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Abstract Bitumen shows visco-elastic behavior, exhibiting both elastic and viscous properties as predicted by dynamic response and phase angle. Modern asphalt bituminous pavements face issues such as early-stage fatigue cracks, rutting, and permanent deformations due to low-temperature cracking, high-temperature deformation, moisture susceptibility, and overloading. These pavement distresses result in the formation of potholes, alligator cracks, and various deformations, which accelerate the need for rehabilitation and maintenance. To address these concerns, this study focused on utilizing Nitrile Butadiene Rubber derived from surgical gloves as an additive in conventional asphalt pavements to assess its effect on stiffness. Nitrile Butadiene Rubber was added in intervals of 2%, 4%, 6%, and 8% to conventional bituminous pavement. The rheological properties, marshall properties, dynamic modulus, and phase angle were evaluated for varying percentages of Nitrile Butadiene Rubber at different temperature, and frequency. The dynamic response was determined using a simple performance tester at four different temperatures (4.4 °C, 21.1 °C, 37.8 °C, and 54.4 °C) and six different frequencies (0.1, 0.5, 1, 5, 10, and 25 Hz). Response surface methodology was employed to establish a relationship between input and output variables and to optimize the amount of Nitrile Butadiene Rubber in the mix based on dynamic modulus and phase angle. The study concluded that adding up to 6% of Nitrile Butadiene Rubber improved Marshall stability, while higher percentages led to reduced stability. A similar trend was observed in the dynamic modulus, which peaked with the addition of 6% Nitrile Butadiene Rubber, regardless of frequency and temperature. The response surface methodology model indicated that coupling the percentage of Nitrile Butadiene Rubber with frequency increased the dynamic modulus at a constant temperature, with the highest value occurring at 4.4 °C. However, the dynamic modulus decreased as the temperature rose for the same combinations of Nitrile Butadiene Rubber percentages and frequencies. Numerical optimization suggested that a maximum of 5.9% Nitrile Butadiene Rubber should be added to achieve the highest dynamic modulus and lowest phase angle.

Background: Diarrhea is cited as one of the main causes of death for infants and children, especially in squatter settlements, owing to poor sanitary conditions. Treatment and prevention of diarrhea can be managed at home by primary caregivers. It is therefore important for mothers and primary care givers to be aware of strategies for management and treatment of diarrhea. Objective: To assess the awareness of mothers regarding home management of childhood diarrhea in a squatter settlement of Karachi. Methods: A cross sectional study was conducted from 2012 to 2013 among mothers from Gulshan-eSikanderabad of Karachi who had at least one child under age of 5years. In total 110 mothers were interviewed. Non probability convenience sampling technique was used. Data was collected by structured questionnaire filled via personal interview. Informed consent was obtained before collection of data. Data Analysis was done by using SPSS version 20. Results: Out of total 110, 93 (84.5%) mothers said that their children had an episode of childhood diarrhea during last 3 months. For the management of diarrhea 91 (82.7%) mothers took their children to PHC centre and 99 (89.9%) mothers were aware about ORS. Almost two third of them aware about the ingredients of homemade ORS but their knowledge about correct amount was poor. Dirty water and food was identified as the important causes of diarrhea by 106 (96%) and 76 (69%) mothers respectively. According to 101 (91.8%) mothers hand washing would be an effective measure to prevent diarrhea. Conclusion: Despite the high rate of diarrhea in this community, knowledge of mothers regarding home management of diarrhea was found satisfactory. Adopting the preventive measures and intensifying the mothers education is the dire need to reduce the high rate of diarrhea in this community. Key Words: Childhood Diarrhea, Home Management, Awareness and Practices of Mothers, Squatter Settlement.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the coronavirus disease 2019 pandemic (COVID-19) has put millions of people at risk in an increasing number of countries, suggesting a serious threat to global public health. The first identification in late 2019, the strain has undergone several changes that have resulted in several genetically different variations that are cause for concern. By comprising the Delta, Gamma, Beta, and Alpha variations, each of which has shown evidence of increased virulence, transmissibility, or capacity for immune evasion as compared to ancestral strains. Their advancement over ancestral strains in transmission was discovered by genomic surveillance, highlighting the vital necessity for monitoring the evolution of SARS-CoV-2. Remdesivir and other treatments showed promising results in reducing the duration of the disease; however, the development of antivirals to prevent the emergence of new variations is still an important goal. The vaccine also provides hope, although its effectiveness against new genotypes needs to be evaluated. Pakistan is also facing the implications of COVID-19. The months-long closing of colleges and universities affected education as well. As SARS-CoV-2 continues to evolve, creating efficient antiviral therapies and guaranteeing vaccination accessibility continue to be critical concerns.

Abstract Food demand is directly associated with the human population. Due to various plant diseases, there has been a reduction in crop yield. There is an extreme necessity to low such losses in crop yield to meet the rising demand for food. Novel and eco-friendly control approaches should be developed for combating bacterial diseases of crops. Recent control strategies that involve the usage of antibiotics or chemicals are no more effective because of resistance developed by bacterial species. Furthermore, the usage of such agents has proven to be not environmentally friendly. To overcome these issues, bacteriophages are used as an alternative solution. Phages are viruses that attack specific bacterial species, and within current years much consideration is received by them in controlling different diseases caused by bacteria. Phages can be used for controlling different crop-related diseases. Several phage-based products are accessible in the market. Compared to chemical control methods, phage biocontrol offers several advantages. Mixtures of phages can be employed to target pathogenic bacteria. Unlike chemical control strategies, phage mixtures can be readily adjusted to counter any potential resistance. This review summarizes the use of phages as a biocontrol agent against phytopathogens.

