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Abstract A four level chiral medium is considered to analyze and investigate theoretically the reflection/transmission coefficients of right circularly polarized (RCP) beam and left circularly polarized (LCP) beam as well as their corresponding GH-shifts under the effect of compton scattering. Density matrix formalism is used for calculation of electric and magnetic probe fields coherence. The polarization and magnetization are calculated from probes coherence terms in the chiral medium. The electric and magnetic susceptibilities as well as chiral coefficients are related with polarization and magnetization. The refractive indices of RCP and LCP beams under compton scattering effect is modified from the electric/magnetic susceptibilities, chiral coefficients, mass and charge of electron as well as compton scattering angle. The giant positive and negative birefringent Goos–Hänchen (GH) shifts in reflection and transmission beams are investigated in this manuscript under Compton scattering effect. The RCP and LCP beams obey the normalization condition $$|R^{(+,-)}|+|T^{(+,-)}|=1$$ | R ( + , - ) | + | T ( + , - ) | = 1 at the interface of a lossy chiral medium of $$|A^{(+,-)}|\simeq 0$$ | A ( + , - ) | ≃ 0 and a thin sheet of balsa wood under the effect of compton scattering angle, incident angle, probe field detuning, control field Rabi frequency, phases of electric and magnetic fields and phase of superposition states. Significant positive/negative giant GH-shifts in reflection and transmission beams are investigated. The results show potential applications in modification of cloaking devices, image coding, polarizing filters and LCD displays.

Abstract Drought is one of the major environmental issues that reduce crop yield. Seed germination is a crucial stage of plant development in all crop plants, including soybean. In soybean breeding, information about genetic mechanism of drought tolerance has great importance. However, at germination stage, there is relatively little knowledge on the genetic basis of soybean drought resistance. The objective of this work was to find the quantitative trait nucleotides (QTNs) linked to drought tolerance related three traits using a genome-wide association study (GWAS), viz., germination rate (GR), root length (RL), and whole seedling length (WSL), using germplasm population of 240 soybean PIs with 34,817 SNPs genotype data having MAF > 0.05. It was observed that heritability (H2 ) for GR, WSL, and RL across both environments (2020, and 2019) were high in the range of 0.76–0.99, showing that genetic factors play a vital role in drought tolerance as compared to environmental factors. A number of 23 and 27 QTNs were found to be linked to three traits using MLM and mrMLM, respectively. Three significant QTNs, qGR8-1, qWSL13-1, and qRL-8, were identified using both MLM and mrMLM methods among these QTNs. QTN8, located on chromosome 8 was consistently linked to two traits (GR and RL). The area (± 100 Kb) associated with this QTN was screened for drought tolerance based on gene annotation. Fifteen candidate genes were found by this screening. Based on the expression data, four candidate genes i.e. Glyma08g156800, Glyma08g160000, Glyma08g162700, and Glyma13g249600 were found to be linked to drought tolerance regulation in soybean. Hence, the current study provides evidence to understand the genetic constitution of drought tolerance during the germination stage and identified QTNs or genes could be utilized in molecular breeding to enhance the yield under drought stress.

Abstract Background The evaluation of undergraduate medical curricula plays a crucial role in ensuring effectiveness and helps in continuous improvement of the learning process. This study aims to compare the effectiveness of online and hybrid teaching models of the first-year MBBS curriculum in the COVID-19 era (2019–20) and the para-COVID-19 pandemic (2020–21). Study methodology Mixed methods study with CIPP model was used. Data was collected by administering a survey and focus group discussions (FGDs) with first-year students from the 2019–2020 and 2020–2021 cohorts, faculty and administrators, which were recorded for analysis. Recorded lectures, guidebooks, planners, and question papers were also scrutinized for quality and adequacy. Furthermore, admission merit, module assessments, and professional examination results were compared and correlated. The learning environment was evaluated through the questionnaire (validated and used by Pakistan Medical and Dental council for inspections of medical schools) and the facilities provided in both years were juxtaposed. The study utilized NVIVO for qualitative and SPSS version 23 for quantitative data analysis. Results Contextual analysis underscored the critical need for online teaching during the COVID-19 pandemic, with provided resources being deemed sufficient. Notably, the student-faculty ratio stood at 4:1, and essential resources were readily available. The fully online batch outperformed the hybrid teaching class in 2020–21. Process analysis revealed successful session delivery in hybrid and online through webinars and Zoom, accompanied by timely provision of study guides and punctual assessments. Moreover, examination papers demonstrated acceptable reliability (Cronbach’s alpha: 0.61) in core subjects. Product analysis indicated that the 2020–21 cohort performed better in modular and professional examinations across all subjects (P

Abstract The plant-available soil phosphorus rate and methods for applying phosphatic fertilizer and soil P-fixation capacity are critical factors for lower cotton productivity in Southern Punjab, Pakistan. Hence, a two-year study was conducted in Central Cotton Research Institute (CCRI), Multan, Pakistan, to examine the effects of various P rates and application methods on cotton crop output during the growing seasons of 2014 and 2015. Phosphorus was applied in four rates (0, 40, 80, and 120 kg ha−1 P2O5) using broadcast, band application, and fertigation methods. Results indicated that the impact of P rates was statistically significant on plant height, the number of nodes, monopodial and sympodial branches, leaf area index, harvest index, and seed cotton yield. The greater P application (120 kg P2O5 ha−1) had a better effect on cotton productivity than the lower application rates (0, 40, and 80 kg P2O5 ha−1). The band application responded better on nodes plant−1, sympodial branches plant−1, boll weight, leaf area index, lint yield, and harvest during the growing season 2015. Therefore, by adopting the band application coupled with 120 kg P2O5 ha−1 rather than the conventional method of broadcast, productivity of cotton crops could be increased.

Abstract NS1 is an elusive dengue protein, involved in viral replication, assembly, pathogenesis, and immune evasion. Its levels in blood plasm are positively related to disease severity like thrombocytopenia, hemorrhage, and vascular leakage. Despite its pathogenic roles, NS1 is being used in various vaccine formulations due to its sequence conservancy, ability to produce protective antibodies and low risk for inducing antibody-dependent enhancement. In this study, we have used bioinformatics tools and reported literature to develop an NS1 variant (dNS1). Molecular docking studies were performed to evaluate the receptor-binding ability of the NS1 and dNS1 with TLR4. NS1 and dNS1 (153 to 312 amino acid region) genes were cloned, expressed and protein was purified followed by refolding. Docking studies showed the binding of NS1 and dNS1 with the TLR4 receptor which suggests that N and C-terminal sequences of NS1 are not critical for receptor binding. Antibodies against NS1 and dNS1 were raised in rabbits and binding affinity of anti-dNS1 anti-NS1 sera was evaluated against both NS1 and dNS1. Similar results were observed through western blotting which highlight that N and C-terminal deletion of NS1 does not compromise the immunogenic potential of dNS1 hence, supports its use in future vaccine formulations as a substitute for NS1.

