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Objective: To compare the assessment of the timing of insertion of supraglottic airway device in children by trapezius squeeze test versus jaw thrust as an indicator of the depth of anaesthesia. Study Design: Prospective comparative study. Place and Duration of Study: Combined Military Hospital, Quetta Pakistan, from Jan to Dec 2021. Methodology: Eighty children undergoing surgical interventions under Sevoflurane anaesthesia with supraglottic airway device having ASA physical status I or II were divided into two sets of 40 children. Both groups were labelled Group-A (trapezius squeeze test) and Group-B (jaw thrust). Supraglottic airway device iGel was inserted immediately after the negative trapezius squeeze test or jaw thrust. A negative test was defined as the absence of cough, reflex movements, breath-holding, gag reflex and laryngospasm. Insertion time and the number of attempts were carefully recorded. Results: The mean age of patients in the study was 4.8±2.028years, and the mean weight was 17.05±5.34. 47% of patients were in ASA-I, 52% in ASA-II in Group-A, 40 % were ASA-I and 60% in ASAII in Group-B. The mean insertion time was 143.42±5.56 seconds in Group-A and 117.525±7.15 seconds in Group-B with a p-value of 0.002. Conclusion: We concluded that the trapezius squeeze test provides better insertion conditions for supraglottic airway devices than jaw thrust during Sevoflurane anaesthesia in pediatric patients.

Chronic obstructive pulmonary disease (COPD) is a major public health problem and leading cause of death globally. COPD fails to receive adequate attention from the health care community and government officials, with these concerns in mind we designed our study. Objective: To find out the incidence of atrial fibrillation in patients with COPD. Methods: A cross-sectional study was conducted from 12th February 2019 to August, 2020 at the Department of Pulmonology, Ghulam Muhammad Maher Medical College teaching Hospital, Sukkur. N=150 patients with chronic obstructive lung disease were involved in this study. The Criterion for the selection of patients for the study was those patients who was a diagnosed case of COPD. The exclusion criteria were known asthmatic patients and the case of restrictive lung diseases; history of ischemic heart disease, already on cardiac medication, patients with hyperthyroidism whereas the percentages, mean and Standard deviation were computed for study variables. Results: During One year and six months phase, patients who had COPD for > 3-Year duration were explored and study. The mean, SD for age (years) of citizens of Sindh Rural and Urban was 59.52 ± 7.81. Regarding gender, male 64 % and female 36 % individuals whereas the Atrial Fibrillation (AF) was identified in 62 % patients of COPD. Conclusions: High risk of AF has been identified among the COPD patients in Pakistani Populace. Hypertension and CHF among the COPD patients were notable as self-sufficient hazard features for new beginning of AF.

Aim: To determine the calcium and bone disorders in pregnancy assessed through radiological imaging. Study design: Prospective study. Place and duration of study: Department of Radiology, Chandka Medical College Hospital, Larkana from 1st July 2022 to 31st December 2022 Methodology: One hundred pregnant women were enrolled. The blood calcium levels were assessed through serum calcium at these stages through 3 cc blood withdrawal. Dietary intake of calcium was also assessed through food frequency charts. Urinary-excretion of calcium was analyzed through cross-linked N-telopeptides (NTx) type I collagen. Each participant was assessed at 3 points including baseline assessment at 1st trimester, then at 2nd trimester and finally at post-partum 4 weeks. At the 2nd trimester ultrasound bone measurement was conducted at distal radius. Quantitative ultrasound was used for this purpose. In the post-partum women, a radiological imaging including DEXA (Dual-energy X-ray absorptiometry) bone scan was performed. Results: The mean age was 26.9±5.5 years. The mean pregnancy was 2.0±1.1 while the mean number of children was 0.9±0.7. The previous months of breast feeding as mean were 6.8±7.9. The calcium intake from food as well as serum calcium levels was below recommended levels in women during their pregnancy and post-delivery. Through the quantitative ultasound and bone density DEXA scan images presented obvious osteoporotic changes in bone density. There were 24% had 2.5 or less meant osteoporosis formation. Conclusion: Women often lead to calcium deficiency during gestation and lactation and thus chances of musculoskeletal disorders escalate manifolds. Radiological imaging can facilitate in detecting these calcium deficiencies. Keywords: Hemostasis, Regulation, Pregnancy, Mineral absorption

Aim: To identify the incidence of spina bifida during gestation and its pregnancy outcomes. Study design: Cohort study Place and duration of study: Department of Radiology, Chandka Medical College Hospital, Larkana from 1st October 2020 to 30th September 2022 Methodology: One thousand pregnant women who were screened for the identification of spina bifida. Doppler based ultrasonography was performed in each patient. The fetus body was examined during sonography Doppler between 18-24 weeks. The body of the fetus was focused and visualized longitudinally in midsagittal section. Spinal cord was traced from neck to sacral, cervical vertebra and thorax. A tram track appearance was observed. Spinal nerve positioning was also observed. In spina bifida nerve tethering was seen. The primary outcomes in reference to baby weight and maturity were recorded while secondary outcomes of the fetuses in terms of any disability were followed up to 12 months of age. Results: The mean age of the women was 25.6±5.6 years. The incidence of spina bifida was 1.1%. Within the primary outcomes observed birth weight ranged within 3.1-3.5kg. Around 81.81% cases were born full term while 18.18 were premature. On 06 months’ follow-up of the spina bifida cases it was observed that 45.45% of new born suffered from skin problems as sores, calluses or and blisters while 36.36% had hydrocephalus with excessive CSF which needed monitoring. Mobility issue and disability was observed in 27.27% cases. Conclusion: Spina bifida cases are identified successfully within gestational period. Prematurity can be significantly noticed in spina bifida cases. The lumbosacral and lumbar lesions are most common as well as skin conditions and hydrocephalus. Key words: Incidence, Spina bifida, Gestation, Outcome

Objective: To evaluate the routine screening for fetal limb abnormalities in the first trimester. Study Design: Prospective study Place and Duration of Study: Department of Radiology and Department of Obstetrics & Gynaecology, Khirpur Medical College, Khairpur Mir’s from 1st October 2020 to 30th September 2022. Methodology: The study enrolled all pregnant women in visiting the Gynaecology OPD for routine check-up. All the cases were referred to ultrasound diagnostic for screening of fetal limb abnormalities. The total sample size of the study was assigned as 1000 fetuses from 980 women as 10 women had twin pregnancies. Limb reduction shortcomings included transverse-limb reduction deficit as well as longitudinal-limb reduction deficit as seen through absent radius and also club hand, absent fibula phocomelia. The diagnosis of the limb shortening was based on the length of long bone if

Solid-oxide fuel cells are efficient devices for the conversion of chemical to electrical energy and a typical solid-oxide fuel cell consists of a solid electrolyte, cathode, and anode. In the last few decades, researchers have been working extensively on materials development for different components of these devices. In this review article, we briefly discuss the requirements for different components and review prominent materials families explored by the scientific community. As the search for greener energy alternatives such as solid-oxide fuel cells have intensified manifold due to the climate change emergency, a substantial literature was produced on the materials development of these devices and, therefore, we believe a brief review article dedicated to the same will be valuable for the scientific community, particularly new young entrant researchers in the field.

