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Mini-Percutaneous Nephrolithotomy (Mini-PCNL) and Retrograde intra-renal surgery (RIRS), can be carried out in a single stage or numerous phases depending on the burden, size, and/or location of the stone. Objective: To check the efficacy of Mini-Percutaneous Nephrolithotomy and Retrograde intra-renal surgery on adult patients with a renal stones. Methods: A total of 101 patients were included who underwent RIRS (n=51) or mini-PCNL (n=50) at Doctors Hospital Jail Chowk in Gujrat, Pakistan in 2021. Retrospective observations were made on 101 individuals who received RIRS or mini-PCNL. Results: The mean hospital stay time was significantly lower in RIRS group i.e., 01.81 ± 0.59 days as compared to mini-PCNL group (p value

Obesity is an excessive accumulation of fat in the body and is measured in terms of increased body mass index. Its prevalence is increasing in all age groups and is now considered to be a global epidemic. Albumin is the most abundant plasma protein synthesized in the liver and is customarily utilised to detect malnourishment and severe starvation. It is one of the poor prognostic factors in medical, surgical, and critically ill patients. Objective: To identify the relationship between obesity and morbid obesity and hypoalbuminemia in adults in Pakistan with no signs of liver or kidney disease. Methods: Jinnah Allama Iqbal Institute of Diabetes and Endocrinology (JAIDE), Jinnah Hospital Lahore Pakistan, was chosen for the completion of this cross-sectional study with a time frame of October 2019 to April 2020. 90 patients, ranging between ages of 18 and 70 years, without liver and kidney diseases, were recruited and were divided into three categories, healthy control, obese, and morbidly obese on the basis of BMI. Venous blood samples for albumin were taken. Results: The percentage of hypoalbuminemia was 10.0% in healthy controls, 40.0% in the obese group, and 46.7% in morbidly obese. Hypoalbuminemia rate was significantly higher in obese and morbidly obese groups (p-value 0.005) as compared to healthy controls, independent of age, sex, and diabetes. Conclusions: Upon completion of this study, it was concluded that the morbid obesity and obesity are the independent forecasters of hypoalbuminemia.

Kidney stones, also known as renal calculi, are crystal concretions that primarily occur in the kidney and are referred to as nephrolithiasis. Ideally, calculi should form in the kidneys and pass out of the body through the urethra painlessly. Larger stones are uncomfortable and thus require surgery. Mini-percutaneous nephrolithotomy (mini-PCNL) and retrograde intrarenal surgery (RIRS) are the minimally invasive procedures employed these days to target renal stones. Objective: To compare the effectiveness of both mini-PCNL and RIRS in terms of targeting larger stones in adult patients along with other factors including hospital stay, operative time, stone passing rate and associated complications. Patients and Methods: In the year 2021, 101 patients undergoing mini-PCNL or RIRS in Doctors Hospital, Gujrat were observed in this study. Effectiveness of both the techniques, exposure time, transfusions required, stone free rates and hospital stay were compared in both groups of patients. Results: It was found that mini-PCNL has greater potential than RIRS in terms of stone clearing and operating time. However, RIRS has performed better in terms of reducing the hospital stay with mild complications in both the procedures. Conclusion: Both RIRS and mini-PCNL are extremely safe and highly efficient treatments for renal lithiasis with a diameter of 1.5 to 2.5 cm, and either one can be chosen to achieve outstanding stone-free rates.