Background & Aims: The article aims to evaluate trends in occupational radiation exposure for employees in different departments at the Center for Nuclear Medicine and Radiotherapy (CENAR), Quetta, Pakistan. Materials & Methods: This retrospective study examination of 9780 film dosimeter dose data was carried out from 2019 to 2023. The quantities analyzed were the highest and minimum annual effective doses, distribution of workers, and their average yearly effective doses in different effective dose intervals. The annual collective effective dose and average effective dosage were also included. Results: Yearly average effective doses in Radiotherapy, Nuclear Medicine, Medical Physics, and Diagnostic Radiology range from 0.5 to 3.00 mSv. Records show that 90% of workers fall within 1-3.00 mSv, with 10% between 0.5 mSv and the minimum detectable level. Minimum and maximum yearly individual doses in Radiotherapy and Nuclear Medicine are 0.10 mSv and 2.3 mSv. Average doses for the fields range from 1.01 to 1.14 mSv. Conclusion: Employees received doses that were lower than the yearly maximum, showing successful radiation shielding. The findings imply that safety measures are followed in the researched departments, which is important for clinical practice. This research improves our understanding of occupational radiation exposure, notably at CENAR, and promotes radiation safety in medical settings.

Abstract The improvement of thermal exchange is of utmost interest in a wide range of engineering areas. The current study focuses on thermal evaluation involving natural radiation and convection in a fractionally arranged moving longitudinal fin model placed under a magnetic field. We implement the Levenberg Marquardt backpropagation (LMB) algorithm for investigating an innovative use of stochastic numerical computation for analyzing the efficiency of the temperature distribution in a porous moving longitudinal fin. The datasets for LMB have been created using a shooting approach for dynamic systems with varying ranges of different parameters. The validation, testing, and training processes are used to simulate networks using the LMB approach for diverse scenarios of moving porous fin models. The reliability of results is assessed based on the regression measures, absolute error, error histograms, mean square error, and other metrics for fuller numerical modeling of the suggested LMB to investigate the thermal efficiency and effectiveness of porous moving fin.

Abstract Preeclampsia, a pregnancy complication characterized by hypertension after 20 gestational weeks, is a major cause of maternal and neonatal morbidity and mortality. Mechanisms leading to preeclampsia are unclear; however, there is evidence of high heritability. We evaluated the association of polygenic scores (PGS) for blood pressure traits and preeclampsia to assess whether there is shared genetic architecture. Non-Hispanic Black and White reproductive age females with pregnancy indications and genotypes were obtained from Vanderbilt University’s BioVU, Electronic Medical Records and Genomics network, and Penn Medicine Biobank. Preeclampsia was defined by ICD codes. Summary statistics for diastolic blood pressure (DBP), systolic blood pressure (SBP), and pulse pressure (PP) PGS were acquired from Giri et al. Associations between preeclampsia and each PGS were evaluated separately by race and data source before subsequent meta-analysis. Ten-fold cross validation was used for prediction modeling. In 3504 Black and 5009 White included individuals, the rate of preeclampsia was 15.49%. In cross-ancestry meta-analysis, all PGSs were associated with preeclampsia (ORDBP = 1.10, 95% CI 1.02–1.17, p = 7.68 × 10−3; ORSBP = 1.16, 95% CI 1.09–1.23, p = 2.23 × 10−6; ORPP = 1.14, 95% CI 1.07–1.27, p = 9.86 × 10−5). Addition of PGSs to clinical prediction models did not improve predictive performance. Genetic factors contributing to blood pressure regulation in the general population also predispose to preeclampsia.

Abstract The current research focuses on the development of Ag–ZnO heterostructures through a “bottom-up” approach involving the assembly and extraction of Aloe barbadensis Miller gel. These heterostructures composed of metals/semiconductor oxide display distinct and notable optical, electrical, magnetic, and chemical properties that are not found in single constituents and also exhibit photocatalytic applications. These synthesized heterostructures were characterized by XRD, FTIR, SEM, and UV–visible spectroscopy. The high peak intensity of the Ag/ZnO composite shows the high crystallinity. The presence of Ag–O, Zn–O, and O–H bonding is verified using FTIR analysis. SEM analysis indicated the formation of spherical shapes of Ag/ZnO heterostructures. The Zn, O, and Ag elements are further confirmed by EDX analysis. Ag–ZnO heterostructures exhibited excellent photocatalytic activity and stability against the degradation of tubantin red 8BL dye under visible light irradiation.

Abstract This paper offers a novel approach to formulate efficient ratio estimator of the population variance using a transformed auxiliary variable. The impact of transformation on auxiliary information has also been discussed. It is observed that incorporating a transformed auxiliary variable result in a high gain in efficiency. Theoretical properties of the newly developed estimators have been derived. The empirical and simulation studies show that the suggested estimators outperformed the existing estimators.

Objectives: The current study is conducted to compare serum 25-hydroxyvitamin D concentrations and total testosterone in young, physically fit adult males. Study Design: the study was based on cross sectional design. Study Settings: The research was conducted in Department of Pathology, Shahida Islam Medical and Dental College situated in District Lodhran between 1st July, 2023 and December, 2023. Methods: This cross-sectional research, which took place at the Department of Pathology at Shahida Islam Medical and Dental College in Lodhran from July 1, 2023, to December 31, 2023, had 176 young male volunteers, all between the ages of 18 and 35. Each participant was given questionnaires to fill out on their prior medical history, food habits, and rigorous exercise levels. Every participant had their blood drawn following a 12-hour fast and a 24-hour period without physical exercise. Separating serum was done with a centrifuge. The blood concentration of LH, FSH, total testosterone, and 25-hydroxyvitamin D were measured by electrochemiluminescence (ECLIA). Results: A total of 176 individuals in good health were registered, with a mean age of 26.62±5.20 years. The presence of vitamin D of less than 10 ng/ml, between 10–20 ng/ml, and greater than 20 ng/ml were reported in 70 (39.8%), 76 (43.2%), and 30 (17.0%) individuals, accordingly. The mean hormone levels (TT, FSH, and LH) in the three 25(OH)D groups did not vary statistically. Our findings showed that there existed no statistically substantial relationship in the categories under study between 25(OH)D and LH, FSH, and TT. Conclusion: We found little variation in the condition of the 25(OH)D concentration and the average hormonal measurements (LH, FSH, and TT). Based on these data, we concluded that in young, healthy guys, there is no relationship between testosterone concentrations and deficient or inadequate 25(OH)D level.

Introduction Despite the evidence against drain placement after thyroidectomy, there is a lack of consensus on drain use in patients with substernal goiter.

Background: Pleural diseases involve the parietal and visceral pleura. They can be of inflammatory or malignant origin. Pleural biopsy is advised for assessment and excluding infectious causes as tuberculosis or malignant disease, particularly malignant mesothelioma. Connective tissue disorders such as rheumatoid disease can also present with involvement of pleura, requiring pleural biopsy for diagnosis. Objectives: The aim of my study was to find out diagnostic outcomes of open pleural biopsy or differentiation between benign (noncancerous) and malignant (cancerous) disease, to diagnose viral, fungal and parasitic diseases of pleura. Materials and Methods: Non-random sampling was used for data collection from Gulab Devi hospital. To find out the clinical value of nonspecific pleural biopsy specimen and fluid malignant neoplasm and tuberculosis. Data was collected from the patients undergoing procedure at Gulab Devi hospital. The collected data consists of 160 patients included females and males of all age groups. Results: 160 patients were undergone biopsies. Out of 160 patients a nonspecific or normal result was found in 53(33.3%). Diagnostic of malignant neoplasm in 18(10.9%) and granulomatous disease in 28(17%). Tuberculosis was found in 46 (28.9%). Histopathologically, pnemonitis was found in 16 (10.1%). Conclusion: Open pleural biopsy is precise and gold standard investigative method for malignancy. Pleural biopsy is safe easily performed and useful in diagnoses of tuberculosis or malignancy.