Background: Because of the increasing number of participants in sports activities and traffic accidents, the frequency of anterior cruciate ligament (ACL) injuries has been increasing. Arthroscopic ACL reconstruction, which is widely used in the treatment of complete ACL tears, is an effective method for preventing chronic instability and early degenerative arthritis. Objective: To determine the postoperative infection in arthroscopic ACL reconstruction using hamstring autograft Methodology: This study was retrospective study carried out at the department of orthopaedics, Afridi Teaching Hospital, Peshawar for a period of six months from February 2022 to July 2022. The postoperative infection status of all the included patients was taken from the hospital record. IBM SPSS version 23 was used to conduct all statistical analyses. Results: In the current study, a total of 60 patients were included. There were 51 (85%) males and 9 (15%) females in our study. Based on the rate of infection amongst 60 patients the frequency of infection was 2 (3.33%). Conclusion: Infection after arthroscopic ACL reconstruction using hamstring autograft is a relatively infrequent but devastating complication for patients. Better knowledge of the proper treatment protocols will contribute to improved quality of care for patients. Keywords: Postoperative infection; arthroscopic ACL reconstruction; hamstring autograft

Background: It is not unusual for oral manifestations to occur in dermatological diseases. The aim of this study was to observe and evaluate oral manifestations in patients diagnosed with dermatological diseases. Methods: A cross-sectional study based on a convenient sampling technique was conducted among patients with dermatological conditions who visited the polyclinic of King Faisal University Polyclinic of Al-Ahsa, Saudi Arabia from Sep-Nov 2021. Results: Sixty-one percent were females, 50% were aged >30 years, 77% had higher education, 61% were unemployed, 82% were non-smokers, and 20% had some medical conditions. 14.5% suffered from immune-mediated skin disease, 25.3% had eczema, 21.7% showed dermatitis infections, 3.6% had Genodermatosis, 9.6% were with psoriasis and other keratinizing disorders, and 25.3% had miscellaneous skin conditions. 85.5% of skin patients did not have any oral manifestations; oral lesions were of perioral dermatitis (1.2%), melanotic macule (1.2%), fissured tongue (2.4%), oral lichen planus (2.4%), mucocele (2.4%), and one case of each with geographic tongue, herpes labialis, and hairy tongue. Practical ImplicationsThis study highlights the importance of integration of oral health into general health for management of oral diseases associated with other body diseases. Conclusion: The majority of the patients in this study sample with skin diseases did not show any oral manifestations. More females and aged patients had more skin conditions. Keywords: Prevalence, Oral manifestations, Dermatological conditions, Cross-sectional study

Objective: To compare the frequency of opioid requirement, after intravenous lignocaine infusion and ketorolac tromethamine in the upper limb surgeries. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Lahore Pakistan, from Oct 2017 to Apr 2018. Methodology: ASA I/II patients of either gender undergoing upper limb surgery were included. Patients were randomly divided into two equal groups, “L” (Lignocaine) and “K” (Ketorolac). In L-group, patients were given intravenous 1.5 mg/kg lignocaine bolus, followed by 2.0 mg/kg/hr infusion during entire procedure; while in K-group, patients were given intravenous 0.5 mg/kg (maximum 30 mg) ketorolac, at induction. The patients were monitored for 12 hours postoperatively and in case of severe postoperative pain (Visual Analogue Scale score >5), rescue analgesia (intravenous Nalbuphine 0.1 mg/kg) was provided. Results: Total eighty patients were included in the study. There was no statistical difference between the two groups with age (p-value 0.823), gender (p-value 0.808) and ASA status (p-value 0.184). There was statistically significant difference between the two groups in terms of opioid requirement at 1-hour (p-value 0.035), 6-hours (p-value 0.032) and 12-hours (p-value 0.035), with K-group showing more requirement as compared to the L-group. Conclusion: Intraoperative administration of intravenous lignocaine infusion is superior to ketorolac in effective postoperative pain management in patients undergoing upper limb surgeries.

Handwritten signature for the identification and authentication of an individual has been widely used in the biometric systems. Due to the intra-class and inter-class variabilities, signature verification has become one of the most challenging problem in the biometric technology. Furthermore, the offline handwritten signature can be forged by the skilled persons due to its static nature. Therefore, in this paper a deep learning-based method using convolutional neural network (CNN) for online signature verification has been developed. Different values of the convolutional kernels such as 1×1, 3×3 and 5×5 are used to extract the discriminative features at multi-scales. The features of the initial and middle layers of the CNN are combined to create more powerful features. An up-sampling method with bilinear interpolation has been used to add the features of convolutional layers with different spatial dimensions. Both the addition and concatenation methods have been used to aggregate the convolutional features. A convolutional transpose method is applied to increase the depth of the convolutional layers while performing an addition operation on the layers with different depths. Finally, the concatenated features are passed to the fully connected layers for high-level feature extraction and classification. To evaluate the performance of the proposed method, an android application was developed where; a custom database of 985 online signatures collected from 197 users has been created. The problem of inadequate training data for online signature verification has been addressed through the data augmentation method. The experimental results show that the deep aggregated convolutional feature representation method achieves an accuracy of 99.32% on the custom developed online signature database.

