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Objective: To evaluate the analgesic potential of pregabalin in ambulatory dacryocystorhinostomy surgeries under general anaesthesia. Study Design: Quasi-experimental study. Place and Duration of Study: Tertiary Care Hospital Rawalpindi, from Nov 2019 to Sep 2020. Methodology: A total of 110 patients undergoing ambulatory dacryocystorhinostomy surgery at our hospital were included in the study. Participants were divided into two groups, group A (n=55) were administered 150 mg oral pregabalin, while a placebo was given to participants of group B (n=55). Post-operative pain was assessed at recovery, four and eight hours after surgery with the help of the visual analogue scale. Results: Mean age of participants was 43.05 ± 7.5 years. Gender wise distribution showed 62 (56.4%) males and 48 (43.6%) females. At recovery, four and eight hours after surgery the mean pain scores in group A (pregabalin) vs group B (placebo) were (2.98 ± 0.8 vs 4.98 ± 0.8, p

Objective: To determine the efficacy of transforaminal epidural steroid injection (TFESI) using conventional versus Kambin’s triangle approaches in patients of lumbar radiculopathy. Study Design: Quasi experimental study. Place and Duration of Study: Department of Pain Medicine, Combined Military Hospital Rawalpindi Pakistan, from Oct 2019 to Apr 2020. Methodology: Eighty patients suffering from lumbar radiculopathy fulfilling the inclusion criteria were included in this study and were randomly assigned to undergo transforaminal epidural steroid injection using either conventional approach (group C) or the Kambin’s triangle (group K) approach. Pain scores and patient satisfaction levels were recorded at 4 and 8 weeks after the procedure. Results: In both groups, the pain score (group C pre-procedure NRS =7.28 ± 1.26 vs post-procedure NRS = 2.14 ± 0.81, group K pre-procedure NRS = 7.33 ± 1.16 vs post-procedure NRS=2.70 ± 0.94) and patient satisfaction improved 4 and 8 weeks after the procedure. The pain score (p-value=0.21) and patient satisfaction score (p-value=0.88) however were not significantly different between groups. Conclusion: This study demonstrated that using conventional or Kambin’s approach exhibits no difference in decreasing pain score or patient satisfaction level.

Objective: To determine the clinical outcome of patients admitted with acute anterior versus acute inferior wall myocardial infarction. Study Design: Comparative cross-sectional study. Place and Duration of Study: The study was conducted in emergency departments and adult cardiology wards of Armed Forces Institute of Cardiology/National Institute of Heart Diseases, from Aug 2019 to Nov 2019. Methodology: This study was conducted on 340 patients (208 patients with Anterior wall myocardial infarction and 132 patients with inferior wall MI who presented with Acute ST-Elevation MI) to emergency department of Armed Forces Institute of Cardiology/National Institute of Heart Disease during specified period. Outcome was calculated using Electrocardiogram, Two-dimensional transthoracic echocardiogram, Troponin-I, baseline investigations and coro angiography Data was entered and analyzed with SPSS-23. Results: Mean age was 59.38 ± 12.91 years in each group. In clinical symptoms chest pain was highest n=255 (71.4%) followed by diaphoresis 55 (15.4%) and breathlessness 51 (14.3%). The most common complications in patients with inferior wall MI were brady arrhythmia 8 (2.3%) whereas left ventricular failure 41 (12.1%) was more prevalent in patients with anterior wall MI after TVCAD. The results of cardiogenic shock 5 (1.5%),ventricular tachycardia 3 (0.8%) in inferior wall myocardial infarction were comparative to the results of cardiogenic shock 18 (5.3%) ventricular tachycardia 2 (0.5%) in anterior wall myocardial infarction. The number of stable patients was 91 (43.7%) in Anterior wall myocardial infarction and 51 (38.6%) in inferior wall MI. Conclusion: The study shows the comparative clinical outcome of anterior wall myocardial infarction versus inferior wall myocardial infarction.

Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA) is a rare coronary artery anomaly which accounts for 0.25–0.5% of all congenital cardiac diseases, where most die within the first year of life. We present a case report of a 50-year-old lady who presented to hospital with persistent palpitations. Her admission electrocardiogram found her to be in Atrial Fibrillation (AF). She was rate-controlled and subsequently discharged. Despite that, she represented with further episodes of AF and was referred for an outpatient transthoracic echocardiogram. This revealed a dilated right coronary artery, retrograde flow in the left coronary artery and collateral flow in the myocardium. To investigate, the patient had undergone further imaging which confirmed the diagnosis. As such, she was later shortlisted for surgical intervention. Conclusively, our case exemplifies the role of multimodal imaging to identify the features of ALCAPA and may be useful for the purposes of surgical intervention.

