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Bacillus thuringiensis (B. thuringiensis) is considered one of the most important entomopathogenic microorganisms. It produces potent toxins against insects. Therefore, the present study investigates the bioacaricidal properties of B. thuringiensis on the Hyalomma tick species. Firstly, we identify Hyalomma ticks based on morphological screening and molecular characterization. The cytochrome C oxidase subunit I (COX1) gene was selected for the polymerase chain reaction (PCR) analysis, which resulted in the amplification of 656 bp. The amplified products were sequenced, and the isolated (COX1) gene of ticks was submitted to the gene bank of NCBI (Accession No. OR077934.1). The nucleotide sequences were retrieved from the NCBI data bank by BLASTn analysis, which confirmed that all obtained sequences belong to genus Hyalomma, and multiple alignments confirmed that the sequence of Hyalomma anatolicum Tandojam‐isolate (HA‐TJ) 100% aligned with Hyalomma analoticum KP792577.1, Hyalomma detritum KP792595.1, Hyalomma excavatum KX911989.1, and H. excavatum OQ449693.1. The generated phylogenetic tree confirmed that sequences of HA‐TJ COX1 clustered with a single clad of H. analoticum, H. excavatum, and H. detritum. The acaricidal effect of B. thuringiensis toxins B. thuringiensis spore crystal mix (BtSCM) and B. thuringiensis crystal proteins (Btcps) was evaluated against larvae and adult life stages of Hyalomma ticks in vitro. We applied Btcps and BtSCM separately with different concentrations and calculated the mortality percentage. Adult mortality was estimated at the 8th, 10th, 12th, and 15th days posttreatment and larval mortality after 24 h. During treatment of the adult life stage, at first, ticks were immersed in different concentrations of Btcps and BtSCM for 5 min after the treatments, and the samples were transferred to sterile containers and placed in an incubator with 80% humidity at 23°C. Furthermore, Btcps produced the highest mortality on Day 15, 89 ± 1.00% at a concentration of 3000 μg/mL, followed by the 12th, 10th, and 8th days produced 83 ± 1.91%, 70 ± 1.15%, and 61 ± 1.00%, respectively. BtSCM produced mortality of 69 ± 1.91% on Day 15 at a concentration of 3000 μg/mL, followed by the 12th, 10th, and 8th days at 57 ± 2.51%, 37 ± 1.91%, and 34 ± 2.00%. The present study revealed that B. thuringiensis toxins produced a significant (p < 0.05) increase in mortality rate in adults of Hyalomma ticks. Additionally, Btcps and BtSCM were used to treat the larval stage. The treatments were applied to calculate the mortality percentage via the Laravel packet test. At a 1500 μg/mL concentration, Btcps resulted in the highest mortality of 98 ± 1.15%; this was followed by 1250 μg/mL, 1000 μg/mL, and 750 μg/mL, which produced mortalities of 76 ± 1.63%, 60 ± 1.63%, and 56 ± 1.63%, respectively. In addition, BtSCM produced a mortality rate of 79 ± 2.51% at a concentration of 1500 μg/mL. Furthermore, 75 ± 2.51%, 65 ± 1.91%, and 58 ± 1.15% mortality were observed at concentrations of 1250 μg/mL, 1000 μg/mL, and 750 μg/mL, respectively. The results showed a significant (p < 0.05) increase in larval mortality compared to the control group. We conclude that B. thuringiensis toxins are applicable as a bioacaricide. [ABSTRACT FROM AUTHOR]

The destructive effects of burning conventional fossil fuels on the environment have created the realisation of the significance of using alternative fuels as a mitigating measure to reduce greenhouse gas emissions. One of the most promising and environmentally friendly substitutes for petroleumbased gasoline fuel is bioethanol. This study uses agricultural residue (bagasse), halophytes and non-edible biomass as feedstocks to produce bioethanol, through lignin content extraction from Panicum antidotale, Phragmites karka, Sugarcane bagasse, Jatropha curcas husk and Conocarpus erectus leaves and then cellulose reduced by acid pretreatment followed by hydrolysis. The cellulose content was found higher in Panicum antidotale (43.39 percent) and lowest in Jatropha curcas husk (35.10 percent), while moderate values of (42.81 percent) in Sugarcane bagasse, Phragmites karka (37.48 percent), and Conocarpus erectus (38.53 percent). At the beginning and end of the fermentation process, the total carbohydrate contents of the hydrolysed biomass were analysed, and their bioethanol yields were measured. Maximum reducing sugar was found 19 gm/L (1.186 lb/ft3 ) in Panicum antidotale followed by Phragmites karka, sugarcane bagasse, Jatropha curcas husk, and Conocarpus erectus leaves as 15.89 gm/L (0.991 lb/ft³ ) and 12.09 gm/L (0.754 lb/ft3 ), 10.52 gm/L (0.656 lb/ft3 ), 4.51 gm/L (0.281 lb/ft3 ), respectively. Bioethanol percentage yield by volume was found as 4.36 percent (Panicum antidotale), 3.93 percent (Phragmites karka), 2.87 percent (Jatropha curcas husk), 2.52 percent (sugarcane bagasse) and 1.64 percent (Conocarpus erectus leaves), respectively. The results showed the potential of producing eco-friendly bioethanol as biofuels from halophytes that will help ease the strain on food crops by providing inexpensive and abundant feedstock. [ABSTRACT FROM AUTHOR]

Purpose: Combustion of fuel with oxidizer inside a combustion chamber of an internal combustion engine forms inevitable oxides of nitrogen (NOx) due to high temperature at different locations of the combustion chamber. This study aims to quantify NOx formed inside the combustion chamber using two fuels, a conventional diesel (n-heptane) and a biodiesel (methyl oleate). Design/methodology/approach: This research uses a computational fluid dynamics simulation of chemically reacting fluid flow to quantify and compare oxides of nitrogen (NOx) in a compression ignition (CI) engine. The study expends species transport model of ANSYS FLUENT. The simulation model has provided the temperature profile inside the combustion chamber, which is subsequently used to calculate NOx using the NOx model. The simulation uses a single component hydrocarbon and oxygenated hydrocarbon to represent fuels; for instance, it uses n-heptane (C7H16) for diesel and methyl-oleate (C19H36O2) for biodiesel. A stoichiometric air–fuel mixture is used for both fuels. The simulation runs a single cylinder CI engine of 650 cm3 swept volume with inlet and exhaust valves closed. Findings: The pattern for variation of velocity, an important flow parameter, which affects combustion and subsequently oxides of nitrogen (NOx) formation at different piston locations, is similar for the two fuels. The variations of in-cylinder temperature and NOx formation with crank angles have similar patterns for the fuels, diesel and biodiesel. However, the numerical values of in-cylinder temperature and mass fraction of NOx are different. The volume averaged static peak temperatures are 1,013 K in case of diesel and 1,121 K in case of biodiesel, while the mass averaged mass fractions of NOx are 15 ppm for diesel and 141 ppm for biodiesel. The temperature rise after combustion is more in case of biodiesel, which augments the oxides of nitrogen formation. A new parameter, relative mass fraction of NOx, yields 28% lower value for biodiesel than for diesel. Originality/value: This work uses a new concept of simulating simple chemical reacting system model to quantify oxides of NOx using single component fuels. Simplification has captured required fluid flow data to analyse NOx emission from CI engine while reducing computational time and expensive experimental tests. [ABSTRACT FROM AUTHOR]

