<0.01). Conclusion: It is concluded from the study results that there is a high prevalence of malnutrition among the enrolled diabetic patients. doi: https://doi.org/10.12669/pjms.39.1.5485 How to cite this: Ahmed I, Kaifi HM, Tahir H, Javed A. Malnutrition among patients with Type-2 Diabetes Mellitus. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.5485 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.