The soil salinity causes physiological drought resulting in hindrance in the bio-availability of essential nutrients. The interaction between salinity and phosphorus uptake by plants is less explored. Two independent incubation experiments were conducted to study the distribution and transformation of various P fractions in normal and salt affected soils as influenced by various organic amendments application. In first experiment, three different levels of P (200, 400 and 600 mg kg-1 of soil) were applied in three soils differing in soil EC and SAR. Changes in various fractions of soil P (Ca2-P, Ca8-P, Al-P, Fe-P, Olsen-P) were estimated at different time intervals. All three soils behaved differently for P distribution among various fractions. Maximum available P (12.18 mg kg-1 ) was found in PROKA soil (saline sodic) at 400 mg kg-1 of P applied. In 2nd experiment, various organic amendments [farmyard manure (FYM), poultry manure (PM), crop residue (CR)] and sewage sludge (SS) were used, with and without adding P fertilizer @ 400 mg kg-1 to study their effect on changes in soil P, at different time intervals. Plant available Olsen-P fraction significantly increased after 90 days in all soils (normal, saline sodic, marginal saline sodic) with amendments FYM and PM but not as much with amendments CR and SS. Overall, increase in Olsen-P was higher with PM (23.2, 21.7 and 19.4 mg kg-1) and FYM (20.6, 17.6 and 20.6 mg kg-1) as compared with SS (14.3, 15.5 and 15.7 mg kg-1) and CR (12.9, 14.4 and 14.0 mg kg-1) in normal, saline sodic and marginal saline sodic soils, respectively. On the basis of these results, it was concluded that integration of PM and FYM with P level 400 mg kg-1 is an effective approach to mobilize more P available for plant uptake in normal and salt-affected soils with order of normal> saline sodic> marginal saline sodic.

Objective: To determine the frequency of haemophilus influenzae infection in children less than 5 years with acute bacterial meningitis (ABM). Study Design: Descriptive Cross Sectional study. Setting: Department of Pediatric Medicine, The Children’s Hospital and Institute of Child Health, Multan. Period: October 2019 to March 2020. Material & Methods: A total of 165 children aged 5 – 60 months of either gender having acute bacterial meningitis with duration of < 2 weeks were enrolled. Cerebrospinal fluid (CSF) of each child was sent for microbiological analysis. Results: There were 106 (64.2 %) boys and 59 (35.8 %) girls. Mean age was 2.72 ± 1.07 years. Most cases, 112 (67.9 %) belonged to urban areas. Maternal literacy was positive in 65 (39.4%) cases while 59 (35.8%) were fully vaccinated. Mean disease duration was 56.25 ± 15.36 hours and 112 (67.9%) had duration of illness more than 36 hours. Frequency of Haemophilus Influenzae was noted in 35 (21.2%) cases. Conclusion: Frequency of Haemophilus Influenzae was high among children with acute bacterial meningitis. Early diagnosis and appropriate management might help reducing prolonged hospitalization and disease morbidity related to Haemophilus Influenza.

Objective: To find out different species of plasmodium (P. falciparum and P. vivax) involved in children with malaria at a tertiary childcare hospital. Study Design: Descriptive, Cross-sectional study. Setting: Department of Paediatric Medicine, The Children’s Hospital and Institute of Child Health, Multan. Period: October 2019 to March 2020. Material & Methods: A total of 281 cases of either gender, aged 1 to 12 years and patients with malaria were enrolled. A special template was designed to record study information. Venous blood as five ml sample was drawn and dispatched to institutional laboratory for ICT malaria, complete blood count and giemsa stain smear and observed under light microscope. Data analysis was performed employing SPSS version 24.0. Results: Out of a total of 281 cases, 177 (63.0%) were male ande 104 (37.0%) female. Mean age of study participants was 4.29±2.48 years. A total of 135 (48.0%) children belonged to rural areas and 197 (70.1%) had monthly family income < 25000 rupees. Mean duration of illness was 4.21 ± 2.12 days. Previous history of use of anti-malarial drugs was noted in 62 (22.1%) of our study cases. Plasmodium falciparum was observed in 52 (18.5%) cases and plasmodium vivax in 229 (81.5%). Conclusion: Plasmodium vivax is predominantly more prevalent in our population as compared with plasmodium falciparum in children with malaria. Plasmodium falciparum and plasmodium vivax were significantly linked with age and disease duration. Malaria was noted to be more prevalent among poor families living in slum areas having inadequate sanitation facilities.