Background: Congenital hydrocephaly, an abnormal accumulation of fluid within the ventricular spaces at birth, can cause disability or death if untreated. Limited information is available about survival of infants born with hydrocephaly in Texas. Therefore, the purpose of the study was to calculate survival estimates among infants born with hydrocephaly without spina bifida in Texas. Methods: A cohort of live‐born infants delivered during 1999–2017 with congenital hydrocephaly without spina bifida was identified from the Texas Birth Defects Registry. Deaths within 1 year of delivery were identified using vital and medical records. One‐year infant survival estimates were generated for multiple descriptive characteristics using the Kaplan–Meier method. Crude hazard ratios (HRs) for one‐year survival among infants with congenital hydrocephaly by maternal and infant characteristics and adjusted HRs for maternal race and ethnicity were estimated using Cox proportional hazard models. Results: Among 5709 infants born with congenital hydrocephaly without spina bifida, 4681 (82%) survived the first year. The following characteristics were associated with infant survival: maternal race and ethnicity, clinical classification (e.g., chromosomal or syndromic), preterm birth, birth weight, birth year, and maternal education. In the multivariable Cox proportional hazards model, differences in survival were observed by maternal race and ethnicity after adjustment for other maternal and infant characteristics. Infants of non‐Hispanic Black (HR: 1.28, 95% CI: 1.04–1.58) and Hispanic (HR: 1.31, 95% CI: 1.12–1.54) women had increased risk for mortality, compared with infants of non‐Hispanic White women. Conclusions: This study showed infant survival among a Texas cohort differed by maternal race and ethnicity, clinical classification, gestational age, birth weight, birth year, and maternal education in infants with congenital hydrocephaly without spina bifida. Findings confirm that mortality continues to be common among infants with hydrocephaly without spina bifida. Additional research is needed to identify other risk factors of mortality risk. [ABSTRACT FROM AUTHOR]

Background: Artificial intelligence (AI) appears capable of detecting diabetic retinopathy (DR) with a high degree of accuracy in adults; however, there are few studies in children and young adults. Methods: Children and young adults (3-26 years) with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) were screened at the Dhaka BIRDEM-2 hospital, Bangladesh. All gradable fundus images were uploaded to Cybersight AI for interpretation. Two main outcomes were considered at a patient level: 1) Any DR, defined as mild non-proliferative diabetic retinopathy (NPDR or more severe; and 2) Referable DR, defined as moderate NPDR or more severe. Diagnostic test performance comparing Orbis International's Cybersight AI with the reference standard, a fully qualified optometrist certified in DR grading, was assessed using the Matthews correlation coefficient (MCC), area under the receiver operating characteristic curve (AUC-ROC), area under the precision-recall curve (AUC-PR), sensitivity, specificity, positive and negative predictive values. Results: Among 1274 participants (53.1% female, mean age 16.7 years), 19.4% (n = 247) had any DR according to AI. For referable DR, 2.35% (n = 30) were detected by AI. The sensitivity and specificity of AI for any DR were 75.5% (CI 69.7-81.3%) and 91.8% (CI 90.2-93.5%) respectively, and for referable DR, these values were 84.2% (CI 67.8-100%) and 98.9% (CI 98.3%-99.5%). The MCC, AUC-ROC and the AUC-PR for referable DR were 63.4, 91.2 and 76.2% respectively. AI was most successful in accurately classifying younger children with shorter duration of diabetes. Conclusions: Cybersight AI accurately detected any DR and referable DR among children and young adults, despite its algorithms having been trained on adults. The observed high specificity is particularly important to avoid over-referral in low-resource settings. AI may be an effective tool to reduce demands on scarce physician resources for the care of children with diabetes in low-resource settings. [ABSTRACT FROM AUTHOR]

Autonomous artificial intelligence (AI) promises to increase healthcare productivity, but real-world evidence is lacking. We developed a clinic productivity model to generate testable hypotheses and study design for a preregistered cluster-randomized clinical trial, in which we tested the hypothesis that a previously validated US FDA-authorized AI for diabetic eye exams increases clinic productivity (number of completed care encounters per hour per specialist physician) among patients with diabetes. Here we report that 105 clinic days are cluster randomized to either intervention (using AI diagnosis; 51 days; 494 patients) or control (not using AI diagnosis; 54 days; 499 patients). The prespecified primary endpoint is met: AI leads to 40% higher productivity (1.59 encounters/hour, 95% confidence interval [CI]: 1.37–1.80) than control (1.14 encounters/hour, 95% CI: 1.02–1.25), p < 0.00; the secondary endpoint (productivity in all patients) is also met. Autonomous AI increases healthcare system productivity, which could potentially increase access and reduce health disparities. ClinicalTrials.gov NCT05182580. [ABSTRACT FROM AUTHOR]