This study retrospects the idea of financial assistance program (school voucher program) proposed by Milton Friedman, lately developed by Peacock, Wiseman and Jencks. It examines the current education voucher program of Punjab education foundation designed for students of low-income families. The research aims to see efficacy of Public Private Partnership in school education in Punjab. It analyzes private schools choices for poor students through government financial subsidy program for basic education in Punjab. The financial subsidy program has become pervasive recently. The research was descriptive in nature based on opinions of Program administrators/Directors of Punjab Education foundation, Schools owners, Principals, teachers and parents related to private schools of Punjab education foundation. The results drawn through observation, questionnaires, interviews. checklists indicated that this program increases choices for poor families to enroll their children in schools of their preference because of quality, pedagogical approaches, affordability and geographical location regardless of financial barriers.

Redox-active organic electrode materials are highly desirable in realizing next-generation all-in-one bendable electronic systems. Herein, a novel flexible supercapacitors (SCs) electrode is fabricated from poly(anthraquinonyl sulfide) (PAQS) and single-walled carbon nanotubes (SWCNTs) suspension by a simple vacuum filtration and named as PAQS-SWCNTs. The PAQS-SWCNTs electrode offered an initial capacitance of 223 F-g−1 and outstanding capacitance retention up to 78.4% after 3 × 104 charge-discharge cycles at 0.5 A-g−1 current density. In a high potential range (0-3 V) and aprotic electrolyte, the PAQS-SWCNTs electrodes in coin cell exhibited an outstanding energy density of 69 Wh-kg−1 at a power density of 90.6 W-kg−1, whereas in the fabricated flexible SCs it retained 63.2 Wh-kg−1. The PAQS-SWCNTs electrodes also showed extraordinary performance at a higher current density (20 A-g−1) and maintained a specific capacitance of 55 and 47 F-g−1 for coin and flexible SCs, respectively. Moreover, the flexible SC is further verified to be able to illuminate up multiple LEDs. These futuristic findings showed that the SCs assembled with flexible PAQS-SWCNTs electrodes have potential application in energy-storage devices and make them highly appealing for future redox supercapacitors.

COVID-19 caused by SARS-CoV-2 is declared global pandemic. The virus owing high resemblance with SARS-CoV and MERS-CoV has been placed in family of beta-coronavirus. However, transmission and infectivity rate of COVID-19 is quite higher as compared to other members of family. Effective management strategy with potential drug availability will break the virus transmission chain subsequently reduce the pressure on the healthcare system. Extensive research trials are underway to develop novel efficient therapeutics against SARS-CoV-2. In this review, we have discussed the origin and family of coronavirus, structure, genome and pathogenesis of virus SARS-CoV-2 inside human host cell; comparison among SARS, MERS, SARS-CoV-2 and common flu; effective management practices; treatment with immunity boosters; available medication with ongoing clinical trials. We suggest medicinal plants could serve as potential candidates for drug development against COVID-19 infection.

Nowadays, it is generally accepted that rising concerns over environmental challenges and deviant climate changes are caused by the profuse utilization of conventional fossil fuels. The use of renewable energy systems, such as wind and solar power, is greatly considered to be one of the most significant replacements to enable more fast societal development and sustainable economic growth. For this purpose, sustainable and promising electrochemical energy storage technologies (ESTs), such as batteries and supercapacitors, can contribute a significantly vital role. Lithium-ion batteries (LIBs) are the only commercially available batteries that are up to date, and their development was acknowledged through the 2019 Nobel Prize in chemistry. To further boost the power and energy densities of LIBs, silicon nanomaterial-based anodes have been widely investigated owing to their low operation potential, high storage capacity, high abundance, and environmentally benign nature. However, the formation of unstable solid–electrolyte interphase (SEI) layers and the large volumetric changes during the discharge/charge processes are the key challenges for the commercialization of these anode materials. Here, the most recent development in the applications of silicon-based nanomaterials in LIBs and supercapacitors is summarized. A brief account on the electrochemical performance of silicon-based hybrid nanomaterials constructed by various strategies is systematically reviewed.

Objective: To examine clinical features, biochemical markers, demographic features, antecedent infections, frequency and treatment strategies. Methods: This case-control study was conducted at Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan and District Headquarters Hospital (DHQ), Rawalpindi, Pakistan from 2018 to 2020. Ninety consecutive patients of Guillain-Barré syndrome (GBS) and 77 healthy controls were enrolled. Patients were diagnosed by clinical presentation, Nerve conduction study (NCS), Electromyography (EMG), Cerebrospinal fluid analysis (CSF) and biochemical profile. Data was analyzed on IBM SPSS version 23. Results: Symmetrical ascending weakness was the striking clinical feature. Mean age was 40.20±14.90 years and male to female ratio was 2.1:1. Acute inflammatory demyelinating polyneuropathy (AIDP) was found to be the most common electrophysiological variant of GBS (46%). There was considerable difference in Interleukin-17(IL-17) levels between GBS patients 23.12 ± 3.41 pg/ml and healthy controls 8.82 ± 2.49. Mean IL-17 level was markedly increased in GBS patients, P=0.006, P