Abstract Handcrafted and deep learning (DL) radiomics are popular techniques used to develop computed tomography (CT) imaging-based artificial intelligence models for COVID-19 research. However, contrast heterogeneity from real-world datasets may impair model performance. Contrast-homogenous datasets present a potential solution. We developed a 3D patch-based cycle-consistent generative adversarial network (cycle-GAN) to synthesize non-contrast images from contrast CTs, as a data homogenization tool. We used a multi-centre dataset of 2078 scans from 1,650 patients with COVID-19. Few studies have previously evaluated GAN-generated images with handcrafted radiomics, DL and human assessment tasks. We evaluated the performance of our cycle-GAN with these three approaches. In a modified Turing-test, human experts identified synthetic vs acquired images, with a false positive rate of 67% and Fleiss’ Kappa 0.06, attesting to the photorealism of the synthetic images. However, on testing performance of machine learning classifiers with radiomic features, performance decreased with use of synthetic images. Marked percentage difference was noted in feature values between pre- and post-GAN non-contrast images. With DL classification, deterioration in performance was observed with synthetic images. Our results show that whilst GANs can produce images sufficient to pass human assessment, caution is advised before GAN-synthesized images are used in medical imaging applications.

This study involves the preparation of cement grout samples by varying proportions of superplasticizer (SP) and water-cement (w/c) ratio (0.25–0.45) which were tested for computing flow value and 1-day, 7-day, and 28-day compressive strength. With 75 data points a neural network model was developed to predict the 28-day compressive strength based on w/c ratio, superplasticizer percentage, flow value, and compressive strengths of 1-day and 7-day as input variables. Due to the better performance of Artificial Neural Networks (ANN) over other applied models, this study predicts a confident pattern of relationship between w/c ratio (indirect), superplasticizer (direct up to 3%), and the corresponding strength characteristics of the study samples. The prediction power of the developed model has been improved from R2 = 0.959 to R2 = 0.984 by optimizing the number of neurons, activation function, and optimizer. The best performance was observed in the case of Model45-R_A. The same model was used for assessing the effect of the percentage of superplasticizer and water cement ratio on 28 days compressive strength where the compressive strength of 73.941 MPa was recorded in the case of 3% superplasticizer and w/c of 0.25.

Background: Stuttering is an organic process utterance condition. This utterance condition is broken by prolongation of sounds and repetitions of part words and phrases. Speech constitution strategies facilitate the client to use a new way of oral communication in stutters. Objective: to determine the effects of prolongation of speech and syllable time speech on reduction of severity of stuttering in stuttering patients. Methods This Randomized clinical trial study design was conducted in National Institute of Rehabilitation Medicine Islamabad. A total of n=30 participants of both gender having developmental stuttering with age between 20-30 years were included in the study through purposive sampling. The n=30 participants were randomly divided in to Group A received prolonged speech protocol (PSP) and Group B received syllable time speech protocol. The data was collected using the Scale of rating severity of stuttering (SRSS) at baseline, after 6th weeks and after 12th weeks of training. The data was analyzed through SPSS-21. Results The mean age of the study participants was 22±2.05 years. The median number of sibling was 4(2), birth order 2.5(2) and age of onset was 4(1) years. With-in group analysis showed that the group received prolong speech protocol {F=25.24(2), p

Background: The stuttering is manifested by disruption in normal speech flow and fluency that also disturbs social and emotional wellbeing. There is immediate need of rehabilitation for the improvement of fluency and reduce the severity of stuttering.Objective:To compare the digital manipulation of thyroid cartilage (DMTC), fluency shaping therapy (FST) and combination of DMTC and FST for improving severity in stuttering patients. Material and Method: A randomized clinical trial was conducted at National Institute of Rehabilitation Medicine. The patients were enrolled through non-probability, convenient sampling technique. The participants were randomly allocated into three equal groups (n=10): DMTC group, FST group and combination of both. The Scale of Rating Severity of Stuttering (SRSS) was used to assess the severity level at baseline, 2ndweek, 4thweek, 8thweek and 12thweek of intervention.Results: The mean age of DMTC, FST and combination group was, 22.25 ±3.33 years, 21.65±3.36 and 21.35±3.76 years respectively. Friedman with post hoc test revealed significant improvement (p

Background: Osteoarthritis (OA) is a persistent joint disorder, which normally affects the weight bearing joints especially knee joint. Lateral wedge insole is one such approach suggested by professionals to manage the knee osteoarthritis. Objective: To determine the effectiveness of lateral wedge insoles on knee osteoarthritis outcomes in Pakistani population Design: A single-blinded, pretest-posttest comparison. Setting: District Headquarter (DHQ) Hospital, Bahawalnagar and National Institute of Rehabilitation Medicine (NIRM), for a time period of one month. Population: Patients with the age criteria of 40-70 years, and who had knee OA were included in the study. Methods: Participants were randomly divided in two groups; lateral wedge insoles (LWI) group (n=20), and conventional physical therapy (CPT) group (n=20). Pain, stiffness, activities of daily living, sports and recreational activities, and quality of life was assessed on Urdu version of Knee Injury and Osteoarthritis Outcome Score scale (KOOS) on every week till 4th week of intervention. Mixed ANOVA was used for interaction effect of between-subject factor (group) and within-subject factor (time) with-in group analysis and one way ANOVA for between group comparisons with their effect size (ɳp2). Results: Significant improvement with large effect size was observed in Symptoms and stiffness (p

