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This paper highlights the power of image in shaping perception of the people regarding post 9/11 American representation in Pakistani print media discourses.  The study deconstructs the semiotic discourse(s) of Pakistani English newspaper Dawn (daily) from September 2018 to February 2019 to argue that linguistic and semiotic devices and techniques work discursively to shape the readers’ perception regarding American foot-prints in Pakistani print media.  It employs Multimodal Critical Discourse analysis approach by drawing upon Machin (2007), Van Leeuwen framework for recontextualization (2008) and Fairclough’s (2003) for visual and linguistic analyses to lay bare embedded ideologies propagated through word-picture conjunction. The levels of analysis include participants, settings, poses, objects, metaphor, inclusion, exclusion and discourse. Moreover, the researchers have validated the findings of their   semiotic analysis by conducting two focus group discussions among the students of linguistics and other disciplines. The findings reveal that print media semiotic discourses provide an appropriate use of language in graphic form.  The findings reveal that no use of language is ideology free and words and pictures work in conjunction to propagate desired ideology to the target readership. Additionally, the study notices the visible change that has taken place regarding American representation from superordinate to back foot and ready-to-hold dialogue through semiotic discourses of mentioned newspaper.

This retrospective cohort study aimed to investigate the impact of maternal cardiac diseases on fetal outcomes at the Liaquat University of Medical & Health Sciences (LUMHS). The study was conducted over one year, from December 2018 to December 2019, and involved a sample size of 120 participants. The study utilized medical records of pregnant women with cardiac diseases who delivered at LUMHS over the past 5 years. The data collected included maternal demographic and medical history, fetal and neonatal outcomes, and other relevant medical information. Descriptive statistics were used to analyze the data and determine the prevalence of maternal cardiac diseases and their impact on fetal outcomes. Logistic regression analysis was used to identify risk factors associated with adverse fetal outcomes, such as preterm birth, low birth weight, stillbirth, and congenital anomalies. The results showed that 20% of pregnant women had cardiac disease, with rheumatic heart disease being the most common. Women with cardiac diseases were found to be at higher risk for adverse fetal outcomes, including preterm birth, low birth weight, stillbirth, and congenital anomalies. Logistic regression analysis revealed that maternal age, parity, and type of cardiac disease were significant predictors of adverse fetal outcomes. These findings emphasize the importance of early identification and managing maternal cardiac diseases to prevent adverse fetal outcomes. The study contributes to growing maternal and fetal health research, particularly in high-risk populations such as pregnant women with cardiac diseases. It underscores the need for multidisciplinary management involving obstetricians, cardiologists, and neonatologists to optimize maternal and fetal outcomes in this population.

INTRODUCTION: Cortical spreading depolarization (CSD) represents a pathomechanistic target for neuroprotective therapy given the association with lesion development and poor outcomes following traumatic brain injury (TBI).METHODS: Experiments were conducted using 9-week-old Sprague Dawley rats. Daily neurobehavioral scores were recorded by trained, blinded observers. Using an established weight-drop model, animals received either single moderate (modTBI; n = 23) or four daily mild (rmTBI; n = 30) head impacts. Sham animals received brief anesthetic without TBI (n = 40). Animals underwent cranial window surgery and CSDs were electrically triggered by cortical stimulation; electrophysiological, imaging and blood-flow were monitored using intravital microscopy. Ketamine (100uM topical and 25 mg/kg IP, respectively) and memantine (10 mg/kg IP) were tested in vivo. Subsequently, a RCT was conducted (N=31) using memantine (10 mg/kg) or saline (2.5 cc/kg). Primary outcome: proportion of animals resilient to rmTBI (neurobehavioral scores ≥ 6 out of 12).RESULTS: In modTBI, and rmTBI animal models, intraperitoneal ketamine and memantine reduced the proportion of electrically triggered CSDs by 79-88%, and 42-73%, respectively. The average relative amplitude of change in ECoG were reduced by 70-75%, and 51-60%, respectively. Memantine significantly reduced spreading depression and cortical hypoperfusion following CSD. RCT animals in the memantine group were more likely resilient to injury (93% vs. 56%; p = 0.023) and had higher mean neurological scores (9.27 (SD 3.08) vs. 5.56 (SD 3.05)), p < 0.001) compared to saline.CONCLUSIONS: The NMDA-receptor antagonist memantine supresses CSDs and reduces pathological cerebral hypoperfusion in vivo following CSDs. In a rmTBI RCT, memantine prevented neurological decline.

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