The substantial reliance of South Asia (SA) to rain-based agriculture makes the region susceptible to food scarcity due to droughts. Previously, most research on SA has emphasized the meteorological aspects with little consideration of agrarian drought impressions. The insufficient amount of in situ precipitation data across SA has also hindered thorough investigation in the agriculture sector. In recent times, models, satellite remote sensing, and reanalysis products have increased the amount of data. Hence, soil moisture, precipitation, terrestrial water storage (TWS), and vegetation condition index (VCI) products have been employed to illustrate SA droughts from 1982 to 2019 using a standardized index/anomaly approach. Besides, the relationships of these products towards crop production are evaluated using the annual national production of barley, maize, rice, and wheat by computing the yield anomaly index (YAI). Our findings indicate that MERRA-2, CPC, FLDAS (soil moisture), GPCC, and CHIRPS (precipitation) are alike and constant over the entire four regions of South Asia (northwest, southwest, northeast, and southeast). On the other hand, GLDAS and ERA5 remain poor when compared to other soil moisture products and identified drought conditions in regions one (northwest) and three (northeast). Likewise, TWS products such as MERRA-2 TWS and GRACE TWS (2002–2014) followed the patterns of ERA5 and GLDAS and presented divergent and inconsistent drought patterns. Furthermore, the vegetation condition index (VCI) remained less responsive in regions three (northeast) and four (southeast) only. Based on annual crop production data, MERRA-2, CPC, FLDAS, GPCC, and CHIRPS performed fairly well and indicated stronger and more significant associations (0.80 to 0.96) when compared to others. Thus, the current outcomes are imperative for gauging the deficient amount of data in the SA region, as they provide substitutes for agricultural drought monitoring.

A study was conducted in the research area of Agronomy Department, University of Agriculture, Faisalabad during 2014-2015 to evaluate a sustainable and economical wheat-based rotation system under agro-climatic conditions of Faisalabad, Pakistan. Guar, maize, mash bean, mung bean, soybean, millet and some fodders (maize, millet and sorghum) were grown in Kharif season while wheat was the main crop in Rabi season. Wheat-fodder millet-grain maize gave the highest net benefits of Rs. 272062 ha-1 but exhausted the soil¬. The maximum value of BCR (2.25:1) was achieved in the same rotation that is, wheat-fodder millet-grain maize followed by wheat-fodder maize-mash bean with BCR of 1.86:1. Keeping in view the soil fertility plus economy, the wheat-fodder maize-mash bean cropping system is not only economical for small landholders but also improve soil fertility status as compare to others. Key words: Crop rotations, cropping patterns, economics, semi-arid and subtropical climate.

Objective: To evaluate the role of needle diameter in causing postdural puncture headache (PDPH) in patients undergoing elective caesarian section. Study Design: Comparative cross-sectional study. Place and Duration of Study: This study was conducted in Department of Anaesthesia and Intensive care PNS Shifa Karachi over duration of six months. Patients and Methods: It was a cross sectional study of 100 patients, which were divided into two separate groups. Group I and Group II were given spinal anaesthesia with 25 gauge and 27 gauge Quincke needles respectively. In both the groups the patients were randomly selected and were blind to size of the spinal needle used. Results: The data was analyzed using Chi-square test. A P value of

Drought is an intricate atmospheric phenomenon with the greatest impacts on food security and agriculture in South Asia. Timely and appropriate forecasting of drought is vital in reducing its negative impacts. This study intended to explore the performance of the evaporative stress index (ESI), vegetation health index (VHI), enhanced vegetation index (EVI), and standardized anomaly index (SAI) based on satellite remote sensing data from 2002–2019 for agricultural drought assessment in Afghanistan, Pakistan, India, and Bangladesh. The spatial maps were generated against each index, which indicated a severe agricultural drought during the year 2002, compared to the other years. The results showed that the southeast region of Pakistan, and the north, northwest, and southwest regions of India and Afghanistan were significantly affected by drought. However, Bangladesh faced substantial drought in the northeast and northwest regions during the drought year (2002). The longest drought period of seven months was observed in India followed by Pakistan and Afghanistan with six months, while, only three months were perceived in Bangladesh. The correlation between drought indices and climate variables such as soil moisture has remained a significant drought-initiating variable. Furthermore, this study confirmed that the evaporative stress index (ESI) is a good agricultural drought indicator, being quick and with greater sensitivity, and thus advantageous compared to the VHI, EVI, and SAI vegetation indices.