Background: Child mortality is a major challenge to public health in Pakistan and other developing countries. Reduction of the child mortality rate would improve public health and enhance human well-being and prosperity. This study recognizes the spatial clusters of child mortality across districts of Pakistan and identifies the direct and spatial spillover effects of determinants on the Child Mortality Rate (CMR). Method: Data of the multiple indicators cluster survey (MICS) conducted by the United Nations International Children's Emergency Fund (UNICEF) was used to study the CMR. We used spatial univariate autocorrelation to test the spatial dependence between contiguous districts concerning CMR. We also applied the Spatial Durbin Model (SDM) to measure the spatial spillover effects of factors on CMR. Results: The study results showed 31% significant spatial association across the districts and identified a cluster of hot spots characterized by the high-high CMR in the districts of Punjab province. The empirical analysis of the SDM confirmed that the direct and spatial spillover effect of the poorest wealth quintile and MPI vulnerability on CMR is positive whereas access to postnatal care to the newly born child and improved drinking water has negatively (directly and indirectly) determined the CMR in Pakistan. Conclusion: The instant results concluded that spatial dependence and significant spatial spillover effects concerning CMR exist across districts. Prioritization of the hot spot districts characterized by higher CMR can significantly reduce the CMR with improvement in financial statuses of households from the poorest quintile and MPI vulnerability as well as improvement in accessibility to postnatal care services and safe drinking water. [ABSTRACT FROM AUTHOR]

The non-traditional threats posed by climate change to India and Pakistan are projected to be far greater than traditional threats in the near future. India is ranked as the fifth most vulnerable country to climate change, while Pakistan is ranked as the seventh most vulnerable. With sea levels expected to rise by 15-38 centimeters in India by 2050, major cities such as Kochi, Kolkata, and Mumbai are at risk. By 2030, over 40% of Indians may not have access to safe drinking water. The severe consequences of climate change will have long-lasting effects not only on India and Pakistan but also on the entire South Asian region. Between 1990 and 2008, over 750 million people, nearly 50% of South Asia's population, were affected by disasters, leading to nearly 230,000 deaths. India and Pakistan bear a greater responsibility to engage in climate diplomacy to protect this critical region from the anticipated dangers of climate change. Therefore, this paper will explore the effects of climate change on India and Pakistan and examine how climate diplomacy can be an opportunity for both nations to abandon their traditional hostility and initiate a new era of cooperation to address the impending threats of climate change. [ABSTRACT FROM AUTHOR]

The main input of this research is the introduction of the concept of double weak Hopf quiver (DWHQ). In addition, the structures of weak Hopf algebra (WHA) are obtained through path coalgebra of the proposed quivers. Furthermore, the module and comodule structures on the said WHA are discussed. Moreover, the classification of the semilattice-graded WHA structures of the path coalgebra obtained from the so called DWHQ was presented. This contributes a step further in the development of the module and comodule structures of more general algebras. These structures are important in the physics for dynamic systems. [ABSTRACT FROM AUTHOR]

Agro-industrial by-products of fruits have turned into an essential source of bioactive products. This study examined the effect of freeze-drying on apple pomace powder (APP) and pomegranate peel powder (PPP) and their utilization in functional yogurt development at different concentrations. Freeze-dried powders in functional yogurt were investigated by chemical profile and bioactive characterization of total phenolic content (TPC), total flavonoid content (TFC), and antioxidant activity. The highest concentration of TPC (4.64) mg GAE/g, TFC (1.73 ± 0.00) CE mg/g, and antioxidant activity (83.87 ± 0.02) % was investigated in the yogurt sample T6, having the maximum amount of PPP in it, which was significantly higher compared to the treatments having APP. Yogurt samples were analyzed for their sensory attributes, which showed a decline with the increase in both APP and PPP concentrations in contrast by introducing the optimum levels of APP and PPP (3% or 6%); hence, no significant loss in sensory profile was found as compared to the control samples. The results were found to be significant at the level (p < 0.05). In terms of the freeze-dried APP and PPP results, the APP samples had the most complete chemical composition, with the exception of fiber and ash concentration. Treatments of functional yogurt were prepared for their physicochemical profile, which demonstrated a straight proportionate relationship between the proportions of both powders in the meantime. Protein and fat levels were likely to decrease as both dry powder levels increased. Hence, apple pomace and pomegranate peel can be used after freeze-drying as a rich source of bioactive compounds in functional yogurt in the food industry. [ABSTRACT FROM AUTHOR]

Purpose: In a modern business scenario, firms have implemented customer-centric approaches to enable customer relationship management (CRM) to trigger business excellence. Business strategies are modernizing business marketing operations that mainly focused on the retention of profitable customers. The purpose of this study is to empirically investigate the impact of marketing strategies (MS), information technology support (IT-S) and knowledge sharing (KS) in the effect of CRM in the pharmaceutical sector of Punjab, Pakistan. Design/methodology/approach: Data were collected from the field force of national and international pharmaceuticals companies (N = 263) through a convenience sampling technique. Partial least squares structural equation modeling was used to examine data in SmartPLS 3.2.6. Findings: The results indicated that IT-S and KS mediate the relationship between MS and CRM. More specifically, MS positively develops CRM through IT-S and KS. Originality/value: This research contributes to the existing literature of pharmaceuticals by disclosing the field-force (medical representatives) specific role in developing CRM performance between pharmaceuticals firms and health-care physicians that are mainly based on knowledge advancement and influence these firms to adopt customer-centric business approaches to gain a competitive advantage to drive firm profitability. [ABSTRACT FROM AUTHOR]

Sentiment analysis and opinion mining is the most explored area of research where an opinion has been analysed for better decision and recommendation. Currently this field has been supported by many decision support systems that not only depend on the preferences of a decision support system (DSS) designer but also affected by the public thoughts and opinions. Potential users along with their opinions also play a vital role in decision making process. Minion's exploration using sentiment analysis is the process of analysing facts, sentiments and opinions that are expressed on different social media forums in the form of tweets or reviews. In this research work, a decision process and sentiment analysis has been amalgamated to strengthen the functionality of traditional DSS for better decision-making process from reviews of open forums. The proposed system comprises of data extraction from social media reviews, pre-processing using natural language processing (NLP), aspects extraction using part of speech (POS) tagger and normalized Google distance (NGD). Aspect optimization using genetic algorithm (GA) and finally polarity estimation of each sentiment expressed in the review using SentiWordNet is computed. The experimental results conclude the supremacy of the proposed work by adding the sentiment and opinion information performed better decision-making process than the existing state-of-art techniques. [ABSTRACT FROM AUTHOR]