OBJECTIVE: To assess the efficacy of posterior sub-tenon injection (PSTI) of Triamcinolone Acetonide (TA) in patients with Uveitis. METHODS: This prospective study was conducted from July 2022 to May 2023. A total of 160 eyes were comprehensively examined at the Kulsoom Bai Valika Social Security Site Hospital and Sindh Government Qatar Hospital. Purposive sampling was employed for participant selection, focusing on the eye with poor vision in patients with Uveitis in both eyes. The sample was stratified into non-infectious posterior Uveitis and non-infectious intermediate Uveitis, maintaining a 1:1 ratio. Statistical analysis was performed using SPSS (version 25.0). RESULTS: The median duration of Uveitis was 20.5 weeks (interquartile range, IQR: 17-25). The medi an best-corrected visual acuity before treatment was 0.5 (IQR: 0.4-0.7). After one week, it improved to 0.2 (IQR: 0.1-0.3), and after three months, it further increased to 0.12 (IQR: 0.1-0.18), showing a statistically significant difference (p-value < 0.01) between baseline and one week after treatment. The difference between one week and after 12 weeks remained consistent. Two-way analysis also revealed a significant difference (p-value < 0.01). CONCLUSION: Posterior sub-tenon injection of triamcinolone acetonide is effective and safe for treating non-infectious Uveitis. The intraocular pressure did not show an increase following the injection, and visual acuity significantly improved after PSTI.

Abstract Prior literature is substantive in highlighting the nexus between pollutant and socio-economic predictors; however, the role of human interaction has not been sufficiently explored. Thus, the present study examines the validity of the environmental Kuznets Curve (EKC) hypothesis in the presence of energy consumption, overpopulation, and human capital index in five South Asian countries. It employs fixed effects, random effects, and dynamic panel causality techniques with a set of panel data from 1972 to 2021. The baseline results validate the existence of the EKC hypothesis in the recipient panel. Nevertheless, the findings reveal that energy consumption and population density have positive effects, while human capital has negative impacts on CO 2 emissions. Furthermore, the study observes that energy consumption and per capita GDP have a significant causal link with CO 2 emissions, whereas CO 2 emissions are evident to have causality with population density and human capital index. The results are robust and suggest that the consolidation of an effective regulatory framework and technological improvements are substantial measures to improve environmental quality in South Asia. Moreover, allocating sufficient resources to uplift contemporary educational and health status would be imperative to improving environmental quality as aspired to by the Paris Agreement.

Abstract The maize (Zea mays L.) is a monocot that is a member of the Poaceae family and a valuable feed for livestock, human food, and raw material for various industries. The halothermal time model determines how plants respond to salt (NaCl) stress under sub-optimal conditions. This model examines the relation between NaClb (g), GR, GP, salinity and temperature stress on germination of seeds dynamics in various crops. Five constant temperatures i.e. 20, 25, 30, 35, and 40 °C and five ψ levels (NaCl concentrations converted to ψ − 0, − 0.2, − 0.4, − 0.6, and − 0.8 MPa) were used in this experiment. In light of the results, the maximum halo-thermal time constant value was recorded at 35 °C temperature, while maximum germination percentage was detected at 30 °C in the controlled condition. Moreover, the lowermost value was recorded at 20 °C at − 0.8 MPa osmotic potential. The highest CAT, APX, and GPX activities were recorded at 15 °C at − 0.8 MPa, while the lowest values were observed for 0 MPa at 30 °C temperature. In conclusion, by employing the halo thermal time model, the germination of maize variety (var.30W52) was accurately predicted for the first time under varying levels of temperature and osmotic potentials.

Abstract The pollution of soil and aquatic systems by inorganic and organic chemicals has become a global concern. Economical, eco-friendly, and sustainable solutions are direly required to alleviate the deleterious effects of these chemicals to ensure human well-being and environmental sustainability. In recent decades, biochar has emerged as an efficient material encompassing huge potential to decontaminate a wide range of pollutants from soil and aquatic systems. However, the application of raw biochars for pollutant remediation is confronting a major challenge of not getting the desired decontamination results due to its specific properties. Thus, multiple functionalizing/modification techniques have been introduced to alter the physicochemical and molecular attributes of biochars to increase their efficacy in environmental remediation. This review provides a comprehensive overview of the latest advancements in developing multiple functionalized/modified biochars via biological and other physiochemical techniques. Related mechanisms and further applications of multiple modified biochar in soil and water systems remediation have been discussed and summarized. Furthermore, existing research gaps and challenges are discussed, as well as further study needs are suggested. This work epitomizes the scientific prospects for a complete understanding of employing modified biochar as an efficient candidate for the decontamination of polluted soil and water systems for regenerative development.

Abstract Background Differentiating sepsis from non-infectious systemic inflammatory response syndrome (SIRS) is challenging. Biomarkers like procalcitonin (PCT) aid early risk assessment and guide antibiotic use. This study aims to ascertain PCT's accuracy as a sepsis biomarker among adult emergency department admissions. Method The PRISMA guidelines were followed to search for relevant articles in five electronic databases between April 14th and August 4th, 2023: PubMed, Cochrane Library, ProQuest, EMBASEs, and ScienceDirect. Studies had to be published in English to avoid directly translating scientific terms. Besides, the inclusion criteria were based on the diagnosis of sepsis in adult patients admitted to an emergency department. QUADAS-2 tool provided by the Review Manager version 5.4.1 was utilized to assess the risk of bias in included studies. STATA (v. 16) software was used to perform the meta-analysis. Results Ten of 2457 studies were included. We sampled 2980 adult sepsis patients for the under-investigated role of PCT in ED sepsis diagnosis. PCT emerged as the primary early diagnostic biomarker with high levels (29.3 ± 85.3 ng/mL) in sepsis patients. Heterogeneity in outcomes, possibly due to bias in cohort and observational studies, was observed. Conclusion PCT tests offer moderate accuracy in diagnosing sepsis and stand out for rapidly and precisely distinguishing between viral and bacterial inflammations.

