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Objective: To determine the effect of two different volumes of 0.5% hyperbaric bupivacaine in relation to epigastric discomfort during Cesarean section under spinal anaesthesia. Study design: Randomized double-blind study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital, Lahore over a period of twelve months from June 2020 to May 2021. Materials and Methods: A total of 168 women presenting for elective Cesarean section were divided into two equal groups. In group A, 2 milliliters of hyperbaric 0.5% bupivacaine were given in intrathecal space while in group B, 2.5 milliliters of hyperbaric 0.5% bupivacaine were given after standard volume loading. The presence or absence of epigastric/visceral pain was observed. Mean arterial pressure was also recorded at 1, 5, 10, 20, and 40 minutes. Results: Demographic data including age, body mass index, and American society of anesthesiology status was comparable in both groups. Hypotension was seen in 44 (52.38%) in group A whereas it was seen in 52 (61.9%) in group B. This difference was insignificant with a p-value of 0.212. In group A, 22 (26.19%) patients complained of epigastric discomfort, while in group B, 12 (14.29%) patients complained of epigastric discomfort. Though fewer patients in group B suffered epigastric discomfort but this difference was statistically insignificant with a p-value of 0.055. Conclusion: It is concluded in our study that there is no statistically significant difference in pain encountered during caesarian section with a volume of 2 milliliters or 2.5 milliliters 0.5% bupivacaine given for spinal anesthesia. [ABSTRACT FROM AUTHOR]

Introduction: Abdominal surgeries or laparotomies are standard procedures for the treatment of different acute gastrointestinal pathologies and gastric decompression is commonly used before the majority of such surgeries. Nasogastric tubes are commonly used in the normal routine of abdominal surgeries and to achieve normal bowel function it is kept post-operatively as well for at least a couple of days. Several surgeons prefer to employ gastric decompression as they consider that it can decrease the incidence of side effects of surgeries such as post-operative ileus, nausea, aspiration, vomiting, and anastomotic leakage. We recommend no nasogastric intubation after small bowel anastomosis as the mean hospital time and stay for passage of first flatus was less compared to the intubated group and also it does not affect the prevention of intestinal anastomotic leak. Objective: To compare mean hospital stay and mean time for passage of first flatus between post-operative nasogastric intubation with no intubation after small bowel anastomosis. Material and Methods: This Randomized controlled trial was conducted at departments of surgery in Lady Reading Hospital and Mercy Teaching Hospital Peshawar from 1st July 2020 to 30th June 2021 as part of an endeavor to do an RCT and included cases operated both in the government and private sector i.e., Lady Reading Hospital Peshawar and Mercy Teaching Hospital Peshawar. In this study, a total of 60 patients in each group were observed. All patients were randomly allocated into two groups by the Lottery method. Patients in group A were not subjected to post-operative nasogastric intubation while patients in group-B were subjected to post-operative nasogastric intubation for 24 hours. Results: Our study shows that in group-A (Non-nasogastric intubation) mean age was 42 years with SD±0.76, whereas in group-B (nasogastric intubation) mean age was 44 years with SD±9.11. In group-A (Non-nasogastric intubation) 55% of patients were male and 45% of patients were female. Whereas in group-B (Non-nasogastric intubation) 52% of patients were male and 48% of patients were female. Group-A (Non-nasogastric intubation), mean hospital stay was 4 days±3.12 and the meantime to pass first flatus was 38 hours±7.42. Where as group-B (nasogastric intubation), mean hospital stay was 7 days±2.91 and the meantime to pass first flatus was 42 hours±8.57. Conclusion:We concludes that mean hospital stay and mean time to pass flatus is less with no nasogastric intubation compared to nasogastric intubation after small bowel anastomosis. [ABSTRACT FROM AUTHOR]