Seismic numerical modeling technique provide most suitable way for the simulation of wave propagation through subsurface rocks and play an essential role in seismic interpretation, seismic inversion and in evaluating and designing a seismic survey. In order to delineate subsurface more precisely, different approaches are proposed for numerical modeling in which the solutions of Biot’s poroelastic equation are given by using reflectivity, finite element and finite difference algorithms. In current study, a finite difference forward modeling method is proposed to quantify the variation in wave properties during its propagation in a poroelastic media exhibiting mesoscopic heterogeneity due to the existence of three phase fluids. The Biot’s poroelastic wave equations are resolved and a generalized finite difference technique in time domain (FDTD) is used to examine seismic responses in a poroelastic media saturated with three phase fluids. So that the ability to detect geo-fluids through forward modeling technique can be improved. The accuracy of the simulation will lay a good foundation for the follow up work and will enhance our understandings about wave propagation through multi-phase poroelastic media and will also assist in detection and discrimination between fluids of different nature. Also, the proposed approach is of great significance for imaging and prediction of subsurface structures and distribution of fluids.

Background: Urdu syntax is diverse in nature and does not relate to parameters established for English syntax in many ways. Speech-Language Pathologists’ (SLPs) assessments based on Ages of Acquisition (AoA) of spatial prepositions cannot be standardized for Pakistani Urdu speaking children until ages of emergence of these prepositions are determined in this population. Objective: to explore ages of acquisition of spatial prepositions in young Pakistani Urdu speaking children. Methodology: This cross-sectional survey explored AoA of spatial prepositions in a sample of N=370 (boys= 128, girls=242) young Urdu speaking children aged 24-48 months residing in Islamabad. Urdu prepositions checklist was given to the parents (mothers=242, fathers=32), teachers (n=63) and significant others (n=33), to fill in accordance to spontaneous speech of their children . Data were descriptively analyzed using SPSS version 21. Results: Urdu spatial prepositions اوپر /uːpər/ (Up/above/on) and نیچے /niːʧæ/ (down/below/under) were acquired in 24-26 months of age and by 42-48 months these were mastered by 89.3% and 88.6% of within age group participants respectively. Spatial prepositions acquired in 30-35 months were آگے /ɑːɡeɪ/ (in front of), پیچھے /piːʧʰæ/ (behind) and ساتھ /sɑːθ/ (beside) with percentages 67.3%, 56.4% and 72.7% respectively. Preposition درمیان /d̪rmjɒn/ (between) was acquired in 42-48 months with response percentage 52.8%. AoA of preposition بیچ میں /biːtʃ meɪ/ (in the middle of) can be considered as later than 48 months because even in highest age limit group i.e., 42-48 months only 49.3% participants acquired this preposition. Conclusion: The findings of current study indicate that acquisition of spatial prepositions follows same order in all children cross-culturally but their age of acquisition can vary according to their locality and language input provided to them.

Background: Hearing impairment is considered as one of the major contributor of drop in low self-esteem of adolescents. Children and adolescents with significant hearing loss have difficulties like communication and social skills in different aspects of their quality of life which later on lead to anxiety, depression and social isolation. Objective: To find out the impact of gender and degree of hearing loss in children and adolescents not using hearing aid. Methodology: A cross sectional survey was conducted in Khyber Pakhtunkhwa. Total participants were 551 selected between 9-15 years age , with mild and moderate degree of hearing loss with no history of using hearing aid. The Rosenberg self-esteem scale was used to measure the self-esteem level. The data was analysed through multiple linear regression testing SPSS version 21. Results: The mean age of the study participants was 12.38±1.773 year. The degree of hearing loss and the gender were statistically significant predictor {F (df) =157.636(2,548), p

In this paper, for the first time, we apply symmetric $ q $ -calculus operator theory to define symmetric Salagean $ q $-differential operator. We introduce a new class $ \widetilde{\mathcal{H}}_{q}^{m}\left(\alpha \right) $ of harmonic univalent functions $ f $ associated with newly defined symmetric Salagean $ q $-differential operator for complex harmonic functions. A sufficient coefficient condition for the functions $ f $ to be sense preserving and univalent and in the same class is obtained. It is proved that this coefficient condition is necessary for the functions in its subclass $ \overline{\widetilde{\mathcal{H}}_{q}^{m}\left(\alpha \right) } $ and obtain sharp coefficient bounds, distortion theorems and covering results. Furthermore, we also highlight some known consequence of our main results.

Purpose: Cell phone has become an important part of our lives. Everyone owns a cell phonewhether it is a child or an elder. Cell phones can perform almost every operation related to workoranything.Itisavailableforindividualsatanyplaceortime.Themainpurposeofourstudywasto find out how smart phones and their wide mix of features, have been making an impact on thesociety in case of their real-life interactions. It’s important to find out what’s the link between thesmartphonesandsocialinteractions. Methodology:Thestudyincludeda12-questionsurveythataskedquestionsif the participants own a cell phone, about participants’ daily use of smartphones, including thehoursspentusingthem.Therewere26participantsinthestudy,amongthem50%weremalesand50%were females.The data obtainedfrom the surveywerecompiledintopie-charts. Findings: The following conclusions were developed based on our research. The participants from age group between 16 and 20 are most affected socially with the use of cell phones. The participants from young age group have more daily usage of cell phones as compared to the elderly ones. The individuals from young age group mostly use smart phones as their means of entertainment while the elders use it for work and communication purpose. Most of the individuals think that cell phone has made their life easier. Implications: The advancement of mobile technology has many uses but at the same time has been limiting individual’s ability because people totally rely on technology instead of challenging their brain.