Abstract To meet the increasing consumer demands for fruits, the implementation of artificial ripening techniques using synthetic chemicals has become increasingly commonplace among less ethical fruit production companies in today’s global market. The objective of present work was to establish a difference in the physiological and biochemical and profiles of naturally ripened mangoes vs. those ripened by application of synthetic calcium carbide and ethylene. The application of calcium carbide at 10 g/kg mangoes resulted early ripening in 2 days, with a 3-day shelf life, as compared with 5 and 6 days, for mangoes ripened by ethylene and naturally, respectively. Higher levels of calcium carbide reduced moisture, fiber, protein and carbohydrates content and increased the ash content of mangoes, as compared to higher levels of ethylene, whereas in naturally ripened mangoes the content percentages were 80.21, 3.57, 3.05 6.27 and 4.74, respectively. Artificial ripening resulted in significant loss of ascorbic, citric and malic acid, as values were recorded 35.94, 2.12 and 0.63 mg/g, respectively, in mangoes ripened with 10 g/kg of calcium carbide. However, in naturally ripened mangoes the amounts of these acids were recorded significantly (p

Abstract Drought stress is a worldwide threat to the productivity of crops, especially in arid and semi-arid zones of the world. In the present study, the effect of selenium (Se) seed priming on the yield of quinoa under normal and drought conditions was investigated. A pot trial was executed to enhance the drought tolerance in quinoa by Se seed priming (0, 3, 6, and 9 mg Se L−1). The plants were exposed to water stress at three different growth stages of quinoa, viz. multiple leaf, flowering, and seed filling. It was noticed that drought significantly affected the yield components of quinoa, however, Se priming improved the drought tolerance potential and yield of quinoa by maintaining the plant water status. Se priming significantly increased main panicle length (20.29%), main panicle weight (26.43%), and thousand grain weight (15.41%) as well as the gas exchange parameters (transpiration rate (29.74%), stomatal conductance (35.29%), and photosynthetic rate (28.79%), total phenolics (29.36%), leaf chlorophyll contents (35.97%), water relations (leaf relative water contents (14.55%), osmotic potential (10.32%), water potential (38.35%), and turgor potential (31.37%), and economic yield (35.99%) under drought stress. Moreover, Se priming markedly improved grain quality parameters i.e., phosphorus, potassium, and protein contents by 21.28%, 18.92%, and 15.04%, respectively. The principal component analysis connected the various study scales and showed the ability of physio-biochemical factors to describe yield fluctuations in response to Se seed priming under drought conditions. In conclusion, a drought at the seed-filling stage has a far more deleterious impact among other critical growth stages and seed priming with Se (6 mg L−1) was found more effective in alleviating the detrimental effects of drought on the grain yield of quinoa.

The 21st century has seen rapid advancements in the diagnosis and treatment of cancer and immune dysfunction diseases. The first step involves the diagnosis and risk stratification of solid organ cancers, haematological malignancies, and disorders of the immune system, which frequently require genetic testing. This genetic diagnosis paves the way for treatment of these disorders, which are fatal or associated with significant disability if left untreated. Recent progress in our knowledge of these genetic pathways has led to the creation of state-of-the-art treatments, such as CAR-T cells,1 mesenchymal

Objective: To determine the frequency of hirsutism and depression in female patients with Polycystic Ovarian Disease and to investigate the association between depression and hirsutism in such patients. Study Design: Cross-sectional study. Place and Duration of Study: Gynecology and Medical Department of Fatima Memorial Hospital, Lahore Pakistan, from Jan to Jun 2022. Methodology: A total of 118 females who fulfilled the inclusion criteria were enrolled after taking written informed consent. Demographic details, clinical history and physical examination findings were noted on a predesigned proforma. Hirsutism was assessed by the Ferriman-Gallwey Method and depression was assessed according to Beck Depression Inventory. Findings were noted down on the proforma and were subjected to statistical analysis. Results: The mean age of our patients was 32.9±7.09 years, the mean BMI was 26.9±3.13 kg/m2, the mean Beck Depression Inventory value was 10.7±1.38 and the mean Ferriman Gallwey Score was 7.8±1.53. Hirsutism was seen in 19(16.1%) patients and depression in 22(18.6%) females. In patients who had hirsutism, depression was seen in 18(94.7%) patients and the association between hirsutism and depression was found to be statistically significant with a p-value of

Objective: To determine the effectiveness of oral Theophylline compared to Non-Steroidal Anti-Inflammatory Drugs in the management of postdural puncture headache in obstetric patients. Study Design: Quasi-experimental Study. Place and Duration of Study: Anaesthesia Department, Combined Military Hospital, Kharian Pakistan, from Apr to Sep 2018. Methodology: Our study enrolled 60 pregnant women suffering from postdural puncture headache. The were divided in to two groups, NSAID-Group (Group-A) who received 30mg of Ketorolac in three divided doses in 24 hours and Theophylline- Group (Group-B) who received 750mg of oral Theophylline in three divided doses in 24 hours after which effects of both drugs were noted. Results: Pregnant women were enrolled in NSAID-Group and in Theophylline Group. Mean baseline Visual Analogue Scale score was 7.500±0.97 in NSAID-Group and 7.33±0.92 in Theophylline Group. Mean weight was 66.86±5.25 kg in NSAID-Group and 67.16±7.01 Kg in Theophylline-Group. In NSAID-Group efficacy was noted in 7(23.3%) patients as compared to 25(83.3%) patients in Theophylline-Group, (p

Salt stress is one of the significant abiotic stress factors that exert harmful effects on plant growth and yield. In this study, five cultivars of mung bean (Vigna radiata L.) were treated with different concentrations of NaCl and also inoculated with a salt-tolerant bacterial strain to assess their growth and yield. The bacterial strain was isolated from the saline soil of Sahiwal District, Punjab, Pakistan and identified as Bacillus pseudomycoides. Plant growth was monitored at 15-days interval and finally harvested after 120 days at seed set. Both sodium and potassium uptake in above and below-ground parts were assessed using a flame photometer. Fresh and dry mass, number of pods, seeds per plant, weight of seeds per plant and weight of 100 seeds reduced significantly as the concentration of NaCl increased from 3 to 15 dSm−1. There was a significant reduction in the growth and yield of plants exposed to NaCl stress without bacterial inoculum compared to the plants with bacterial inoculum. The latter plants showed a significant increase in the studied parameters. It was found that the cultivar Inqelab mung showed the least reduction in growth and yield traits among the studied cultivars, while Ramzan mung showed the maximum reduction. Among all the cultivars, maximum Na+ uptake occurred in roots, while the least uptake was observed in seeds. The study concludes that NaCl stress significantly reduces the growth and yield of mung bean cultivars, but Bacillus pseudomycoides inoculum alleviates salt stress. These findings will be helpful to cultivate the selected cultivars in soils with varying concentrations of NaCl.

Background 18Fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) CT imaging has been used in many inflammatory and infectious conditions to differentiate areas of increased metabolic activity. FDG uptake differs between areas of normal lung parenchyma and interstitial lung disease (ILD).Objectives In this study, we investigated whether FDG-PET/CT parameters were associated with a change in the quality of life (QoL) in patients with ILD over 4 years of follow-up.Methods Patients underwent PET-CT imaging at diagnosis and were followed up with annual QoL assessment using the St George’s Respiratory Questionnaire (SGRQ) until death or 4 years of follow-up. Maximum standard uptake value (SUVmax) and Tissue-to-Background Ratio (TBR) were assessed against SGRQ overall and subscale scores.Results 193 patients (94 patients in the idiopathic pulmonary fibrosis (IPF) subgroup and 99 patients in the non-IPF subgroup) underwent baseline FDG-PET/CT imaging and QoL assessment. Weak-to-moderate correlation was observed between baseline SUVmax and SGRQ scores in both ILD subgroups. No relationship was observed between baseline SUVmax or TBR and change in SGRQ scores over 4 years of follow-up. In the IPF subgroup, surviving patients reported a decline in QoL at 4 years post diagnosis whereas an improvement in QoL was seen in surviving patients with non-IPF ILD.Conclusions Weak-to-moderate positive correlation between baseline SUVmax and SGRQ scores was observed in both ILD subgroups (IPF:rs=0.187, p=0.047, non-IPF: rs=0.320, p=0.001). However, baseline SUVmax and TBR were not associated with change in QoL in patients with IPF and non-IPF ILD over 4 years of follow-up. At 4 years post diagnosis, surviving patients with IPF reported declining QoL whereas improvement was seen in patients with ILD who did not have IPF.