Introduction: Forearm is considered as a functional joint, therefore near anatomical reduction is essential to regain normal supination and pronation. In older children many forearm fractures can be treated conservatively, but failures continue to occur despite good orthopaedic intentions. The fracture which are irreducible or unstable fracture which tends to re-displace needs surgical interventions. Among various surgical treatment one is internal xation using TENS. Various studies in the recent shows excellent to good clinical outcomes using TENS. Aims: Our study is intended to evaluate the clinical and radiological outcomes in paediatric both bone forearm fracture using TENS. Materials and methods: A total of 30 patients are included in our study. All are investigated, undergone preanesthetic check-up and taken for TENS application under image intensier. Nail diameter taken as 33-40% of narrowest diameter of diaphysys were introduced proximally in ulna and distally in radius under image intensier in closed manner. Postoperatively, patients encouraged for active shoulder, elbow and nger movements and suture removal done after 2 weeks. All patients are followed up to 24 week, when implant removal was done. Results: In our study 90% patients show excellent functional results. Conclusion: We conclude that TENS in both bone forearm fractures in adolescent age group in terms of union and range of motion is a minimally invasive and effective method of xation

Objective: To assess trends of real-time Polymerase Chain Reaction test in Coronavirus infected Patients. Methods: This cross-sectional analytical study was conducted at Tertiary Care Institute, Rawalpindi from March 2020 to June 2020. All patients confirmed COVID positive by real-time Polymerase Chain Reaction (PCR) with recent travel history, close contact with known diagnosed patients and had symptoms of fever or upper respiratory tract with body aches. Nasopharyngeal swabs were taken and results generated within 48 hours. Positive PCR was admission criteria follow up was carried out at 7th and 8th day, with negative PCR were discharged. However, those who had persistent positive PCR on the 8th day were tested again on 11th and 12th day. Those with persistent positive results beyond 12th day were shifted to specialized quarantine centres. Results: A total of three hundred and ninety-two patients with mild to moderate illness, PCR positive for COVID 19 were included study with age range 9 - 45 and mean 33.22±7.98 years. A total of 8 (2%) patients were females and 384(98%) males. The duration of the negative test result was Mean ± Std. Deviation 9.05±2.00 with 7 – 8 days 152(38.8%)in and 11 – 12 days in 160(40.8%). PCR results on Day 7 and 8 were negative in 144(36.7%) patients whereas positive in 248(63.3%). PCR results on Day 11 and 12 were negative in 312(79.6%) patients whereas positive in 80 (20.4%). Conclusion: To conclude Real-Time Polymerase Chain Reaction (rT-PCR) inclines to give false negative results additionally can stay positive in asymptomatic patients for moderately longer-term. Hence decision to discharge ought to be intricately adjusted between RT-PCR, clinical judgement, radiological examinations, and biochemical assays. doi: https://doi.org/10.12669/pjms.37.1.3000 How to cite this:Abbas S, Rafique A, Abbas B, Iqbal R. Real-Time Polymerase chain reaction trends in COVID-19 patients. Pak J Med Sci. 2021;37(1):180-184. doi: https://doi.org/10.12669/pjms.37.1.3000 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objectives: To evaluate the frequency, distribution, characteristics, and biochemical features of Guillain-Barre syndrome (GBS). Methods: This retrospective, case-control study was conducted between November 2018 and February 2020 at PIMS Hospital, Islamabad and Arid Agriculture University, Rawalpindi, Pakistan. The GBS patients were diagnosed through physical examination and nerve conduction study (NCS). Hemoglobin (Hb), liver function tests, renal function tests, lipid profile, and interleukin-17 levels were investigated through the blood. Cerebrospinal fluid analysis (CSF) was performed to measure albuminocytological dissociation (ACD). Results: One hundred and ten patients and 130 controls participated in this study. Fifty-nine (53.63 %) patients had gastrointestinal infection while 52 (47.27 %) had AIDP. IL-17 serum levels were associated with GBS showing elevated values 18.49 pg/mL (SD=4.10) in cases as compared to controls 10.66 (SD=2.09), p Conclusion: The results of the current study suggest that IL-17 levels trigger autoimmunity in GBS patients. The ACD could be used as a diagnostic marker of GBS along with NCS. Antecedent infections were common in a majority of GBS patients.

