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Background: This retrospective study assesses patient satisfaction following short-segment fusion with posterior instrumentation in thoracolumbar fractures. A total of 100 patients were enrolled in the study, which was conducted in the Department of Orthopedic KTH Hospital in Peshawar from January 2020 to January 2021. The patients were followed up at 6 weeks, 3 months and 6 months post-operatively. The satisfaction score was assessed using a visual analog scale (VAS) and divided into four categories: very satisfied, satisfied, dissatisfied and very dissatisfied. The results showed that 81% of the patients were very satisfied and 19% were satisfied with the procedure. The mean VAS score was 8.58 ± 0.67. No significant differences were found in the satisfaction scores between male and female patients (p=0.731). This study provides valuable insight into the effectiveness of short segment fusion with posterior instrumentation in the treatment of thoracolumbar fractures and highlights the importance of post-operative follow-up in determining patient satisfaction. Objection: The study provides valuable insight into the effectiveness of short-segment fusion with posterior instrumentation in the treatment of thoracolumbar fractures and highlights the importance of postoperative follow-up in determining patient satisfaction.

Background: Some observational evidence suggests an effect of hormones on Osteoarthritis (O.A.), especially in premenopausal women. Aim: To determine the frequency of knee osteoarthritis among postmenopausal females. Secondly, assess the symptoms and severity of stiffness and pain. Thirdly, to assess the effect of Osteoarthritis on quality of life. Methods: The study was conducted among 50 patients with knee osteoarthritis among postmenopausal females. Aged above 45 years were included in the study. Male Participants with Amenorrhea and Traumatic Knee Injury were excluded from the study. The non-probability sampling was used for sample selection. The sample size was calculated using an open-Epi tool. Results: Most women with symptoms sometimes and often in knee osteoarthritis experience moderate and severe knee pain in rest and activity. Most women have moderate and severe difficulty in activities of daily living, difficulty in sport and recreation function, and disturbance in their quality of life in knee osteoarthritis of postmenopausal women. This study can help raise awareness and provide valuable insights into the challenges and limitations that postmenopausal women with knee osteoarthritis face daily. This can help develop more targeted and effective interventions that address the unique needs of this population. Conclusion: The study concludes that postmenopausal females have knee osteoarthritis that produces symptoms with severe pain. Their functional, daily, sports and recreational activities are moderately affected by the quality-of-life effects. Keywords: Knee Osteoarthritis, Postmenopausal women, Rehabilitation, Quality of life, Stiffness, Pain

Introduction: One of the familiar Pulmonary tuberculosis includes TB spine especially in developing countries [1].Extra-pulmonary tuberculosis approximately involves 14% of patients, with 1% to 8 % having osseous diseases of which 30% to 50% have spinal involvement. The results of this study will direct policy makers of health management system to conceive significant involvement at clinical as well as community level. Objective: To determine the outcome in terms of improvement in segmental kyphosis in patients with thoraco-lumber spine TB medicated with combination of debridement (radical), cage fixation and grafting bones. Material and Methods: 73 patients were taken as total sample. Researchers had taken detailed history of patients and then clinically examined. All patients in whom clinical suspicion of spinal tuberculosis found was subjected to spinal cord and vertebral imaging, CT scan X-rays as well as MRI spine. Radiographs were reported by consultant radiologist. Results: 48 years was mean age of patients. Among them 65% patients were male and female patients were 35%. Furthermore segmental kyphosis has been improved in 93%victims and has not been improved in 7% victims with thoraco-lumber spinal TB spine managed with combination of cage fixation, radical debridement and grafting of bones.

Perovskites are a significant class of materials with diverse uses in modern technology.