Background: Adhesive capsulitis is a condition that presents with pain and progressive limitation of both active and passive shoulder movements. It can be primary or secondary, the latter includes causes such as rotator cuff tear, cardiovascular disease, and diabetes mellitus. The American Shoulder and Elbow Surgeons defines that adhesive capsulitis is a condition of uncertain ethology characterized by a significant restriction of both active and passive shoulder motions that occur in the absence of known intrinsic shoulder disorder. Commonly described as: Stage 1 – Freezing stage, with pain and stiffness lasting around 9 months. Stage 2 – Frozen stage, with persistent stiffness lasting 4–12 months. Stage 3 – Thawing stage, with spontaneous recovery lasting 12–42 months. Ultrasonography (USG)-guided hydrodissection is used for adhesive capsulitis of the shoulder due to its cost-effectiveness and acceptance among patients. As adhesive capsulitis is postulated as an i nflammatory and fibrotic disease, easy treatment with intra-articular corticosteroids (CSs) injection may reduce synovitis, limit the development of capsular fibrosis, and alter the natural history of disease. CS injections are effective for shorter duration, but newer agents such as platelet-rich plasma (PRP) are more effective with no serious side effects. Materials and Methods: In this study, 40 patients were taken of adhesive capsulitis of the shoulder and were divided randomly into two groups. One group received injection PRP and the other group received injection CS. The outcome was recorded. Results: There was a statistically significant reduction in numeric rating scale pain scores in both the groups over a time period of 6 weeks, but the PRP injection was observed to be better in reducing the pain scores when compared to the CS injection after the 6th week (P = 0.037). Initially, the CS injection performed better in the 1st week due to anti-inflammatory action. By the 3rd week, both the injections showed a similar effect. However, at the end of the study period (6 weeks), there was a better reduction in the Shoulder Pain and Disability Index (SPADI) pain scores (P = 0.0057) and SPADI disability scores (P = 0.029) of the group PRP. Conclusion: We concluded that USG-guided hydrodissection with PRP is more effective therapy than CS in terms of reduction of pain and improvement in shoulder function in the treatment of adhesive capsulitis of shoulder. [ABSTRACT FROM AUTHOR]

In quantitative structure-property relationship (QSPR) and quantitative structure-activity relationship (QSAR) studies, computation of topological indices is a vital tool to predict biochemical and physio-chemical properties of chemical structures. Numerous topological indices have been inaugurated to describe different topological features. The ev and ve-degree are recently introduced novelties, having stronger prediction ability. In this article, we derive formulae of the ev-degree and ve-degree based topological indices for chemical structure of Si2C3 -- I [a,b]. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of aprepitant and dexamethasone versus metoclopramide and dexamethasone combination in prevention of post-operative nausea and vomiting in females undergoing laparoscopic cholecystectomy. Study Design: Prospective Comparative study. Setting: Department of Anesthesia, CMH Lahore. Period: October 2019 to April 2020. Material & Methods: A total of 140 female patients planned for laparoscopic cholecystectomy under general anesthesia, of age ranges from 35-65 years and ASA classification I and II were recruited for the study and were divided into two equal groups. In group A (n=70), patients were given oral aprepitant 80 mg with once sip of water one hour prior to induction and dexamethasone 8 mg upon induction. In group M (n=70), patients were given a placebo one hour prior to induction and intravenous metoclopramide 10 mg and dexamethasone 8 mg upon induction. Results: Age range in this study was from 37 to 65 years with mean age of 46.82 ± 7.29 years. The mean age of patients in group A was 45.73 ± 6.77 years and in group M was 47.91 ± 7.66 years with p-value of 0.076. In our study, significant difference was found between the efficacy of two groups of drugs. The efficacy of aprepitant and dexamethasone was found in 62 (88.57%) patients, while with metoclopramide and dexamethasone, it was found in 51 (72.86%) patients with p-value of 0.031. Conclusion: it is concluded that aprepitant and dexamethasone combination has higher efficacy as compared to metoclorpromide and dexamethasone in prevention of post-operative nausea and vomiting in elective laparoscopic cholecystectomy. [ABSTRACT FROM AUTHOR]