Objective: To compare manual H-File with ProTaper Retreatment files for the abolition of Gutta Percha filling material from the root canals with or without solvent use (Eugenate). Study Design: Quasi-experimental study. Place and Duration of Study: Operative Dentistry Department, Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Sep 2019 to Feb 2020. Methodology: Forty mandibular premolars with previously failed root canal treatment were chosen. They were randomly divided into four groups, each with ten teeth. Gutta-percha filling material elimination was done with manual H-Files and rotary ProTaper with and without Eugenate and evaluated radiographically. The time duration for complete removal was also noted and evaluated by stopwatch. Results: Out of the total 40 patients 22(55%) were female and 18(45%) were males. Comparison of mean operating time duration of elimination of Gutta Percha filling material from the canals was less with ProTaper with Eugenate compared with the other three groups; however, it showed statistically significant differences among groups (p

Objective: To determine the frequency of depression, anxiety, and stress among medical students and to compare between undergraduate and postgraduate students. Study Design: Comparative cross-sectional study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, Public Sector Medical College, Pakistan Jul to Dec 2019. Methodology: A study was carried out on 200 medical students. One hundred undergraduates from all five years and 100 postgraduates/residents from varying specialities were asked to complete DASS 21(depression, anxiety, and stress score 21). Results: Out of 200 students who completed the questionnaire, 116(58%) were depressed. Among the postgraduates, females were more likely to be depressed (p=0.029). 135(67.5%) students suffered from anxiety. Undergraduates were statistically more likely to suffer from anxiety (p=0.011). 101(50.5%) students were stressed. Overall, females were more stressed than male students (0.012). Among postgraduates, females were more likely to be stressed than males (p=0.013). Marital status does not appear to have any effect on depression, anxiety, and stress. 25(12.5%) students had suicidal ideation. Conclusion: Depression, anxiety and stress are present in over half of our medical students, both undergraduates and postgraduates/residents. We need to address this in our hospitals and medical schools by providing easily accessible counselling facilities and psychologists to help them.

Objective: To investigate the association among high haemoglobin (Hb), high hematocrit (HCT), and thrombosis in individuals exposed to high-altitude (HA) environments, contributing to our understanding of haematological changes and thrombotic risk associated with HA exposure. Study Design: Retrospective longitudinal study Place and Duration of Study: High Altitude Medical and Research Cell (HALMARC) Pakistan, from Jan 2021 and Dec 2022. Methodology: The total number of 91 participants who were exposed to high-altitude were included. All age groups were included. Participants were categorized based on altitude, stay duration, Hb, and HCT levels. All types of thrombotic events were recorded. Results: Participants were exposed to altitudes ranging from less than 15,000 feet to greater than 18,000 feet, with varying durations of stay. The majority of the male participants were non-smokers. The mean Hb was 16.76±2.03 g/dl, and the mean HCT was 52.17±6.1%. More than half (53%) of the participants experienced thrombosis, with most cases involving brain thrombosis. However, there was no significant effect of elevated Hb (p=0.10) or HCT (p=0.75) on the incidence of thrombosis. Conclusion: Extended stays at high altitudes were associated with elevated hematocrit levels. However, no direct association was found between high Hb and HCT levels and the incidence of thrombosis. Thrombotic events at high altitudes are likely influenced by multifactorial factors beyond haematological parameters, including individual variations in blood coagulation, genetics, and environmental influences.

OBJECTIVE: To determine the health-related quality of life (HRQOL) among patients with Cirrhosis of the liver using a short form of liver disease quality of life (SF-LDQOL) instrument, also to correlate HRQOL scores with relevant factors. METHODOLOGY: This prospective, cross-sectional study was carried out in the medical department of Civil Hospital Karachi from May 2021 to April 2022. One hundred ninety-seven confirmed cases of Cirrhosis from either gender over 18 years of age without malignancy, HIV infection, or Psychiatric/ Neurological diseases were enrolled using convenient sampling. The SF-LDQOL instrument assessed HRQOL, summarizing overall disease-targeted HRQOL (0 to 100), where a higher score shows good HRQOL or otherwise. RESULTS: Using SPSS version 23, the SF-LDQOL score was 44±7.3. The severity of liver cirrhosis by CTP-A correlated weakly (-0.1294), while CTP B and CTP C strongly correlated with SF-LDQOL scores (-0.9894 and -0.9912), respectively. The p-value for CTP A (0.705) is insignificant; however, for CTP B and C (p < 0.00001 & p < 0.00001) is significant. Demographically, the age and income status correlated strongly to SF-LDQOL scores, displaying considerable p-values (p

Abstract Corals are sessile invertebrates living underwater in colorful structures known as reefs. Unfortunately, coral’s temperature sensitivity is causing color bleaching, which hosts organisms that are crucial and consequently affect marine pharmacognosy. To address this problem, many researchers are developing cures and treatment procedures to restore bleached corals. However, before the cure, the researchers need to precisely localize the bleached corals in the Great Barrier Reef. The researchers have developed various visual classification frameworks to localize bleached corals. However, the performance of those techniques degrades with variations in illumination, orientation, scale, and view angle. In this paper, we develop highly noise-robust and invariant robust localization using bag-of-hybrid visual features (RL-BoHVF) for bleached corals by employing the AlexNet DNN and ColorTexture handcrafted by raw features. It is observed that the overall dimension is reduced by using the bag-of-feature method while achieving a classification accuracy of 96.20% on the balanced dataset collected from the Great Barrier Reef of Australia. Furthermore, the localization performance of the proposed model was evaluated on 342 images, which include both train and test segments. The model achieved superior performance compared to other standalone and hybrid DNN and handcrafted models reported in the literature.

Abstract Brain metastasis in gastric cancer (GC) patients is a rare phenomenon that is associated with adverse clinical outcomes and poor survival rates. We conducted a retrospective cohort study to investigate the incidence, risk factors and prognostic factors of brain metastasis in GC patients. Data on sociodemographic and tumor characteristics of GC patients from 2010 to 2019 was extracted from the Surveillance, Epidemiology and End-Results (SEER) database. Descriptive statistics, multivariable logistic and Cox regression were applied on SPSS. Kaplan–Meier-Survival curves and ROC curves were constructed. A total of 59,231 GC patients, aged 66.65 ± 13.410 years were included. Brain metastasis was reported in 368 (0.62%) patients. On logistic regression, the risk of brain metastasis was significantly greater in males, patients aged

Abstract Clostridioides difficile (C. diff.) infection (CDI) is a leading cause of hospital acquired diarrhea in North America and Europe and a major cause of morbidity and mortality. Known risk factors do not fully explain CDI susceptibility, and genetic susceptibility is suggested by the fact that some patients with colons that are colonized with C. diff. do not develop any infection while others develop severe or recurrent infections. To identify common genetic variants associated with CDI, we performed a genome-wide association analysis in 19,861 participants (1349 cases; 18,512 controls) from the Electronic Medical Records and Genomics (eMERGE) Network. Using logistic regression, we found strong evidence for genetic variation in the DRB locus of the MHC (HLA) II region that predisposes individuals to CDI (P > 1.0 × 10–14; OR 1.56). Altered transcriptional regulation in the HLA region may play a role in conferring susceptibility to this opportunistic enteric pathogen.