With the spread of the COVID-19 pandemic, the importance of online learning has grown up worldwide and many higher education institutions used this mode of learning to save the timings of students. Just Online learning does not fulfill all the learning requirements of undergraduate students, therefore, there is a need for the blended learning (BL) method to be adopted in higher educational institutes for the enhancement of students’ learning outcomes. This research paper focuses on the development of an integrated blended learning model and the performance of the model on students’ learning has been predicted using a Bayesian network (BN) classifier. The proposed model is based on the medium impact blend of the Rotation model and the Enriched Virtual Model and applied to undergraduate computing students. The Data Structures and Algorithms course is targeted for the prediction of students’ performance. The findings of the proposed Integrated BL model show that when students properly attend the classroom lectures followed by their associated lab practical in the Rotation Model and follow the online learning activities in the Enriched Virtual Model properly, then their learning outcomes may be increased as predicted using BN method. The proposed model also reports an overall accuracy of 88.5% on the collected data.

The World Health Organization has stated Covid-19 as a pandemic that has posture a current hazard to humanity. Covid-19 pandemic has magnificently forced global shutdown of several events, including educational activities. This has caused in tremendous crisis-response immigration of educational institutes with online smart learning helping as the educational platform. Smart learning targets at providing universal learning to students consuming modern technology to completely prepare them for a fast-changing world everywhere. In this research paper an evaluation system has been developed that is based on bloom taxonomy. A Neuro-fuzzy system for the training and testing of the data for smart and traditional learning outcomes has been applied on collected data. For this research work, we have selected students of the computing discipline and focus on core-computing subjects. The findings of this research work shows the importance of smart learning and its positive impact on student learning outcomes. The evaluation criteria are based on revised bloom taxonomy levels, such that all six levels have been covered. The students’ performance are very much encouraging when compared with ground truth values and reported 91.2% overall accuracy of proposed model on collected samples.

Background: People with multiple sclerosis face significant employment-related challenges, with little known of the drivers of these outcomes. Objective: We examined prospective trajectories of employment-related outcomes up to 11 years following a first episode of central nervous system (CNS) demyelination (FCD). Methods: Participants were aged 18–59 years, at FCD, with at least two observations and were employed at study entry or anytime during follow-up ( n = 207). Outcomes were employment status (full-time, part-time and unemployed), average workhours per week and disability support pension (DSP; receiving/not receiving). We used group-based trajectory modelling to identify groups with common trajectories. Factors associated with trajectory membership were explored using log-multinomial regression. Results: Distinct trajectories were identified for employment (4), workhours (4) and DSP (2). Compared with stable full-time, female sex was strongly associated with being in the stable part-time trajectory (risk ratio (RR): 5.35; 95% confidence interval (CI) = 2.56–11.20; p Conclusion: These trajectories indicate substantial heterogeneity and the complex impact of MS on employment from its earliest timepoints. Understanding these trends could enable better targeting of interventions to facilitate workforce retention, particularly for females, those with a higher number of comorbidities, more frequent relapses and greater rate of disability accrual.

In this paper, we are putting forward the periodic solution of non-linear oscillators by means of variational iterative method (VIM) using Laplace transform. Here, we present a comparative study of the new technique based on Laplace transform and the previous techniques of maximum minimum approach (MMA) and amplitude frequency formulation (AFF) for the analytical results. For the non-linear oscillators, MMA, AFF and VIM by Laplace transform give the same analytical results. Comparison of analytical results of VIM by Laplace transform with numerical results by fourth-order Runge–Kutta (RK) method conforms the soundness of the method for solving non-linear oscillators as well as for the time and boundary conditions of the non-linear oscillators.

Aims: To evaluate the effect of intracanal cryotherapy on surface temperature change in the root apex with different thickness. Study Design: Comparative Study. Place and Duration of Study: Operative Dentistry Department: Altamash Institute of Dental Medicine, Karachi, Pakistan: July 2020 till June 2021. Materials & Methods: Sixty extracted single-rooted teeth were randomly divided into two groups: 30 each with one group consisting of teeth with ≤3 mm root thickness and another group consisting of teeth with thickness >3mm. Both groups were equally subdivided into Group A and Group B. After endodontic preparation of teeth, Group A underwent room temperature saline irrigation and Group B cold temperature saline (2.5°C) irrigation. A digital thermometer was used to measure the external root surface temperature by placing the thermocouple at 2 mm from the apex of the root’s buccal surface. Results: Initial and final temperatures were compared using paired t-test. Independent t-test was applied to compare the final temperature between ≤3mm and >3mm thickness groups. P-value less than or equal to 5% level of significance was defined as statistically significant. In group A, An average temperature decrease of 4.4 ± 0.5°C was observed in the final temperature when thickness was ≤3mm (p=0.040) while a reduction of 2.6 ± 0.5°C was seen in the final temperature when thickness was >3mm (p=0.008). When thickness was ≤3 mm, final temperature among group A and Group B was significantly different with higher mean final temperature in Group A (p3mm, final temperature between Group A and Group B was different with significantly lower final temperature in Group B than Group A(p

This study presents a checklist of the flora of three coniferous forests of the Himalayan biodiversity hotspot in Kashmir: low-level blue pine (BP), mixed coniferous (MC) and subalpine (SA) forests. The list includes altitudinal distribution and conservation status of 272 vascular plant species representing 196 genera and 64 families. Excluding neophytes (70 taxa, 62 genera, and 27 families), Magnoliophyta comprised 190 taxa, 139 genera, and 50 families; Pinophyta seven taxa, six genera, and three families; and Pteridophyta three taxa, three genera, and two families. Most speciose families from Magnoliophyta include Compositae, Apiaceae, and Rosaceae. Genera such as Artemisia, Potentilla, Viola, and Saussurea contributed the maximum number of species. In case of Pinophyta, the principal families are Pinaceae with four taxa followed by Cupressaceae (2 taxa), whereas genus Juniperus comprised two species. In Pteridophyta, Pteridaceae (2 taxa) formed the most speciose family. The herbs contributed 177 taxa, followed by tress (15 taxa), shrubs (8) and subshrubs (2). The maximum number of taxa belongs to SA (136 taxa) followed by MC (134 taxa) and BP (83 taxa) forests. The species distribution reveals 20, 30, and 46 taxa are exclusive to BP, MC, and SA forests. More than 16% of taxa are categorized in the International Union for Conservation of Nature (IUCN) Red List, and 24 taxa are endemic to the Himalayan landscape. The checklist provides a roadmap for research, protection and conservation of plant diversity, especially the threatened taxa.