This paper presents a taxonomic study of genus Vincetoxicum s.str. from southern Asia. Eleven regional endemic species are recognized on the basis of herbarium studies and fieldwork. Three new species are described: V. lenifoliumsp. nov. (endemic to Pakistan), V. stewartianumsp. nov. (endemic to India), and V. subcanescenssp. nov. (endemic to Pakistan, Kashmir and Tibet). Three species names, V. cabulicum, V. glaucum and V. kenouriense, previously treated as synonyms of V. glaucum, V. canescens and V. hirundinaria, respectively, are resurrected. A neotype is designated for the Afghani endemic V. cabulicum. A lectotype is chosen from the syntypes of V. glaucum. We resolve the long-standing taxonomic problems in three species complexes: V. arnottianum, V. luridum, V. sakesarense, and V. stocksii; V. glaucum, V. canescens and V. cabulicum; and V. hirundinaria and V. kenouriense. Geo-taxonomic distinctions of southern Asian taxa are highlighted by excluding from henceforth the long misrecognized western Eurasian taxa V. canescens and V. hirundinaria. Furthermore, a detailed account of the genus including illustrations of whole plants, leaves and corona, distribution maps, a taxonomic key, morphological descriptions, synonymy, notes, and information on phenology, distribution and habitats is provided. Finally, provisional conservation assessments are provided, which indicate that V. cardiostephanum and V. sakesarense are critically endangered.

Purpose In drought-prone soils, plant growth-promoting rhizobacteria (PGPR) and arbuscular mycorrhizal fungus (AMF) might positively affect water uptake and crop yield via rhizosphere interactions. Methods Sole and combined additions of Bacillus amyloliquefaciens producing 1-aminocyclopropane-1-carboxylic acid (ACC) deaminase and Rhizophagus irregularis into rhizospheric soils were performed under well-watered (WW; 80% field water capacity), moderate water stress (MWS; 50% FWC) and severe water stress (SWS; 35% FWC) in pot-cultured wheat (Triticum aestivum L.). Results In moderate and severe drought stress, water use efficiency (WUEB) was increased by 27.9–34.3% in PGPR and 20-22.1% in AMF treatments, respectively, and grain yield was improved by 20.03–30.77% in PGPR and 12.13–34.34% in AMF treatments, respectively, compared with CK. Importantly, the co-inoculation of AMF and PGPR significantly promoted WUEB by 57.46–98.49% and grain yield by 131.82–94.94% compared to the average value of two sole inoculations in MWS and SWS treatments, respectively. Biomass production followed a similar trend as yield. Particularly, the above parameters were significantly enhanced with the prolonged developmental stages (p

This study aims to determine the factors of consumer willingness to buy gray-market goods. The authors considered the impact of gray-market products on the product's brand image through Pakistan's empirical evidence. This study included three factors of gray goods: price consciousness, price-quality inference, and risk averseness and to check their impact individually and collectively on brand image. A field survey was conducted in this study to check the respondent's behavior toward gray markets and its impact on their brand image. The respondents of this research were those individuals who were habitual buyers of gray-market perfume products. Therefore, the population size was large enough to apply the probabilistic sampling method of Simple Random Sampling. The sample size of 350 was determined adequately. Hence, 350 respondents were asked to fill the questionnaire. The instrument of this study was self-developed. The close-ended questions by a Likert scale (7 points) were used to collect quantitative data. The internal consistency of the data was checked through the «Cronbach's Alpha» value. Hence, Cronbach's alpha's value was 81.7%. It was more than 70% threshold and showed the data was reliable and internally consistent for further data analysis. Regression analysis was performed on the data set to test the significance of hypothesized hypothesis. The result indicated that overall, there was a significant positive impact of gray-market goods on the companies' brand image. This study concluded that price consciousness did not significantly impact the purchase of gray goods. Thus, consumers are not price-sensitive, particularly in the Pakistan market. At the same time, gray goods impact the brand image in the Pakistani context. Simultaneously, the price-quality and risk averseness factors of gray goods a concern. These factors showed that companies' brand image is affected negatively. The policy and market regulators must consider the two factors pointed out in this research to mitigate the problem of gray-market goods in the developing economies.