The main purpose of this study is to shed light on the relationship between corporate governance, tax avoidance, and corporate social responsibility disclosure in emerging and frontier markets Nigeria and Pakistan, respectively. The current study employs a unique set of datasets about 91 companies from the Nigeria Stock Market and 121 companies from the Pakistan Stock Market for the period of ten years from 2011 to 2020. We used a fixed effect regression model to analyze the panel data. From the analysis, we find that corporate social responsibility is positively and significantly associated with tax avoidance in the case of Nigeria. Meanwhile, CSR has a positive but insignificant effect on tax avoidance in the case of Pakistan. However, board nationality shows a positive and insignificant impact on CSR, whereas board independence, board ownership, board diversity, and board size are negatively and insignificantly associated with CSR in Nigerian firms. In the case of Pakistani firms, both board ownership and board independence are positively and insignificantly associated with CSR, though board nationality has a negative but significant relationship with CSR, and board diversity and board size are negatively and insignificantly related to CSR. The paper’s findings have vital implications for policymakers, academics, and capital market users in the frontier and emerging economies. It has better significance for the government and companies to pay attention to CSR.

Objective: To establish the accuracy of computed tomography(CT) chest in the diagnosis of COVID-19 pneumonia by taking reverse transcriptase-polymerase chain reaction(RT-PCR) as a reference standard and to analyze discordant CT chest and RT-PCR results. Materials and Methods: A retrospective cross-sectional study of patients presented to a tertiary health care hospital in Punjab, Pakistan for CT examination with suspicion of COVID-19 from April 1, to June 30, 2020. Each CT chest was categorized as positive/negative for COVID-19 pneumonia and the results were compared with the RT-PCR test. Discordant CT chest and PCR results were also investigated. Results: The study population had a mean age of 48 years ± 6.6 years with 54.5% males and 45.4% females. Sensitivity(Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CT in diagnosing COVID-19 pneumonia taking RT- PCR as the gold standard was 92.5%, 46.6%%, 82.2%, 70%, and 80% respectively. Conclusion: CT chest has high sensitivity but modest specificity in the diagnosis of COVID-19 pneumonia. It can be employed as an adjunctive screening and diagnostic test for early diagnosis of disease in places where disease prevalence is high.

Abstract Background Most of the head and neck cancers are time-critical and need urgent surgical treatment. Our unit is one of the departments in the region, at the forefront in treating head and neck cancers in Pakistan. We have continued treating these patients in the COVID-19 pandemic with certain modified protocols. The objective of this study is to share our experience and approach towards head and neck reconstruction during the COVID-19 pandemic. Results There were a total of 31 patients, 20 (64.5%) were males and 11 (35.4%) patients were females. The mean age of patients was 52 years. Patients presented with different pathologies, i.e. Squamous cell carcinoma n = 26 (83.8%), mucoepidermoid carcinoma n = 2 (6.4%), adenoid cystic carcinoma n = 2 (6.4%) and mucormycosis n = 1 (3%). The reconstruction was done with loco-regional flaps like temporalis muscle flap n = 12 (38.7%), Pectoralis major myocutaneous flap n = 8 (25.8%), supraclavicular artery flap n = 10 (32.2%) and combination of fore-head, temporalis major and cheek rotation flaps n = 1 (3%). Defects involved different regions like maxilla n = 11 (35.4%), buccal mucosa n = 6 (19.3%), tongue with floor of mouth n = 6 (19.3%), mandible n = 4 (12.9%), parotid gland, mastoid n = 3 (9.6%) and combination of defects n = 1 (3%). Metal reconstruction plate was used in 3 (9.6%) patients with mandibular defects. All flaps survived, with the maximum follow-up of 8 months and minimum follow-up of 6 months. Conclusion Pedicled flaps are proving as the workhorse for head and neck reconstruction in unique global health crisis. Vigilant use of proper PPE and adherence to the ethical principles proves to be the only shield that will benefit patients, HCW and health system.

In this paper our aim is to study some valuable problems dealing with newly defined subclass of multivalent $q$-starlike functions. These problems include the initial coefficient estimates, Toeplitz matrices, Hankel determinant, Fekete-Szego problem, upper bounds of the functional $\left \vert a_{p+1}-\mu a_{p+1}^{2}\right \vert $ for the subclass of multivalent $q$-starlike functions. As applications we study a $% q $-Bernardi integral operator for a subclass of multivalent $q$-starlike functions. Furthermore, we also highlight some known consequence of our main results.

The main purpose of this article is to introduce a class of meromorphic functions associated with the symmetric points in circular domain. We investigate the necessary and sufficient conditions, distortions theorem for this class. Furthermore, we obtain closure and convolutions properties, radii of starlikeness and partial sum results for these functions.

Theories of fuzzy set and rough set are powerful mathematical tools for modelling various types of uncertainty. In this paper, we introduce the notions of bi-hyperideal, fuzzy bi-hyperideals of hyperquantales and their related properties is given. Furthermore we introduce the notion of generalized rough fuzzy bi-hyperideals. Moreover, we will describe the set-valued homomorphism and strong set-valued homomorphism of hyperquantales and some related properties will be study.