School dropout is known to be a major issue individually, socially, educationally, and economically. Primary school dropout has been increasing in Pakistan in general and in Balochistan in particular. The determinants of primary school dropout vary across the province to province and district to district. This study finds the determinant of primary school dropout in district Kech of Balochistan. Primary data has been collected randomly from all tehsils of the district. Data were collected from 100 respondents using the Z-score method of sample size selection. Moreover, the study uses frequency distribution and charts to represent the data and applies Cronbach's Alpha for the reliability of the responses. The findings of the study showed that there are many economic, social, and cultural factors that are causing primary school dropout in the district such as distance of the school from home, uneducated parents, cultural issues regarding female education, lack of transportation, child labor issue, non-availability of teachers, a high number of dependent children and unemployed parents. Thus, it is recommended that the Government should take into consideration the aforementioned factors to improve human capital and business productivity across the industries. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of fragmented QRS complex in patients with acute non-ST elevation myocardial infarction (NSTEMI). Study Design: Cross-Sectional Study. Setting: Department of Cardiology, Faisalabad Institute of Cardiology, Faisalabad. Period: July 15, 2019 to January 15, 2020. Material & Methods: One hundred and forty five diagnosed patients of NSTEMI on the basis of chest pain and positive troponin-I were included in this study. The electrocardiography (ECG) was performed to document the presence or absence of f QRS complex in these patients. A 12-lead ECG with paper speed of 25 or 50 mm per second and a voltage of 10 mm/mv was used. FQRS was labeled (as per operational definition). The collected data were entered and analyzed statistically by using SPSS v25.0. Data were stratified for age, gender, diabetes, smoking and hypertension. Post-stratification, f QRS complex was compared by Chi-Square test in stratified groups. A p-value ≤0.05 was taken as significant. Results: Total 145 patients presenting with NSTEMI were selected for this study. Mean age of the patients was 48.2±12.3 year. Among these patients, 90(62.1%) were males, while 55(37.9%) were females. Overall frequency of fQRS complex in patients with NSTEMI was 64(44.1%). Conclusion: There is an association of fQRS among patients with acute non-ST elevation myocardial infarction (NSTEMI). Further prospective studies are needed to determine the clinical significance of fQRS complex and identify its correlation with the incidence of possible complications. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence and causes of blindness, vision impairment and cataract surgery coverage among Rohingya refugees aged ≥ 50 years residing in camps in Cox's Bazar, Bangladesh. Methods: We used the Rapid Assessment of Avoidable Blindness (RAAB) methodology to select 76 clusters of 50 participants aged ≥ 50 years with probability proportionate to size. Demographic and cataract surgery data were collected using questionnaires, visual acuity was assessed per World Health Organization criteria and examinations were conducted by torch, and with direct ophthalmoscopy in eyes with pinhole-corrected vision <6/12. RAAB software was used for data entry and analysis. Results: We examined 3,629 of 3800 selected persons (95.5%). Age and sex adjusted prevalence of blindness (<3/60), severe visual impairment (SVI; >3/60 to ≤6/60), moderate visual impairment (MVI; >6/60 to ≤6/18), and early visual impairment (EVI; >6/18 to ≤6/12) were 2.14%, 2.35%, 9.68% and 14.7% respectively. Cataract was responsible for 75.0% of blindness and 75.8% of SVI, while refractive error caused 47.9% and 90.9% of MVI and EVI respectively. Most vision loss (95.9%) was avoidable. Cataract surgical coverage among the blind was 81.2%. Refractive error was detected in 17.1% (n = 622) of participants and 95.2% (n = 592) of these did not have spectacles. In the full Rohingya cohort of 76,692, approximately 10,000 surgeries are needed to correct all eyes impaired (<6/18) by cataract, 12,000 need distance glasses and 73,000 require presbyopic correction. Conclusion: The prevalence of blindness was lower than expected for a displaced population, in part due to few Rohingya being ≥60 years and the camp's good access to cataract surgery. We suggest the United Nations High Commissioner for Refugees include eye care among recommended health services for all refugees with long-term displacement. [ABSTRACT FROM AUTHOR]

Objective: To determine the correlation between mean RDW values and mean SYNTAX scores in patients of non ST elevation myocardial infarction. Methodology: This descriptive study was conducted at adult Angiography Department of Faisalabad Institute of Cardiology, Faisalabad from September, 2018 to October, 2018. A total of 130 patients were enrolled in this study. Patients were divided into high (n=89) and low (n=41) SYNTAX groups. The high SYNTAX group was defined as patients with value in the third tertile (SYNTAX score, SX score ≥ 33) while the group with low SNTAX score was defined as patients with values in the lower 2 tertiles (SYNTAX score, SX score < 33). The high RDW group was defined as patients with RDW value > 16% and the low RDW group as those with RDW value < 16%. Results: The mean RDW value was correlated with mean SYNTAX score in both groups. The RDW levels were significantly high in patients with high SNTAX score than those with low SYNTAX score (16.2± 1.8 vs. 14.2 ± 1.2, p <0.001). Pearson's coefficient was used to determine the correlation between RDW levels and SYNTAX scores. There was a significant positive correlation between mean RDW value and mean SYNTAX score value (r=0.831, p <0.001). Conclusion: We found a positive and significant correlation between mean RDW values and mean SYNTAX scores in patients of non-ST elevation myocardial infarction. This reflects the utility of RDW being a non-invasive and readily available laboratory test to determine the severity and complexity of coronary disease in these patients. [ABSTRACT FROM AUTHOR]

Ecological and economics issues are caused to give careful consideration to electric vehicles (EV) and sustainable power source assets. One of the proposed answers for increment the impact of these assets, is to utilize the electric vehicles potential. The capability of electric vehicles require planning for Smart Distribution Systems (SDS). Request reaction programs, as a suitable device to utilize endorsers' potential in ideal administration of the system, gives dynamic nearness of supporters in control framework execution change and these projects, in basic conditions, can give the request prerequisites diminishment, in a brief timeframe. In this work, attempts to presents a multi-objective scheduling of EV based on the sustainable assets in smart grid, cover uncertainty caused by inexhaustible assets and EVs, by considering of the request reaction projects and EV battery stockpiling framework, limit the working expenses and the measure of intensity framework contamination, with enhancing procedures. Improved optimization algorithm is utilized for taking care of the advancing issue. Operating costs dropped much further utilizing monetary model of the demand response and vehicle charge/discharge and smart program in the hours when the load is lower. Effectiveness of proposed method is applied on 33 bus standard power system. [ABSTRACT FROM AUTHOR]