Background Cerebral venous thrombosis (CVT) is an uncommon cause of stroke in humans and the mainstay of treatment is anticoagulation unless contraindicated. Non-vitamin K oral anticoagulants have not been duly evaluated in randomized controlled trials in CVT. Objective To compare the efficacy and safety of oral rivaroxaban with vitamin K anticoagulant (warfarin) in preventing recurrent venous thromboembolism (VTE) in patients with CVT. Methods Adult patients with CVT, who were stable after 5–12 days of treatment with parenteral heparin 1 mg/kg, were screened for eligibility. The patients were randomly divided into two groups to receive oral rivaroxaban 20–30 mg daily or warfarin 1, 3 or 5 mg daily (with the dose adjusted to maintain an INR of 2–3), for 3–12 months. Recanalization rates, periprocedural complications, and clinical outcomes were assessed by Magnetic Resonance Venography (MRV) and National Institutes of Health Stroke Scale (NIHSS) at 3rd, 6th and 12th month follow-ups. Results In total, 45 patients with CVT were randomized to the two treatment groups (21 to rivaroxaban and 24 to warfarin). Overall recanalization was achieved by 18 (86%) and 20 (83%) cases from rivaroxaban and warfarin group, respectively at 6th month follow-up; and by all 45 (100%) cases from the both groups at 12th month follow-up. Excellent outcome (NIHSS score 0) was obtained by 20 (95%) cases from rivaroxaban group at 3rd to 12th month follow-ups; and by 23 (96%) cases at 6th to 12th month follow-ups. There were no major bleeding events during the trial. None of the patients developed recurrence of thrombosis. Statistically, no significant difference between the two treatment groups in terms of recanalization and clinical outcomes could be observed. Conclusion Rivaroxaban is a safe option in CVT however; larger randomized controlled studies will impact the results validity.

Post-harvest agricultural products are highly perishable due to containing higher moisture contents. Most of agricultural product need special storage like relatively low temperature and higher relative humidity to store for some time duration. In this regard, low cost Zero-energy cool chamber (ZEC) is constructed through locally available material for short-term storage of products. Thermodynamic evaluation of ZEC is mainly investigated by measuring its temperature and relative humidity in comparison with Outside/Ambient (OS) and Room (RM) conditions and its performance is based on evaporation rate that take place through medium. The cooling efficiency of ZEC is then determined under varying ambient conditions. The average temperature and relative humidity difference measured between ZEC and OS about 9°C and 45% respectively. Different analyses are performed including the comparison of physiological weight loss (PWL) and visual appearance (VA) for stored tomatoes at different three environmental conditions such as outside (OS), room (RM) conditions and zero energy cool chamber (ZEC). These analyses are performed on 1st, 4th, 8th, 12th, 16th, 20th, 24th, 28th, 32nd, 36th and 40th days of storage.

The higher relative humidity inside wet-markets results in the growth of pathogenic micro-organisms that affect qualitative and nutritive attributes of the products prompting epidemic health problems to the occupants as well as consumers. In this study, M-cycle evaporative cooler (MEC) coupled solid desiccant air conditioning system (DAC) was investigated for wet market applications in Punjab, Pakistan. The model of Beccali was used for performance investigation of the desiccant wheel while MEC and heat exchanger were evaluated by governing equations from literature. The study area (i.e. Punjab) was divided into four zones i.e. Northern Punjab (Z1), Upper Punjab (Z2), Central Punjab (Z3), and Lower Punjab (Z4) based on variations in environmental conditions. The results revealed that the proposed DAC system can effectively achieve optimum temperature and relative humidity conditions in the summer season in Z2, Z3, and Z4. However, the proposed system was not applicable in Z1 because of the lower temperature and humidity conditions in this zone.

Catheter ablation is indicated for the management of supraventricular tachycardias (SVTs). We investigated the effect of sex on short-term outcomes after catheter ablation for SVTs other than atrial fibrillation (AF). Using the Healthcare Cost and Utilization Project Nationwide Readmission Database for the years 2016-2018, SVT patients who underwent catheter ablation were identified using the appropriate International Classification of Diseases, 10th Revision, codes. The primary outcome was 30-day readmissions. Secondary outcomes included 30-day readmissions for SVT, postprocedural bleeding, acute myocardial infarction, transient ischemic attack, stroke, hemopericardium, cardiac tamponade, length of stay (LOS) in the hospital, and total hospital charges (in USD). Female sex was not associated with an increased risk of the primary outcome (

Chronic obstructive pulmonary disease (COPD) is a risk factor for the development of atrial fibrillation (AF). There is a paucity of contemporary data studying the association between COPD and outcomes of AF ablation. The objective of this study was to investigate the impact of COPD on AF ablation outcomes using a large nationwide database. This study was a retrospective analysis of the National Readmission Database for the years 2016-2018 and included patients admitted with a diagnosis of AF who underwent catheter ablation. Admissions were stratified according to COPD diagnosis using International Classification of Diseases, 10th Revision, Clinical Modification codes. Multivariate, linear, Cox, and logistic regressions were performed to study the impact of COPD on AF ablation. A total of 18,224 admissions (mean age, 68 years; standard deviation, 10 years) were included, of whom 3,494 (19%) had a diagnosis of COPD. The COPD group was older (72 ± 8 vs. 67 ± 11 years