Background: It is estimated that about 16–17 percent of all fractures in pediatric patients are supra-condylar fractures of the elbow. Different techniques are used for the management of supracondylar displaced fractures of elbow in children. Objective: To find out the outcomes of percutaneous cross- K-wire fixation for the management of supracondylar displaced fractures of elbow in children Methodology: This descriptive cross sectional study was carried out at Orthopedic Department of Khyber Teaching Hospital Peshawar for duration of one year from June 2021 to July 2022. A total of 80 patients were included in the current study. All the patients were followed for up to six months. At last follow-up, all patients were evaluated using Flynn's criteria. All the data analysis was done by using IBM SPSS version 23. Results: On the basis of Flynn’s criteria, excellent results were observed in 54 (67.5%) patients, good results in 20 (25%) patients, fair results in 4 (5%) patients while poor results were observed in 2 (2.5%). Based on the post-operative associated problems, pin-tract infections were observed in 7 (8.75%) patients, cubitus varus deformity was observed in 2 (2.5%) and temporary ulnar nerve deficit was observed in 5 (6.25%) patients. Conclusion: Our study concludes that in children, type-II & III supra-condylar displaced fracture of elbow can be managed easily and effectively with a low rate of complications. Keywords: Percutaneous cross- K-wire fixation; Supracondylar displaced fractures; Elbow

OBJECTIVE: To screen the females presenting with Polycystic Ovarian Syndrome (PCOS) for underlying pre-diabetes and to correlate pre-diabetes with the various diagnostic criteria of PCOS. METHODS: This descriptive cross-sectional study was conducted at Lady Reading Hospital Peshawar, Pakistan from March, 2020 till December, 2020. One hundred & fifty one cases of PCOS, ranging in age from 17-40 years, were selected through purposive sampling. The Rotterdam criterion was used to diagnose PCOS, the details of history, physical examination and biochemical investigations like luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, thyroid stimulating hormone (TSH), glycosylted hemoglobin (HBA1c), prolactin and pelvic ultrasound were recorded on a structured questionnaire. RESULTS: Mean age of the patients was 23.42±4.88 years. Mean BMI was 33.27±26.98 kg/m2. Pre-diabetes was detected in 19.2% (n=29) and overt diabetes in 4.0% (n=6) of the women with PCOS. Hypertension, dyslipidemia and hypothyroidism were reported by 11 (7.2%), 9 (5.9%) and 4 (2.6%) patients respectively. Delayed menstrual cycle was reported by 44.8% (n=52); 27.6% (n=8) & 33.3% (n=2) cases of normoglycemic, prediabetes and diabetes mellitus respectively. Oligomenorrhoea was present in 69.0% (n=20) of pre-diabetics. Moderate and severe hirsutism was present in 44.8% and 10.3% PCOS patients with pre-diabetes. There was no significant correlation between pre-diabetes and the criteria of PCOS diagnosis. CONCLUSION: Women with PCOS are at increased risk of pre-diabetes and other metabolic complications like obesity, hypertension and dyslipidemia at an earlier age. However, there was no significant correlation between pre-diabetes and the criteria of PCOS diagnosis.

Background: Currently, there has been a rise in severe trauma that occurs as a consequence of road accidents. Different treatment modalities are used for open tibia fracture but currently ilizarov ring fixator is used with better outcomes. Objective: To assess the outcomes of open tibia fracture using ilizarov ring fixator Methodology: This prospective study was carried out at the Orthopedic Department of Mercy Teaching Hospital Peshawar for duration of two years from November 2019 to November 2021. The Ilizarov ring fixator was scheduled for all of the participants in our research. Proper radiographs of the affected leg were acquired, comprising antero-posterior and lateral views. Postoperative radiographs were also collected. All the data was analyzed statistically by using SPSS version 24. Results: In this study, totally 40 patients were included. Based on radio-graphical results, 10 (25%), 18 (45%) and 12 (30%) and 00 (00%) patients have excellent, good and fair and poor results respectively while on the basis of functional outcomes, 12 (30%), 22 (55%), 2 (5%) and 4 (10%) patients have excellent, good and fair and poor results respectively. Complications like pin tract infection, superficial skin infection and chronic osteomyelitis were observed in 10 (25%), 6 (15%) and 2 (5%) patients respectively. Conclusion: Our study concludes that ilizarov external fixator can be effectively used for the management of open tibial fractures. Keywords: Open tibia fracture; Ilizarov ring fixator; Radiographs; Complication

Introduction: Bleeding disorders are a group of disorders which results from defective platlets functions or coagulation or both and it can be classified into platlets disorders, blood vessel disorders and coagulation factors disorders. Bleeding disorder patients undergoing dental procedures may need special management before dental procedure. Aim: To assess the awareness level of the dental students and practitioners in Saudi Arabia about the bleeding disorders. Materials and Methods: This cross-sectional study was conducted among 502 dental students and dentists in Saudi Arabia. This was a questionnaire based internet survey consisted of 331 clinical year dental students and 171 dentists. The questionnaire contained 15 questions. Results: The highest percentage of participants were from the Eastern Province (31.1%). Almost half of the participants were males (51.2%). The dentists represented (34.1%). Around (47.8%) of participants reported that they had encountered bleeding disorder patients before. Almost (50.8%) participants who encountered those patients said that they referred them to a physician for a consent. Six questions were used to assess the knowledge of the participants about the bleeding disorders based on the number of the correct answers. Only (1%) were able to answer all the questions correctly. Most of the participants (93.8%) said that they need to learn more about bleeding disorders. Conclusion: Majority of the dental students and general practitioners had poor knowledge of the management of bleeding disorder patients.We strongly recommend intensifying dental educational programs and more training is required in management of patients with medical complications.

Objective The aim of this study was to evaluate decayed, missing, and filled teeth (DMFT) experience among married females in Saudi Arabia and provide an exploratory data for subsequent primary prevention. Materials and Methods A cross-sectional quantitative study was conducted at a general hospital in Hofuf, Saudi Arabia. All married women attending the general hospital from March 1st to April 15th, 2021 were requested to participate. Data was collected on a validated self-reported questionnaire consisting of sociodemographic factors, medical history, dietary pattern, and DMFT. Descriptive and regression analyses were performed using p ≤0.050. Results Four hundred forty-eight married females with the mean age of 30.81 ± 6.11 years, mean duration of marriage of 9.55 ± 6.58 years, and having average number of children 2.32 ± 1.69 participated in the study. 61.7% mothers had ≥10 years of education. 63.6% were non-working and 56.5% were found with low family income. 66% participants reported of doing exercise less or more often yet 51.7% were ≥overweight. Consumption of energy drinks and dairy products was found significantly associated with increasing number of DMFT. Use of fluoridated toothpaste and dental visits was also found associated with increasing number of dental caries. Increasing age (p = 0.040), increasing number of children, and middle family income were also significantly associated with higher DMFT, respectively (p = 0.002, p = 0.022). In multi-logistic adjusted analysis, only consumption of dairy products, dental visits, and the unsure status of the use of fluoridated toothpaste were significantly associated with DMFT ≥1. Conclusion DMFT status in married Saudi women was associated with participants' dietary habits, oral health-related practices, family income, married years, and number of children.