The uni-soft type of bi-ideals in ordered semigroup is considered. The notion of a uni-soft bi-ideal is introduced and the related properties are investigated. The concept of δ−exclusive set is given and the relations between uni-soft bi-ideals and δ−exclusive set are discussed. The concepts of two types of prime uni-soft bi-ideals of an ordered semigroup S are given and it is proved that, a non-constant uni-soft bi-ideal of S is prime in the second sense if and only if each of its proper δ−exclusive set is a prime bi-ideal of S. The characterizations of left and right simple ordered semigroups are considered. Using the notion of uni-soft bi-ideals, some semilattices of left and right simple semigroups are provided. By using the properties of uni-soft bi-ideals, the characterization of a regular ordered semigroup is provided. In the last section of this paper, the characterizations of both regular and intra-regular ordered semigroups are provided.

Background: The aim of this study was to validate and compare Guy's and S.T.O.N.E. scoring systems in predicting perioperative and postoperative outcome following percutaneous nephrolithotomy (PCNL). Materials and Methods: From November 2015 to June 2017, 190 patients with renal stones who underwent single tract unilateral PCNL in the prone position were included in our study. Guy's and S.T.O.N.E. nephrolithometry scores were calculated in each case based on preoperative computed tomography images. The association of these scoring systems with stone-free status, length of hospital stay, operative time, and postoperative complications was studied. Regression analysis was done, and receiver operating characteristic curves were plotted. Results: Mean S.T.O.N.E. and Guy's stone scores were 8.76 ± 2.29 and 2.70 ± 1.0, respectively. When compared with patients with residual stones, stone-free (SF) patients had significantly lower mean Guy's score (2.58 ± 1.01 vs. 3.23 ± 0.77 [P < 0.001]) and S.T.O.N.E. scores (8.44 ± 2.24 and 10.17 ± 2.0 [P < 0.001]), respectively. On logistic regression analysis, both Guy's score (odds ratio [OR] = 0.48, P = 0.001) and S.T.O.N.E score (OR = 0.78, P = 0.001) were found to be significantly associated with SF status. Both of these scoring systems were also significantly associated with longer operative time (>90 min), prolonged hospital stay (>3 days) and overall complications. No significant difference was found in the area under curve for both scoring systems for stone clearance. Conclusion: Both the S.T.O.N.E and Guy's scoring systems were found to predict the outcome of PCNL, either of these could be used in the routine clinical practice for patients' counseling.

ABSTRACT Objectives: Objectives of this study are to do the analysis of chest X-ray and High-resolution CT scan findings in patients who are clinical suspects of COVID-19 infection. The other objective is to classify the radiological findings in mild, moderate or severe diseases according to BSTI criteria for chest X-ray and CTSS for high-resolution CT scan. Methods: This is a cross-sectional descriptive study. A group of 50 patients who were clinically suspected cases of COVID-19 infection, presented to Corona flu filter clinic of Holy Family Hospital (HFH) or admitted to corona isolation wards were included. The time duration of the study was from 15 May 2020 to 15 June 2020. Patients labelled as clinically suspected cases were having positive contact with confirmed positive (based upon positive PCR) patients. Recent travel history from the area having an outbreak. They were having clinical signs/symptoms of fever, cough, and shortness of breath, lethargy and loss of sense of smell or taste. CXR and HRCT was the investigation of choice for all the 50 patients. I also did PCR to make a correlation with the other two tests. All radiological findings were analyzed based upon Fleischner society glossary of terms for thoracic imaging. Two radiologists then assessed CXRs findings based upon BSTI criteria. They marked those CXR findings as low, moderate and high probability for COVID-19 infection. HRCT findings were analyzed using CT-SS, and researchers labelled outcomes as mild, moderate and severe disease. Results: Out of 50 patients, 33(66%) were males, and 17(34%) were females. Mean age was 51 with ages ranging from 30-72 years. Presenting complaints were fever in 42(84%) patients, cough in 37(74%), lethargy in 33(66%), shortness of breath in 41(82%) and loss of sense of smell and taste in 21(42%) patients. Out of these 50, 32(72%) were having positive PCR for COVID-19 infection. On CXR 5(10%) patients showed classic findings which were highly probable for COVID-19. 19(38%) patients showed intermediate results for COVID-19, 7(14%) patients had a low probability of COVID-19 infection on CXRS. Out of 50, 19(38%), patients showed normal CXR with no evidence of COVID-19 infection. We did HRCT of the same patients on the same day; it showed 21(42%)patients with mild disease,23(46%)patients with moderate disease and 6(12%)patients with the severe disease according to CTSI.HRCT of 3(6%)patients was ok with no evidence of illness in bilateral lungs. Conclusion: The role of radiology is crucial in the diagnosis of this viral illness. CXR, with its ability to detect changes of COVID-19 in lungs, should be used as a first-line imaging modality in clinically suspected patients. Moreover, it should also be used for follow up of patients with COVID-19. HRCT is very sensitive in the diagnosis of COVID-19 infection in its milder forms. Due to lack of its widespread availability in countries with inadequate medical facilities, it was not the primary imaging tool/screening tool. Due to risk of infection to radiological staff as well as non-covid-19 patients due to surface contact, due to reduced infection control issues, due to increased burden of ionizing radiations in patients. All these factors limit the role of HRCT as a primary imaging modality for COVID-19 infection

Thymic CYSTs of the mediastinum are rare. It has been reported that their incidence is between 1 to 4.8%. They usually present as an asymptomatic mediastinal mass and are mostly found incidentally. This study reports a rare presentation of a mediastinal thymic CYST in a 50-year-old male, whose chronic right sided chest pain prompted him to visit a local hospital where his chest x-ray revealed a large mediastinal mass at the right cardiophrenic angle. His chest CT revealed a large multilocular hypodense cystic lesion that was resected completely by median sternotomy. On Histopathological examination, Hassals corpuscles confirmed the diagnosis of thymic CYST.