To utilize wastes and residues sustainably and excellently, there is a need to fend for efficient methods and resources for biogas production. Use of poultry waste for biogas production represents one of the most important routes toward reaching global renewable energy targets. The current study involves microbial pretreatment of chicken feather waste, followed by its co-digestion with rice husk and green grocery waste in batch and continuous reactors, respectively. Microbial pretreatment of chicken feathers by keratinase secreting Pseudomonas aeruginosa was an effective and eco-friendly approach to make its recalcitrant structure available as a raw substrate for biogas production. The current study also addressed the enhancement and stability of anaerobic digestion by co-digestion. Results demonstrated that biogas production was increased by microbial pretreatment of chicken feathers and that the percentage increase in biogas yield was 1.1% in microbialy pretreated feathers compared to mono-digestion (non-pretreated feathers) in batch fermentation. The highest yield of biogas was obtained in a batch reactor having co-digestion of pretreated rice husk and microbial pretreated chicken feathers. The co-digestion of chicken feathers hydrolysate with green grocery waste in continuous fermentation mode has also enhanced the biogas yield as compared to average of mono-digestion (chicken feather hydrolysate and green grocery waste) and, therefore, improve the efficiency of the overall process.

The current study was aimed to enzymatically modify maize flour by using amylase and pullulanase in combination for increasing the yield of resistant starch type III (EM-RSIII). The enzymatic treatment imparts unique desired physicochemical properties to the maize flour including resistant starch content, amylose content, milk, oil, and water interaction ability. The sensory analysis was performed by distributing questioners among individual and results were interpreted by 5-point hedonic scale. Result indicated an increase in the stability, amylose content, and milk absorption capacity of maize flour, while a decrease in swelling power, water absorption, and oil absorption capacity. The enzymatic treated maize flour led to the transformation of amorphous native structure into a crystalline structure which was confirmed by light microscopy, scanning electron microscopy, X-ray diffractograms analysis, and in vitro digestibility of EM-RSIII. The EM-RSIII rich maize flour was used in cookies preparation and a significant difference in palatability and color parameters was observed. Crispiness and texture of EM-RSIII containing cookies was increased due to its low swelling power, water absorption, and oil absorption capacity. The sensory analysis showed that consumers depicted the highest acceptability of EM-RSIII supplemented cookies specifically for its appearance, sharp aroma, texture and accepted as nutritionally important food item for consumers.

Low use efficiency of nitrogen (N) and phosphorus (P) is major challenge of modern agriculture. Coating of conventional fertilizers with nanomaterials is a promising technique for improved nutrient use efficiency. In current study, nanoparticles (NPs) of potassium ferrite (KFeO2 NPs) were coated on di-ammonium phosphate (DAP) fertilizer with three rates (2, 5, 10%) of KFeO2 NPs and were evaluated for release of N, P, K and Fe supplementation in clay loam and loam soil up to 60 days. The NPs were characterized for crystal assemblage, bond formation, morphology and configuration using the x-ray diffraction (XRD), scanning electron microscope (SEM) and Fourier transform-infra red spectroscopy (FT-IR). The results showed that size of NPs ranged between 7 and 18 nm. The controlled release of P in 10% KFeO2 nano-coated DAP was observed throughout the incubation period. The P release kept on increasing from day-1 (14.5 µg g−1) to day-60 (178.6 µg g−1) in coated DAP (10%) in loam soil. The maximum release of 50.4 µg g−1 NH4+1-N in coated DAP (10%) was observed after 30 days of incubation. The release of NO3−1-N was consistent up to 45 and 60 days in clay loam and loam soil, respectively. The average release of potassium and iron in 60 days was 19.7 µg g−1 and 7.3 µg g−1 higher in 10% coated DAP than traditional DAP in clay loam soil. It was concluded that KFeO2 nano-coated DAP supplied P and mineral N for longer period of time in both soils, and some higher coating levels should be tested in future.