Green Human Resource Management (henceforth, green HRM) has gained worldwide recognition nowadays. It brings together human capital for the welfare and sustainability of the organization. Green HRM undertook eco-friendly human resource practices, promoting higher efficiency, lowering costs, and better relationships among employees. It also helps the organization reduce CO2 emissions by resorting to e-filing, online job advertising, online conferencing, online interview, online advertisement so on and so forth. This study, therefore, aims to examine the manager’s perception about Green Human Resource Management and its practices in the corporate sector of Khyber Pakhtunkhwa (henceforth, KP), Pakistan. Data has been collected from the corporate sector of KP using a questionnaire. The sample size consists of 64 managers. A total of 24 questions have been asked from the managers of KP’s corporate sector about green HRM. The questionnaire was divided into three different categories. The data analysis shows that on average 63 percent of the managers do green practices and 38 percent do not, 64 percent of managers do eco-friendly practices in their industries while 53 percent of managers do not, and 42 percent of managers are working to expand the sphere of green HRM practices but 57 percent of managers do not work as such to expand green HRM practices in their organization. The study suggests that organizations need to start giving training on Environmental Management, designing waste management policy, using public transport, employees’ hiring and firing based on green actions, using software to go green, and incentives to employees for maintaining a green work environment.

Background: Codman was the scientist who first used the term frozen shoulder in 1934.He explained usual characteristics of steady start of pain around insertion of deltoid muscles, sleeping problems and restriction in external movement and active as well as passive elevation, but with a normal radiological appearance. Moreover no satisfactory discussion on the top appropriate procedure of disease management despite of this information of the pathology. A few learnings describe that hydrostatic distension and intra articular steroid injections lessen pain within a short period if given at the start of the disease. Objective: To find and compare the efficacy of hydrostatic shoulder distention with intra articular steroid injection in idiopathic frozen shoulder. Material and methods: 142. (71 in each group) is the total sample taken. Class a patients were injected steroid mixed with Lignocaine intraarticularly while patients in Class B were injected with some another solution. All patients of both groups were allowed for different movement exercises on instruction of a physiotherapist for some days. Patients were then asked at six weeks follow up. Result: In this study 38 years is mean age in class a while in class B mean age was 40 years.

Hereditary neurological disorders (HNDs) are a clinically and genetically heterogeneous group of disorders. These disorders arise from the impaired function of the central or peripheral nervous system due to aberrant electrical impulses. More than 600 various neurological disorders, exhibiting a wide spectrum of overlapping clinical presentations depending on the organ(s) involved, have been documented. Owing to this clinical heterogeneity, diagnosing these disorders has been a challenge for both clinicians and geneticists and a large number of patients are either misdiagnosed or remain entirely undiagnosed. Contribution of genetics to neurological disorders has been recognized since long; however, the complete picture of the underlying molecular bases are under-explored. The aim of this study was to accurately diagnose 11 unrelated Pakistani families with various HNDs deploying NGS as a first step approach. Using exome sequencing and gene panel sequencing, we successfully identified disease-causing genomic variants these families. We report four novel variants, one each in, ECEL1, NALCN, TBR1 and PIGP in four of the pedigrees. In the rest of the seven families, we found five previously reported pathogenic variants in POGZ, FA2H, PLA2G6 and CYP27A1. Of these, three families segregate a homozygous 18 bp in-frame deletion of FA2H, indicating a likely founder mutation segregating in Pakistani population. Genotyping for this mutation can help low-cost population wide screening in the corresponding regions of the country. Our findings not only expand the existing repertoire of mutational spectrum underlying neurological disorders but will also help in genetic testing of individuals with HNDs in other populations.

OBJECTIVES To determine the frequency of renal lithiasis among patients coming to Khyber Teaching Hospital Peshawar. METHODOLOGY This Observational cross-sectional study was undertaken at Khyber Teaching Hospital Peshawar, period (January 2021 to August 2021). Data were collected through a self-administered questionnaire. Non-probability convenient sampling technique was used to recruit 61 patients. Institutional Review Board approval was obtained prior to data collection. SPSS version 20 was used to analyze data. RESULTS Out of 160 patients, 61(37.5%) patients were having renal calculi. Among those 61 patients, n=49(80%) were male participants and 12(20%) female participants said that they are having renal calculi. The age of the participants was 12-65years. The proportion of males was approximately higher as compared to the females. Most of the participants have renal calculi at the time of the examination. CONCLUSION There is a high rate of renal lithiasis in mostly male patients and at young ages. These demographic factors may be potentially associated with the occurrence of renal lithiasis. Further research is required to study these factors in detail in relation to renal lithiasis