Abstract This investigation relates to the research on Hall current on propagation and reflection of elastic waves through non-local fractional-order thermoelastic rotating medium with voids. The system is split up into longitudinal and transverse components using the Helmholtz vector rule. It is observed that, through the frequency dispersion relation four coupled quasi-waves exist in the medium. The rotating solid modifies the nature of purely longitudinal and transverse waves toward the quasi-type waves. All the propagating waves are dispersive as they depend upon angular frequency. The quasi-longitudinal wave qP and quasi-transverse wave qSV faces cut-off frequencies. The nonlocal parameter affect all the waves except the quasi void wave. Analytically, the reflection coefficients of the wave are computed using suitable boundary conditions. MATLAB software is used to perform numerical computations for a chosen solid material. The amplitude ratios and the speed of propagation of the wave are plotted graphically for rotational frequency, nonlocal, fractional order, and Hall current parameter. The significant effect of the physical parameters on the computed results has been observed. The cut-off frequency of the waves is also presented graphically. The energy conservation law is proved in the form of energy ratios. The earlier findings in the literature are obtained as special case in the absence of rotation, Hall current parameter and porous voids.

Introduction: The planning of oral reconstruction after tumor resection is a pivotal point for head and neck surgeons. It is mandatory to consider two aspects: the size of the surgical defect and the complexity of the oral cavity as an anatomical region. We offer a review of the literature that focuses on four types of locoregional flaps that can be profitably used for such reconstruction: infrahyoid (IF), nasolabial (NF), platysma (PF), and submental (SF). Methods: The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This systematic review was carried out according to the PICOS acronym through a comprehensive electronic search on PubMed/MEDLINE, Cochrane Library, and Google Scholar databases. For each selected article, we extrapolated eight main parameters, of which all mean values were compared through an ANOVA test. The dimensions of the oral defects were referred to as “small” (2), “medium” (7–50 cm2), or “large” (>50 cm2). Results: A total of 139 articles were selected with a total of 5898 patients. The mean ages for each type of flap were not statistically significant (p = 0.30, p > 0.05). Seven sublocations of oral defects were reported: The most common was the tongue (2003 [34.0%] patients), followed by the floor of the mouth (1786 [30.4%]), buccal mucosa (981 [16.6%]), cheek (422 [7.2%]), hard palate (302 [5.1%]), alveolar ridge (217 [3.7%]), and retromolar trigone (187 [3.2%]). The defects were mainly medium-sized (4507 [76.4%] patients), and fewer were small-sized (1056 [17.9%]) or large-sized (335 [5.7%]). Complications were noted, the most frequent of which was flap necrosis, seen in 0.57% of cases. The functional and esthetical results were mainly positive. Conclusions: Locoregional flaps represent a good alternative in medium-sized defects as well as a fairly good alternative in small- and large-sized defects when other options are ruled out.

Objective: To determine the aetiology, severity and outcome of patients admitted with acute pancreatitis at Hamdard University Hospital Karachi, Pakistan. Methods: This retrospective cross-sectional study was conducted at Hamdard University Hospital Karachi from January 2021 to June 2023. Patients aged 18 years and above who were admitted to the hospital with confirmed acute pancreatitis, admitted through the emergency department or by direct admission were included. Patient’s demographic data, aetiology, along with the severity of disease and outcome, such as alive or dead, were noted. Bedside Index of Severity in Acute Pancreatitis was used to assess the severity of the disease. Results: Of the 188 patients, the mean age was 59.14 ±9.52 years. Mild acute pancreatitis was observed in 58 (30.9%), moderate in 95 (50.5%), and severe in 35 (18.6%) patients. Biliary pancreatitis was the most common etiology in 129 (68.6%) participants, whereas symptoms of abdominal pain and abdominal distension were observed in all 188 (100%) patients. A significant association of acute pancreatitis was observed with age (p-value

Soft tissue swellings on the forearm can present with a range of clinical and histopathological diagnosis. Ancient Schawanoma is a rare benign condition that can develop over the flexor surface of the forearm as a cystic swelling and can involve the median or the ulnar nerve. However, the presentation of this condition on the extensor surface with involvement of the radial nerve is an extremely uncommon diagnosis. A 69 year old female presented at the outpatient department with a swelling on the extensor aspect of her right forearm for the past 2 years. Ultrasound examination showed a mixed cystic solid mass and MRI report revealed a complex predominantly cystic mass in the extensor compartment of the forearm, measuring 4.3 x 5.3 x 7.2 cm size. ---Continue

Objective: To compare the association of Socio-demographic factors in Polycystic Ovarian Syndrome (PCOS) patients with healthy controls. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi, Pakistan, in collaboration with Department of Gynecology and Obstetrics PEMH, Rawalpindi, Pakistan from Apr to Aug 2023. Methodology: The study comprised 300 females within reproductive age groups. Participants were separated into two groups. Group-I included 150 diagnosed PCOS patients, and Group-II had 150 healthy females selected by non-probability purposive sampling. Results: The PCOS patients exhibit a higher mean weight than the control Group (p-value; 0.017). The comparison of PCOS patients and controls showed significant association with physical activity (p-value: 0.038), hirsutism (p-value: 0.010) and Ferriman-Gallwey score (p-value: 0.001) and consanguineous marriages (p-value: 0.076). Conclusion: This study underscores the significance of socio-demographic factors in the manifestation of PCOS in Pakistan, emphasizing the need for early diagnosis, intervention, and tailored healthcare strategies, particularly among young women.

Objective: To Compare the Diagnostic Accuracy of the Colour Doppler twinkling artefact with Computed Tomography of the Kidney, ureters, and bladder in the detection of Nephrolithiasis - Point of Care Ultrasonography. Study Design: Comparative prospective study. Place and Duration of Study: Department of Diagnostic Radiology, Combined Military Hospital, Pakistan, from Jan 2023 to Apr 2023. Methodology: A total of 370 patients referred from hospital emergency for evaluation of renal colic of the age group 18-65 years were evaluated. Greyscale ultrasound and Colour Doppler TA were performed at the emergency department as a pointof-care ultrasonography. All patients were subsequently referred for Computed Tomography of the Kidney, ureters. Results: Diagnostic yield of Colours Doppler TA was comparable to CT KUB and slightly greater GSU. The sensitivity, Specificity, Positive predictive value, Negative predictive value and Accuracy for TA and GSU was 99.33%, 92.01%, 96.92%, 83.64%,92.97% and 89.63%, 88.0%, 95.28%,75.86% 89.19% respectively. The mean time required for GSU / Colour Doppler TA diagnosis was 39.32 ± 9.36 Minutes and 27.87 ± 15.45 hours for CT KUB. Conclusion: The diagnostic yield of colour Doppler twinkling artefact is comparable to Computed Tomography of the kidney, ureters, and bladder in diagnosing acute renal colic. It is a reliable alternative to GSU and CT-KUB in emergency setups as a point-of-care ultrasonography.