Aim: This study was aimed to evaluate the oral health status and knowledge of diabetic and nondiabetic patients attending College of Dentistry clinics, Hail, the Kingdom of Saudi Arabia. Materials and methods: It was an observational cross-sectional study. Using nonprobability convenient sampling technique, data were collected from 202 respondents. A total of 202 diabetic and nondiabetic patients were screened for the study. Data were collected by interview using the structured, self-administered questionnaire, and assessment of oral health status was done by clinical examination. The collected data were analyzed using IBM SPSS software. The data were displayed as numbers and percentages and association among the variable of interests was measured using Pearson Chi-square. Results: Of the 202 patients, 102 (50.6%) were males and 100 (49.4%) were females. Majority of the patients, 71 (35.2%) were in the age-group of 30-40 years. In all, 128 (63.4%) participants knew the effect of diabetes mellitus (DM) on oral health, 167 (82.7%) knew that diabetic patients needed special healthcare, 152 (75.25%) had never spoken to their doctors about oral health, and 164 (81.19%) had never spoken to their dentists regarding diabetes. Conclusion: The complications associated with oral health are more common in diabetic patients when compared to the nondiabetic patients. This is the case in both male and female patients visiting the College of Dentistry in the Hail region. Clinical significance: Diabetes mellitus is associated with increased susceptibility to oral infections especially periodontal disease. Role of a general dentist in diagnosis and raising patient awareness toward DM and its effects on oral health need to be emphasized.

Background Water resources are very important to agricultural crop production due to increasing demand for food, feed, and fiber. There is a growing requirement for more use of our natural resources of land, soil, and water. There is ever-increasing pressure on water resources for our extensive use in agricultural production. There needs to be innovative solutions for more efficient irrigation techniques for better development of agricultural irrigation management. Main body of the abstract This review paper shows the consequences of partial root-zone drying happening on various plant species, its advantages and disadvantages, and also the hormone production under partial root-zone drying. In this technique of irrigation, a wet-dry cycle irrigates the crop, i.e., irrigation is scheduled at a regular interval with half way root drying. Short conclusion This is a water-saving irrigation strategy used in arid and semi-arid environments for increasing irrigation water use efficiency and water productivity as compared to fully irrigated crop plants in area with limited water resources. Scientists have worked a lot with different morphological, physiological, and yield related parameters of horticultural crops with partial root-zone drying but little work with agronomic crops.

Background & aim Hepatitis B and C infections are global issues that are associated with a massive financial burden in developing countries where vertical transmission is the major mode and remains high. This cross-sectional study was designed to investigate the seroepidemiology and associated risk factors of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among 375 pregnant women attending antenatal care health facilities at Bacha Khan Medical Complex (BKMC) Shahmansoor and District Head Quarter (DHQ) Hospital Swabi, Khyber Pakhtunkhwa, Pakistan. Methodology From a total of 375 pregnant women selected using systematic random sampling from both hospitals, 10 ml of blood samples were collected and alienated serum was examined for indicators identification through the Immuno-Chromatographic Test (ICT) and 3rd Generation Enzyme-Linked Immunosorbent Assay (ELISA). A pre-structured questionnaire was used to collect the socio-demographic data and possible risk factors. The data was analyzed via SPSS 23.0 statistical software. A chi-square analysis was performed to determine the association between variables. P-value < 0.05 was set statistically significant. Results The overall frequency of HBV and HCV among 375 pregnant women involved in the study was 3.7% and 2.1% respectively. None of the pregnant women were co-infected with HBV and HCV. Dental extraction (P = 0.001) and blood transfusion (P = 0.0005) were significantly allied with HBV infection while surgical procedure (P = 0.0001) was significantly associated with HCV infection. Moreover the sociodemographic characteristics: residential status (P = 0.017) and educational level (P = 0.048) were found significant risk factors of HBsAg and maternal age (P = 0.033) of anti-HCV, respectively. Conclusion & recommendation HBV and HCV infections are intermediary endemic in the study area. A higher prevalence of HBV was detected among pregnant mothers with a history of dental extraction, history of blood transfusion, resident to the urban area and low educational level. The age and surgical procedures were the potential risk factors found significantly associated with HCV positivity among pregnant mothers in our setup. Future negotiations to control vertical transmission should include routine antenatal screening for these infections early in pregnancy and the requirement of efficient preventive tools including the birth dose of the hepatitis B vaccine in combination with hepatitis B immune globulins to the neonate.

Organic-Inorganic perovskites CsPbX3 (X = Cl, Br, I) are investigated for their potential ability and use as solar cells and energy storage materials, using density function theory, generalized gradient approximation and modified Becke-Johnson (TB-mBJ) exchange potential. Structural analysis shows that the lattice constant and unit cell volume varies when CsPbX3 (X = Cl, Br, I) change from cubic phase to tetragonal and orthorhombic structures. The electronic properties show that CsPbCl3, CsPbBr3 and CsPbI3 all are semiconductor in with bandgap between 0.79 eV and 2.54 eV. It is also observed that the bandgap changes when the structure changes. Optical properties show that these materials have a good absorption ability of photons due to their narrow bandgaps. The real e1(ω) and imaginary e2(ω) parts of their dielectric functions show that CsPbCl3, CsPbBr3 and CsPbI3 also possess a great ability of retaining the energy it absorbs. These properties make them very suitable for solar cells and energy storage applications. These materials also behave as superluminescent material at high photon energy.