The growth in number of electric vehicles (EVs) has resulted in increased dependence of transportation on the power sector. During power outages, especially for elongated time spans, the locally available energy may not be sufficient to fulfill the energy needs of all the EVs. Therefore, a multicriteria EV prioritization scheme is proposed in this study to fairly allocate available energy among EVs during power outages. The five major factors considered for EV prioritization are trip purpose, EV occupants, energy gap, departure time, and customer behavior. With different combinations of the five prioritization factors, three indices are formulated, one each for social welfare, community wellbeing, and individual satisfaction of the EV owners. To this end, a multiobjective optimization problem is formulated, based on the three indices, to allocate the available power among EVs with higher index values. The formulated multiobjective optimization problem is solved using the lexicographic method, which has superior performance over the conventionally used weighted-sum method and $\varepsilon $ -constraint (EC) method. The proposed method is not sensitive to the weights of individual functions and has the ability to handle multiple priority levels. In order to quantify the results, percent served and unserved indices are formulated for each of the three parameters (social welfare, community wellbeing, and individual satisfaction) and the results of the proposed method are compared with those of the weighted-sum method and the EC method. Sensitivity analysis of different uncertain factors, such as number of EVs, uncertainty in EV demand, uncertainty in renewable power, and error in battery state-of-charge estimation, is also carried out. Simulation results have shown the superiority of the proposed method in allocating power to EVs during outages.

BackgroundUncontrolled diabetes can lead to exacerbation of symptoms and life-threatening complications. Consequently, there is a need to explore patient experience regarding the prevention and treatment of diabetic patients amidst the restrictions and lockdown measures in response to COVID-19. The objective of this study was to assess the response of the healthcare system for preventive care and treatment of people with diabetes in Bangladesh during COVID-19, and to analyze the health-seeking behavior of diabetes patients amidst social distancing and lockdown measuresMethodA descriptive qualitative design was used to collect data regarding the ability of people living with diabetes to access medication, laboratory services, and preventative care during the pandemic. The data collection process involved 12 focus group discussions (FGDs) with people living with diabetes, and 30 key informants’ interviews (KIIs) with senior diabetologist, health service managers, leaders of different diabetes-related associations, and policymakers from the local to the national level. The discussion issues were structured around the WHO framework that describes health systems in terms of six “building blocks”. In addition, different treatment guidelines, scientific articles, relevant reports, and 20 well-circulated newspapers were analyzed concerning the treatment of diabetic patients.Results44% of the respondents were aged 55-60 years, with an informed noticeable disruption of essential diabetes care services, intensified by high COVID-19 infection rates. Besides, 78% of the service receiver participants reported not seeing any government-issued public announcements regarding diabetes management on television or newspapers. There are also concerns with the current heath sector.ConclusionsThe study findings highlighted major concerns surrounding the healthcare response to deliver care for patients with diabetes during the pandemic, driven mainly by restricted access to treatment under lockdown measures coupled with a reluctance from health care providers to see patients due to high COVID-19 infection rates arising from concerns with a lack of personal protective equipment. Necessary measures can gradually bring some change in the healthcare system promote healthy lifestyles and adherence to prescribed medicines together with raising awareness about the potential risk factors of diabetes.

The electrochemical CO2 reduction reaction can lead to high value-added molecules production while helping decrease anthropogenic CO2 emissions. Copper can reduce CO2 to more than thirty different hydrocarbons and oxygenates, but it lacks the required selectivity. We present a computational investigation of the role of nano-structuring and alloying in Cu-based catalysts on the activity and selectivity of CO2 reduction to one-carbon products: carbon monoxide, formic acid, formaldehyde, methanol, and methane. The adsorption, activation, and conversion of CO2 were computed on monometallic and bimetallic (decorated and core-shell) 55-atom Cu-based clusters. The dopant metals considered were Ag, Cd, Pd, Pt, and Zn, located at different coordination sites. The relative binding strength of the intermediates at different applied potentials were used to identify the optimal catalyst for the selective CO2 conversion to one carbon products. It was discovered that single atom doping with Cd and Zn is optimal for the CO2 to carbon monoxide conversion. The core-shell models with Ag, Pd, and Pt provided higher selectivity for formic acid and formaldehyde. The Cu-Pt and Cu-Pd showed lowest overpotential for methane formation.

Electrochemical CO

This paper presents the importance of Artificial intelligence (AI) in the computing education, which has become an important and powerful aspect of human lives. It is still a field in its beginnings, but as time progresses, we will observe how AI evolves and explores its untapped potential. The rapid development regarding scrutiny of learning outcomes for higher education, establishment and implementation of international standards shows the need of the technology. Many higher education institutes of the world are adopting information and communication technology (ICT) to enhance the Course Learning Outcomes (CLO) of the students based on the revised Bloom Taxonomy that assists the institutions to analyze the outcomes of students in planning the course and techniques to improve and enhance the performance of students. This research paper analysis the importance of blooms in integration of computing technologies and smart learning environment and provides the encouraging results when analyzed by using supervised machine learning methods during the COVID-19 pandemic situation. In this research, we have designed an ICT based framework to achieve the learning outcomes of the students in computing subjects. It is worth mentioning that the proposed educational model reports the promising results of a bout of 83% accuracy. The accuracy of the model is also verified from self-assessment reports of the students., {"references":["[1]\tN. Nurdyansyah, P. Rais, and Q. Aini, \"The Role of Education Technology in Mathematic of Third Grade Students in MI Ma'arif Pademonegoro Sukodono,\" Madrosatuna: Journal of Islamic Elementary School, vol. 1, no. 1, pp. 37–46, Apr. 2017, doi: 10.21070/madrosatuna.v1i1.923. [2]\tS. Cardoso, M. J. Rosa, and B. Stensaker, \"Why is quality in higher education not achieved? 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Introduction: The median axes of the arm and forearm form an angle known as carrying angle when fully supinated and extended. This posture is crucial while carrying objects because it enables the forearms to pass across the hips in swing motions when walking Objective: To find out the mean carrying angle of elbow in children less than ten years of age. Methodology: This study was Cross Sectional Study carried out at the Outpatient Department of Orthopedic Surgery, Khyber Teaching Hospital, Peshawar for duration of six months from 20 Dec, 2021 to 20 Jun, 2022. Goniometer was used for the measurement of the carrying angle. All information such as age, height, weight, length of arm, and carrying angle was documented in a pre-designed Performa. Results: Totally, 250 children were included in this study. On the basis of gender wise distribution, 194 (77.6%) children were recorded as male children and 56 (22.4%) children were recorded as female children. The mean (SD) age, height, length of forearm, weight and carrying angle was 6 (1.05) years, 105.5 (3.75) cm, 18.2 (2.23) cm, 12 (2.84) kg and 8.5 (0.82) degree respectively. Significant association of carrying angle was observed with height, weight, forearm length and limb dominancy (p≤0.05). Conclusion: Our study concluded that age, gender, height, weight and dominant side are important factors that affect the value of the carrying angle. Keywords: Elbow; Carrying Angle; Correlation

