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Urban aquifers are experiencing increasing pressures from climate change, land-use change, and abstraction, consequently, altering groundwater levels and threatening sustainable water availability, consumption, and utilization. Sustainability in such areas requires the adaptation of groundwater resources to these stressors. Consequently, this research made projections about future climate, land use, and abstraction, examines how these drives will affect groundwater levels, and then proposes adaptation strategies to reduce the impact on Lahore's groundwater resources. The objectives are achieved using an integrated modeling framework involving applications of Soil Water Assessment Tool (SWAT) and MODFLOW models. The results indicated a projected rise in Tmin by ~2.03 °C and Tmax by ~1.13 °C by 2100 under medium (RCP 4.5) and high-end (RCP 8.5) scenarios, respectively. Future precipitation changes for mid, near and far periods are projected to be −1.0%, 25%, and 24.5% under RCP4.5, and −17.5%, 27.5%, and 29.0% under RCP8.5, respectively. The built-up area in the Lahore division will dominate agricultural land in the future with an expansion from 965 m2 to 3716 km2 by the year 2100 under R1S1 (R2S2) land-use change scenarios (significant at p = 5%). The future population of the Lahore division will increase from 6.4 M to 24.6 M (28.7 M) by the year 2100 under SSP1 (SSP3) scenarios (significant at p = 5%). Groundwater level in bult-up areas will be projected to decline from 185 m to 125 m by 2100 due to increasing groundwater abstraction and expansion in the impermeable surface under all scenarios. In contrast, agricultural areas show a fluctuating trend with a slight increase in groundwater level due to decreasing abstraction and multiple recharge sources under combined scenarios. The results of this study can be a way forward for groundwater experts and related institutions to understand the potential situation of groundwater resources in the Lahore division and implement adaptation strategies to counteract diminishing groundwater resources. [ABSTRACT FROM AUTHOR]

Growing population, depleting fossil fuels, economic expansions, and energy intensive life style demand are resulting in higher energy prices. We use energy as of heat and electricity, which can directly be obtained from sun using thermal collectors and solar cells. Solar thermal systems are gaining attention for water and space heating applications due to green aspects of solar energy. A solar thermal collector is a vital part of solar thermal energy system to absorb radiant energy from the sun. In this study, a solar water heating (SWH) system has been designed and simulated in the TRNSYS ® software using thermal and chemical properties of heat transfer fluids using REFPROP for dwellings located on ±31° latitudes (+31 Lahore in Pakistan and -31° Perth in Australia). We present an efficiency parametric optimization-based model for water and space heating. Simulation results for four types of solar thermal collectors are presented, and performance is analyzed on the basis of output temperature ( T out ), solar fraction (f), and collector efficiency (η). This study evaluates the comparative performance of evacuated tube collector (ETC), flat-plate collector (FPC), compound parabolic concentrator (CPC), and thermosiphon-driven systems. Our findings conclude the evacuated glass tube collector achieves the highest solar fraction, i.e., 50% of demand coverage during August in Pakistan and February in Australia, with an overall average of 43% annually. [ABSTRACT FROM AUTHOR]

OBJECTIVE: CONCLUSION KEYWORDS To find out the relationship between frustration intolerance, self-efficacy, and sleep quality in medical students and to determine the moderating role of self-efficacy in relationship between frustration intolerance and sleep quality in Medical Students. STUDY DESIGN: Correlational study. PLACE AND DURATION OF STUDY: The study was conducted from November 2020 to January 2021 and the data was collected from different medical colleges of Lahore and Faisalabad. SUBJECTS AND METHODS: The sample comprised of 150 MBBS (Bachelor of Medicine and Bachelor of Surgery)students from different medical colleges, 126 (84%) were females and 24 (16%) were males. The participants' age range was between 18-26 years and their mean age was 21.79 + 1.74 years. Self-constructed demographic form, Frustration discomfort scale, Generalized Self efficacy Scale and Sleep quality scales were also used to assess the sample. Data were collected online by employing a non-probability convenient sampling strategy. RESULTS: Frustration intolerance is positively related with poor sleep quality indicating higher frustration linked with acute sleep problems, while self-efficacy showed a negative relationship with poor sleep quality indicating higher self-efficacy decreased the sleep problems. The results also showed that self-efficacy moderates the effect of frustration intolerance on sleep problems in medical students. CONCLUSION: This study identified a high prevalence of frustration intolerance and poor sleep quality in medical students during the pandemic of Covid-19 and highlighted the role of self efficacy in dealing with frustration intolerance and sleep problems among medical students. [ABSTRACT FROM AUTHOR]