This research focuses to propose a new hybrid approach which combined the recurrent fuzzy neural network (RFNN) with particle swarm optimization (PSO) algorithm to simulate the flyrock distance induced by mine blasting. Here, this combination is abbreviated using RFNN–PSO. To evaluate the acceptability of RFNN–PSO model, adaptive neuro-fuzzy inference system (ANFIS) and non-linear regression models were also used. To achieve the objective of this research, 72 sets of data were collected from Shur river dam region, in Iran. Maximum charge per delay, stemming, burden, and spacing were considered as input parameters in the models. Then, the performance of the RFNN–PSO model was evaluated against ANFIS and non-linear regression models. Correlation coefficient (R2), Nash and Sutcliffe (NS), mean absolute bias error (MABE), and root-mean-squared error (RMSE) were used as comparing statistical indicators for the assessment of the developed approach's performance. Results show a satisfactory achievement between the actual and predicted flyrcok values by RFNN–PSO with R2, NS, MABE, and RMSE being 0.933, 0.921, 13.86, and 15.79, respectively. [ABSTRACT FROM AUTHOR]

Objective: To compare nickel ion concentration in saliva of candidates whether wearing fixed orthodontic appliances or not presenting for their routine orthodontic assessment. Study Design: Cross sectional study. Place and Duration of Study: Department of Orthodontics, Dental Section, Sandeman Provincial Hospital, Quetta, from Mar 2017 to Aug 2017. Methodology: All patients presenting to orthodontic department who fulfilled inclusion criteria were included in this study. Sample was collected after rinsing mouth with distilled water for 30 sec, and their saliva was collected after 2 mins. Saliva (5ml) was collected from each subject. The samples were stored in the refrigerator for up to 7 days before submitting for analysis of nickel concentration in saliva. Results: The mean age of candidates was 15.95 ± 3.63 years in arch wire group and 17.25 ± 3.91 in control group. There were 5 (25%) males and 15 (75%) females in arch wire group and 4 (20%) males and 16 (80%) females in control group. In this study, mean nickel concentration was 15.83 ± 12.96ng/ml in arch wire group while 10.21 ± 9.56ng/ml in control group. The difference was insignificant (p>0.05). Conclusion: The concertation of nickel was high in arch wire wearers but the difference was observed to be insignificant regarding nickel concentration in saliva whether patients wear arch wire or not. [ABSTRACT FROM AUTHOR]

Background: There is a growing awareness that addressing chronic as well as acute health conditions may contribute importantly to the well-being of displaced populations, but eye care service has generally not been prioritized in crisis situations. We describe a replicable model of eye care provision as delivered by Orbis International and local partners to the Rohingya and host population in Cox's Bazar, Bangladesh, and characterize the burden of vision impairment and demand for sight-restoring services in this setting.Methods and Findings: Orbis International and local secondary facility Cox's Bazar Baitush Sharaf Hospital (CBBSH) provide eye care support to the Rohingya population and the host community of all ages in Cox's Bazar, Bangladesh, with fixed vision screening locations established in Camps 4 and 11 of the Kutupalong refugee settlement. Structured outreach targets these camps and four surrounding local subdistricts, with referrals made as needed for refraction (glasses measurement) and cataract surgery to CBBSH. Between February 2018 and March 2019, 48,105 displaced Rohingya (70.3%, among whom 71.6% were children and 46.5% women) and 20,357 local residents (29.7%, 88.5% children, 54.4% women) underwent vision screening. Displaced Rohingya sought services from a total of 12 surrounding camps, within which coverage was 17.3%, including 43.3% (27,027/62,424) of children aged 5-11 years and 60.0% (5,315/8,857) of adults ≥ 60 years old. The prevalence of blindness (presenting acuity < 3/60) among Rohingya patients exceeded that among local residents by 3- to 6-fold in each 10-year age group between 18 and 59 years (P < 0.001 comparing vision between the two groups in this age range), and the prevalence of cataract requiring surgery was also higher in Rohingya patients (18-29 years: 4.67% versus 1.80%, P = 0.0019; 30-39: 7.61% versus 2.39%, P < 0.001; and 40-49 years: 7.91% versus 3.77%, P = 0.0014). A limitation of the study is lack of data on population prevalence of eye disease.Conclusions: The burden of untreated eye disease is very high among the Rohingya, particularly those in their peak working years who could contribute most to the resiliency of their community. Demand for eye care service is also great among children and adults in this population with many competing healthcare priorities. Research is needed, building on strong evidence of benefit in settled populations, to explore the specific impact of vision care on the well-being of displaced populations. [ABSTRACT FROM AUTHOR]

Objective: To compare the position of hyoid bone in different skeletal malocclusions in both genders from records of patients of orthodontic department, Sandeman Provincial Hospital Quetta. Study Design: cross sectional study. Place and Duration of Study: Department of Orthodontics dental section Sandeman Provincial Hospital Quetta, from Mar 2017 to Aug 2017. Methodology: This study was carried out with the help of patient radiographs from records of Orthodontics department Sandeman Provincial Hospital Quetta. Beginning of study followed Ethical committee approval. The Sample size was 60. For the data collection, Non probability consecutive sampling technique was used. Samples were collected from Baluchistan. Results: Each gender had 30 cases; 10 in each three of the classes. There was a greater horizontal linear measures C3-H, C3-Rgn found in males across all three classes. Conclusion: There was a greater C3-H and H-Rgn found in males in comparison to females in all the class groups. Additionally, C3-H was found to be of the greatest distance in males in class 1 and 3 groups. [ABSTRACT FROM AUTHOR]

Background: Recognizing the need for improving maternal and newborn care, the Punjab public health department (Pakistan) launched emergency obstetric neonatal care (EmONC) services under WHO guideline. Unfortunately, the program implementation is facing some serious problems. The purpose of this study was to identify barriers to implementation of EmONC in district Bahawalnagar (Pakistan). Methods: This study used sequential exploratory design. Specifically, a qualitative study was conducted to identify barriers to EmONC. Subsequently, the relative importance of these barriers was determined in a quantitative study. Participants were health service providers involved in 24-hours basic EmONC services in the basic health units of district Bahawalnagar (Pakistan). Qualitative data were gathered by interviewing the participants using key informant guide. Quantitative data were collected in a rank order survey of the same participants. The methodological quality was assessed using mixed methods appraisal tool (MMAT) version 2011. Results: The results indicate that lack of teamwork, conflict management, communication, and improper power distribution are important interpersonal barriers. The significant organizational-level barriers include job insecurity, lack of organizational culture, human resource deployment issues, and lack of role clarity. Lack of target management, lack of resource availability, house job requirement, and dual practice issues were identified as major system-level barriers. Conclusion: Barriers to EmONC implementation must be addressed for improving maternal and neonatal care in district Bahawalnagar. [ABSTRACT FROM AUTHOR]