Objective: To investigate clinical correlation of ovarian cyst malignant or benign with ultrasound reports. Study Design: Prospective observational study Place and Duration of Study: Department of Radiology, Ghulam Muhammad Mahar Medical College, Sukkur from 1st November 2019 to 31st July 2021 Methodology: Ninety five patients with accidental diagnosis of ovarian mass were enrolled as patients and had symptoms of abdominal pain, palpable-mass as well as irregularities in the menstrual cycles. Diagnosis of each patient was based on ultrasound which was assisted with TVS or Doppler depending upon the cases under consideration. The ultrasonographical reports were correlated with the clinical examination and diagnosis findings for better assessment of the ovarian mass. Results: Mean age was 42 years with 62.3% those women who were in reproductive age while rest were having menopause. 70% were presenting abdominal pain and 2% were asymptomatic. Doppler scan reports showed that all cases of malignancy were having high vascularity with R1< 0.4 in 100% of cases while R1>0.4 was highest in benign cases. The ultrasonographical imaging showed an obvious variance in the imaging reports of benign verses malignant cases where an irregular margin mass was prominently noticeable in cases of malignant ovarian tumor. Conclusion: High sensitivity and specificity was also seen among clinical cases correlated with ultrasound having Doppler scanning. Keywords: Ultrasonography, Ovarian cyst, Tumors, Adnexal masses

Aim: To compare chest computed tomography (CT) diagnosis of ground glass opacities in the COVID-19 patients. Study design: Retrospective study. Place and duration of study: Department of Radiology, Ghulam Muhammad Mahar Medical College Sukkur from 1st July 2020 to 31 August 2021. Methodology: Fifty patients on differential CT diagnosis of ground glass opacities seen in COVID 19 patients were enrolled. Thoracic CT images by applying auto exposure-control settings and ranges of scan were done. The noise-index was kept as 12.3. Using helical 16 slice Alexion CT-Toshiba. Keeping a comparison with viral infection CT images a list of 7 signs which were positive for Covid CT scan were recorded. Peripheral lesions meant any lesions which effects peripheral area up to 3 to 4 cm lung periphery with/without having central dispersal. A hazy-opacity was termed as ground glass. Results: Mean age of the patients was 49.1±10.2 years with 27 (54%) males and 23(46%) females. Mix ground glass opacitites and consolidation were also the features of the CT imaging in coronavirus posisitve cases. Man-Whitney test results showed that combined-CT scoring had a SE value as 0.044 with a confidence interval between 0.756-0.927. Comparing the differential CT values within COVID and non COVID patients based on RT PCR results it was observed that posterior region lower lobe involvement was a feature of COVID-19 patients while crazy paving pattern and peripheral distribution was also seen in corona patients. Conclusion: Present study highlights that chest CT helps in differentitaing corona virus from other causes of pneumonias and grond glass opacities. Key words: Chest CT; Differential diagnosis; COVID-19; Ground glass opacities (GGO)

Provision of primary healthcare in India received thrust of National Health Policy 2017. Vacancy, chronic absenteeism and non-availability of allopathic doctors is a chronic problem of the public health system. Engagement of alternative human resources could get the ailing health system rid of this shortage. AYUSH doctors in Odisha are involved in clinical and public health activities since 1970s. This study aims to examine perspectives of key stakeholders on ‘task shifting’ as a possible policy alternative. We reviewed the policies and guidelines of government of Odisha on human resources deployment, recruitment, retention and terms of reference of their engagement in the public health sector. Further, 76 AYUSH doctors and 30 key informants were interviewed. Ethical clearance was obtained beforehand. Most AYUSH doctors were involved in monitoring and supervising community-based public health programmes and village-level health service providers, respectively. Their involvement in the implementation of national health programmes was found to range from 8% to 62%. A sizeable proportion of AYUSH doctors had not been trained on management of national vector borne disease control, Tuberculosis control, immunisation (RI) and disease surveillance. More than 70% of respondents showed interest in implementing and managing public health programmes. Almost all key informants recommended for improved involvement of AYUSH doctors in public health activities. Inadequate logistics support, insufficient training on public health and unequal administrative authorities was perceived to be systemic bottlenecks. Job enrichment, management capacity development, and pre-deployment orientation of AYUSH doctors may precede the opportunity of ‘task-shifting’ of public health functions.