Accurate detection of leptomeningeal metastasis (LM) is critical for risk stratification and treatment of pediatric brain tumors. Poor-quality staging MRI has been associated with decreased survival in this population, but technical factors differentiating good from poor quality screening MRIs remain undefined. To test the hypothesis that key technical factors are associated with accurate MRI diagnosis of leptomeningeal metastasis in children with leptomeningeal seeding brain tumors.MRIs acquired at outside facilities and repeated in our institution within 35 days for 75 children with leptomeningeal seeding tumors were assessed for slice thickness and gap; use of T2 FLAIR + Contrast, acquisition plane of 3DT1WI + Contrast (brain); axial T1 + Contrast sequence, and use of pre-contrast T1 images (spine). Reported findings were recorded as positive, negative, or equivocal for LM and classified as true positive (TP; unequivocal metastasis), false negative (FN; not reported), false positive (FP; resolved without treatment), or true negative. Wilcoxon signed-rank and Fisher's exact test were used to assess technical differences between TP and FN MRIs.Rate of LM detection was greater with smaller interslice gap in brain (P = 0.003) and spine (P = 0.002); use of T2 FLAIR + Contrast (P = 0.005) and sagittal plane for 3DT1WI + Contrast (P = 0.028) in brain; and use of alternatives to axial TSE/FSE in spine (P = 0.048). Slice thickness was not significant. Pre-contrast T1WI did not contribute to LM diagnosis in spine.Using post-contrast T2 FLAIR and sagittal 3DT1 in brain, small/no interslice gap, and avoiding TSE/FSE axials in spine may facilitate leptomeningeal metastasis detection in children with brain tumors.

Owing to the tremendous energy storage capacity of two-dimensional transition metal carbides (MXenes), they have been efficiently utilized as a promising candidate in the field of super-capacitors. The energy storage capacity of MXenes can be further enhanced using metal dopants. Herein, we have reported the synthesis of pristine and nickel doped niobium-carbide (Nb2C) MXenes, their computational and electrochemical properties. Upon introduction of nickel (Ni) the TDOS increases and a continuous DOS pattern is observed which indicates coupling between Ni and pristine MXene. The alterations in the DOS, predominantly in the nearby region of the Fermi level are profitable for our electrochemical applications. Additionally, the Ni-doped sample shows a significant capacitive performance of 666.67 F g-1 which can be attributed to the additional active sites generated by doping with Ni. It is worth noting that doped MXenes exhibited a capacitance retention of 81% up to 10 000 cycles. The current study unveils the opportunities of using MXenes with different metal dopants and hypothesize on their performance for energy storage devices Owing to the tremendous energy storage capacity of two-dimensional transition metal carbides (MXenes), they have been efficiently utilized as a promising candidate in the field of super-capacitors. The energy storage capacity of MXenes can be further enhanced using metal dopants. Herein, we have reported the synthesis of pristine and nickel doped niobium-carbide (Nb2C) MXenes, their computational and electrochemical properties. Upon introduction of nickel (Ni) the TDOS increases and a continuous DOS pattern is observed which indicates coupling between Ni and pristine MXene. The alterations in the DOS, predominantly in the nearby region of the Fermi level are profitable for our electrochemical applications. Additionally, the Ni-doped sample shows a significant capacitive performance of 666.67 F g-1 which can be attributed to the additional active sites generated by doping with Ni. It is worth noting that doped MXenes exhibited a capacitance retention of 81% up to 10 000 cycles. The current study unveils the opportunities of using MXenes with different metal dopants and hypothesize on their performance for energy storage devices

In this work, the structural, electronic, magnetic and elastic properties of the xenon-based fluoroperovskites XeMF3 (M = Ti, V, Zr, Nb) have been studied using density functional theory.