The consumption of food production demand for quality of food and the environmental impact of agriculture have led to utilize the information and communication technology in the agricultural sector. The Internet of Things (IoT) has become a contemporary technology, which is evolving quickly in recent years and brings many benefits with it to modernize the agriculture. The scientific groups and research institutes are working to deliver clarifications and solutions for the use of IoT to address various aspects of agriculture. The focal point of this research is to present an SLR (Systematic Literature Review) by collecting the valid and innovative research on IoT in agriculture which has been done during 2019 at School of System and Technology, University of Management and Technology, Lahore, Pakistan. This SLR has been conducted through research articles which were published in the prestigious venues from 2006 to 2019. In order to conduct this SLR concerned studies have been clustered into different classifications: type of the concerned research, empirical type, technological solutions for agriculture like monitoring, control, prediction, logistics and their sub-domains. Moreover, an IoT based framework of smart agriculture has been presented that indicate the current solutions of agricultural problems. The selected 80 research papers have been classified as per defined criteria. The findings of this research have been discussed in detail and summarize the practice of IoT in agriculture. [ABSTRACT FROM AUTHOR]

Objective: To determine and compare results of intervention day vs over-night stay patients after elective PCI with stable coronary artery disease. Methodology: This corss-sectional study was conducted at Army Cardiac Center, Lahore from June 2017 till July 2018. Patients with stable CAD were recruited after their informed consent and were divided in to two groups. Patients were randomized through lottery method using list of patients. Inclusion Criteria was patients of either gender with age <75 years undergoing elective PCI with no acute decompensated CHF or shock, LVEF>30%, serum creatinine<1.5 mg/dl and no contrast allergy. All adverse cardiac and cerebral outcomes were recorded in the first 24 hours. One month clinical follow up was also done. Data was analyzed using SPSS version 23. Results: Total 100 patients ware included. Mean age of the patients was 54±3.8 years, 81 male patients. About 50 patients were discharged on intervention day of PCI while 50 patients stayed over-night. Most common comorbidity was hypertension in 62 patients followed by diabetes in 43, dyslipidemia in 39 patients and current smokers 20(20%).Haematoma formation [3(6.0% vs 4(8.0%); p=0.04], allergic reaction [5(10.0% vs 6(12.0%); p=0.50] and rehospitalization for chest pain [5(10.0% vs 2(4.0%); p=0.50] were almost the same. No cardiac death, MI, repeat PCI, urgent CABG, stroke, re-hospitalization for bleeding or non-cardiac death were observed in both groups. Conclusion: Our study results yielded that intervention day discharge after elective PCI is a good practice. Post-procedural outcomes are the same in same day group and over-night stay group. Intervention day discharge strategy is a cost effective approach and should be considered for the future. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the safety and effectiveness of the dTRA from both the right and left arm. Study Design: Prospective longitudinal study. Place and Duration of Study: The study was conducted in Army Cardiac Centre, Lahore Pakistan, from Nov 2018 to Dec 2018. Methodology: Forty-five consecutive patients who were undergoing coronary angiography/angioplasty were included regardless of indication. Right dTRA was used in 22 patients and left dTRA was used in 20 patients. Procedural success was defined as ability to complete the procedure without conversion to different access site due to failure of coronary artery cannulation. Radial artery patency was checked with doppler ultrasonography both at forearm and snuff box 24 h after successful hemostasis by manual method. We monitored for bleeding and ischemic complications and failure of hemostasis while hospitalization. Results: Procedure was successful in 42 cases (93.3%), 22 (52.3%) diagnostic and 20 (47.6%) coronary intervenetional procedures, 22 (52.3%) cases from right dTRA and 20 (47.6%) cases from left dTRA. 3 (6.6%) cases were unsuccessful because of weak pulse/hypoplastic distal radial artery or vessel spasm. Manual hemostasis was applied in all cases. There were no ischemic or bleeding complications. No distal or forearm radial artery occlusion (RAO) was observed on doppler ultrasonography 24 h after successful hemostasis. Conclusion: dTRA is a safe and feasible radial arterial access which is comfortable for both operator and patient and especially left dTRA provides improved operator ergonomics. Also despite longer time to access distal radial artery and a steeper learning curve, dTRA is a reproducible procedure for coronary interventions in a radial experienced catheterization lab. [ABSTRACT FROM AUTHOR]