Pile as a type of foundation is a structure which can transfer heavy structural loads into the ground. Determination and proper prediction of pile bearing capacity are considered as a very important issue in preliminary design of geotechnical structures. This study attempts to develop several intelligent techniques for prediction of pile bearing capacity in cohesionless soil. To show the effects of fuzzy inference system and imperialism competitive algorithm (ICA) on a pre-developed artificial neural network (ANN), two hybrid ANN models namely ICA-ANN and adoptive neuro-fuzzy inference system (ANFIS) were considered and developed to estimate pile bearing capacity. Then, results of these techniques were compared with those of ANN model and the best one among them was chosen according to the results of performance indices. Several parameters (i.e., internal friction angle of soil located in shaft and tip, effective vertical stress at pile toe, pile area, and pile length) were set as model inputs, while the output is the total driven pile bearing capacity. As a result of the developed models, coefficient of determination (R2) values of (0.895, 0.905), (0.945, 0.958), and (0.967, 0.975) were obtained for training and testing data sets of ANN, ICA-ANN, and ANFIS models, respectively. The results showed that both hybrid models are able to predict bearing capacity with high degree of accuracy; however, ANFIS receives more applicable based on used performance indices and it can be utilized for further researchers and engineers in practice. [ABSTRACT FROM AUTHOR]

Rock shear strength parameters (interlocking and internal friction angel) are considered as significant factors in the designing stage of various geotechnical structures such as tunnels and foundations. Direct determination of these parameters in laboratory is time-consuming and expensive. Additionally, preparation of good quality of core samples is sometimes difficult. The objective of this paper is introducing and evaluating two hybrid artificial neural network (ANN)-based models by considering genetic algorithm (GA) and fuzzy inference system for prediction of interlocking of shale rock samples. Therefore, hybrid GA-ANN and adoptive neuro-fuzzy inference system (ANFIS) were developed and to show the capability of the hybrid models, the predicted results were compared to those of a pre-developed ANN model. In development of these models, the results of rock index tests, i.e., point load index, dry density, p-wave velocity, Brazilian tensile strength and Schmidt hammer were taken into account as the input parameters, whereas the interlocking of the shale samples was set as the output. The results obtained in this study confirmed the high reliability of the developed hybrid models, however, ANFIS predictive model receives slightly higher performance prediction compared to GA-ANN technique. The obtained results of the developed models were (0.865, 0.852), (0.933, 0.929) and (0.957, 0.965) for ANN, GA-ANN and ANFIS models, respectively, based on coefficient of determination (R2). ANFIS can be introduced as an innovative model to the field of rock mechanics. [ABSTRACT FROM AUTHOR]

Sustainability of brackishwater shrimp farming is of paramount importance for socio-economic development of southwest coastal Bangladesh. Here, shrimp farming is predominantly traditional, which is more vulnerable to climate change. Lack of understanding exists regarding the adaptation measures of local shrimp farmers in response to emerging impacts of changing climatic variables. This study provides the perceptions and adaptations of shrimp farmers in changing climatic context. A systematic random sampling method was employed to conduct a total of 240 questionnaire surveys and 60 key informant interviews from six sub-districts (Upazila) of southwest coastal Bangladesh to collect primary data. Changes in climate variables largely affect the shrimp yield by increasing frequency of shrimp disease, causing physical damage to farm structure and deteriorating quality of water. Shrimp farmers try to adapt to those changes in various ways, including increasing pond depth, exchanging tidal water, providing shade using aquatic plants, strengthening earthen dike and netting and fencing around the dike. Shrimp mixed cultivation is the most popular form of shrimp farming in the study area. More emphasis on implementing polyculture shrimp farming is necessary to improve climate change adaptation and to promote sustainability of this aquaculture practice in southwest coastal Bangladesh. [ABSTRACT FROM AUTHOR]

Disproportionate or progressive collapse is a phenomenon in which entire structure or large part of it collapses because of the local failure of a structure. Resistance to such progressive collapse depends on continuity between elements and ductility of the connections. The ductility of commonly used bolted end plate connections may depend on the T-stub component of the connection. The aim of this paper is to study the behaviour of T-stub components of beam to column end plate bolted connections under large deformation demands associated with column loss scenario. For this purpose, a parametric study is carried out to evaluate the ultimate strength and deformation capacity considering two parameters i.e. distance between the bolts and endplate thickness. Based on the experimental data, numerical model has been validated and employed in a parametric numerical study aimed at improving the response under large deformation demands. The study indicate significant role of bolts in development of catenary forces since the ultimate tensile capacity of T-stub after undergoing large deformation in a ductile failure mode was controlled by the failure of the bolts. Parametric study reveals much higher bolt force in comparison with displacement controlled induced axial force in the T-stub indicating failure of the bolts at much lower applied axial force. [ABSTRACT FROM AUTHOR]

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Higher mode effects play a major role in the seismic demands of high-rise buildings. Several recent studies have shown that seismic design demands such as design shear and bending moment in high-rise buildings cannot be predicted by the conventional code-based response spectrum analysis procedure. These can be determined by the more rigorous and accurate non-linear response history analysis procedure, but this procedure is computationally very extensive and time consuming. Yet a non-linear static pushover analysis cannot account for higher mode effects. Therefore, the applicability of a multi-modal pushover analysis (MMPA) procedure using elastic target displacement to cases of 20- 30- and 40-storey high-rise reinforced concrete core wall buildings is investigated in this study. The results obtained by the elastic displacement MMPA (EDMMPA) procedure are compared with those obtained from non-linear analysis. The comparison shows that EDMMPA can satisfactorily estimate the design shear force, bending moment and deformation demands with a variation of 10–20%. Thus, this computationally less demanding analysis can serve as a base line for preliminary design of high-rise reinforced concrete core wall buildings. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to study the semen parameters and its relation to hormonal status in infertile men. Study Design: Cross sectional study. Period: March 2015 to April 2017. Setting: Jinnah Hospital Fertility Centre; Department of Obstetrics and Gynecology, Lahore. Method: A total of 70 infertile men were included in this study. Semen samples for semen analysis and serum for hormonal analysis were obtained and further tests were performed. Results: The results of our study show that 28.57% were Normospermic, 18.56% were azoospermic and 52.85% were Oligospermic. In Oligospermic and azoospermic patients significant low levels of testosterone and prolactin were noticed. The results indicate that along with semen parameters hormonal levels should also be assessed to diagnose the underlying cause of infertility. Conclusion: It is concluded from our study that both quality of semen and hormonal levels cause infertility in men. Therefore the patients should be properly investigated and should be treated accordingly to the underlying abnormality. This is a regional study and further studies should be conducted to have a conclusive evidence at national level. [ABSTRACT FROM AUTHOR]