Background: Malocclusion is recognized as one of the most common dental problems affecting the young adults and adolescence globally. Oral functions and facial aesthetics are influenced by the severity of malocclusion and it's of great concern to the individual, their families and health authorities as well. Most of the reported studies for Kingdom of Saudi Arabia are from the eastern, southern and central region. To the best of our knowledge no data is available for the northern region of Hail; therefore the aim of this study was to determine the prevalence of malocclusion among the population of Hail city. Methodology: Descriptive study having a cross sectional study, convenient sample size of 504 Saudi populations between the age group of 13 – 50 years. Informed consent was taken from the participants before conducting the examination, parents’ consent was sought for children. Malocclusion was recorded as described by WHO, oral health Survey, and basic methods. Each subject was examined for the type of malocclusion according to Angle’s classification. Results: Most predominant malocclusion was Angle’s Class I 41.7% in females and 26.2% in males.15.4% males and 23.3% females had excessive overjet (>2mm) compared to 38% males and (24.3%) females who had reduced overjet (2mm) whereas 32.3% males and 20.5% females had reduced overbite (

Background/Aim: Diabetes mellitus (DM) is a considerable systemic metabolic disorder to exhibit various metabolic and cardiovascular disorders, mainly hyperglycemia. Our study aims to evaluate oxidative stress markers in DM patients and to determine the clinical correlates affecting the investigational parameters. Methodology: To evaluate oxidative stress, the following parameters were included: tri-glycerides(TG), total cholesterol, low density lipoprotein cholesterol(LDL), oxidized LDL cholesterol(Ox LDL), superoxide dismutase(SOD), glutathione peroxidase(GSH-Px) and plasminogen activator inhibitor(PAI) which were measured at single observation point. Patient clinical and demographic data were taken from registered medication profiles from the Outpatient Department. Results: The diabetic subjects have significantly high measured values of endocrine(p

Wheat is one of the major staple food of the world, which is badly affected by water deficit stress. To fulfill the dietary needs of increasing population with depleting water resources there is need to adopt technologies which result in sufficient crop yield with less water consumption. One of them is partial root zone drying (PRD). Keeping in view these conditions, a wire house experiment was conducted at University College of Agriculture and Environmental Sciences, The Islamia University Bahawalpur during 2015, to screen out the different wheat genotypes for PRD. Five approved local wheat cultivars (V1= Galaxy-2013, V2= Punjab-2011, V3 = Faisalabad-2008, V4 = Lasani-2008 and V5 = V.8200) and two irrigation levels (I1 = control irrigation and I2 = PRD irrigation) with completely randomized design having four replications were used in the experiment. Among the varieties Galaxy-2013 performed the best and attained maximum plant height, leaf area, stomatal conductance, photosynthesis, total sugars, proline contents and antioxidant enzymes activities and minimum values of all growth and physiological parameters were recorded in variety V.8200. For irrigation levels, higher values of growth, physiological and water related parameters were recorded in control treatment (I1) except leaf water potential, osmotic potential, total sugars and proline contents. However enzymes activities were higher under PRD treatment for all varieties. It was concluded that Galaxy-2013 was the most compatible and V.8200 was the most susceptible variety under PRD condition, respectively and more quality traits and enzymatic activities were recorded under PRD condition as compared to control treatment.

Purpose – The purpose of the paper is to find the factors which affect dividend policy of commercial banks in Pakistan. Design/Methodology/Approach – The paper examines the factors affecting dividend policy of commercial banks in Pakistan using Primary as well as secondary data. The primary data consists of feedback from Board of Directors and the higher management involved in dividend paying decision of Commercial banks while secondary data includes analysis of financial statements of commercial banks in Pakistan. Findings – The paper finds that the dividend policy of commercial banks in Pakistan is influenced by the five major factors which are Prior Dividend, Earnings Growth, Size of the Bank, Poor Management and Market to book value of the share. First three factors affect dividend policy positively and last two affect it negatively. Practical Implications – The practical implication of the paper is that managers should consider the factors also keeping in view the profit maximization of shareholder should control the controllable factors like Non-Performing loans. Originality/value – The paper investigates the factors that affect the dividend policy and also consider the behavioral issue of dividend payments.