Objective: To determine and compare the safety and outcomes of same day discharge patients with over-night stay patients after elective percutaneous coronary interventions with stable coronary artery disease. Study Design: Randomized controlled trial. Place and Duration of Study: This study was conducted at Army Cardiac Center, Lahore from, Jun 2017 to Jul 2018. Methodology: Hundred patients with stable CAD were recruited after their informed consent. Patients were randomized through lottery method using list of patients. Fifty patients were discharged on the same day of PCI while 50 patients stayed over-night. Inclusion Criteria was patients of either gender with age <75 years undergoing elective PCI with no acute decompensated CHF or shock, LVEF > 30%, Serum creatinine <1.5 mg/dl and no contrast allergy. While those excluded were with multi vessel disease, bifurcation disease or left main disease, saphenous vein graft or internal mammary disease, recent ACS, ≥3 stents or Femoral access. Immediate adverse cardiac and cerebral events were noted in the first 24 hours. The procedural result followed by a 6-hours observation period allowed adequate triage of patients to same-day discharge or to extended clinical observation. The one month clinical follow up was also done. Data was analyzed using SPSS 23. Confidentiality of data was maintained. Results: Mean age of the patients was 54 ± 3.8 years, 81 male patients while 19 female patients. Most common comorbidity was hypertension in 62 patients followed by diabetes in 43, dyslipidemia in 39 patients and current smokers 20 (20%). Haematoma formation [3 (6.0% vs 4 (8.0%); p=0.04], allergic reaction [5 (10.0% vs 6 (12.0%); p=0.50] and re- hospitalization for chest pain [5 (10.0% vs 2 (4.0%); p=0.50] were almost the same. No cardiac death, MI, Repeat PCI, urgent CABG, stroke, re-hospitalization for bleeding or non-cardiac death were observed in both groups. When patients were asked about their preference of discharge, 47 (47.0%) patients preferred for same day discharge, 22 (22.0%) for over-night stay while 31 (31.0%) preferred whatever their doctor considered best for them. Conclusion: Our study results yielded that same day discharge after elective PCI is a safe practice. Postprocedural outcomes are the same in same day group and over-night stay group. Same day discharge strategy is a cost effective approach and should be considered for the future. [ABSTRACT FROM AUTHOR]

Background: Coronary artery bypass grafting (CABG) has long been regarded as the treatment of choice for unprotected left main coronary artery (LMCA) disease. Left main stem stenting remains a dilemma despite the latest developments in percutaneous coronary stenting. Percutaneous coronary intervention can be a safe and effective method for revascularization in this subset of patients however it has typically been reserved for poor surgical candidates. Recently some randomized data has emerged comparing unprotected left main stem stenting to CABG. We wanted to share our experience regarding left main stem stenting as Army Cardiac Centre is a high-volume Centre, has skilled operators and cardiac surgical backup. Objective: To share experience of Left main stem stenting from Army Cardiac Centre Lahore and determining that left main stem stenting is a suitable alternative to coronary artery bypass grafting in selected patients. Study Design: A observational study. Place and Duration of Study: Army Cardiac Centre Lahore during the period 1st January 2013 to 26 May 2018. Material and Methods: Fifty Six patients who underwent left main stenting at Army Cardiac Centre Lahore during the period 1st January 2013 to 26 May 2018 were included in the study. A list of variables was devised to be included in the study. All patients underwent provisional left main stem stenting. Results: Out of 56 patients 14 had ostial and midshaft disease while rest had distal left main stem disease. A provisional stenting approach was taken in all of the patients. Single stent was used in 50 patients while 6 patients went under bifurcation stenting. All patients had TIMI III flow in both Left Anterior Descending (LAD) and Left Circumflex (LCx) arteries after stenting. Conclusion: Left main stenting is a safe procedure in selected patients however technique, operator skill and cardiac surgical backup play a vital role in the success of this procedure. [ABSTRACT FROM AUTHOR]

Objective: To determine the clinical outcomes of successful versus unsuccessful PCIs in CTOs. Study Design: Single center, comparative cross-sectional study. Place and Duration of Study: Army Cardiac Center, Lahore from January 2017 till December, 2018. Material and Methods: A total of 218 patients of PCI for CTO with native CAD were recruited in our study. Patients with CTO lesion ≥3 months were included in our study. All the included patients had CTO lesion ≥3 months. All Patients information was recorded. Patients were followed for 2 year. Data was entered and analyzed in SPSS-21. Results: We enrolled 218 patients, 200 (91.3%) were male patients while 18(8.2%) were females. Mean age of patients was 58.5 ± 9.4 years and range 37-87 years. 103 (47.0%) patients were hypertensive, 93 (42.7%) were smokers and 89 (40.8%) were diabetic. Out of 218 PCIs in CTOs successful were 14 7(67.4%) while unsuccessful were 71 (32.6%). The comparison between the two groups showed that gender, arteries involved, J-CTO score and initial approach to the lesion were found to be statistically significant (p<0.05). Most frequent reason of failure of procedure was inability of wire to cross the CTO lesion 65 (91.5). No deaths were reported during the procedures. Conclusion: With increasing experience and better equipment recanalization of CTO coronary lesions is a safe and effective treatment option for patients with persistent Angina even on appropriate medical treatment. [ABSTRACT FROM AUTHOR]