A simplex-centroid design for q mixture components comprises of all possible subsets of the q components, present in equal proportions. The design does not contain full mixture blends except the overall centroid. In real-life situations, all mixture blends comprise of at least a minimum proportion of each component. Here, we introduce simplex-centroid designs which contain complete blends but with some loss in D-efficiency and stability in G-efficiency. We call such designs as shrinkage simplex-centroid designs. Furthermore, we use the proposed designs to generate component-amount designs by their projection. [ABSTRACT FROM AUTHOR]

Background: Surveillance of disparities in healthcare insurance, services and quality of care among children are critical for properly serving the medical/healthcare needs of underserved populations. The purpose of this study was to assess racial/ethnic differences in children's (0 to 17 years old) health insurance adequacy and consistency (child has insurance coverage for the last 12 months). Design and methods: We used data from the 2011/2012 National Survey of Children's Health (n=79,474). Descriptive statistics and logistic regression analyses were conducted to examine the distribution and influence of several sociodemographic/family related factors on insurance adequacy and consistency across different racial/ethnic groups. Results: Stratified analyses by race/ethnicity revealed that white and black children living in households at or below 299% of the Federal Poverty Level (FPL) were approximately 29 to 42% less likely to have adequate insurance compared to children living in families of higher income levels. Regardless of race/ethnicity, we found that children with public health insurance were more likely to have adequate insurance than their privately insured counterparts, while adolescents were at greater risk of inadequate coverage. Hispanic and black children were more likely to lack consistent insurance coverage. Conclusions: This study provides evidence that racial/ethnic differences in adequate and consistent health insurance exists with both white and minority children being affected adversely by poverty. Establishing outreach programs for low income families, and cross-cultural education for healthcare providers may help increase health insurance adequacy and consistency within certain underserved populations. [ABSTRACT FROM AUTHOR]

Cotton bollworm, Helicoverpa armigera (Hubner) is very important polyphagous insect pest with wide host range known for its economic losses worldwide. Its ability to develop resistance to insecticides faster to identify alternates like biocontrol agents, plant extracts etc. In the present study the extract of Citrullus colocynthis in different solvents were evaluated on second instar larvae of H. armigera under laboratory studies for toxicity, sublethal and antifeedant effect. The result showed that ethanol based extract was the most effective to control the H. armigera followed by the ethyl acetate. The sublethal concentration of ethanol based extract of C. colocynthis increased larval and pupal duration as compared with control. The percent pupation, adult emergence and pupal weight decreased in treated populations as compared with control populations. The results of this study can be used in integrated pest management program for the management of H. armigera. [ABSTRACT FROM AUTHOR]

Shrimp ( Penaeus monodon) farming is a traditional aquaculture in southwest coastal Bangladesh. Changes in both the farming practice and yield of shrimp since the advent of commercial production in this area are evident in scientific studies. We assessed the historical perspective of shrimp farming indicating the major phase changes and present situation of the shrimp farming practice including recent changes in yield and cost-benefit. A systematic random sampling method was employed to conduct a total of 240 questionnaire surveys, 24 focused group discussions, and 60 key informant interviews in six sub-districts (upazila) from southwest coastal Bangladesh. We identified four major phase changes in the history of shrimp farming in southwest coastal Bangladesh and found that shrimp mixed culture is the most preferable form of extensive cultivation at present. Shrimp farmers' perceptions about changes in shrimp yield and changes in availability of ecosystem services represent declining trends over the last two decades. For 2015, shrimp yield was not significantly different with respect to salinity levels. The net benefit from shrimp mixed culture in 2015 was 121,000 taka/ha, which is 2.35 times higher compared to the net benefit from only shrimp (51,500 taka/ha). In this context, promoting shrimp mixed cultivation could be a management solution for sustainable development of shrimp farming in southwest coastal Bangladesh. The National Shrimp Policy of the government also emphasized on promoting environment-friendly shrimp mixed cultivation for sustainable development of shrimp farming. However, more institutional support such as training, extension support, technical assistance, and credit facility is required to implement the policy. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to provide a comprehensive view of barriers that restrict the adoption of new specializations and courses in the higher education institutions of Southern Punjab, Pakistan.Design/methodology/approach Quantitative methods were used to get the responses from the respondents of different institution of target areas. Results were further analyzed with the help of statistical tools. In total, 203 respondents were approached to fill the carefully designed questionnaire.Findings Results of the study clearly show four major factors, including internal barrier, external barrier, cultural barrier and leadership barrier, that are restricting the introduction and adoption of new specialization courses in higher education institutes of Southern Punjab. Suggestions at the end are made to address the restrictions.Research limitations/implications The current study states only six higher education institution of Southern Punjab, which is a kind of limitation itself. This study is conducted by taking into account the needs and trends of the businesses and markets; student perspective is not taken about the situation in this study, which is an another limitation of the study. To get more accurate and validated results, the higher education institutions located in other areas of Pakistan could be studied, which was not done in this study because of time and resource limitations.Practical implications This study may prove worthy to bring a positive and practical shift in the Pakistani higher education system. This study may also prove beneficial to show the actual picture of the situation to national leaders, academician and policy maker so that things are taken seriously to actually align the Pakistani higher education system with the emerging market demands and trends. Suggestions made in this study may provide comprehensive guidelines to the academic strategists to uplift the higher education institutions of Pakistan up to the international standards and requirements, so the Pakistani higher education institutions can get a respectful place in the international academic rankings.Originality/value The paper highlights the restrictions and helps the institutions to introduce new specialization courses. [ABSTRACT FROM AUTHOR]