This paper presents a systematic investigation of an extension of the developments concerning the q-contractions, which were proposed in 2014 by Jleli and Samet. This paper generalizes the notion of the q-contractions to the case of non-linear qL-contraction mappings, and prove multi-valued fixed point results in b-metric-like spaces. The paper also includes a tangible example, which displays the motivation for such investigations as those presented here. This paper is completed by giving an application of the proposed non-linear qL-contractions to the Liouville-Caputo fractional derivatives and fractional differential equations. [ABSTRACT FROM AUTHOR]

Burns are one of the most severe forms of trauma to skin and tissue which results due to contact with hot substances (liquid or solid), radiation, radioactivity, electricity, friction, or contact with chemicals. Every year, nine million people are injured due to fire, heat, and hot substances worldwide, out of which 120,632 die (1.34%). In India, with a population of over 1.3 billion, the registered annual burn admissions are 7,00, 000–8,00, 000. This review is to identify studies on virtual reality (VR) therapy in the management of burn patients in terms of their pain, anxiety, and stress during treatment and rehabilitation, in the context of the scientific world of literature. Literatures from web-based scientific databases, PubMed, Cochrane, MEDLINE, and Clarivate, National Science Library, were searched to identify the studies conducted on the use of VR in the management of pain related to burns and their dressings. Randomized controlled trials and case series were included in this review. All these studies were organized and tabulated according to the methodology and type of interventions done. Few of the studies were also analyzed to present the highlighted current trends in VR and pain management. A brief overview of the observations at this center with the use of VR technology and its role in alleviating pain during the procedures for burn management has also been included. VR is a nonpharmacological complementary strategy with proven benefits in the management of burn patients. The findings of this literature review and analysis demonstrate that the use of VR in burn patients significantly reduces pain during treatment and rehabilitation and averts its consequences. VR can be easily used in the hospital setting and offers a safe, nonpharmacologic adjunctive therapy in the management of burn patients. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the conditions for the existence of the common fixed points of generalized contractions in the partial b -metric spaces endowed with an arbitrary binary relation. We establish some unique common fixed-point theorems. The obtained results may generalize and improve earlier fixed-point results. We provide examples to illustrate our findings. As an application, we discuss the common solution to the system of boundary value problems. [ABSTRACT FROM AUTHOR]

This manuscript examines fuzzy fixed point results using the concepts of S -metric space. We introduce two contractive maps, γ - and γ -weak contractions, within the context of S -metric spaces. These contractive maps form the cornerstone of our research, offering a novel approach to solving mathematical problems. We explore fixed point results derived from the application of these maps, showcasing their utility in finding solutions in diverse mathematical scenarios. Furthermore, we provide concrete examples that illustrate the practical relevance and versatility of our theorems, emphasizing their potential applications across a wide range of scientific and engineering domains. This manuscript presents the novel concepts of γ - and γ -weak contractions and establishes their importance in mathematical research. By demonstrating their effectiveness in solving real-world problems and offering illustrative examples, our work contributes valuable tools and insights to the broader scientific community, enhancing our understanding of contractive maps and their applications. [ABSTRACT FROM AUTHOR]

Recently, k -fuzzy metric spaces were introduced by connecting the degree of nearness of two points with k parameters (t 1 , t 2 , t 3 , ⋯ , t k) and the authors presented an analogue of Grabiec's fixed-point result in k-fuzzy metric spaces along with other necessary notions. The results presented only addressed continuous mappings. For discontinuous mappings, there is no result in k-fuzzy metric spaces. In this paper, we obtain some fixed-point results stating necessary conditions for the existence of fixed points of mappings eliminating the continuity requirement in k-fuzzy metric spaces. We illustrate the hypothesis of our findings with examples. We provide a common fixed-point theorem and fixed-point theorems for single-valued k-fuzzy Kannan type contractions. As an application, we use a fixed-point result to ensure the existence of solution of fractional differential equations. [ABSTRACT FROM AUTHOR]