Abstract:: The present study was conducted to describe the variations in morphological characteristics of different selected populations of indigenous chickens. Five populations of chickens in different (localities) of Chhajjian, KP, Pakistan, were studied based on qualitative traits recorded for a total of 100 chickens. Each of the study populations contains multiple variants of plumage colors and other physical features. The average flock size was observed to be 38. Predominant plumage color was grayish and other mixtures along with different percentages in different localities. Pea comb was the dominant comb type in all localities. Most of the chickens were yellow skinned. Males in all populations were heavier and taller than the females. This recorded variation in morphological traits will help in the conservation of these chickens.

BackgroundImage-guided tissue biopsies are critically important in the diagnosis and management of cancer patients. High-yield samples are also vital for biomarker and resistance mechanism discovery through molecular/genomic analyses.Patients and MethodsAll consecutive patients who underwent plugged image-guided biopsy at Royal Marsden from June 2013 until September 2016 were included in the analysis. In the next step, a second cohort of patients prospectively treated within two clinical trials (PROSPECT-C and PROSPECT-R) were assessed for the DNA yield from biopsies assessed for complex genomic analysis.ResultsA total of 522 plugged core biopsies were performed in 457 patients [men, 52%; median age, 63 years (range, 17–93)]. Histological diagnosis was achieved in 501 of 522 (96%) performed biopsies. Age, gender, modality, metastatic site, and seniority of the interventionist were not found to be significant factors associated with odds of failure on a logistic regression. Seventeen (3.3%) were admitted due to biopsy-related complications; nine, three, two, one, one, and one were admitted for grade I/II pain control, sepsis, vasovagal syncope, thrombosis, hematuria, and deranged liver functions, respectively; two patients with right upper quadrant pain after liver biopsy were found to have radiologically confirmed subcapsular hematoma requiring conservative treatment. One patient (0.2%) developed grade III hemorrhage following biopsy of a gastric gastrointestinal stromal tumor (GIST). Overall molecular analysis was successful in 89% (197/222 biopsies). Prospective validation in 62 biopsies gave success rates of 92.06 and 79.03% for DNA extraction of >1 μm and tmour content of >20%, respectively.ConclusionThe probability of diagnostic success for complex molecular analysis is increased with plugged large coaxial needle biopsy technique, which also minimizes complications and reduces hospital stay. High-yield DNA acquisition allows genomic molecular characterization for personalized medicine.

Introduction: Chest X-ray and Computed tomography(CT) of chest play an important role in the diagnosis and management of the Coronavirus disease (COVID-19). As chest CT may not be readily available in most clinical setups X-ray Chest plays a pivotal role in such clinical scenarios and an irreplaceable initial radiological investigation of these patients. Objective: The objective of this article is to identify and elaborate the commonest appearances and patterns of lung changes on Chest X rays in COVID-19 positive patients confirmed on RT-PCR COVID testing. Materials and Methods: Cross-sectional descriptive-analytical study of Chest X-ray findings of 294 RT-PCR confirmed COVID-19 patients admitted across 3 hospitals (Rawalpindi institute of urology (RIU), Benazir Bhutto Hospital (BBH) and Holy Family Hospital (HFH)) from March 30th, 2020 till April 30th, 2020. CXR was analyzed for consolidation patches, ground-glass opacification (GGO), multi-lobe involvement, bilateral distribution, and pleural fluid. The chest X-ray with positive findings was graded into mild, moderate, and severe grades using BSTI (British Society of Thoracic imaging) guidelines. Results: Mean age of study patients was 45.5 years. Among the study population 230 (78.2 %) were male and 64 (21.8%) female. On baseline chest X rays, consolidations were the commonest finding (n=84, 28.5%), followed by ground-glass opacity (n=17, 5.7 %). The more common locations were peripheral and lower zones, and the majority had bilateral lung involvement (Table 1). Pleural effusions were found in only 5 of the study patients. Among these patients, 187 (63.6%) had an initial normal chest X-ray. Moreover, 35, 34, and 38patients had mild, moderate, and severe diseases respectively. Conclusion: Chest X-ray is an important initial radiological investigation for COVID 19 patients and plays an important role in the management during the course of the disease.

In recent years, special functions such as Bessel functions have been widely used in many areas of mathematics and physics. We are essentially motivated by the recent development; in our present investigation, we make use of certain conic domains and define a new class of analytic functions associated with the Dini functions. We derive inclusion relationships and certain integral preserving properties. By applying the Bernardi-Libera-Livingston integral operator, we obtain some remarkable applications of our main results. Finally, in the concluding section, we recall the attention of curious readers to studying the q-generalizations of the results presented in this paper. Furthermore, based on the suggested extension, the (p,q)-extension will be a relatively minor and unimportant change, as the new parameter p is redundant.