BACKGROUND: Medication adherence is critical for the realization of pharmacotherapy benefits and reduced healthcare expenditure. Studies have shown up to 60% of people with Multiple sclerosis (MS) experience suboptimal medication adherence, which is associated with poorer health outcomes and subsequent discontinuation. The current systematic review reported on objectively measured adherence and discontinuation rates for self-administered oral and injectable disease-modifying therapies (DMTs). OBJECTIVES: To identify whether, in people with MS, the introduction of oral DMTs has improved medication adherence when compared with injectable DMTs. The secondary aim was to report synthesized objectively measured medication adherence and persistence rates for both oral and injectable DMTs in MS across varying study durations. METHODS: Literature searches were conducted through PubMed, Web of Science, Scopus, and PsycINFO. Inclusion criteria were limited to English, peer-reviewed, objective, self-administered DMT articles, published between July 1993 to December 2019. Publications reporting combined intravenous and self-administered DMT data, or that did not account for DMT switching in discontinuation rates, were excluded. Data were synthesized into observation lengths ranging from less than 8 months to greater than 36 months. Meta-analysis and meta-regression were undertaken on both oral and injectable 12-month adherence and discontinuation data. RESULTS: In total, 61 articles were included; 46 articles examined adherence and 26 examined discontinuation. Twelve-month adherence ranged between 53.0% to 89.2% for oral (N = 7) and 47.0% to 77.4% for injectable DMTs (N = 7). Results from the meta-analysis and meta-regression show significantly higher pooled mean medication possession ratio (MPR) adherence for oral DMTs (91.0%) when compared to injectable DMTs (77.0%) over 12 months (β = -0.146; 95% CI: -0.263 to -0.029). Results indicate major asymmetry across studies (LFK index: -5.18), proposing the presence of significant publication bias. Mean discontinuation over 12 months was between 10.5% to 33.3% for oral (N = 7) and 15.2% to 50.8% for injectable DMTs (N = 10), with meta-analysis results indicating the presence of significant heterogeneity (I2 Injectable: 99.5%; I2 Oral: 93.1%) between studies included in each subgroup. However, no appreciable difference in mean discontinuation rates across groups (Injectable: 27%; 95% Cl: 19.0%-34.0%; Oral: 24%; 95% CI: 17.0%-31.0%) was found. CONCLUSIONS: Medication adherence for oral DMTs suggests a significant improvement compared to adherence for injectable DMTs. No significant difference in discontinuation rates between oral and injectable DMTs was found. Oral DMT adherence and persistence studies are limited, given their relatively recent introduction. Suboptimal medication adherence and discontinuation issues remain present for both oral and injectable DMTs. Future studies would benefit from improved consistency in methodology, such as comparable adherence and persistence definitions. DISCLOSURES: The authors did not receive any funding for this study. Mardan and Hussain have nothing to disclose. Grech reports grants from Merck Pharmaceutical, outside the submitted work. Allan reports grants received from Merck Pharmaceutical outside the submitted work. Allan holds advisory board and consulting positions with Merck and advisory board positions for Bristol Myers Squibb and Novartis, for which Monash Institute of Neurological Diseases receives consulting fees.

In the medical era the Brain tumor is one of the most important research areas in the field of medical sciences. Researcher are trying to find the reliable and cost effective medical equipment’s for the cancer and its type for the diagnosed, especially tumor has deferent kinds but the major two type are discussed in this research paper. Which are the benign and Pre-Malignant, this research work is proposed for these factors such as the accuracy of the MRI image for the tumor identification and actual placing were taken into consideration. In this study, an algorithm is proposed to detect the brain tumor from magnetic resonance image (MRI) data simple. As enhance the image quality for the easiness the tumor treatments and diagnosed for the patients. The proposed algorithm enhances the MR image quality and detects the Brain tumor which helps the Physician to diagnose the tumor easily. As well this algorithm automatically calculates the area of tumor, size and location of the tumor where it is present for diagnostic the Patient.

Background The purpose of this research is to generate new evidence on the economic consequences of multimorbidity on households in terms of out-of-pocket (OOP) expenditures and their implications for catastrophic OOP expenditure. Methods We analyzed Social Consumption Health data from National Sample Survey Organization (NSSO) 75th round conducted in the year 2017–2018 in India. The sample included 1,13,823 households (64,552 rural and 49,271 urban) through a multistage stratified random sampling process. Prevalence of multimorbidity and related OOP expenditure were estimated. Using Coarsened Exact Matching (CEM) we estimated the mean OOP expenditure for individuals reporting multimorbidity and single morbidity for each episode of outpatient visits and hospital admission. We also estimated implications in terms of catastrophic OOP expenditure for households. Results Results suggest that outpatient OOP expenditure is invariably lower in the presence of multimorbidity as compared with single conditions of the selected Non-Communicable Diseases(NCDs) (overall, INR 720 [USD 11.3] for multimorbidity vs. INR 880 [USD 14.8] for single). In the case of hospitalization, the OOP expenditures were mostly higher for the same NCD conditions in the presence of multimorbidity as compared with single conditions, except for cancers and cardiovascular diseases. For cancers and cardiovascular, OOP expenditures in the presence of multimorbidity were lower by 39% and 14% respectively). Furthermore, around 46.7% (46.674—46.676) households reported incurring catastrophic spending (10% threshold) because of any NCD in the standalone disease scenario which rose to 63.3% (63.359–63.361) under the multimorbidity scenario. The catastrophic implications of cancer among individual diseases was the highest. Conclusions Multimorbidity leads to high and catastrophic OOP payments by households and treatment of high expenditure diseases like cancers and cardiovascular are under-financed by households in the presence of competing multimorbidity conditions. Multimorbidity should be considered as an integrated treatment strategy under the existing financial risk protection measures (Ayushman Bharat) to reduce the burden of household OOP expenditure at the country level.

The current study is an effort to empirically assess the effect of various macroeconomic factors on inflation in Pakistan by utilizing ordinary least squares (OLS) method and Granger non-causality test in the time-series framework from 1973-Q3 to 2017-Q2. The empirical results confirm that real GDP, money supply, imports, government expenditure, and lagged inflation have a positive and considerable influence on inflation while interest rate has an adverse impact on inflation. Additionally, the findings demonstrate bidirectional causality between money supply and inflation, while the unidirectional causal relationship is found from government expenditure and imports to inflation. These results signify that inflation does not depend solely on monetary growth in Pakistan; however, imports and fiscal policy are also contributory factors that have a considerable impact on inflation. The study concludes that central authority would not accomplish the stabilize prices through changing the monetary policy until and unless the government will not fix the fiscal deficit.