Objective: To explore a novel and dynamic role for neurogenin-2 in promoting cortical neurogenesis in cells produced from co-culturing neonatal cortical neural progenitor cells with bone marrow stromal cells. Method: The experimental study was conducted from June 2016 to January 2019 at the neuropharmacology laboratory of the Hussein Ebrahim Jamal Research Institute of Chemistry, International Centre for Chemical and Biological Sciences, Karachi. The growth of cells at different stages in harvested cells was determined by 3-(4, 5- dimethyl thiazol-2-yl)-2, 5-diphenyl tetrazolium bromide assay. Immunocytochemistry was used to evaluate the protein expressions of neuronal markers and transcription factors. Data was analysed using SPSS 20. Results: Data showed significant generation of neuronal cells and this was also verified by increased expression of nesting in cortical co-cultures with bone marrow stromal cells. Immunoreactive outcomes showed over expressions in co-cultured chlorotoxin cells. Subsequently, neurogenin-2 was found intermixed with induced expressions of transcriptional factor NeuroD1 and reduced glial fibrillary acidic protein-labelled cells. Conclusion: Better understanding of the mechanisms underlying transcriptional modulation of neurogenic events hold the key for emerging treatment approaches towards neurodegeneration. Key Words: Coculture, Glial Fibrillary, Bromides, Immunohistochemistry, Chlorotoxin, diphenyl, Neuropharmacology, Mesenchymal, Neurogenesis, Stem Cells.

Abstract Background and Aims Breast cancer is the most common type of cancer in women. The genetic polymorphism in HER (HER1–rs11543848 and HER2–rs1136201) were found to be associated with breast cancer risk in different ethnicities worldwide with inconsistent results. The aim of this research study was to evaluate the association of HER1–rs11543848 and HER2–rs1136201 polymorphisms as a risk of breast cancer in Pashtun population of Khyber Pakhtunkhwa, Pakistan. Methods A total of 314 women including 164 breast cancer patients and 150 age and gender‐matched healthy controls were enrolled from June 2021 to May 2022. All the samples were subjected to DNA extraction followed by Tetra‐ARMS‐PCR for genotyping and gel electrophoresis. Results Our results indicated that HER1–rs11543848 risk allele A (p = 0.0001) and heterozygous genotype GA (p = 0.0001) displayed highly significant association with breast cancer, while the homozygous mutant genotype AA indicated association but nonsignificant results (odds ratio [OR] = 2.637, 95% confidence interval [CI] = 1.2258–5.6756, p = 0.0833). Similarly, the HER2–rs1136201 risk allele G (p = 0.0023), the heterozygous genotype AG (p = 0.0530) and homozygous mutant genotype GG showed significant association (OR = 2.5946, 95% CI = 0.9876–6.8165, p = 0.0530) with breast cancer risk. Both the SNPs presented a higher but nonsignificant risk of breast cancer in postmenopausal women (OR = 2.242, p = 0.08 and OR = 2.009, p = 0.06). However, both the SNPs showed significant association (p

Objective: To determine the combined column tibial plateau fracture treated with a hybrid external fixator in terms of knee functionality, union outcome and complications. Method: The quasi-experimental study was conducted at the Department of Orthopaedic Surgery, Mayo Hospital, Lahore, Pakistan, from July 5, 2019, to December 31, 2021, and comprised patients of either gender aged 20-50 years who presented with 2-column or 3-column fractures of proximal tibia classified according to the 3-column classification system after being diagnosed using radiographs and three-dimensional computed tomography scan. Knee function, union and complications, like neural, vascular, infection, delayed union, nonunion, malunion and implant failure, were evaluated. The Knee Society Score was used to assess knee function, and modified Rasmussen score for the union, while complications were assessed clinically on the 2nd, 6th, 12th, 16th, 24th, 36th weeks and one year post-operatively. Data was analysed using SPSS 26. Results: Of the 113 patients, 91(80.53%) were males and 22(19.47%) were females. The overall mean age was 35.56±9.00 years. From the 12th week to the 24th week 45(39.83%) patients had good and 59(52.21%) patients had excellent functional outcomes. Union outcome in the 16th and 24th week was good in 57(50.44%) patients and excellent in 47(41.59%) patients. No neurovascular injury was observed. Superficial pin tract infection was observed in 21(18.6%) cases that healed with wound debridement and antibiotics. No delayed union, malunion and implant failure was observed. Conclusion: Good to excellent functional and union outcomes with minimum complications were observed with the hybrid external fixator. Key Words: Tibial plateau fracture, Knee joint, Hybrid external fixator, Union, Combined column.

Contaminated air quality, in lieu of massive industrial pollution, is severely attributing to health anomalies in the proximity of industrial units. Cardiovascular Disease (CAD) is rising around industrial units in the planned capital city of Pakistan, Pakistan. To study self-reported CAD in the proximity of Industrial Estate Islamabad (IEI) by equating two distinct study groups as 'Band-I': the residence 0-650 meters and 'Band-II' 650-1300 meters radius around the perimeter of IEI. The perimeters were digitized using Google Earth and GIS. Field survey was conducted on deploying 388 (194 in each Band) close-ended (self-administered) questionnaires at the household level, after adjusting the potential confounding variables. The research calculated odds ratios (ORs) of the CAD at 95% CI. The study's findings of the multiple logistic regression for ORs confirmed a significant increase in CAD problems due to industrial affluents in Band-I than in Band-II which were less severe and less life-threatening. Study confirmed high incidences of high blood pressure and breathing issues (up to 67%), due to accumulation of unhealthy affluents thus leading to heart stroke (Band I = 56.20% and Band II = 60.30%). It is aided by smoking that has increased CAD in Band-I. Societal attributes of knowledge, beliefs, attitudes, and preferences fail to safeguard the local residents amid high concentration of harmful pollutants. As a counter measure the affected respondents engaged in highlighting the issue to the concerned public offices, yet there is a high need on part of the capital government to take mitigative measures to immediately halt the disastrous industrial air emissions to save precious lives.

Nutrition is an important aspect of a healthy lifestyle for all individuals, including adolescents. The objective of this cross-sectional descriptive survey study was to investigate university students’ awareness of immunity enhancing foods, food nutritive values, and eating practices during the COVID-19 pandemic. A total of 839 university students from four different universities in Pakistan participated in the study from October 2021 to January 2022, 397 of which were male and 442 were female. A total of 419 students were studying in medical disciplines while 420 were non-medical students. The students had significant knowledge (p

The secret keys produced by current image cryptosystems, which rely on chaotic sequences, exhibit a direct correlation with the size of the image. As the image dimensions expand, the generation of extensive chaotic sequences in the encryption and decryption procedures becomes more computationally intensive. Secondly, a common problem in existing image encryption schemes is the compromise between privacy and efficiency. Some existing lightweight schemes reveal patterns in encrypted images, while others impose heavy computational burdens during encryption/decryption due to the need for large chaotic sequences. In this study, we introduce a lightweight image encryption scheme that involves partitioning the image into uniformly sized tiles and generating a chaotic sequence accordingly. This approach diminishes the necessity to create extensive chaotic sequences equal to the tile size, which is significantly smaller than the original image. As a result, it alleviates the processing burden associated with generating sequences equivalent to the original image size. The results confirm that our proposed scheme is lightweight and secure compared to the latest state-of-the-art image encryption schemes. Additionally, sensitivity analysis demonstrates that the proposed image encryption technique, with a UACI value of 33.48 and NPRC value of 99.96, affirms its resistance to differential attacks.