The data provided in this data set is the study of organic-inorganic hybrid perovskite solar cells fabricated through incorporating the small amounts of ammonium halide NH4X (X = F, Cl, Br, I) additives into a CH3NH3PbI3 (MAPbI3) perovskite solution and is published as “High-Performance CH3NH3PbI3 Inverted Planar Perovskite Solar Cells via Ammonium Halide Additives”, available in Journal of Industrial and Engineering Chemistry [1]. A compact and uniform perovskite absorber layer with large perovskite crystalline grains, is realized by simply incorporating small amounts of additives into precursor solutions, and utilizing the anti-solvent engineering technique to control the nucleation and growth of perovskite crystal, turning out the enhanced device efficiency (NH4F: 14.88 ± 0.33%, NH4Cl: 16.63 ± 0.21%, NH4Br: 16.64 ± 0.35%, and NH4I: 17.28 ± 0.15%) compared to that of a reference MAPbI3 device (Ref.: 12.95 ± 0.48%). In addition, this simple technique of ammonium halide addition to precursor solutions increase the device reproducibility as well as long term stability. Keywords: CH3NH3PbI3 perovskite, Inverted planar structure, Ammonium halide additives, anti-solvent engineering, Perovskite grain size

Objective: To determine the effectiveness of kinesio taping (KT) with oromotor exercises (OME) in improving drooling in children with cerebral palsy. Material and Methods: A randomized control trial (RCT) was conducted at National Institute of Rehabilitation Medicine (NIRM). Forty eight CP children, age ranged 4-8 years, having good head control and fair comprehension for verbal commands with drooling severity ≥ 3 rated on Thomas Stonells drooling scale were included in the study. The n=48 CP children were equally divided into two groups. Group A (n=24) participants were given an hour time which included taping of orbicularis oris muscle followed by oral motor exercises. Group B (n=24) participants were given the same treatment except there was only application of Kinesio taping of orbicularis oris muscle without oral motor exercises. The participants were assessed 5 times; at week 0 (Baseline) and then during intervention at week 4, week 8, week 12 and finally at week 16 after completion of intervention. Data was collected through Thomas Stonells drooling scale and drooling impact scale. Data was analyzed by using SPSS version 21. For presentation of categorical and demographic variables, mean and standard deviation were used. RM-ANOVA was used to analyze changes within the groups and independent samples t-test was used for differences between the groups. Results: The mean age in group A is 3.93±1.7 years and the mean age in group B is 3.66±1.26 years. The result showed significant improvement within both groups (p≤0.05). Between groups comparison revealed more significant decrease in drooling severity and its impact in group A (KT+OME) as compared to group B (KT) at p≤0.05. in case drooling frequency no significant difference was observed. Conclusion: The results of the study indicated that kinesio tapping along with oro-motor exercises were more effective management option for drooling severity and impact on CP children life. Keywords: Cerebral palsy, drooling, kinesio tapping, oro-motor exercises, Thomas Stonells drooling scale, drooling impact scale.

OBJECTIVE: To compare the effectiveness of digital manipulation of thyroid cartilage (DMT) with Fluency Shaping Therapy (FST) for the management of stuttering in adults. METHODS: This randomized clinical trial was conducted in Speech-Therapy department of National Institute of Rehabilitation Medicine Islamabad. Twenty male adult patients were recruited in the current study through non-probability, convenience sampling. The participants were randomly allocated into two equal groups (n=10): DMT group & FST group. Scale of rating severity of stuttering was used to assess the severity level at baseline and after the completion of 24 training sessions. Three vowel approaches with four sets of 5-repetition each were performed for each vowel in DMT group. Training in FST group comprised of speech techniques like easy onset, prolongation of speech, continuous phonation and light articulatory contact in reading and conversation in three speaking situations (speaking with therapist, reading aloud and free conversation). RESULTS: Mean age of the participants in DMT group was 21.4±2.2 years and FST group was 20.9±3.2 years. At baseline, there was no significant difference between DMT and FST groups regarding the severity of stuttering (5.3±0.94 vs. 5.6±0.96; p=0.492). As a result of 12 weeks of treatment, both groups demonstrated significant improvement (p

In this paper we define a new class k −Umα [A,B] of Janowski type k−uniformly alpha convex functions. We use the method of differential subordinations theory to obtain some new results like sufficient condition, inclusion relations, coefficient estimate and covering properties. The results presented here include a number of well-known results as their special cases.

District Charsadda is a very important center of plant biodiversity in the central plain of Peshawar valley, Pakistan. The present study was carried out during March 2015 to April 2016 to investigate the ethnobotanical profile of common weed flora present in district Charsadda, KP, Pakistan. The study revealed that there were 40 weed species belonging to 21 families. Among them 25 weeds were annual herb, 9 weeds were perennial herb, three were annual grass, one was climbing herb, one was the parasitic weed, and one was rhizomatic grass. The dominant families were Asteraceae, Fabaceae and poaceae having 5 species (12.5%) each followed by Ranunculaceae 3 species (7.5%). plants were systematically arranged into botanical names, local names, families, habit, habitat, partly used, flowering periods, locality and ethnobotanical uses. The main aim of the study is the documentation and ethnobotanical information of the weed flora growing in the area.

The microflow equipment monitored with micro X-ray computerized tomography (CT) is employed to investigate the microoccurrence of the irreducible water in a low-permeability sandstone core. By means of image segmentation and the three-dimensional (3D) image reconstruction technique, the visual microdistribution characteristics of irreducible water in two-dimensional (2D) slices and the 3D pore-throat system are quantitatively evaluated. Some interesting findings are list as below. Firstly, due to the variant micro geometric structures of the pore-throat systems, specific core slices showed significantly different irreducible water saturation even though these slices had same areal porosity. Secondly, due to the influence of capillary trapping and the existence of oil-wetting clay (main chlorite), the irreducible water saturation in the throat system (64%) is much larger than that in the pore system (36%). Furthermore, the wetting phase (irreducible water) did not spread all over the surface of the pore-throat network which caused a much more complicated oil-water two-phase interface. Thirdly, in micro scale, the main irreducible water occurrence mode in the pore system is much different from that in the throat system. In the pore system, the irreducible water principally existed in the corner of the pores which are linked through a water film. While in the throat system, the irreducible water occurrence is dominated by the water film. However, 25.5% of the throats are blocked by the irreducible water which cut off the crude oil drainage channels.