Background and purpose: This study was undertaken to identify clinically meaningful comorbidity patterns and their associations with the demographic/clinical characteristics of people with multiple sclerosis (MS). Methods: We conducted latent class analysis to identify clinically distinct comorbidity patterns in MS using the 15 most common comorbidities among 1518 Australian Multiple Sclerosis Longitudinal Study participants. The associations between demographic/clinical characteristics and comorbidity patterns were examined using log-binomial and multinomial logistic regression. Results: Five distinct comorbidity patterns were identified: "minimally diseased class" (30.8%), consisting of participants with no or one comorbidity; "metabolic class" (22.7%); "mental health-allergy class" (21.7%); "nonmetabolic class" (7.6%); and "severely diseased class" (7.0%), consisting of participants with higher prevalence of these comorbidities. The relative probabilities of being assigned to comorbidity classes compared to the minimally diseased class were significantly increased for participants who were older (metabolic: relative risk ratio [RRR] = 1.09, 95% confidence interval [CI] = 1.06-1.11; nonmetabolic: RRR = 1.07, 95% CI = 1.04-1.11; severely diseased: RRR = 1.04, 95% CI = 1.01-1.08), female (nonmetabolic: RRR = 5.35, 95% CI = 1.98-14.42; severely diseased: RRR = 2.21, 95% CI = 1.02-4.77), and obese (metabolic: RRR = 4.06, 95% CI = 2.45-6.72; mental health-allergy: RRR = 1.57, 95% CI = 1.00-2.46; severely diseased: RRR = 4.53, 95% CI = 2.21-9.29) and who had moderate disability (mental health-allergy: RRR = 2.32, 95% CI = 1.47-3.64; severely diseased: RRR = 2.65, 95% CI = 1.16-6.04). Conclusions: Comorbidity patterns exist in MS. Women, people who were older, people who were obese, and people who had higher disability levels were more likely to be in classes with higher levels of comorbidity. These findings may offer opportunities for designing more personalised approaches to comorbidity prevention and treatment.

This study examined the associations between diabetes and self-reported/familial COVID-19 infection and investigated health-related outcomes among those with diabetes during China's nationwide quarantine. The 2020 China COVID-19 Survey was administered anonymously via social media (WeChat). It was completed by 10 545 adults in all of mainland China's 31 provinces. The survey consisted of 74 items covering sociodemographic characteristics, preventive measures for COVID-19, lifestyle behaviors, and health-related outcomes during the period of quarantine. Regression models examined associations among study variables. Diabetes was associated with a six-fold increased risk of reporting COVID-19 infection among respondents or their family members. Among people with diabetes, individuals who rarely wore masks had double the risk of suspected COVID-19 infection compared with those who always wore masks, with an inverse J-shaped relationship between face mask wearing and suspected COVID-19 infection. People with diabetes tended to have both poor knowledge of COVID-19 and poor compliance with preventive measures, despite perceiving a high risk of personal infection (40.0% among respondents reporting diabetes and 8.0% without diabetes). Only 54-55% of these respondents claimed to consistently practice preventive measures, including wearing face masks. Almost 60% of those with diabetes experienced food or medication shortages during the quarantine period, which was much higher than those without diabetes. Importantly, respondents who experienced medication shortages reported a 63% higher COVID-19 infection rate. Diabetes was associated with an increased risk of self-reported personal and family member COVID-19 infection, which is mitigated by consistent use of face masks.This study examined the associations between diabetes and self-reported/familial COVID-19 infection and investigated health-related outcomes among those with diabetes during China’s nationwide quarantine. The 2020 China COVID-19 Survey was administered anonymously via social media (WeChat). It was completed by 10 545 adults in all of mainland China’s 31 provinces. The survey consisted of 74 items covering sociodemographic characteristics, preventive measures for COVID-19, lifestyle behaviors, and health-related outcomes during the period of quarantine. Regression models examined associations among study variables. Diabetes was associated with a six-fold increased risk of reporting COVID-19 infection among respondents or their family members. Among people with diabetes, individuals who rarely wore masks had double the risk of suspected COVID-19 infection compared with those who always wore masks, with an inverse J-shaped relationship between face mask wearing and suspected COVID-19 infection. People with diabetes tended to have both poor knowledge of COVID-19 and poor compliance with preventive measures, despite perceiving a high risk of personal infection (40.0% among respondents reporting diabetes and 8.0% without diabetes). Only 54–55% of these respondents claimed to consistently practice preventive measures, including wearing face masks. Almost 60% of those with diabetes experienced food or medication shortages during the quarantine period, which was much higher than those without diabetes. Importantly, respondents who experienced medication shortages reported a 63% higher COVID-19 infection rate. Diabetes was associated with an increased risk of self-reported personal and family member COVID-19 infection, which is mitigated by consistent use of face masks.

The bioessential nature of cobalt and the rich photochemistry of its coordination complexes can be exploited to develop potential next-generation photochemotherapeutics. A series of six novel mixed-ligand cobalt(III) complexes of the formulation [Co(B)2(L)]ClO4 (1-6), where B is an N,N-donor phenanthroline base, namely, 1,10-phenanthroline (phen in 1 and 4), dipyrido[3,2-d:2',3'-f]quinoxaline (dpq in 2 and 5), and dipyrido[3,2-a:2',3'-c]phenazine (dppz in 3 and 6), and L is an O,O-donor dianionic ligand derived from catechol (1,2-dihydroxybenzene, cat2-, in 1-3) or esculetin (6,7-dihydoxycoumarin, esc2-, in 4-6), have been prepared and characterized, and their light-triggered cytotoxicity has been studied in cancer cells. The single-crystal X-ray diffraction structures of complexes 1 (as PF6- salt, 1a) and 2 show distorted octahedral geometries around the cobalt(III) center formed by the set of N4O2 donor atoms. The low-spin and 1:1 electrolytic complexes 1-6 display a d-d transition around 700 nm. Complexes 4-6 with a coordinated esc2- ligand additionally display a π → π* intraligand transition centered at 403 nm. Complexes 4-6 possessing a naturally occurring and photoactive esc2- ligand show high visible-light-triggered cytotoxicity against HeLa and MCF-7 cancer cells, yielding remarkably low micromolar IC50 values while being much less toxic under dark conditions. Control complexes 1-3 possessing the photoinactive cat2- ligand show significantly less cytotoxicity either in the presence of light or in the dark. The complex-induced cell death is apoptotic in nature caused by the formation of reactive oxygen species via a type 1 photoredox pathway. Fluorescence microscopy of HeLa cells treated with complex 6 reveals mitochondrial localization of the complex. A significant decrease in the dark toxicity of free esculetin and dppz base is observed upon coordination to cobalt(III). Complexes bind to calf-thymus DNA with significant affinity, but 6 binds with the greatest affinity. Complex 6 efficiently photocleaves supercoiled DNA to its nicked circular form when irradiated with visible light via a photoredox type 1 pathway involving hydroxyl radicals (HO•). Thus, complex 6 showing remarkable visible-light-triggered cytotoxicity but negligible toxicity in the dark is a good candidate for cancer photochemotherapy applications.