This study examines the physical, mechanical, microstructural, and attenuation properties of high-density concrete exposed to temperatures ranging from 200°C to 1200°C. For this purpose, heavy-density concrete containing 25%, 50%, 75%, and 100% dolerite aggregates was developed and compared with three ordinary concrete mixes. Pre- and post-heated concrete specimens were evaluated for mass and density loss, compressive strength, rebound hammer, X-ray and gamma-ray attenuation, Half Value Layer (HVL), and Ten Value Layer (TVL) along with microstructural properties determined by scanning electron microscopy and Energy Dispersive X-ray. The results showed that the incorporation of 75% dolerite aggregate during pre- and post-heating yielded high compressive strength whereas low mass and density loss. The same mixture showed significant improvement in gamma ray shielding at all temperatures. The Half Value Layer and Ten Value Layer values showed a reduction in the thickness of concrete as a shield. It is recommended that dolerite heavy-density concrete is a potential radiation shield at high temperatures ranging from 200°C–1200°C in fourth-generation nuclear power plants.

In the last twenty years’ Pakistani media have experienced remarkable progress and transformation in its role. There have been serious setbacks in current years. Almost more than one hundred private TV channels are currently broadcasting. Pakistan is one of the unsafe counties of the world for journalists as per the 2020 report of the International Federation of Journalists Pakistan. Pakistan has been a war zone for almost forty years, where 140 journalists were killed in Pakistan from 2000 to 2020 but still, Pakistani law does not guarantee journalists' safety. Are they feeling safe and secure and which steps will be important for journalists’ security and safety? This researcher is qualitative. The data have been collected by conducting interviews and applying the social responsibility theory to investigate, what is about the freedom of speech because this theory describes the claims that the journalist always plays a responsible role of passing the information with freedom and the task of the press is to make journalism better.

OBJECTIVES: Antenatal care focuses on the complication of obstetric conditions and to provide information about lifestyle, pregnancy, and delivery. The aim of this study was to evaluate the knowledge of pregnant females regarding the antenatal care in government hospitals, Peshawar. METHODOLOGY: A cross-sectional descriptive study was carried out in tertiary care government hospitals of Peshawar. A convenient sampling technique was used to select participants from gynecology outpatients departments. Sample size was calculated using Riosoft sample size calculator. 280 participants responded to the antenatal care questionnaire. The study was approved from ethical review board of Khyber Medical University. Data was analyzed using SPSS version 22. RESULTS: The mean age of the participants were 28.7 years. Most of the pregnant mothers had limited understanding regarding the antenatal care. The study provided significant association of knowledge regarding antenatal care with husband support, parity of the women and participant education level (p

The politics of the Holy land is of crucial importance to the followers of the three Abrahamic religions in terms of religious beliefs, which metamorphosed into military and political significance in the 20th Century. The United States (U.S) support for Israel is especially visible during the republican presidencies. The U.S had five republican presidents from 1980 to 2020, and their evangelical beliefs shaped American foreign policy toward this region, a policy that may loosely be termed as affected by Christian Zionism, which was originally a 16th Century religious Puritan movement, who latter shaped into Christian political movement. U.S Christian Zionism reiterates favourable images of Jews and is pessimistic about peace in Holy land. Christian Zionists believe Lord has bestowed the land of Palestine to Jews and have held up this claim since the turn of the 20th Century. This paper first describes the fundamental nature of Christian Zionism, their view of the modern Israel and resultant political and military policies. This also focuses Christian Zionists support of republican presidents and specially President Trump relationship with Christian Zionism. The shifting of U.S embassy to Jerusalem, the formal approval to Jerusalem as the capital of Israel by President Trump are studied.