Hodgkin’s lymphoma and disseminated Mycobacterium avium complex (MAC) infection share similar clinical features; both may affect human immunodeficiency virus (HIV)-positive individuals. We discuss a patient with poorly controlled HIV-infection presenting with chest sepsis, dyspnoea and weight loss. Whilst the initial working diagnosis was that of MAC infection, pathology results had not met diagnostic criteria. Lymph node biopsy instead revealed classical Hodgkin’s lymphoma. We discuss the role of radiological examination in cases of diagnostic uncertainty.

The aim of the pictorial review are to review the HIV manifestations within the gastrointestinal tract. We have detailed five conditions, with reference to the patients’ CD4 count – gastrointestinal tuberculosis, Kaposi’s sarcoma, small bowel lymphoma, cytomegalovirus colitis and anal carcinoma.

ABSTRACT: BACKGROUND: Febrile seizures (FS) affect 3-4% of children under the age of 5 years. It is benign and has an excellent prognosis. Male children with family history of febrile seizures, low serum calcium, sodium & blood sugar and microcytic hypochromic anemia are more prone to FS. Iron deficiency has been postulated to contribute to FS as it has a key role in brain energy metabolism, myelination, long term behavioral changes and cognitive impairments. PATIENTS AND METHODS: A case-control study was conducted in the Department of Pediatrics Allied Hospital, Faisalabad from December 2014 to November 2015. Forty five children with fever and seizures and 45 children with fever but no seizure, of age 6 months to 60 months, were recruited. Blood samples of the children were obtained. Serum ferritin and Mean Corpuscular Volume (MCV) levels were assessed. Iron deficiency was labeled at Serum ferritin

Objectives: Primary retroperitoneal mature cystic teratomas are exceedingly uncommon in males aged 50 years and above, and only seven cases have been reported in the literature so far. They usually occur in infants less than 6 months and young females. The aim of this article is to present a rare case of a 51-year-old male with a primary retroperitoneal mature cystic teratoma located in the right infrarenal area adherent to the psoas muscle and to discuss a historical literature review. Methods: An incidental hypoechoic, solid appearing 8.2 × 7.6 × 7.8 cm 3 mass arising off the inferior pole of the right kidney was found on abdominal ultrasound during evaluation for a history of alcoholism. Computerized tomography (CT) scan revealed small calcifications in the lower part of the cystic mass. Laparotomy with excision of the retroperitoneal mass was performed. Results: On gross examination, the specimen consisted of a cyst filled with pale yellow greasy material with entrapped hair. Histopathologic examination revealed a dermoid cyst with focal chronic inflammation, dystrophic calcification, and foreign-body giant cell reaction. Conclusions: Retroperitoneal mature cystic teratoma in an older male is extremely rare. Primary gonadal teratoma with retroperitoneal metastasis should be excluded first. Evaluation of age and location of tumor are critical for its prognosis. Complete excision of tumor is necessary to evaluate whether there are immature and solid elements which need long-term follow up due to the increased risk of malignancy.

Due to the strong heterogeneity between the fracture and the matrix in fractured oil reservoirs, injected water is mainly moved forward along the fracture, which results in poor water flooding. Therefore, it is necessary to reduce the water cut and increase oil production by using the conformance control technology. So far, gel particles and partially hydrolyzed polyacrylamide (HPAM)/Cr3+ gel are the most common applications due to their better suitability and low price. However, either of the two alone can only reduce the conductivity of the fracture to a certain extent, which leads to a poor effect. Therefore, to efficiently plug the fracture to enhance oil recovery, a combination of gel particles and the HPAM/Cr3+ system is used by laboratory tests according to their respective advantages. The first step is that the gel particles can compactly and uniformly cover the entire fracture and then the fracture channel is transformed into the gel particles media. This process can enhance the oil recovery to 18.5%. The second step is that a suitable HPAM/Cr3+ system based on the permeability of the gel particles media is injected in the fractured core. Thus, the fracture can be completely plugged and the oil in the matrix of the fractured core can be displaced by water flooding. This process can enhance oil recovery to 10.5%. During the whole process, the oil recovery is increased to 29% by this method. The results show that this principle can provide a new method for the sustainable and efficient development of fractured oil reservoirs.

By using a certain general conic domain as well as the quantum (or q-) calculus, here we define and investigate a new subclass of normalized analytic and starlike functions in the open unit disk U . In particular, we find the Hankel determinant and the Toeplitz matrices for this newly-defined class of analytic q-starlike functions. We also highlight some known consequences of our main results.

We present the synthesis of 2-ferrocenylbenzoic acid (FcOH) and its electrochemical and spectroscopic characterization. FcOH was characterized for interaction with DNA using theoretical and experimental methods. UV-visible spectroscopy and cyclic voltammeter (CV) were used for the experimental account of FcOH-DNA complex. The experimental results showed that the FcOH interacts by electrostatic mode. The binding constant (Kb) and Gibbs free energy (ΔG) for the FcOH-DNA complex have been estimated as 5.3 × 104 M−1 and −6.44 kcal/mol, respectively. The theoretical DNA binding of FcOH was studied with AutoDock molecular docking software. The docking studies yield good approximation with experimental data and explain the sites of binding.