Objective: Aim of the study is to compare the efficacy of Ephedrine and Phenylephrine for treatment of hypotension afterspinal anaesthesia for elective caesarean section. Study design: Randomized Clinical Trial. Setting: Operation theatre Department ofAnaesthesiology, Combined Military Hospital Quetta. Duration of study: Six month from 16th Sep 2011 to 15th March 2012. Materialand Method: Seventy women undergoing LSCS for singleton pregnancy under spinal anesthesia were randomly assigned in group A andB (35 in each group). All patients preloaded with Lactated Ringer’s solution 15ml/kg body weight 10 minutes before administration ofspinal anaesthesia. Mean Arterial Pressure (MAP) was recorded before administration of spinal anaesthesia considered as Base-lineMAP and then at 1 Minute, 3 minutes & at 5 minutes after administration of spinal anaesthesia. When hypotension developed (MAP falls>20% from base line), intravenous single dose of ephedrine administered in group A patients, while in group B, Phenylephrine was given.Blood pressure was recorded after 1 minute following drug administration and up to 3 minutes at 1 minute interval. Patient handed over forprocedure after 10 minutes of spinal block. The SPSS version 13 was applied to the data. Mean and standard deviation were computed fornumerical variables like age, weight, height, systolic blood pressure, Diastolic blood pressure, and Mean Arterial pressure; whereasfrequency and percentages were employed to assess the categorical variable like efficacy. Chi-square test was used to compare theefficacy of intravenous bolus of ephedrine and phenylephrine. Statistical significance was taken at p

Inertial measurement unit (IMU) has been widely used for autonomous vehicles navigation. The accuracy of IMU specifies the performance of the inertial navigation system (INS).The errors in the INS are mainly due to the IMU inaccuracies, initial alignment, computational errors and approximations in the system equations. These errors are further integrated over time due to the dead-reckoning nature of the INS, which leads to unacceptable results. These errors need an accurate estimation for high precision navigation. INS is integrated with Global Positioning System (GPS) to estimate the errors and enhance the navigation capability of the INS. Linearized Kalman Filter (LKF) is proposed for estimating the errors in the low cost INS using Loosely Coupled integration approach, which is opted for its simplicity and robustness. Prediction part of the LKF is used during the GPS lag for errors estimation, which is found very effective for low cost sensors. The resulting GPS-INS integration algorithm is evaluated on simulated Autonomous vehicle trajectory, generated from 6-DOF model. The integrated system limits the attitude errors less than 0.1 deg and velocity errors of the order of 0.003 meter per second. Furthermore, it provides an optimal navigation solution than can be achieved from individual systems.

Background: Intravenous drug abuse can lead to vascular complications, most frequent of which is pseudoaneurysm. Thesepseudoaneurysms (false aneurysms) are prone to rupture, leading to profuse hemorrhage and death. Objective: To evaluatepseudoaneurysms in intravenous drug addicts for the site, mode of presentation, management and outcome. Design: Descriptive study.Place and duration of study: Surgical unit I, Combined Military Hospital, Rawalpindi. Surgical unit 2, Combined Military Hospital, Lahore.January 2006 to September 2010. Subjects and methods: All cases of pseudoaneurysms in intravenous drug addicts who presented to asingle vascular surgeon, between 1st January 2006 and 30th September 2010, were evaluated for site, mode of presentation, treatment andthe outcome. Surgical procedures included excision of pseudoaneurysm with interpositioning of graft, repair of vascular rent, ligation of vesseland debridement. All cases were referred to psychiatrist for management of drug addiction. Results: Total 12 cases of pseudoaneurysms dueto IV drug abuse were included in our study. Arteries affected included 9(75%) common femoral arteries (CFA). In 3(25%) cases, both commonfemoral artery and vein were involved with arteriovenous fistula between them. There was 1(8.3%) pseudoaneurysm each of external iliacartery, superficial femoral artery and brachial artery. Nine cases (75%) presented with recurrent hemorrhage from a swelling while in 3(25%)cases there was swelling with no history of hemorrhage. In 7(58.3%) cases, repair/grafting, while in 5(41.6%) cases ligation and debridementwas done. There was seroma formation in 1(8.3%) case after excision and grafting. In none of the cases, in which artery was ligated, critical limbischaemia occurred. Conclusions: Common femoral artery is the most frequent site of pseudoaneurysms in IV drug abuse. In those caseswhere vascular reconstruction is not possible due to extensive skin necrosis or infection, ligation of affected vessel is not only a life savingprocedure but a safe option also.