The seismic response of the high-rise reinforced concrete (RC) wall structures is really complicated as several vibration modes other than the fundamental mode normally contribute significantly to the response-commonly recognized as 'higher mode effects'. Response spectrum analysis (RSA) procedure, which can account for higher mode effects, is usually employed to compute the seismic design demand for the high-rise structures. Recent studies show that the inelastic seismic force demands obtained from the rigorous nonlinear response history analysis procedure are much larger than the seismic force design demands obtained from the code-based RSA procedure for the high-rise RC wall structures. Though, the nonlinear response history analysis procedure is widely accepted for its ability to provide the most accurate estimate of nonlinear seismic responses, the obtained responses are generally so complex that it is quite difficult for engineers to grasp the overall picture of the responses and gain some insight into them and use them to understand the cause of high seismic demands. Another important issue related to the nonlinear seismic response prediction of the high-rise RC wall structures is the realistic and accurate numerical modeling of RC walls. In this study, a simplified but reasonably accurate procedure called the uncoupled modal response history analysis procedure is used to interpret the complex nonlinear behavior of high-rise RC wall structures. Moreover, a finite element model based on modified compression field theory is employed for accurate numerical modeling of RC walls by incorporating the axial-flexure-shear interaction. This study, by making use of a better computer modeling approach and an in-depth analysis by modal decomposition, aims to resolve some of the unanswered questions regarding realistic prediction of nonlinear seismic demands of high-rise structures. [ABSTRACT FROM AUTHOR]

Conventionally, a flexural plastic hinge is assigned and detailed at the core wall base and coupling beams ends to control seismic responses. This strategy is based on allowing damage to main structural components. To avoid damage to main structural components, an alternative strategy using energy dissipating devices, such as fluid viscous dampers (FVDs), is currently being studied and implemented. In this study, the effect of FVD locations on a 40-storey, high-rise, reinforced-concrete core wall case study building has been studied in detail using non-linear response history analysis for seven spectrally matched ground motions. FVDs were installed at strategic locations, identified based on maximum 'design basis earthquake' elastic modal racking shear deformation demands and force (shear and moment) demands in three different options. The force, deformation and energy demands on structural components are compared for conventional design and different options of FVDs. The comparison with conventional design shows that FVDs are effective not only for reducing shear force demand along wall height, bending moment demand at midheight and deformation demands by 10, 45 and 35%, respectively, but also significantly reduce the rotation and energy demands in the core wall by 60 and 450%, respectively. [ABSTRACT FROM AUTHOR]

High-rise reinforced-concrete core wall buildings are a very popular choice in areas of high seismic activity. Conventionally, a single plastic hinge is allowed at the base of the wall to control responses in these buildings. Recent studies, however, show that these core walls will be subjected to large inelastic seismic demands in a seismic event. It is not economical and sometimes difficult to design these walls for large shear and moment demands. To reduce these demands, a multiple plastic hinges concept is proposed in this study. Locations of the multiple plastic hinges are identified using elastic modal decomposition analysis. A 40-storey case study building is investigated in detail to check the effectiveness of the proposed approach. The seismic demands are found using non-linear response history analysis at maximum considered earthquake level. A comparison of the multiple plastic hinges approach with the single plastic hinge approach shows that seismic shear demand reduces 17% at the base of the wall, whereas moment demand reduces 33 and 60% at the base and mid-height of the wall, respectively. [ABSTRACT FROM AUTHOR]

The fisheries sector is crucial to the Bangladeshi economy and wellbeing, accounting for 4.4% of national gross domestic product and 22.8% of agriculture sector production, and supplying ca. 60% of the national animal protein intake. Fish is vital to the 16 million Bangladeshis living near the coast, a number that has doubled since the 1980s. Here, we develop and apply tools to project the long-term productive capacity of Bangladesh marine fisheries under climate and fisheries management scenarios, based on downscaling a global climate model, using associated river flow and nutrient loading estimates, projecting high-resolution changes in physical and biochemical ocean properties, and eventually projecting fish production and catch potential under different fishing mortality targets. We place particular interest on Hilsa shad (Tenualosa ilisha), which accounts for ca. 11% of total catches, and Bombay duck (Harpadon nehereus), a low price fish that is the second highest catch in Bangladesh and is highly consumed by low-income communities. It is concluded that the impacts of climate change, under greenhouse emissions scenario A1B, are likely to reduce the potential fish production in the Bangladesh exclusive economic zone by ,10%. However, these impacts are larger for the two target species. Under sustainable management practices, we expect Hilsa shad catches to show a minor decline in potential catch by 2030 but a significant (25%) decline by 2060. However, if overexploitation is allowed, catches are projected to fall much further, by almost 95% by 2060, compared with the Business as Usual scenario for the start of the 21st century. For Bombay duck, potential catches by 2060 under sustainable scenarios will produce a decline of ,20% compared with current catches. The results demonstrate that management can mitigate or exacerbate the effects of climate change on ecosystem productivity. [ABSTRACT FROM AUTHOR]

Conventionally, a flexural plastic hinge is designed and detailed at the core wall base and coupling beams ends to control the seismic responses. This strategy is based on allowing the damage to be concentrated on main structural components. To avoid such damage, an alternative strategy using energy dissipating devices (EDDs) such as buckling restrained braces (BRBs) is being studied and implemented nowadays. In this study, effect of BRBs locations on forty- (40-) story high-rise RC core wall case study building has been studied in detail using Nonlinear Response History Analysis (NLRHA) for seven spectrally matched ground motions. BRBs have been installed at critical locations identified with respect to the maximum DBE elastic modal racking shear deformation demands and force (shear and moment) demands in three different options. The force, deformation, and energy demands on structural components are compared for conventional design and different options of BRBs. The comparison with conventional design shows that BRBs not only are effective for reducing shear force demand along wall height, bending moment demand at mid height, and deformation demands by 10%, 45%, and 45%, respectively, but significantly reduce the rotation and energy demands in the core wall by 90% and 250%, respectively. [ABSTRACT FROM AUTHOR]

Objective: This study was done to find HbA1c levels in diabetes mellitus (DM) patients presenting at Bolan Medical Complex Hospital Quetta and observe the effects of antihyperglycemic treatment and physical exercise on HbA1c level. Study design: A cross sectional comparative study. Patients and methods: One hundred (100) patients were selected from Bolan Medical complex Hospital Quetta. Patients were divided in three groups. Group A included the patients who were on antihyperglycemic drugs, following dietary restrictions and doing physical exercises. Group B included patients who were on antihyperglycemic drugs following dietary restrictions but not doing physical exercises. Group C included the patients who were not using any antihyperglycemic drug, not following dietary restriction and not doing any physical exercise. HbA1c of all patients was determined, data was analyzed using SPSS. Anova was applied. Results: HbA1c of group A was higher than group B and group C. HbA1c of group B was higher than group C. Conclusions: HbA1c is a valuable test for monitoring glucose control over extended period of time and plays role in taking measures to avoid diabetes mellitus complications, therefore it should be tested regularly. [ABSTRACT FROM AUTHOR]