Abrasion has a strong relationship with the overall performance of fabrics. There are number of factors that have an impact of abrasive strength of textile materials. These include type of fiber, nature of yarn, yarn number, weave structure and type, number of interlacing in warp and weft. Abraded fabrics look bad in appearance and they no longer can be able to give required service for which they are intended to provide. This study aimed at determining the effect of various weave types on abrasive strength of cotton fabric. The fabric was manufactured through ring spinning technique with three weave structures such as plain, twill and satin. Manufactured fabrics were evaluated for their abrasive strength by following ASTM 4966 test standard. These were evaluated at various laundering intervals such as at 0, 5, 10 and 15. The mass loss in percentage of was then calculated. It was concluded that plain weave structure was the most strongest in terms of its abrasive strength followed by twill and satin. Small floats helped to make the fabric hold components yarns together and provide cohesion to the finished product. It is important for the textile manufacturers and fashion designers to look for various weave structures and their impact on products in order to make creative variations to attract their customers. Keywords: Abrasion; Plain; Satin; Twill; Washing Cycles; Weave http://dx.doi.org/10.19045/bspab.2020.90192

Metabolic syndrome is the condition that includes hypertension, increased blood sugar level, dyslipidaemia, fats around abdominal organs in abdominal cavity. In our study we conducted a survey to find out “pervasiveness of metabolic syndrome among Nurses and its alliance with anxiety as well as depression” in General hospital of Lahore City. Research design (survey & questionnaire) was based on quantitative and descriptive cross-sectional correlations. Samples were 100 percent of female nurses of Lahore general hospital Lahore. SPSS version 21 was used for data analysis. Demographic and descriptive analyses were carried out. This study suggested a weak alliance between variables of metabolic syndrome and anxiety as well as the variables of depression. This study suggests that there is need of adopting better strategies for providing better occupational health to nursing personnel’s in hospitals.

Thermoplastic processing and spinning of native starch is very challenging due to (a) the linear and branched polymers (amylose and amylopectin) present in its structure and (b) the presence of inter-and-intramolecular hydrogen bond linkages in its macromolecules that restrict the molecular chain mobility. Therefore, in this study, oxidized starch (OS) (obtained after oxidation of native starch with sodium perborate) was melt-blended with polylactic acid (PLA) polymer to prepare PLA/OS blends that were then mixed together with ammonium polyphosphate (APP), a halogen-free flame retardant (FR) used as acid donor in intumescent formulations on twin-screw extruder to prepare PLA/OS/APP composites. OS with different concentrations also served as bio-based carbonic source in intumescent formulations. PLA/OS/APP composites were melt spun to multifilament fibers on pilot scale melt-spinning machine and their crystallinity and mechanical properties were optimized by varying spinning parameters. The crystallinity of the fibers was studied by differential scanning calorimetry and thermal stabilities were analyzed by thermogravimetric analysis. Scanning electron microscopy was used to investigate the surface morphology and dispersion of the additives in the fibers. Needle-punched non-woven fabrics from as prepared melt-spun PLA/OS/APP fibers were developed and their fire properties such as heat release rate, total heat release, time to ignition, residual mass % etc. by cone calorimetry test were measured. It was found that PLA/OS/APP composites can be melt spun to multifilament fibers and non-woven flame-retardant fabrics produced thereof can be used in industrial FR applications.

Phosphorus (P) is a non-renewable resource which may be depleted within next few decades; hence high P use efficiency is need of time. Plants have evolved an array of adaptive mechanisms to enhance external P acquisition and reprioritize internal utilization under P deficiency. Tissue specific biomass and P allocation patterns may affect the P use efficiency in plants. six rice cultivars were grown in solution culture for 20 days and then were divided into two groups to receive either adequate P or no P that were harvested at 30, 40 and 50 days. Plants were dissected into various tissues/organs. Two rice cultivars viz Super Basmati (P-inefficient) and PS-2 (P-efficient) were grown in soil with no or 50 mg P kg−1 soil till maturity. Rice cultivars PS-2 and Basmati-2000 had higher P uptake, utilization efficiency and internal remobilization than other tested cultivars after P omission. Young leaves and roots were the major sinks while stems and mature leaves were the sources of P during P omission. In conclusion, biomass allocation and P accumulation among various tissues and P remobilization were major factors responsible for P efficiency.