Sturge- Weber syndrome (SWS), is a rare neuro-cutaneous angiomatosis which affects male and females alike. The clinical manifestations include angiomas, haemangiomas of the lips, tongue and palatine region. The oral manifestations are usually unilateral and are susceptible to bleed. Patients can also present with macroglossia and maxillary bone hypertrophy which can lead to malocclusion of the oral cavity. Food accumulation due to occlusion can cause growth of bacteria which can intensify infections and can cause gingival hyperplasia. A case of a middle-aged 39 year old female was reported in the Ziauddin Hospital, Karachi on 2nd of February,2022 with the presenting complaints of intermittent fever and drowsiness for 10 days. On examination she had massive tongue enlargement, drooling, malocclusion, difficulty in eating and breathing. ---Continue

Objective: The objective of this study was to assess the patterns of maxillofacial injuries, etiology and their management during the pandemic of Covid-19 in a tertiary care hospital in Lahore, Pakistan. Methods: This is a single center, prospective cross-sectional study. Patients from all age groups who were presented at the Emergency room of Jinnah Hospital Lahore and managed by the Oral and Maxillofacial Surgery Department during 1st December 2020 till 31st January 2021 were included. Data were analyzed using IBM SPSS for Windows, Version 20.0. Results: Total 202 patient were analyzed, 161 (79.7%) were male and 41 (20.3%) were females. Male to female ratio was 4:1. About fifty three percent of patients belonged to the age group 15-35 years. The most common cause was road traffic accidents (RTA), followed by fall. Eighty-three (41.1%) had only soft tissue injuries without any bony fracture and 119 (58.9%) had facial bones fractures. Zygomatic bone fracture was most common (53.8%) followed by mandible fracture (31.1%). Sixty-one out of 119 patients with fractures were treated with Open Reduction Internal Fixation (ORIF). Three patients had complete loss of vision because of facial trauma. Only 56 (28%) patients were managed under General Anesthesia. Conclusion: During initial pandemic era, a large majority of patients presented with maxillofacial injuries were young male adult. The most common cause of maxillofacial trauma was RTAs. Soft tissue injuries were predominant followed by facial bone fractures and zygomatic bone was more frequent among the fracture cases. Covid-19 pandemic increased the difficulties faced in the management of maxillofacial trauma patients. Keywords: Covid -19, Maxillofacial Injuries, Tertiary Care Centers.

Objective When considering proposals to improve diets, it is important to understand how factors like price and income can affect saturated fat (SF) intake and demand. In this study, we examine and estimate the influence of price and income on intake across 160 countries, by age and sex, and derive sensitivity measures (price elasticities) that vary by age, sex and world region.Design We econometrically estimate intake responsiveness to income and prices across countries, accounting for differences by world region, age and sex. Intake data by age, sex and country were obtained from the 2018 Global Dietary Database. These data were then linked to global price data for select food groups from the World Bank International Comparison Programme and income data from the World Development Indicators Databank (World Bank).Results Intake differences due to price were highly significant, with a 1% increase in price associated with a lower SF intake (% energy/d) of about 4.3 percentage points. We also find significant differences across regions. In high-income countries, median (age 40) intake reductions were 1.4, 0.8 and 0.2 percentage points, given a 1% increase in the price of meat, dairy, and oils and fats, respectively. Price elasticities varied with age but not sex. Intake differences due to income were insignificant when regional binary variables were included in the analysis.Conclusion The results of this study show heterogeneous associations among prices and intake within and across countries. Policymakers should consider these heterogeneous effects as they address global nutrition and health challenges.

This study evaluated the usability of a direct manipulation device (touchscreen) vs. indirect manipulation devices (mouse and touchpad) on the selected Microsoft (MS) Word tasks as per ISO-9241-11 standard. MS Word was taken as an example of a complex application. The tasks were evaluated in terms of touch-friendly or click-friendly using efficiency, effectiveness, and satisfaction parameters to propose a customized task menu. The experiment was conducted with fifty-four participants, divided into three MS Word usage-based expertise groups. Each participant performed fifty-six tasks using a mouse, a touchpad, and a touchscreen. To assess task-level usability, individual one-way ANOVAs were performed for each task to gauge both efficiency and effectiveness. It's worth noting that the touchscreen significantly outperformed other input methods in just one specific task regarding effectiveness. Consequently, an ANCOVA was employed, with task completion time as the independent variable and the number of errors as a covariate, to further investigate effectiveness. A total of 19 (34%) of the total tasks were found to be significantly efficient with a mouse, while 21 (37.5%) were significantly efficient with a touchscreen. Based on the results, a customized menu is recommended for MS Word-like applications that combine actions in touch-friendly tasks and mouse-friendly tasks separately.

Introduction: Femoral fractures are one of the most common issues in the childrens population. Between 6-16 age, there's no strong agreement as to the favored therapy. The therapy of femoral fractures in children has progressively changed towards a more operative tactic within the past two decades. This is because healthcare criteria demand more rapid mobilisation , early discharge and return to family with normal activity. Operative treatment results in short hospitalization and early mobilization, which has psychological, social, educational and economic advantages over conservative treatment. Aims & Objectives: The aim of our study is to determine the frequency of functional outcome with Flynn’s criteria in shaft of femur fracture stabilization with elastic nails in pediatric population between 5 to 10 years of age presenting in a tertiary care hospital. Place and Duration of Study: We conducted ‘Descriptive case series’, in the unit of Orthopedic Surgery, Services Hospital, Lahore from 01-09-2021 to 01-03-2022. Material & Methods: Sixty patients ranging from 5-10 yrs of age, fulfilling the selection criteria were enrolled after the informed consent in the study through the emergency of the Department of Orthopedic Surgery, Services Hospital, Lahore. Surgery for femoral fracture was performed in these patients under general anesthesia by a single surgical team with the assistance of the researcher. The children were followed up at 1, 2, 3, and 6 months. After 6 months, patients were evaluated according to Flynn’s criteria for femoral fracture outcomes with nailing and results were noted as excellent, satisfactory and poor. All the information was recorded in proforma. Data was entered and analyzed using SPSS version. 25.P-value ?0.05 was taken as significant. Results: Out of 60 patients, 23.3 % ( n=14) were in age group of 5-7 years and 76.7 %( n=46) were in age group of 8- 10years and mean age was 8.17±1.01years. 65.0 %( n=39) were male and 35.0 %( n=21) were females. Out of 60 patients, 21.7 % ( n=13) had road traffic accident, 63.3 %( n=38) had history of fall and 15.0 %( n=9) had miscellaneous cause of injury. The frequency of functional outcome according to flynn’s criteria was excellent in 51.7 %( n=31). Conclusion: We concluded that elastic nail is moderately simple to utilize and an compelling treatment for fractures of femoral shaft in legitimately chosen children by applying Flynn's criteria for functional outcome and can further be compared with other treatment modalities.