We present a novel semiconducting alloy, silicon-tin (SiSn), as channel material for complementary metal oxide semiconductor (CMOS) circuit applications. The material has been studied theoretically using first principles analysis as well as experimentally by fabricating MOSFETs. Our study suggests that the alloy offers interesting possibilities in the realm of silicon band gap tuning. We have explored diffusion of tin (Sn) into the industry's most widely used substrate, silicon (100), as it is the most cost effective, scalable and CMOS compatible way of obtaining SiSn. Our theoretical model predicts a higher mobility for p-channel SiSn MOSFETs, due to a lower effective mass of the holes, which has been experimentally validated using the fabricated MOSFETs. We report an increase of 13.6% in the average field effect hole mobility for SiSn devices compared to silicon control devices. [ABSTRACT FROM AUTHOR]

This article proposes four distinct kinds of symmetric contraction in the framework of complete F-metric spaces. We examine the condition to guarantee the existence and uniqueness of a fixed point for these contractions. As an application, we look for the solutions to fractional boundary value problems involving a generalized fractional derivative known as the fractional derivative with respect to another function. [ABSTRACT FROM AUTHOR]

This is a comparative study of the teaching strategies practised for English essay writing at Secondary School Certificate (SSC/Matriculation) and the General Certificate of Education-Ordinary level (GCE-O-Level) in Khyber Pakhtunkhwa Province, Pakistan. The study has the objectives to compare and contrast the teaching strategies for English essay writing at SSC and O-Level in order to propose effective teaching strategies for the improvement of students' English essay writing skills. The population of the study has included English Language teachers and students of SSC and O-Level in Khyber Pakhtunkhwa Province through the Stratified Random sampling technique. By adopting the Mixed Methods Research approach, questionnaires having both open and close-ended questions were employed for collecting data from teachers and students. The data obtained through questionnaires were analyzed descriptively and by applying the T-test. The study has revealed that O-Level teachers follow students-centered approaches i.e. Direct and Activity-based methods that ensure the participation of the students during the process of teaching and learning. Whereas, the SSC level teachers frequently use teachers-centered approaches i.e. Grammar Translation Method (GTM) and Lecture Method that ultimately develop cramming in students. The study has recommended the provision of proper professional training to SSC level teachers and modern facilities in classrooms in Government schools. [ABSTRACT FROM AUTHOR]

There is more than a decade-long history of using static analysis to find bugs in systems such as Linux. Most of the existing static analyses developed for these systems are simple checkers that find bugs based on pattern matching. Despite the presence of many sophisticated interprocedural analyses, few of them have been employed to improve checkers for systems code due to their complex implementations and poor scalability. In this article, we revisit the scalability problem of interprocedural static analysis from a "Big Data" perspective. That is, we turn sophisticated code analysis into Big Data analytics and leverage novel data processing techniques to solve this traditional programming language problem. We propose Graspan, a disk-based parallel graph system that uses an edge-pair centric computation model to compute dynamic transitive closures on very large program graphs. We develop two backends for Graspan, namely, Graspan-C running on CPUs and Graspan-G on GPUs, and present their designs in the article. Graspan-C can analyze large-scale systems code on any commodity PC, while, if GPUs are available, Graspan-G can be readily used to achieve orders of magnitude speedup by harnessing a GPU's massive parallelism. We have implemented fully context-sensitive pointer/alias and dataflow analyses on Graspan. An evaluation of these analyses on large codebases written in multiple languages such as Linux and Apache Hadoop demonstrates that their Graspan implementations are language-independent, scale to millions of lines of code, and are much simpler than their original implementations. Moreover, we show that these analyses can be used to uncover many real-world bugs in large-scale systems code. [ABSTRACT FROM AUTHOR]