Objective: To determine the frequency of intra-operative hypotension following induction of Anesthesia in patients continuingtheir routine dose of angiotensin system inhibitor therapy before surgery. Study design: Cross-sectional study. Setting: Department ofAnaesthesiology, Combined Military Hospital, Quetta. Duration of study: One year from 20-08-2010 to 19-08-2011. Subjects and methods:Total 92 hypertensive patients were included in this study. Diagnostic criteria for patients was those cases receiving ACEI/ARA therapy for atleast 3 months with admission preoperative arterial blood pressure of >150/90mmHg. Results: Mean age of the patients was 47.70±8.47years. Out of 92 patients, 38 patients (41.3%) were male while remaining 54 patients (58.7%) were female. Distribution of cases by hypotensionafter induction of anesthesia shows, hypotension at 30 minute in 55 patients (59.8%) and hypotension at 60 minute in 37 patients (40.2%). Outof 55 hypotensive patients (at 30 minute) 17 patients (30.9%) had mild hypotension, 32 patients (58.2%) had moderate hypotension and 6patients (10.9%) had severe hypotension. Out of 37 hypotensive patients (at 60 minute) 8 patients (21.6%) had mild hypotension, 25 patients(67.6%) had moderate hypotension and 4 patients (10.8%) had severe hypotension. Conclusions: Hypertensive patients continuing theirroutine angiotensin system inhibitors therapy (

There is increase incidence of Lower Segment Caesarian section (LSCS) being performed under sub-arachnoid block (SAB)because it is relatively safe. One of the complications of SAB is Post Dural Puncture Headache (PDPH) which is very distressing to the patient.Objective: To observe the incidence of PDPH by using two different types of spinal needle of 25 gauge in females undergoing LSCS underSAB. Currently, in our setup 25G cutting (quincke) spinal needle is routinely used. Study design: Randomized controlled trial. Setting:Department of Anesthesia, Officers Family Hospital, Rawalpindi Cantt. Duration of study: 6 months from 15 February 2011 to 15 July 2011.Material and Method: 100 pregnant patients undergoing elective CD under spinal anaesthesia were randomized into two groups A & B. GroupA received SAB with 25G Quincke needle; Group B- received SAB with 25G pencil-point needle. Follow up was done upto 72 hours after thesurgery. Data obtained through study was analysed through computer software SPSS version 12. Quantitative variables like age, weight andheight are presented as mean and standard deviation. The frequency of PDPH was qualitatively analysed in percentage. The frequency ofPDPH was compared between two groups with the application of Chi-square as test of significance at P- value

The diagnosis of acute pulmonary embolus is often difficult. We present a case history where bedside transthoracic echocardiography provided a rapid and convenient aid to diagnosis by demonstrating a venous "thrombosis in transit" as a spiral shaped mass in the right atrium prolapsing into the right ventricle. We also review the management and outcome in recent, similar cases. Overall mortality is 33% for pulmonary embolus and associated thrombus in transit. Transthoracic echocardiography may be a useful tool in the diagnosis of pulmonary embolus. The presence of thrombus in the right heart is a rare finding. The outcome in these patients is determined by the clinical presentation rather than by the identification of thrombus.

A 17-year-old male patient presented to the emergency department with sudden onset of palpitations after drinking high caffeine preparations at the gym. He had no relevant medical history or family history of sudden cardiac death. He denied any use of regular medications, alcohol or illicit drugs. On arrival, he was tachycardic (ECG in figure 1—top) but haemodynamically stable. Cardiovascular examination was otherwise unremarkable; chest X-ray and routine blood tests were normal. He was given intravenous metoprolol with no significant effect. Subsequently, his blood pressure deteriorated (ECG in figure 1—bottom) and intravenous adenosine was administered followed by further blood pressure reduction. The on-call cardiologist was …

The `Full Chip' module of an ASIC is made up of various partitions and similar to individual partitions, it also goes through various stages of the physical design. The initial design-planning works on the existing pins of a partition, adds feed-thru pins and performs custom placement and routing on signal and clock nets. Near tape-in, ECO (Engineering Change Order) forces manual changes to design as opposed to taking it through full implementation cycle. At the final stages, when layout database of each partition meets the requirements, a bottom up integration is carried out to create full chip layout. All these stages can create logical differences between layout and RTL of the top level interface. In order to verify that no unintentional logical change has happened to full chip, a robust formal verification strategy with numerous practical considerations is necessary. Designers also make use of 100% or partial shell models at the floor-planning phase which does bring advantages but also creates challenges for the formal verification flow. This article documents these challenges by explaining the formal verification approach taken on Intel's next generation network processing chip.

The impact of supply voltage scaling on the retention time of a 2-transistor (2T) gain-cell (GC) storage array is investigated, in order to enable low-power/low-voltage data storage. The retention time can be increased when scaling down the supply voltage for a given access statistics and a given write bit-line (WBL) control scheme. Moreover, for a given supply voltage, the retention time can be further increased by controlling the WBL to a voltage level between the supply rails during idle and read states. These two concepts are proved by means of Spectre simulation of a GC-storage array implemented in 180-nm CMOS technology. The proposed 2-kb storage macro is operated at only 40% of the nominal supply voltage and leverages the GCs to enable two-port operation with a negligible area-increase compared to a single-port implementation.