OBJECTIVES: The accuracy of clinical tests (Lachman, McMurray, Anterior Drawer) in the diagnosis of knee joint injuries in comparison to arthroscopy taken as gold standard. METHODOLOGY: This cross-sectional study was conducted at the Department of Orthopedic Surgery, Khyber Teaching Hospital, Peshawar for 3 years. Total of 48 patients were recruited in the study. Data was collected after ethical approval from the hospital ethical committee using consecutive non-probability sampling techniques. Written informed consent was obtained from the patients. Arthroscopy examination was taken as a gold standard. Data analysis was performed using statistical software SPSS 21 and MEDCALC online software for calculating sensitivity and specificities of the clinical tests. RESULTS: Mean age was 26.4+6.5 years. Lachman and Anterior Drawer tests were noted to have 91.67% and 66.67% sensitivity for anterior cruciate ligament while McMurray test was noted only 66.67% sensitive for both meniscal injuries. On the other hand, Lachman was 95.8% specific, McMurray was 77.78%, and Anterior Drawer was 79.2% specific. Regarding accuracy, Lachman was 93.7%, McMurray 70.8% and Anterior Drawer was 72.9% accurate. CONCLUSION: Among clinical examination and specific examination tests, Lachman has high sensitivity, specificity and accuracy followed by Anterior Drawer test and MacMurray for diagnosing anterior cruciate ligament and meniscal injuries of knee joint.

the chalcopyrite alloys Cu1–xNaxTlSe2, with x = 0.00, 0.25, and 0.50 were studied through density functional theory calculations. The Wu–Cohen generalized gradient and the Tran–Blaha modified Becke–Johnson approximations have been employed to describe the exchange–correlation potential. Energy band structure analysis reveals that CuTlSe2 is a semi-metal, while Cu0.25Na0.75TlSe2 and Cu0.50Na0.50TlSe2 alloys are semiconductors with gaps of approximately 0.17 eV and 0.35 eV, respectively. The total and partial densities of states were calculated and discussed. Examining the charge density, we point out the formation of the Na–Se ionic bond when Cu is replaced by the Na atom, which is responsible for the metal–semiconductor transition in the Cu1–xNaxTlSe2 alloys. Moreover, variations of the Seebeck coefficient, electrical conductivity, electronic and lattice thermal conductivity, power factor, and figure of merit of the Cu1–xNaxTlSe2 alloys with temperature and chemical potential were explored. The obtained results show that the value of the figure of merit increases when doping CuTlSe2 with sodium to reach 0.46 and 0.87 for p-type Cu0.75Na0.25TlSe2 and n-type Cu0.50Na0.50TlSe2, respectively the chalcopyrite alloys Cu1–xNaxTlSe2, with x = 0.00, 0.25, and 0.50 were studied through density functional theory calculations. The Wu–Cohen generalized gradient and the Tran–Blaha modified Becke–Johnson approximations have been employed to describe the exchange–correlation potential. Energy band structure analysis reveals that CuTlSe2 is a semi-metal, while Cu0.25Na0.75TlSe2 and Cu0.50Na0.50TlSe2 alloys are semiconductors with gaps of approximately 0.17 eV and 0.35 eV, respectively. The total and partial densities of states were calculated and discussed. Examining the charge density, we point out the formation of the Na–Se ionic bond when Cu is replaced by the Na atom, which is responsible for the metal–semiconductor transition in the Cu1–xNaxTlSe2 alloys. Moreover, variations of the Seebeck coefficient, electrical conductivity, electronic and lattice thermal conductivity, power factor, and figure of merit of the Cu1–xNaxTlSe2 alloys with temperature and chemical potential were explored. The obtained results show that the value of the figure of merit increases when doping CuTlSe2 with sodium to reach 0.46 and 0.87 for p-type Cu0.75Na0.25TlSe2 and n-type Cu0.50Na0.50TlSe2, respectively

In this chapter, we have focused on the journey of sorting genes and the connotation of genetic counseling started. In a literal sense, we will understand how genetic counseling could contribute to identifying pathogenicity and penetrance of genetic mutation/s in high-risk individual/s or populations. Great strides have been achieved in terms of diagnosis, management, and treatment of various genetic disorders due to rapid advancements in genetic research. The national Thalassemia Prevention Program of Cyprus has been one of the earliest and most celebrated successes in lowering the disease burden and improving life quality and survival rate in patients. The knowledge regarding gene/s and variant/s is quite instrumental for making important reproductive decisions and therapeutic interventions for both rare and common disorders. We also touch upon the associated ethical issues and challenges.